NCG020129_MONITORING INFO_20170606

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
0 HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ (JtoIqU�UL
YYYYMMDD

STORMWATER DISCHARGE MONITORING REPORT (I)MR)
Please Mail Original And One Copy To Mailing Address Below
GENERAL PERMIT NO. NCG020000
Part A: Facility Information
Samples Collected In Calendar Year: 20 i (all samples shall be reported within 30 days following monitoring period)
Certificate Of Coverage No. NCG02 000 ppo County of Facility
Facility Name �c.ad— L*45Z.--_902!�r_-- Name of Laboratory
Facility Contact J . CGGfi-G _ Lab Certification #
Facility Contact Phone No. (&�X) %y_ 102o
t'art a: Lana VlSturDanCe ana rrocesS area Momrorrn me ueremenrs
.. Date 0053:00076 , ;fl0545
...•.�50050 0 =�
Ontfall Receiving Stream : Sample t tital Total Settleable'.
Name CbII&te Suspended lnrliidlty
Na: Fyaw Solids
Solids:-
.. : ma/dd/yr. MG :. i.. mJl . `:: ..:NTIJs .j ...` mill .
— /% o.+F.((
Part D: Storm Event Characteristics
Total Event Precipitation (inches): S
Event Duration (hours):
Part E. Certification
art L:•
t4"
Outfall
Recervuig Stream
Sample
I `.
Oil and
total
.::
Na
Name
Coilecte
otal
Flow
Grease
Sn ende
pFT
d
d Sohds
':unEt =-
Total Event Precipitation (inches): � Event Duration (hours):
(if a separate stonn event is sampled)
"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 t e are significant penalties for submitting false information,
Including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee) (Date)
Pan F. Mailing Address
Attn: Central Files, DENR, N.C. Division of Water Quality,1617 Mail Service Center, Raleigh, NC 27699-1617
SWU-243-012005

4
Kj�L'Ar
�
NC®ENR
Stormwater Discharge Outfall.(SDO)
Qualitative Monitoring Report
Forguidance on filling out thisform, please visit htti?;//aortal.ncdenr.orgJweb/Ir/nodes-storinwater/
Permit No.: lj/_Q/�z/ Q/Q/i'O/ q O/0/ or Certificate of Coverage No.:
Facility Name: I AA*k - t"Zmpse-
County: L./a 1 Phone No. kZS-- fw y— 5-20 -
Inspector: ib
Date of Inspection:
Time of Inspection: lOcn,
Total Event Precipitation (inches): -- ?_ S
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
)Yes Ej No
Please verify whether Qualitative Monitoring must be performed during a "representative storm
event" or "measureable storm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be
performed during a "representative storm event' or during a "measureabie storm event." However,
some permits do not have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall
and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the
permitted site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter
interval is representative for local storm events during the sampling period, and the permittee
obtains approval from the local DWQ Regional Office.
By this sign4ti.},re, I cerVfpthat this is accurate anA complete to the best of my knowledge:
(Signature of Permittee or Designee)
Page 1 of 2
SM-242, Last modified 7/31/2013
J

1. Outfall Description:
Outfall No. �- Structure (pipe, ditch, etc.)
Receiving Stream: Mec�, aZ -A _
Describe the industrial activities that occur within the outfall drainage area:
- f''1 i n'%M . .. s Td ^G
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(Iight, medium, dark) as descriptors: AA2
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil,
weak chlorine odor, etc.): A)Vnc — A) -© G
4. Clarity: Choose the number which best describes the clarity of the discharge, where I is
clear and 5 is very cloudy: A f
1 2 3 4 5 ��J
5. Floating Solids: Choose the number which best describes the amount of floating solids in
the stormwater discharge, where 1 is no solids and. 5 is the surface covered with floating solids:
��1�2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended
solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes o ,
8. is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition
may be indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 7/31/2013

Certificate of Coverage No. NCG02 ❑O 10©ff
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. 1 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 §122.2ZLo-1,
Signature
. 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 — 9/30/2020
Last Revised 10-2-2015

