NCG190050_MONITORING INFO_20190222

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STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC-TYPE 0 HISTORICAL FILE
"ONITORING REPORTS
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STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year e?Ole
General Permit No. NCG190000
Certificate of Coverage No. NCG190 2VW_
This monitoring,report summary of the calendar year should be kept on file on -site with the facility
SPPP.
Facility Name: USCG SfeViC ��4 D«�� ii /N9�D�✓ -
County: --
Phone Number. (aza) Total No. of SDOs monitored:
Outfall No.: '
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No M'
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No 2'
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DEAMLR to reduce monitoring frequency ❑
Other ❑
_
Outfall I
Total
Rainfall,
inches
00530
TPHbymethod
1664 SGT-HEM
01119
-01104
01094
01114
TSS,
mglL
Non -polar Oil
& Grease,
mglL
Copper,
mglL.
Aluminum,
mg/L
Zinc,
mgll
Lead,
mglL
Benchmark
Freshwater
Saltwater
N/A
100
15
0.010
(0.005)
0.75
0.126
(0.095)
0.075
(0.220)
Date Sample
Collected,
molddlyr
e
'
J N-JWJr?o1ff
410F2dld
jv, Td
�g-
, t��Sr,,
�33
6
, 03
/-7/
.Daly
Gi
SW U-250 N CG 19-060815

J!�
Additional Outfall Attachment
Outfall No. NJ M
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No ❑
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No ❑
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
00530
TPH by method
01119
01704
01094 ....
01114
1664 SGT-HEM)
TSS,
Non -polar Oil
Copper, .,
Aluminum,`
Zinc,
Lead,
Total :'
Outfall
Rainfall, ,.
mglL ,
& Grease,
mglL
mg/L
mglL
mglL
inches _
mglL
:.
Benchmark
0.010
0.75
0.126
0.075
Freshwater
N/A
100
15
(0.005)
(0.095)
(0.220)
Saltwater
Date Sample
Collected,,.
-
a
x
d, . d
P-
W
SWU-250NCG19-060815

"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_"
Signature
Date ZO6E zo 1 q
Mail Annual DMR Summary Reports to:
DEMLR Regional Office Contact Information:
Asheville Office ......
[phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
[phone]
Washington Office ...
[phone]
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........
[phone]
.VILLE REGIONAL OF
2090 US Highway 70
Swannanoa, NC 28778
[phone]
3800 Barrett Drive
Raleigh, NC 27609
[phone]
585 Waughtown Street
Winston-Salem, NC 27107
[phone]
225 Green Street
Systel Building Suite 714
Fayetteville, NC 28301-5043
[phone]
dOORESVILLEREGIONAL OFFICE
610 East Center Avenue/Suite 301
Mooresville, NC 28115
[phone]
LWASHINGTON REGIONAL -OFFICE l W1LMING'r0N.REGIONAL OFF11
943 Washington Square Mall 127 Cardinal Drive Extension
Washington, NC 27889 Wilmington, NC 28405-2845
[phone] [phone]
CE�INTRAL OFFICE
1617 Mail Service Center
Raleigh, NC 27699-1617
[phone]
SWU-250NCG 19-060815

STORMWA'I ER DISCHARGE OUTFALL (SDO)
GENERAL PERMIT NO. NCG190000
DISCHARGE MONITORING REPORT' (DMR)
CERTIFICATE OF COVERAGE (COC) NO.: NCGl9❑o ®0® SAMPLE COLLECTION CALENDAR YEAR: bEG .)o 17
RECE(l HiSl pitoring report is ducat the Division no later than 30 days from
FACILITY NAME: (JSL'c� .$'�G%DZ �Ez Qr�GL 1,14 'pN t e date the facility receives the sampling results from the laboratory.)
SAMPLI; C01,LECI'I0N NAM1,: s"�.r.., �c-�9�� vfs�:,�, - �.��.���aN 2 5 �(13
CENTRAI- FIB _S FACILITY COUNTY: 1 9i-f i' 7—
Lab LABORATORY: Lab 4 DV/FF SFCTION 1111ONE NO.: ?S '-'y7- 1157Z
Part A: Snecitic Monitorine Reauirements
Outfall
Sample
00530
T1'tl.nymeuiod
01119
01104
r 01094
101714
"
]h64 SC IIEMj
;,
, I otnl:Suspended
,Non l olkr;Oil &
;Copper mg/1
Aluminum.;;mg/l
; /roc
,;m
u l
No.
Cnllectron,Date,
Total Rainfall,
malddl i
_ ruches:....
Snlii3sCrease
rn"g/L
t ,;
reshwaler
- 100 "
l5 ,
0.01.0
0 75
0'126
S rlhv�tcr
ai
5)�i
Ii
(0220)!,
Renc}ima'rlcv.
:Ja
!'
TI ...:.
.. .
d FLO/V
Yp S4!� %�f
cii �R�/1}/N
LrM�p,(3Dif/
..SOG4% ,dM
7/+10US7" /
Z- /�7c7/[/iT/c
LiJfa/IL eOti
%.}7G7�
/1 G� /ice U �/
S U�',/ �'
GNG G�'��
`�
�pf✓ Giv%�7CS
j��/f{✓�}` 49
t'T� SGrGT/�.•�
(7v /�/
If a value is in exrrss of the henchmark- von must imnlemPnt thr. Tier I nr TIP.r � resnnnses in IhP General Vermit
z Total recoverable metal.
3 ,Mese benchmarks are water hardness dependant. Values shown based on a hardness of 50 mg/L.
Solvent Manatement Plan Certification:
Mail original and one copy for `Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit requirement for
Division of Water Resources managing solvents, I certify that to the best of my knowledge and belief, no leak, spill, or dumping of concentrated solvents
Attn: Central riles into the stormwater or onto areas which are exposed to rainfall or storrtiwater runoff has occurred since filing the last discharge
1617 Mail Service Center monitoring report. I further certify that this facility is implementing all the provisions of the Solvent Management Plan
Raleigh, North Carolina 27699-1617 included in the Stormwater Pollution Prevention Plan,"
(Signatur of Permittee) (Date)
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"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 hest 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."
natur of Permittee)
lit e:6/02/2015-5/31/2020
ti
(Date)
S WU-253-060515
Page I of I

