NCG020204 DMR SW

REPORT DIVIR— S 1 ORMWATE
L-
SUBMITTO diFNtC AL +®F0000 -L 1_CE*-
General Permit No. NCG020000
Calendar Year ;:��Q 15
Report ALL STORMWATER monitoring,data ori this form (include "No Flow "i'No Discharge' and Benchmark
Excesdances) from the previous calendar year to the DEQ by MARCH 1 of each near.
Certificate of Coverage No. N0002
Facility Name: itc-�,n5Qn t\!a!Grp_!rA eS L (11,Y•► Q �� uCar��
County:
Phone Number: (q d q ) 3 agn - P-`7 `l a Total no. of SDOs monitored
Certified Laboratory _Pc ,✓e-Anc Iy+1' cctI lab # WW 007
%ir�nson i�t� e i�S Lab # 5 3`7 r
Stormw►ater Discharge Outfall (SDO) No. SDD- ! VMA Outfall? Yes ® Noi4
Is this outfall currently in 'tier 2 for any parameter? Yes ❑ No'W
Was this outfall ever in tier 2 during the past year? Yes ® No�j
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑
Other ❑
Outfall No.
®
Total
Rainfall,
inches
TSS,
mg/I
SS,
mUl
Turbidity,
NTu
Upstream
(u) Turbidity,
NTu
Downstream
(D) Turbidity,
NTU
I
Non -polar
OCG, mg/I
(VMA)
New
Motor Oil
usage
aVmoa
li Wates .
Benchmarrk
IndleamNO
a °, ,a ',10®/50
Bemch�rc
-
0.1
BC=fimark
a0/Za/10
N/�,
st Water rd°appIs
N/A_ - -
Standardaty unter � ea9
�`�
average requires
°&Gri�nl Nati
n®r
Date Sample
Collected,
mo/dd/ r
tSr
r
q Q
t
u
Permit Date 10/1/2019 m 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 Q®[D®
CERTIFICATION
" I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Required by 40 CFR §122.221
Sign-,
Date
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 10/1/2015 — 9130/2020
Last Revised 10-2-2015