STORMWATER DISCHARGE MONITORING REPORT (DMR)
11 Please Mail Original And One Copy To Mailing Address Below h
GENERAL PERMIT NO. NCG020000
Part A: Facility Information
Samples Collected In Calendar Year: 6 (all samples shall be reported within 30 days following monitoring period)
Certificate Of Coverage No. N G02GQ70W6 _ County of Facility
Facility Name fie. — ��� _ Name of Laboratory
Facility Contact -J • Cc�.Y��`__ ___ __ Lab Certification #
Facility Contact Phone No. ($z 8^)
Pint B: Land Disturbance and Process Area Monitorine Reauirements
.Date 'SOOSD : 00530 : ; :00076 .'00545
Ontfall TteceivingStream Sample ' ;Total .Total :'Settleable:
Collecte Suspended Tnrhid�ty
No: hTame Flow Sal[ds -"
G. m' 1VT[Js :J mlll
r-
u4- le s f�fV y/W!b /./>9- Nam, .. A)A'
WV1.sc� - t" _
Part D: Storm Event Characteristics
Total Event Precipitation (inches): . iD
Event Duration (hours): 2 `j
Part E: Certification
art c;: ventcie maintenance monttortne xeautrements
Date ".::;.
;: 50050
:::; 00536
; 00530 ....1
00400
Recelvmg Stream
Sample
Total
Outfall
Name ; :
CoIIecte
`: Total
Qil and
'Grease
Snspende
'pll
IVo
.
d
Flow .
`
d Solids
nioldd/vr
` -'MG
`uiipJl
Total Event Precipitation (inches):
Event Duration (hours):
(if a separate storm event is sampled)
"1 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 violatio '
y
(S ute ture of Perm(Date)
Part F: Mailing Address
` Attn: Central Files, DENR, N.C. Division of Water Quality,1617 Mail Service Center, Raleigh, NC 27699-1617
S %U-243-012005

a
�- ANNUAL SUMMARY DISCHARGE MONITORING
- REPORT DMR — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year
"Report ALL STORMWATER monitoring data on this form (include "No RoverNo Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. N CG02
Facility Name: UQ.{ n+c _o-F -- b4xr
t
County: - lG ^ - -
Phone Number fs( Z'Y Total no. of SOOs monitored 4
Certified Laboratory Lab #
Lab #
Stormwater Discharge Outfall (SDO) No. I- VMA Outfall? Yes ❑ Nam
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
g�
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 0-
Other ❑
Stormwater
N/A
NIA
Water Quanty
Wader Quallty
__ '+.....Y':=.:.y-.S'i
C
hF._�_':.i•i.tiA
..t].
1.4
-,l.'ti •i�,
££ee- �'.\�=.3::,:^..': Yf' _a.T.H-n
Y
'•F'„_ __ :xS
} ,J'4 -
•+ic �v.i:.2.:
y _ ��
F
V-_-
I
_
•..
[hK
_:
3rnC
t xS� - -f
4ycM1+ Il.
r
-t t
•
� ��''"' F
.+.,,.5 ,., `n � J S'r
F 5 t} 5S4#."
�.i" � L Y f�
� S Rkzr�3-s.� }
P� � �,�� �+� �� 1
� ,u xv �� �F
� n � - -S,
��
Permit Date 10/1/2015 - 9/3012020
Last Revised 10-2-2015

4
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Permit No.: N/C/ ZO/ 6/ 6 /O/o/ D/ or Certificate of Coverage No.: N/C/GI 1 1 /YI_I 1
Facility Name:
County: L/ci , Phone No. 9 z k- — q.-
Inspector: _) r-6
Date of Inspection: ZT19
By this signature, I ceA ify that this report is curate and complete to the best of my knowledge:
of Permittee or
1. Outfall Description
Outfall No. _ _ Structure (pipe, ditch, etc.) ; P e—
Receiving Stream: � (A 456,-L AJ"-,,
Describe the industrial activities that occur within th//e��outfall drainage area:
2. Color
Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium,
dark) as descriptors: AJ A
3. Odor
Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
etc.) /V A
4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy:
/V
1 2 3 4 5 6 7 8 9 10
Page 1
SwU-242-101599

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids: A 3�
1. 2 3 4 5 6 7 8 �LJ 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where 1 is no solids and 10 is extremely muddy;
1 2 3 4 5 6 7 8 9 10
7. Foam ,{ F
Is there any foam in the stormwater discharge? Yes No
8. Oil Sheen /i k
Is there an oil sheen in the stormwater discharge? Yes No
9. Other Obvious Indicators of Stormwater Pollutions
List and describe � V - r J, b�c a:' 'el -
Note. Low clarity, high solids, and/or the presence of foam or oil sheen may be indicative of pollutant
exposure. These conditions may warrant further investigation.
Page 2
SWU-242-101599