STOR.MWATER DISCHARGE OUTFALL (SDO)
GENERAL PERMIT NO. NCG190000
DISCHARGE MONITORING REPORT (DMR)
CERTIFICATE, OF COVERAGE (COC) NO.: NCG19K 0E] SAMPLE COLLECTION CALENDAR YEAR: 1WV aa1e'
("I'his monitoring report is ducat the Division no later than 30 days from
FACILITY NAME: (Js'C� .�c2aaC jiczo G �iG� ii. M/!C'o� the date the facility receives the sampling results from the laboratory,)
SAMPLE COLLECTION NAME: �i6r,.,1�� d)-�cscD�a- GrtytL
FACILITY COUNTY:
CERTIFIED LABORATORY: A, A11RzY7-1494_f 114'4XZ01'C Lab #
Lab # PHONE NO.: ,;?{-R)
Part A: Snecific Monitorine Renuirements
911
'Sample
P
OOS
9
1,_
01104
01094
01114..
Cnllect►on Datc
Tatni R�mfnll
abb4{S�'[' FIFM)
y
1 ntat;Sus eriderl
Non l ol►r0il &,
Co cr m /I ^''
PP g
Alum►num m II
g
I►nc�: rn /L
�, g
2,3 'm II J
g
ino/cid/vr :-` ,.
, ;; `'1rIChES . ...
So1►ils, mrease,
mg/L
_
Freshwater
:,i
100.
15
0 010, U
„ 0 75
0126
0.075
{S iltrvater)
`°
(0 OOS)
-
(0 95)
O
(0.220)
RenchMrlcc
,=
i7
vP/y
zy d
s
I
If a value is in excess of the benchmark. von must irnnlement the Tier 1 or Tier 2 responses in the O"enerai Permit.
t� ri
'Ibtal recoverable metal. !7U!JSECTION
3 These benchmarks are water hardness dependant. Values shown based on a hardness of 50 mg/L.
SolventiManagement Plan Certification:
Mail original and one copy to: "Based upon my inquiry orthe person or persons directly responsible for managing compliance with the permit requirement for
Division of Water Resources managing solvents, I certify that to the best of my knowledge and belief, no leak, spill, or Clumping of concentrated solvents
Attn: Central Files into the stormwater or onto areas which are exposed to rainfall or stormwater rfulOff has Occurred since filing the last discharge
1617 Mail Service Center monitoring report. I further certify that this facility is implementing provisions of the Solvent Management Plan
Raleigh, North Carolina 27699-1617 included in the Stormwater Pollution Prevention Plan."
Z /ZZ,
(Signature of Permittee) (Date)
YOU MUST SIGN TILTS CERTIFICATION FOR ANY INFORMATION REPORTED:
"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 bdiefrtrue, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the
possibility��r f lines a ) priso,44hent for knowing violations."
C
(Signature of Permittee)
Permit Date: 6/02/2015-513 1/2020
/A/y1/ 20If
(Date)
SWU-253-060515
Page 1 of 1

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year
General Permit No. NCG190000
Certificate of Coverage No. NCG 19 [❑0 S❑❑
This monitoring report summary of the calendar year should be kept on file on -site with the facility
SPPP. _
Facility Name:
County:
Phone Number: Y7- Total No. of SDOs monitored:
Outfall No.:
Is this outfall currently in Tier 2 (monitored monthly)? YeSM No ❑
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes M No ❑
if this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DEMLR to reduce monitoring frequency ❑
Other ��f'��.��,�:r % a ������ ac�iG ❑
Outfall
Total
Rainfall,
inches
00530
TPH by method
.1664 SGT-HEM
01119
01104
01094
o1114
ASS
'
mg1L
Non-polar Oil
& Grease, -
mg/
Copper,
mglL
Aluminum,
mg/L
Zinc,
mg1L
Lead,
mglL
Benchmark
Freshwater
Saltwater
N/A
100
15
0.010
(0.005)
0.75
0.126
(0.095)
0.075
(0.220)
Date Sample
Collected;
moldd/yr
�-
- - -
63
7.2
ArAU7�/
33a
'j
N
-,
a 3
. vyj3
Al 6
CEIVE
t Z Z�
SWU-250NCG 19-060815

r.'
Additional Outfall Attachment
Outfall No.
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No ❑
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No ❑
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
00530:
TPH by method
01119
01104
01094
01114
1664(SGT-HEM)
'
TSS,
Non -polar Oil
Copper,
Aluminum,
Zinn,
Lead,
Total
Outfall.-
Rainfall,
mg1L :
& Grease,
mglL
mg1L _.:
mglL.::..
mglL
inches
mg/L
Benchmark
0.010
0.75
0.126
0.075
Fresh wa ter
NIA
100
15
(0.005)
(0.095)
(0.220)
Saltwater
Date Sample
A
Collected,
y
molddlyr
Y� `•� F „ ` fi �
���
a
C
'tO
SW U-250NCG 19-060815

