NCG020124 DMR SW

-
�� .�fT TO CENTRA OFFICE*
General Permit No. NCG020000
Calendar Maar a C 157
*Report ALL STORMWATER monitoring data an this form (include 'No Flout/°No ,Discharge" and 8enchrnarl -
Exceedences)_from the prevl us calendar year to the DEQ by MARCH F of each year.
Certificate of Coverage No. NCGO2
Facility Name:jjctin5on
County: zy-a1') ISS 4 r
Phone Number: (9 I q ) 3 go - ?_ 1 y G Total no. of SDOs monitored
Certified Laboratory Ps e -e- A n I y + I c« I lab # W W 0C,,7
_i-krlson Agq'ce"-s Lab# 53172
Storrnwater Discharge Outfall (SDO) No. -5Q2 -1 VMA Outfall? Yes No
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No
Was this outfall ever in Tier 2 during the past year? Yes ❑ No
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency El
Yes, received approval from DEMLR to reduce monitoring frequency 13
No, turbidity benchmark exceedances did not require monthly monitoring 13
Other 11
Outfall N®.
apo I
Total
Rainfall,
inches
TSS,
mg/l
SS,
MI/I
Turbidity,
�,
NTU
Upstream
U Turbidity,
() urbidi ,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
0&G, mgil
(VMA)
New
Motor Oil
usage
aUmo.
�a,g
Ic76®P'�6AW����- -
-Benchmaift
Circle -
lndxal®NO + -®enihmnrk
Fcowlr - ' 1,®Q/ Q
a wawa ,
-
�:'I
- - Cllcie`- -- -- - - _, - -- - -- -- --- -- >8&gal/ma.-' -
BenchLLmarBc — N/�t-.? _ - 111A - r aue0ge rebores,
��%d�!°I® ire Wakrdopp9i s Stan aeda�pp I� TSS and 08G eilt pr
Date Sample
Collected,
rno/dd! r
103 JI S'
I �00
2,,39 .0 O.a
N /A
Lit 10
56,0
I 1 1E
I o
q l, I
-'(0.1
,4 e (U
10.
1 5"
< S a O
7 �J
1
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CI
e
03
r
5T
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e `%
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Permit Date 10/1/2016 m 9/30/2020
Last Revised 10-2-2095

Certificate of Coverage No. NCG02 ®QQ©
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 §122.22]
Signe,
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