STORMWATER DISCIIARGE MONITORING REPORT (DMR)
Please Mail Original And One Copy To Mailing Address Below
GENERAL PERMIT NO. NCG020000
Part A: Facility Information f
Samples Collected In Calendar Year: (all samples shall be reported within 30 days following monitoring period)
Certificate Of Coverage No. NCG02_4vp e> mwb County of Facility
Facility Name ?-AG'A &x r oF_ - ni+rs Name of Laboratory
Facility Contact 'Dz Lab Certification #
Facility Contact Phone No. (bzr ) _i6 y- Sot 0
Part B: Land Disturbance and Process Area Monitorin Requirements
Date : " '
, 50050 .
:.:. 00530:.."
U0076
00545.::. `
Outfall:
Receiving Stream ,'
Sample;
7 otal
:Total
Settleable
No
Name ;
Collette'
Flow
Suspended
:.,
:.Turbidity
Solids
. ,...
d..:�
......_ .
,'.� Solids .
:. ::
............:.......
/dJ r
mod
M G
:.• : m
NT1Ja .
mUi...
l
ti
/Ua Di-, J...,
Part D: Storm Event Characteristics
Total Event Precipitation (inches): ! - 6
Event Duration (hours): ^ -;Z y
Part E: Certification
'art C.• Vehicle Maintenance Monitorin¢ Reauirements
Date
~.50050
.,00556 '
- ,00530`7,:
: 00400
Receiving Stream
Sample
Total:,-:
.
Outfall
Dame
Coiiecte
Total
Oil and
Suspcade
- _ pIi;
;No
'.,
:
d
Flow
rea Gse
-.
`,.d Solids
nia d1 r.
:.
,MG :::..
:.:.m :....
m 1
Ab%n
Total Event Precipitation (inches):
Event Duration (hours):
(if a separate storm event is sampled)
"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 t ere are significant penalties for submitting false information,
Including the possibility of fines and imprisonment for knowing violations."
3 6
XL,f� a � z--- �—
(Signature ofye(Date)
Part F.- Mailing Address
Attm Central Files, DENR, N.C. Division of Water Quality, 1617 Mail Service Center, Raleigh, NC 27699-1617
SWU-243-012005

Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Permit No.: N/Cl ZK7/D /D IQi 0Q / or Certificate of Coverage No.: N/C/G/ I_l_I 1_I 1
FacilityName: Vcvz
County: Phone No. t2t - f-61-f xrf
Inspector: Dc&
Date of Inspection:. _�(4
By this signature, I cep[fy that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description
Outfall No. _ Structure (pipe, ditch, etc.) P pe-
Receiving Stream: 111 y 4(— FVA _t c'-,)
Describe the industrial activities that occur within the outfall drainage area:
2. Color / ,[ A -
Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium,
dark) as descriptors:
3. Odor (V A -
Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
etc.) ----- -
4. Clarity n V
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy:
1 2 3 4 5 6 7 8 9 10
Page L
SWU-242-101599

�t
5. Floating Solids /U
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids-
1 2 3 4 5 6 7 8 9 10
6. Suspended Solids A '�
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where 1 is no solids and 10 is extremely muddy:
1 2 3Ak
4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yes No
S. Oil Sheen'
Is there an oil sheen in the stormwater discharge? Yes No
R. Other Obvious Inndficators of Storrmwater Pollution
List and describe 1 V INS
Note: Low clarity, high solids, and/or the presence of foam or oil sheen maybe indicative of pollutant
exposure. 'These conditions may warrant further investigation.
Page 2
SWU-242-101599