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."
Sig
Dat
Mail Annual DMR Summary Reports to:
DEMLR Regional Office Contact Information:_
Asheville Office ...... [phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
[phone]
Washington Office...
[phone]
Wilmington Office-...
[phone]
Winston-Salem ......
[phone]
Central Office .........
[phone]
'ASHEVILLE REGIONAL OFFICE
FAYET�I'F LLE,`RECIONr1L UFEICE
l�'IOORESVII LE REGIONr1L OFFICE
2090 US Highway 70
225 Green Street
610 East Center Avenuc/Suite 301
Swannanoa. NC 28778
Systel Building Suite 714
Mooresville. NC 28115
[phone]
Fayetteville, NC 28301-5043
[phone]
[phone]
RALEIGH REGIONAL: OFFICE
INVASHING7,-,;ON:REGIONAL OFFICE
NVILINUIINGTON REGIONAL OFFICE
3800 Barrett Drive
943 Washington Square Mall
127 Cardinal Drive Extension
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
[phone]
[phone]
N�'I\STO\-SALEi�I REGIONr 1L
�OFFICI
CE,NTRAL, OFFICE �
'
1617 Mail Service Center
585 Waughtown Street
Raleigh, NC 27699-1617
Winston-Salem; NC 27107
[phone]
[phone]
SWU-250NCG 19-060815

JUL 2 0 1Ulb
CENTRAL FILES
DWR SECTION
STORMWATER DISCHARGE OUTFALL (SDO)
GENERAL PERMIT NO. NCG190000
DISCHARGE MONITORING REPORT (DMR)
CERTIFICATE OR COVERAGE (COC) NO.: NCG190®07ci
FACILITY NAME: (/SC(i S&G7a-c /i G1-fc'- F, 10q9l0u
SAMPLE COLLECTION NAME;-s577>�,., l o7sm- Qyr�ytL
CERTIFIED LABORATORV:
Parr A: Isneeme monitortne Reaulrements
Lah 4
Lab It
RtUM+ V Vl
JUL % 0 4
CENTRAL FILES
DWR S CTJON
SAMPLE COLLECTION CALENDAR VEAR: i•+a-,2017
(This monitoring report is due at the Division no later than 30 days from
the date the facility receives lire sampling results from the laboratory.)
FACli,rrY COUNTY: �A
PHONE NO.: (�S�}„ a?'ll 17s3y
OutfalE
No li
- = Sample :
!:Collection Bate,
mo/dd/vr -
T661IRaiiifill,
_ „ iriclie;
04530_
;t'rtt by meulod
=1664(SGT.that)2
01119
111104„ .
O1094
. I otal:Snspendcd
Snl�ds m IL",=,
NoR-I ohr,0i1 &
- ,Cr'ease; nrblL
3-
,'Copper ;� mg/L,
iAluminum ,.mg/L
3
31'' 7tnc2': , rnglL
Lc.'id
t reshwalcr
(S a[t`vntcr}
Ile nchmarkl;.=..
„
10f1
I5
0 010,
0 75
0:126'
j72 ((}.1}95)
0 075;,::'
(0.220)
O �LON
N�BL�
S'9�nP� �"
�i�v�
su�vas-r
Et�E
v� 7a Ti
11 a Ya1 Ll6 1J 111 UAli-33 V1 LIIG JGMA1[1[d1 R,''UU I111JJl Il1JP CHIC111 411G 1101 1 V[ 11EA L IChP"11SW Ill LI1G 1jr-Hul 11 rcuuu.
z 'Total recoverable metal.
3'These benchmarks are water hardness dependant. Values shown based on a hardness of 50 mg/L.
Solvent Marraeement Plan Certification:
Mail original and one copy to: "Based upon my 'inquiry of the person or persons directly responsible for managing compliance with the permit requirement for
Division of Water Resources managing solvents, 1 certify that to the best of my knowledge and belief, no leak, spill, or clumping of concentrated solvents
Attn: Central files into the stormwater or onto areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge
1617 Mail Service Center monitoring report. I further certify that this facility is implementing all the provisions of the Solvent Management Plan
Raleigh, North Carolina 27699-1617 included in the Stormwater Pollution Prevention Plan." I f
(Signature of Permittee)
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"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
possjklity of fines and imprisonment for knowing violations."
Jav jl-' .�o a
(Signature of f ermittee)
Permit Date: 6/02/2015-5/31I2020 SWU-253-060515
Page I of 1

STORMWATER DISCHARGE OUTFALL (SDO)
GENERAL PERMIT NO. NCG190000
DISCHARGE MONITORING REPORT (I)MR)
CERTIFICATE OF COVERAGE (COC) NO.: NCG19❑❑❑❑ �D 0,50 SAMPLE COLLECTION CALENDAR YEAR:
n �- (This monitoring report is (file at the Division no Eater than 30 days from
FACIL1TV NAME: USCG sla*,C 4pEFiG� �i. s%91�N� ji ftWirate the facility receives the sampling results from the 1.iboratory.)
SAMPLE COLLECTION NAME: s7�rr'�i L✓�g�C Dr/T/�.1tG 1 V L
CERTIFIED LABORATORY:
Part A: Specific Monitoring I
Outf dl K. Sample
l. No. Collectio►r
I�reshwaler I I� - ,� -
13eRchmarks' ' '
uirements
Lab ff JUN ], 6 zov FACILITY COUNTY:
Lah #€ PHONE NO.:
CENTRAL FILES
00530 rt>II byt��n�a �] 119 01 1114
1C64'(Wr-IIF.NI)
Tnt d Raifall! 1>I otal'Suspcnded Non=1'ol �r Oit QGopperZ mg/L : Aluminum2mglL
0.7
01094 it O]114
1,3 _,ImgIL I ead , mg/L.
0 126 i 0 075;,
{0 09S) { I {0 220)
' 11'a value is in excess of the benchmark, you must implement the Tier 1 or Tier 2 responses in the General Permit.
Z Total recoverable metal.
3 These benchmarks are water hardness dependant. Values shown based on a hardness of 50 mg/L.
Solvent Mannaemenl Plan Certification:
Mail original and one copy to: `Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit requirement for
Division of Water Resources managing solvents, I certify that to the best of my knowledge and belief, no leak, spill, or dumping of concentrated solvents
Attn: Central Files into the stormwater or onto areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge
1617 Mail Service Center monitoring report. I further certify that this facility is implementing all the provisions of the Solvent Nlanagentent Plan
Raleigh, North Carolina 27699-1617 included in the Stormwater Pollution Prevention Plan." r
(Sign ture of Perini
YOU MIDST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"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 hest 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."
:t')
aa of Permittee)
ate: 6/02/2015-5/31/2020
V �
(Date)
SWU-253-060515
Page 1 of 1

STORIIWATER DISCHARGE: OUTFALL (SDO)
GENERAL PERMIT NO. NCG190000
DISCIIARGE MONITORING REPORT(I)MR)
CERTIFICATE OF COVERAGE (COC) NO.: NCG1990 5❑ O❑ SAMPLE COLLECTION CALENDAR YEAR: ZWK O/ 7
��JJ (This monitoring report is clue at the Division no later than 30 days from
FACILITY NAME: USCG SaWt 4Rp � ielr �i[T __ III- "da-t the facilityy receives the sampling results from the laboratory.)
SAVII'l,l? COLLECTION NAME; Srb/li., 4.,tr� dv'�i�-v��� �_ ����i*v�� p g ��)
CERTIFIED LABORATORY: P/r�d4vl4G r![9L I.ab# a8o�8 APR 1 7 2D11 FACILI'1'YCOUN'['Y: Gr4iCTE�C�'�
Lab # CENTRAL FILES PHONE NO.: (�se�) �y7- ys3y
Part A: Specific Monitoring Requirements nIA1q et=rTlnni
Outfall
No.
Sample
Collection Date,
moldd/vr
Totm Rainfall,
inches
00530
1'Nt[ by method 1
1664(SMAJb;N1)"
109
01104
01094
.01 11a
"Total Suspended
Solids, m IL
Non -Polar Oil &
Grease, mg/L
CopperZ' , mg/L
Aluminum", mg/L.
/.inc ' , mg/L
Lead ' ; ntglL
Freshwater
(Saltwater)
1
Benchmarks
-
_
100
Dr �aovGH
15
0.010
(Omos)
0.75
0.126
(0.095)
0.075.
(0.220)
is i7
' If a value is in excess of the benchmark, you must implement the Tier I or Ticr 2 responses in the General Permit.
Total recoverable metal.
''These benchmarks are water hardness dependant. Values shown based on a hardness of 50 mg/L.
Solvent Management Plan Certification:
Mail original and one copy to. "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit requirement for
Division of Water Resources managing solvents, I certify that to the best of my knowledge and belief, no leak, spill, or dumping of concentrated solvents
Attn: Central Files into the stormwater or onto areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge
1617 Mail Service Center monitoring report. I further certify that this facility is implementing all the provisions of the Solvent Management Plan
Raleigh, North Carolina 27699-1617 included in the Stormwater Pollution at
Plan." I
C)'
re of Permittee) (Date)
YOU MUST' SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document anti 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."
ture of Permittee)
Date: 6/02/2015-5/31 /2020
(Date)
S WU-253-0605 l 5
Page I of I

STORMWATER DISCHARGE OUI'FALL (SDO)
GENERAL PERMIT NO. N'CG190000
DISCHARGE MONITORING REPORT (DMR)
CERTIFICATE OF COVERAGE (COC) NO.: NCG19a0 E Ella SA!'IPLE COLLECTION CALENDAR PEAR: -, 10 / 7
,� AEI` rLf�- t�ionitoring report is due at the Division no later than 30 days from
FACILITY NAME: Use's �G�Ty�� 4 =��1� /'T C 14 the (late the facility receives the sampling results from the laboratory.)
SAMPLE COLLECTION NNAMI,: APR 0 5 2017
ll FACILITYCOUNTY: 2i
CERTIFIED LABORATORY: t�j Lab # CENTRAL_ FILES
Lab # DWR SECTION PHONE NO.: ( y7- ySa
Part A: Specific Monitoring Requirements
Outfalt
No.
Sample
Collection Date,
too/dd/ r
Total Rainfall,
inches'
00530
'I'PII bymethod
1664 (S, 'T-HE11
01119
01104
01094 •
01114
Total Suspended
'Solids; m IL
Non -Polar Oil &
Grease, mg/l1 ;
Copper ' , nig/L
Aluminum , mg/L
Zinc, ,'mg/ll y
Lead , mglL
Freshwater
(Salovater)
Brnch marks
-
-
100
15'
0.010
(0.005)
0.75
0.126 ,"-' �
(0.095):..
0.075
(0.220)
i
l--!�'Z- -
l- ok-
27ICU :e
��-� ���
4�r,,•� /%/'..
�,� � �„�
; v� T/
If a value is in excess of the benchmark, you must implement the Tier I or Tier 2 responses in the General Permit.
'- Total recoverable metal.
31fhese benchmarks are water hardness dependant. Values shown based on a hardness of 50 mg/1—
Solvent Manaacment_Plan _Certification:
Mail original and one copy to: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit requirement for
Division of Water Resources managing solvents, 1 certify that to the best of my knowledge and belief, no leak, spill, or dumping of concentrated solvents
Attn: Central Files into the stormwater or onto areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge
1617 Mail Service Center monitoring report. I further certify that this facility is implementing all the provisions of the Solvent Management Plan
Raleigh, North Carolina 27699-1617 included in the Stor-nwater Pollution Prevention Plan."
(Signature of Permince) (Date)
YOU M UST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"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 gatheFand 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 t1fdt there are significant penalties for submitting false information, including the
possibility of fines and imprisonment for knowing violations."
(S oat re of Permittee)
Permit Date: 6/02/2015-5/31/2020
(Da te)
W
S W U-253-0605 l 5
Page I of I