a=ew Foe- tWls -Cyr S
STORMWATER DISCHARGE MONITORING REPORT (DMR)
Please Mail Original And One Copy To Mailing Address Below
GENERAL PERMIT NO. NCGO20000
Part A: Facility Information
Samples Collected In Calendar Year: Z 0r%C (all samples sball be reported within 30 days following monitoring period)
Certificate Of Coverage No. NCG020 ( - County of Facility We.+c-nk _
Facility Name A&CI -4 dI.JC.II+rS Name of Laboratory VSL- i tPp�ttt�jt e
Facility Contact _ 7 Cfd: i e Lab Certification #
Facility Contact Phone No. (M. Zvi Y-700%
tart B: Land LAsturbance anti.Process Area Monttortne Aeautrements
Date 50050, : r 00530 :_: 1A0076; .00545
Outfali Receiving Stream Sample :. Total .i °tal Settleable
Name Cvuecte _ Suspended Turbidity
a, _ Flow Solids :,Solids .
:moldd/yr: MG mg/1 NTUs- m1R: `W a :var I" < r
Part D: Storm Event Characteristics
Total Event Precipitation (inches): L O
Event Duration (hours): 12 h I$
Part E. Cert f cation
Part C: Vehicle Maintenance Monitoring Requirements
0 atfall
No.
Receiving Stream -
Name. �.
Date ,.
.50050
00556.,
00530 .:
'00400
- Sample -
CollecteSuspende
d
Total
Flow
Oil and.
. Grease
Total
d Solids
pB'
moldd/
MG
m
m
unit
J.
Total Event Precipitation (inches):
Event Duration (hours):
(if a separate storm event is sampled)
"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 th re significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations.'
,1
(Signatur Q Pe ittee) (Date)
Part : Mailing Address
Attn: Central Files, DENR, N.C. Division of Water Quality, 1617 Mail Service Center, Raleigh, NC 27699-1617
SWU-243-012005

dis STAiZq
Stormwater Discharge Outfall (SDO)
'Qualitative Monitoring Report
Permit No.: NIC1012101_0 DI'01_I or Certificate of Coverage No,: N/C/G/ 0/2/0l 1 l Z 191
Facility Name: �Q er, e 5
County: ti1ILZ+A1AQA- Phone No. _ STR-Z(64- 7009
Inspector: ��w_��:TOMQs- or ID ,' eQC 1-V - -
Date of Inspection: ) Z /?
By thisure, I certify that this report is accurate and complete to the best of my knowledge:
I
(Sig nre ol'PeNnittcc or Designee)
1. outfall Description
Outfall No. 1 Structure (pipe, ditch, etc.)
Receiving Stream: lAw le*.O�- '
Describe the industrial activities that occur within the outfall drainage area: 153
2. Color
Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium,
dark) as descriptors: r 01%W teas
3. Odor
Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
etc.) !a d+y
4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy:
p2 3 4 5 6 7 8 9 10
Page l
SWU-242-101599

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids:
2 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where 1 is no solids and 10 is extremely muddy:
5 2 3 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yes —0
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes No
9. Other Obvious Indicators of Stormwater Pollution
List and describe 4 Mnale )'a eW cl Qa� M
IF
Note: Low clarity, high solids, and/or the presence of foam or oil sheen may be indicative of pollutant
exposure. These conditions may warrant further investigation.
Page 2
S WU-242-101599

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT,TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year 2 vl s
"'Report ALL STORMWATER monitoring data on this form (include"No Flow7'No_ Discharge" and. Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG02 ®�®�
Facility Name: R4,jrDvd &Ar es &wAaO &Awrey
County: Ct*
.Phone.Number: Ia6N-..?.0_�If7_ Total.no...af_SDOs monitored
Certified Laboratory W L Lab # 5
Lab #
Stormwater Discharge Outfall (SOO) No, 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 ❑
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, :
mgli
SS;1
mlll
:Turbidity,
NTU
Upstream
(U) Turbidity,.
NTU
Downstream
(D) Turbidlty,
: NTU
Non -paler
0&G; mg) 9
(VMA)''
New
Motor,0il
Usage :.:.
gal/mo. .
_ Stormwater
Benchmarks
lndlcate NO
F'0'"
a ticable'
Circle
Benthmarit
.100150.
�•� -
BenCirchmark
Benchmark
-.50125110-.
NIA
.,, WaterQuallty
Standard applles
N/A
wataiQuallty
Standard applies
+�
a66 a regUi
average -requires _
TS5and Non -polar
O&G monitoring
Date Sample
Collected
m old dl r
kill" 1,7
107
„�
�.,
Permit Date 10/112015 — 9130/2020
Last Revised 10-2-2015