FEB 10 4�014
sTORMwATER DISCHARGE ouTFALI1(sno) CENTPAL PILES�WR �ECT10A�
GENERAL PERMIT NO. NCG190000
DISCHARGE MONITORING REPORT(Dti1R)
CERTIFICATE OF COVERAGE (COC) NO.: NCG19k�]F0©- SAMPLE COLLECTION CALENDAR YEAR: .2a1 7
(This monitoring report is due at the Division no later than 30 days from
FAC11,ITY NAMF,:L LSC'G •. rc `��� (�,� i �- r .�'i /s7 C� the date the facility receives the sampling results from the laboratory.)
SAMPLE COLLECTION NAME: %I
FACILITY COUNTY- L fic'TLa,'c7 —
CERTIFIED LASOIZA'I'ORY: ti� Lab #
Lab # PHONE NO.:ys3�/
Part A: Specific Monitoring Re uirements
Outfall
No.
Sample
Collection Date,
moldd/vr
Total Rainfall,
inches
0{)530
11'fl by method
1664 (SCT-1IH;,1t)
01 I l9
' 01104
01094
01114 ,
Total Suspended
Solids, rn /L
Non -Polar Oil &
Grease, mgIL
233
Copper ' -, mg/L
: Aluminum , mg/L
Zinc"', mg/L
Lead-' , mg/L
Freshwater
(Saltwater)
Benchmarks
-
-
100 '
15
0.010
(0.O05)
0.75
0.126
(0.095)
0.075
(0.220)
i�Z i
c=�C� ��
y� �•cu�.
�,.� n�c� x.
��' L� �
PCs ��� s=y
%�i�c� LG -
:�► t�.v r�stc .
-�r?�-�
'If a value is in excess of the benchmark, you must implement the Tier 1 or `bier 2 responses in the General Permit.
Total recoverable metal.
3 These benchmarks are water hardness dependant. Values shown based on a hardness of 50 mg/L.
Solvent Management Plan Certification:
Mail original and one copy to: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit requirement for
Division of Water Resources managing solvents, I certify that to the best of my knowledge and belief, no leak, spill, or dumping of concentrated solvents
Attn: Central riles into the stortmvater or onto areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge
1617 Mail Service Center monitoring report. [ further certify that this facility is implementing all the provisions of the Solvent Management Plan
Raleibh, north Carolina 27699-1617 included in the Stortnwater Pollution Prevention Plan."
{Sign ure of Permittee) (Date)
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"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 hest 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."
I A ao �-
(Sign tore of PermitteeK (Date)
Date: 6/02/2015-5/31/2020 SWU-253-060515
Page 1 of 1

STORMWATER DISCHARGE OUTFALL (SDO)
GENERAL PERMIT NO. NCG190000
DISCHARGE MONITORING REPORT (DMR)
CERTIFICATE OF COVERAGE (COC) NO.: iN'CG1920 91 E` RECEI SAMPLE COLLECTION CALENDAR YEAR: a7oIG
I_ YTEEsPonitoring report is due at the Division no later than 30 days from
FAC11,]TV NAME: (%S'('G Sffe //>W �fiie� r� ,.� JAN 11 M e date the facility receives the sampling results from the laboratory.)
SAMPLI?. COLLECTION NAME:
CENTRAL FILES FACILITY COUNTY: e1411f
CERTIFIED LABORATORY: lQvr AiYgLyT1C.gG Lab # 32/gAr SECT IOC?
Lab # PHONE NO.: (2sg �Y7- S'S3y
Part A: Specific Monitoring Requirements
Outfall
No.
Sample
Collection Date,
Imo/dd/yr
Total Rainfall,
inches
00530
'rt,lI 1)y method
1664 sG'1'-IIENI
01119
ill 104
01094
01114
Total Suspended
Solids, m /L
Non -Polar Oil &
Crease, m1;/I.
Copper ' , mg/L
Aloniinum , mg/L,
Lines'. , mg/L
`
Lead" , mg/L
Freshwater
altwaler
1 enc i mxr s
_
100
15
0.010
(0.005)
0.75
0.126
(0.095)
0.075
(0.220)
0/091
If a value is in excess of the benchmark, you must implement the "Pier 1 or Tier 2 responses in the Genera! Permit T..�i�1E�F,vTrv� Ti�� o? %�B�PvNS�
`'Total recoverable metal.
3 These benchmarks are water hardness dependant. Values shown based on a hardness of 50 rng/L.
Solv_ent_iManagement Plan Certification:
Mail original and one copy to: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit requirement for
Division of Water Resources managing solvents, 1 certify that to the best of my knowledge and belief, no leak, spill, or dumping of concentrated solvents
Attn: Central Files. into the stormwater or onto areas which are exposed to rainfall or storn ater runoff has occurred since filing the last discharge
1617 Mail Service Center monitoring report. i further certify that this facility is implementing all the provisions of the Solvent Management Plan
Raleigh, North Carolina 27699-1617 included in the Stormwater Pollution Prevention Plan."
(Sig ature of Permittee) (Date)
.YOU MUST SIGN THIS CERTiFiCATiON FOR ANY INFORMATION REPORTED:
"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."
4=_� lz�� _�_ Il' cb,_ (144AID I tj­
(Sig tture of ermittee) (Date)
Date: 6/02/2015-5/31 /2020 , S W U-253-060515
Page 1 of l

e
RECEIVED
STORMWATER DISCHARGE OUTFALL (SDO)
GENERAL PERMIT NOVN'CG190000
DISCHARGE MONITORING REPORT (DMR)
AUG 12 Nib
CENTRAL FILES
DWR SECTION
CERTIFICATE OF COVERAGE (COC) NO.: NCGBR0j O K© SAMPLE COLLECTION CALENDAR YEARN>>�
(This monitoring report is clue at the Division no later than 30 clays from
F ACI LI I l INAM L: V
SAMPLE COLLECTION NAME:.SToPial,.•���/' (G a
CERTIFIED LABORATORY:I�e �i',9Ly71c'rgL Lab # '7�?2,030-�00
Lab #
Part A: Specific Monitoring Requirements
the date the facility receives the sampling results from the laboratory.)
FACILITY COUNTY:
PHONE NO.: (� -/7-
Outfall
No.
Sample
Collection Date,
mo/ddI r
Total Rainfall,
inches
00530
TPII by method
1664 (S(.TI'-11E11
01119
01104
01094.
01114
"Total Suspended
Solids, m IL
Non -Polar Oil &
Grease, mglL
Copper ' , mg/L
Aluminum , mg/L
Zinc' ; mgn .
Lead ' , mg/L
Freshwater
(Saltwater)
Benchmarks
_
_
100
15
0.010
(0.005)
0.75
0.126
(0.095)
0.075
(0.220)
v� .2
-7. a
4'
If a value is in excess of the benchmark, you must implement the Tier 1 or Tier 2 responses in the General Permit.
2 Total recoverable metal. -'4� 1MA1%CA,77J✓C
These benchmarks are water hardness dependant. Values shown based on a hardness of 50 mg/L.
Solvent Management Plan Certification -
Mail original and one copy to: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit requirement for
Division of Water Resources managing solvents, 1 certify that to the best of my knowledge and belief, no leak, spill, or dumping of concentrated solvents
Attn: Central files into the stormwater or onto areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge
1617 ;Mail Service Center monitoring report. I further certify that this facility is implementing all the provisions of the Solvent Management Plan
Raleigh, North Carolina 27699-1617 included in the Stornnvater Pollution Prevention Plan."
(Sign tore of Permittee) (bate)
YOU MUST SIGN TII[S CERTIFICATION FOR ANY INFOILtilA"1'10\' REPORTED: ,�/J
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance `►=ith 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."
1)P—
(Signature of Permittee)
(Date)
6102/20 l 5-5131 /2020 S W U-253-060515
Page I of I

�II Unirted States Coast Guard
U.S. t7tp3rt" d H..d..d '
EXPOSED SIGNIFICANT MATERIALS ASSESSMENT
FORM 4
EXPOSED SIGNIFICANT MATERIALS ASSESSMENT
SFO Fort Macon
Inspector: EPS-Todd Ogle, / Date:
Instructions: Describe the significant materials that were exposed to storm water during the past year and/or are currently exposed. Significant materials
include, but are not limited to raw materials, fuels, solvents, detergents, metals, hazardous substances, fertilizers, pesticides and waste products that
have a reasonable potential to release pollutants into storm water discharges.
Description of
Period of
Quantity
Location (as
Method of Storage
Description of Proper Material Management Practices
Exposed
Exposure
Exposed
indicated
or
(e.g., pile covered, drum sealed)
Significant Material
(units)
on the site map)
Disposal (e.g., pile,
drum, tank)
Diesel ASTs
> I year
2 rr 1000 gallon
Multi Purpose Bldg
AST
Double -walled tanks
Gasoline and Diesel
> I year
I @ 500 gallon
Station Fuel on Pier
AST
Double -walled tanks
AST
I a 1000 gallon
Used Oil AST
> I year
I a 500 gallon
Station Pier
AST
Double -walled tank
Used oil and oily
> l year
l a 500 gallon
1-Iazwaste Shed Area
Mobile
Double -walled tanks
water trailer
2 a 1000 gallon
Containers
Recycle Metals
> I year
Mise metal
Between Engineering
Pile
None, working to relocate inside pebble shed or out of
and IPD
stormwater path to SDO pipe.
Private Boats
> 1 year
Approx 20
Near shoreline
Boats
None
revetment on NW
side
Buoy and. Chain
> 1 year
Varies
Near NE corner and
Piles of chain
None
Storage
at A'1'ON area
Buoys
.
Surveyed 55 ANB
< 1 year
Exposed antifoul,
Near SDO location,
On jack stands,
one, 55 ANB sold and removed Apr 2016.
ull, shaft zincs
adjacent to 110 pier.
awaiting disposal