n
Certificate'of Coverage No, NCG02 ❑O 0©�
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. 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 ❑
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
mg111
'SS, .�
: mill
Turbidity,
NTU ...
Upstream
(U): Turbidity,
NTU ..'
Downstream
(D) Turbidity,
NTU
Non polar
O&G m II
!, g .
(VMA)
New
Motor.011i
Usage.
slime.) ,
Stormwater
Benchmarks
!ndlcate NO
applicable
Circle
9enchmark
l)U150
0.1
Circle
Benchmark
50I25I1
NIA
Standard applater ies
NIA
Standard applies
`�
>56
rage m°'
average raqukres
TS5 and O&0 m n/tOrinlar
Date Sample
Collected,
molddI r
MN ii9�
it
n'0. A
�y.IY. i i
��¢l:
"t::.�
,iilk'
se'3i i^T�
i3
Rl
Permit Date 1011/2016 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 [0 �©A
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 CfoiLki22,22]
Signature
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 Fifes
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 — 9/30/2020
Last Revised 10-2-2015

NoeMCeW Fee— � r I lt4,- - L, (aq k4 .&:
STORMWATER DISCHARGE MONITORING REPORT (DMR)
Please Mail Original And One Copy To Mailing Address Below
GENERAL PERMIT NO. NCG020000
Part A: Facility Information
Samples Collected In Calendar Year- Z Jr 1 (all samples shall be reported within 30 days following monitoring period)
Certificate Of Coverage No. NCGU201 County of Facility _ _ t ��
Facility Name QGd /tei dh(l:E( Name of Laboratory W&L +� PP st4
Facility Contact D-S MAE Lab Certification #E 544
Facility Contact Phone No. { 1 269,-
tart ts: Lana Disturbance and Process Area Monxtorm
Xe uzrements
.. _:..:. ..
.., bate ,,
50050' .
'..D0530.`.;:
a00076.:.
';..00545.:.-
Outfail
:ReceiviagStream
Sample
Total
Total:
-
Settleable:
No..:Flow
Name
Collecte
" 'Suspended
...
.'Turbidity
:.Solids
.
..
ino7ddlyr.
1VIG .;
Part D: Storm Event Characteristics
Total Event Precipitation (inches : D •
Event Duration (hours): 1{
Part E: Certification
Part C: Vehicle Maintenance Monitoring Reauirements
.......
bate ::.
50
0055
0530
00400
Rece' rig Stream
' Sample `
O all
_ Name, j
Couecte
Total'-
OO and
-Suspendc-:
pH
Flow..,..
. Greas e..
"
.
d;:
d Solids
!
mold d/vr.
MG
mjll,
moll
unit'.
Total Event Precipitation (inches):
Event Duration (hours):
(if a separate storm event is sampled)
"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 the —Ore significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations.'
(Signatur of Per ittee) (Date)
Part F. Mailing Address
Attn: Central Files, DENR, N.C. Division of Water Quality, 1617 Mail Service Center, Raleigh, NC 27699-1617
SWrU-243-012005

wI
ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) -- STORMWATER
S.UBM1 T T� CENTRAL OFFICE
General Permit No. NCG020000
Calendar Year 019
*Report ALL STORMWATER_rnonitoimg data on this.forrn (include "No'Flaw'1°No Discharge". and BenchmarEc
Exceedances) frorn:the.previous calendar;year-to.the-DEQ by -MARCH 1. of. e.ach,.year.
Certificate of Coverage No. NCG02 [V ®�
Ti Facility Name: A ",rrk
County: Q
Phone Number Total no, of SDOs monitored
Certified Laboratory . V Lab # 5f
Lab #
Stormwater Discharge Outfall (SDO) No. I 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 ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑
Other ❑
s.
o:Standard
�.
-NIA.
applies
NIA
standard appifes
.
• .
= IT ..
;o
K I e
r
x'i�«,r . t
sL Sey:ayC
3-Z'.�
'y.
-2 z�
Fta12M i.Jx�T ,A�.lk�-�
u..L ZOLA
Permit Date 10/1/2015 — 9130/2020
Last Revised 10-2-2015