;1' United States Coast Guard
US. Dn aroieM of HmrclaM Semny
FORM 5
FACILITY PREVENTATIVE MAINTENANCE INSPECTION REPORT
Building/ Area: /, S/} [:- c- /""j1 1
Date: /S.jUL y
Inspector: �04 5 6,.-z r �t�%� .S�t%z •t✓
Time:
Perform facility inspection and inspect all applicable storm water management devices. Check yes or no,
and provide details under comments. List suggested corrective actions at bottom of form.
Are the following storm water management and/or pollution control measures in place, maintained,
and functioning properly? Look for evidence of leaks or potential storm water contamination
problems.
MEASURE/ ITEM
YES
NO
COMMENTS
Facility storm water drainage system (i.e., catch
basins, inlets, culverts, headwalls, ditches)
/
Existing sediment and erosion control devices
Retention ponds/ detention basins
Temporary storm water diversion dikes/ devices
--
tj
Subsurface storm drains
—
N lA
Graded pavement
Nh
Oil/water separators/ grit chambers
Fuel/ oil sumps
Fuel/ oil/ other pumps and hose connections
Secondary containment structures
AP NJLT?LSXPm�a
Pipes, valves, and valve fittings
�-
Mobile equipment
A71rlZV /jvs 41
Dumpsters/ bins (garbage, grease, crap metal)
�[d
Other equipment
/ff,7�/l /�/xGLf1/.✓/� L-S
�i7-+• s 7W /n5�l�C_ utizl
�'��'.�! �Ji� /� �i/ �/-�T/rG.
�7�
i � /N'
[-�%l- ✓J. �vF.�r C'L�9.v D!i%
Corrective Actions:
7a rutz ;'ve4 Z, .aA'y zwl -ox- l C7—
4/- 6I'vz- 4/L On -� f lv7iN/,•� 30�- DI— 4�� A,4,—AP-L -<2' tnr,
(,/' 41,17i41 D/Ly/,��C 7a
SFO Fort Macon

APR D 4 Z�16
TORMWATER DISCHARGE OUTFALL (SDO)
"j3r; AL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year
General Permit No. NCG190000
Certificate of Coverage No. NCG1901a0al
This monitoring report summary of the calendar year should be kept on file on -site with the facility
SPPP.
Facility Name: LJS ��-� GL •�,� -� 5c .sir G�� %F•�^�— s-�?�l�
County:
Phone Number:
Outfall No,:
Total No. of SDOs monitored:
Is this outfall currently in Tier 2 (monitored monthly)?
Was this outfall ever in Tier 2 (monitored monthly) during the past year?
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
Yes ❑ No 2'_
Yes ❑ No
00530
�x5
? TPH by methods
1664 5Gi HEM
—Q1119
01104` a
,° ,01094 =
01114
s +
S
�ro�
A
F
r
`Na_n polar OBI
I
Coppe�Aiumii�um
a°
a -.
Lead,'
-t
I s
4� Total
�Outfail r
Rainfall,
T5$'$�
Grease,'t
_
,Zinc;'=�`
- -
,
x mg1L
mglL`rnglL
mglL
ri mglL
arches sm
!L a
_
a
Benchmark
r
All
i
-
45
0#010
= 0 75
0 1260
075"
Frewa shter'
N/A
100
00
095j
(0 2 20j
Saltwater
s- ,� •
�. � �..
�u�
-� "
Date.Samplet
.,�COElected,mo_lildJyr
wall-
_.
0-7
7Y
4
D
C'
L7
SWU-25ONCG 19-060815

/ 1a
"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. 1 am aware that there are significant
penalties for submitting false information, including the possibility of fines and imprisonment for knowing
violations."
Signature
Date
Mail Annual DMR Summary Reports to:
DEMLR Reaional Office Contact Information:
Asheville Office ......
[phone]
Fayetteville Office
... [phone]"'Val
Mooresville Office..,
[phone]
Raleigh Office ........
[phone]
Washington Office
... [phone]
Wilmington Office
... (910) 796-7z15 j,
Winston-Salem ......
[phone] a
Central Office .........
[phone]
NSHE 46rTA
1hLE�REGIONAL:OF LGE
AIOORE.S !1LLt EGIO AL: OFFi - E
2090 US Highway 70
225 Green Street.
610 East Center Avenue/Suite 301
Swannanoa, NC 28778
Systel Building Suite 714
Mooresville, NC 28115
[phone]
Fayetteville, NC 28301-5043
[phone]
[phone]
_ 1 EIG.IPREGIONN11OFFiCFr
«'ASHTiYG`10,�REGIONA OFI?ICiEi
943 Washington Square Mall
�V.IEL♦it[\GTO '?REC.I NA1GOFF,IGE
3800 Barrett Drive
127 Cardinal .Drive .Extension
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
[phone]- .
[phone]
SIN TOiV"SALE141 REGION-[:
CE€VTRAL;OFEICE
OFFICE
1617yMail Service Center
585 Waughtown Street
Raleigh, NC 27699-1617.
Winston-Salem, NC 27107
[phone]
[phone]

r r4
STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year 9,013
General Permit No. NCG190000
Certificate of Coverage No. NCG1 %N[ ©®❑
This monitoring report summary is due to the DWO Regional Office no later than 30 days from the date
the facility receives laboratory sampling results from the final sample of the calendar year.
Facility Name: U.S. Co sI _�--ii.wh Ss e-roa F►e,14 OFF e-[ 1�;rzt- M:y�o,u
County: C4jTCR CT
Phone Number:
Outfall No. I —
Total no. of SDOs monitored
Is this outfall currently in Tier 2 (monitored monthly)?
Was this outfall ever in Tier 2 (monitored monthly) during the past year?
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below.benchmarks to decrease frequency ❑
Received approval from. DWO to reduce monitoring frequency ❑
Other _ 0
Yes ❑ No [%
Yes❑ No (A
Outfall _�
N Total
Rainfall,
inches
00530.
00400
00556,
01119
01104:
01094
01114
_: TSS ",.:
mg/L
, .. p��.
s.u...,
Oil &,.
Grease,
mg/L
C
tng/L
At
m
Zinc, mg/L'.
mgfL
Benchmark
N/A
700
6.0 — 9.0
30
A07
0.75
0.067
0.03
Date Sample
Collected,,�
mo/ddtyr
.-7 - T.k.'
! ib
-
R .a
� r�h�
_'..'�...,r-+spa,,
; S
'•max K`M
a�
� �t ,� �
a.`�?r::-.,... 'i.,:c.
� lf,
,�� ��
r ^u 7
Fc rVPa: a✓�y
���
-; X. GLky
� � �
:%... I -r
`. 7?
�� ����
.�cc �i..^z"r: o-:..m
Elm
y riI r3
.61
19i.1
7.
�Olkl
111
0 70
to h
HECEWEr'
MAY 0 12013
BY•
SW U-250NCG19-092309

ace Analytical
WWW'PWalebs.WM
Project: Stormwater 4112/13
Pace Project No.: 92154550
Pace Analytical Services, Inc.
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
HITS ONLY
Pace Analytical Services, Inc.
2225 Riverside Dr.
Asheville, NC 28804
[phone]
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Lab Sample ID
Client Sample 1D
Method
Parameters
Result Units
Report Limit
Analyzed Qualifiers
92154550001
Stormwater 4112I13
EPA 200.7
Aluminum
234 ug/L
100
04/19113 23:39
EPA 200.7
Copper
1.8.4 ug1L
5.0
04/19/13 23:39
EPA 200.7
Zinc
76A ug1L
10.0
04/19/13 23:39
SM 2540D
Total Suspended Solids
19.2 mg1L
5.3
04/18113 10:55
SM 4500-H+B
pH at 25 Degrees C
7.8 Std. Units
1.0
04120/13 16:55 H6
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Anatocal Services, Inc..
Page 4 of 14

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year ao/l
General Permit No. NCG190000
Certificate of Coverage No. NCG190®©®❑
This monitoring report summary is due to the DWQ Regional Office no later than 30 days from the date
the facility receives laboratory sampling results from the final sample of the calendar year.
Facility Name: 0. S Go q,3t- Gu>
County. _ _� r�T-uz, F�
Phone Number: a(!a } a o -Yq F Total no. of SDOs monitored
Outfall No. �! _
Is this outfall currently in Tier 2 (monitored monthly)?. Yes ❑ No)—Z
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No .
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Outfall
Total
Rainfall,
inches
.00530"
00400'..
00556
01119 :
01104.
01094
01114
TSS,
mg/I-1..
pH, Y '
s,u.
t7il,& ' `
Grease,
mg2
: `Copper,
rrig/l-
Aluml�uin,
- mglL
:.
Zinc, mg/L
Lead,
mg/L
Benchmark
N/A
100 .d
6.0 - 9.0
30
0.007
0.75
0,067
0.03
Date Sample
Collected,
y
sy
�,.12J�;
f._ "°
YS' .+.
r u
f'mRA'Cy'b� W+
£ �S
l
y.S,:`Sb ,
�,,��
��
3 4 S
4
1, h ,�
�,
- ,5 +J y.y
i�
-
-
r n
K
1
,aL
I;.�
ND
:00
a 006'e
52
oil
APR
K
SW U-25ONCG 19-092309

"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."
Sign
Date
Mail Annual DMR Summary Reports to:
DWQ Regional Office Contact Information:
Asheville Office ......
[phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
[phone]
Washington Office ...(252)
946-6481
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........(919)
807-6300
a;SHI VILI F_RFGI[)hAT C)FFIC I+: I A)VII;LE. RE(UIONAI ;O FICF oS MOORVILLUREGIONAI° OFI?iCl; TT77—
2090 US Highway 70
i 225. Green Street
610 East Center Avenue/Suite 301 '
Swannanoa, NC 28778
SysteI Building Suite 714
;t
Mooresville, NC 28115
F [phone]
Fayetteville, NC 28301-5043
[phone]
E
[phone]
RAI EIGH REGInNAI_,[)fFICE
i WASHINGTON�REGI NA1 OFFICE
�`I7 MIN(�TnN RI+GInN4� nI�,IC)+
3800 Barrett Drive
j 943 Washington Square Mall
127 Cardinal Drive Extension
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
' [phone]
i .[phone] i
[phone]
i
�— WINST[}N 5AI }AL.REC�I[)NAL
1
CENTRAL OFFICE
I 0FIf I C L,
1617 Mail Service Center
585 Waughtown Street
Raleigh, NC 27699-1617,
Winston-Salem, NC 27107
[phone]'--
[phone]
SW €J-25ONCG 19-092309

STORMWATER DISCHARGE OUTEALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year of g; q
General Permit No. NCG190400 Certificate of Coverage No. NCG 19 0❑®ii51
©❑
This monitoring report summary is due to the DWO Regional Office no later than 30 days from the date
the facility receives laboratory sampling results from the final sample of the calendar year.
Facility Name: .;. roq5j WAAD 5 roc �Ei D -orl'r(t FORT /144tonl
County: _ (&&T t:Y
Phone Number: Laj)a 40 Total no. of SDOs monitored
o
utfall No. 4
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Outfail
Rainfall
inches t
00530] 00400. 00558 01119
� � -.... Oil,&....�_, ,.
iSS, pH, " Grease . Capper,::
mgL.. s.u. .. mg/L '- rng/L
01104 01094. 01114
.
` 'uminuin, zinc, mglL read,
::....� mgll.
Benchmark
N/A
100. 6.0 - 9.0 30 0.007
0.75 0.067 0.03
Date Sample
Collected,
mo/dd/yr
-} u " Y,i k x r e -- tI� .JK'„c+ d 5c-.-'* •G- `� S� � ems+,.., ? `�_
-
a 14
I 7.1 db 0
1 ,a b 9
R 5 cu
SW U-250NCG'19-092309