V
Certificate of Coverage No. NCG02 ��©®
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. 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 ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑
Other ❑
F
1 '
y .
` Upstream `1
Downstream
I
New
�'
Total
1
TSS; i
Turbi.ditY�;
U Turbidit
( ) Y
rb
(D) Tu ldii
Non polar
Motor 011 "
Outfall No '
Rainfall,
mgll
m5lllti
-
NTU
NTU
NTU
O &G',mgll
Usage
-- '.....::.: ..:.
inches
rIndicate
l
A}
:'[VMzi
allmo:
Stormwater
'. NO
.~ Circle
Benchmark.,.'
....
_.. .Circle..-.
Henchrriark
NIA
-
NIA
.a66 gallmo.
average requires
Benchmarks.
a'0 8bi
100/50
; '" U•;1 '
-,60/25/1 O
Water
Standard applies
-S andard apWater tpliea
15-
T080 monitorinSS and tar
Date Sample;;
Rem
M-M
moolddlvr� t aW-IN.'
1-1
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 []D [L-©9
CERTIFICATION
" 1 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_,-,
Signature
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 10/112015 -- 9/30/2020
Last Revised 10-2-2015

Stormwater Discharge Outfall -(SDQ)
'Qualitative Monitoring Report
Permit No.: N/C/01 /n/ a' IOIO —/ or Certificate of Coverage No.: N/C/G/ Q/Zl0l 1 I2191
Facility Name: &Af-041 nUd a+ es
County: WO+FAt, q& _ Phone No. 700C
Inspector: TO ne t. or D X C ek i� .0
Date of Inspection:
By this ' re, I certify that this report is accurate and complete to the best of my knowledge:
/ l ohobwv
(Signure oiPe 'ttee or Designee) N
1. Outfall Description
Outfall No, Structure (pipe, ditch, etc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
2. Color
Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium,
dark) as descriptors:
3. Odor
Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
etc.)
4. Clarity
Choose the number which best describes the clarity of the discharge where I is clear and 10 is very
cloudy:
1 2 3 4 5 h 7 8 9 1Q
Page 1
S WU-242-101599

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids:
1 2 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where 1 is no solids and 10 is extremely muddy:
1 2 3 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yes No
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes No
9. Other Obvious Indicators of Stormwater Pollution
List and describe
Note: Low clarity, high solids, and/or the presence of foam or oil sheen may be indicative of pollutant
exposure. These conditions may warrant further investigation.
Page 2
S WU-242-101599

No. /(N -
,y
STORMWATER DISCE ARGE MONITORING REPORT (DMR)
Please Mail Original And One Copy To Mailing Address Below
GENERAL PERMIT NO. NCG020000
Part.A: Facility Information
Samples Collected In Calendar Year: 2-013 _ (all samples shall be reported within 30 days following monitoring period) 1 "
Certificate Of Coverage No. NCGO201.2R County of Facility Wa �qk
Facility Name - Name of Laboratory V&L \o
Facility Contact _ ? i�C,A� Lab Certification # S�� tfr �tC4 ' e
Facility Contact Phone No. ( I 264 —lob%
Fart tf: Lana Disturbance and.Process Area Monitonne Aeoutrements
Date :50050' 00530:: �700076 00545 :
60 Oritfali ReceiAhkStre2m. _Saiople xotal ': Total :Settleable
Name Collette Suspended ,Turbidity
No Flow Solids Snuds
molddlvr. ..: `MG _..:::...mall '. NTUs .:.. -nilll
Part D: Storm Event Characteristics
Total Event Precipitation (inch; --O—y—
Event Duration (hours): 5 !•l .j
Part E: Certification
Part C: Vehicle Maintenance Monitorinz Requirements
Date SOo50 : 00556. 00530 00400,
Receiving Stream S' . I Total.
Ontfalf .
Total .Oil and'
Name; :Collecte•` Suspgade'. .. pff..,
No ,..:.. Flow. Grease,:.
d. < d'Sulids .
molddlyic MG ni Jl. , :'mpll . ' unit
Total Event Precipitation (inches):
Event Duration (hours):
(if a separate storm event is sampled)
"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 th re significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations.
eh at %3
(Signstur of Pe 'ttee) (Date)
Part F: Mailing Address
Attn: Central Files, DENR, N.C. Division of Water Quality,1617 Mail Service Center, Raleigh, NC 27699-1617
SW-U-243-012005

K
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Permit No.: N1CT—1 nl a O I I or Certificate of Coverage No.: NICIGI 0/2/Q/ 1 1 Z 191
Facility Name: Ra' fbrd &UQa%'
County: LI►ILl' e t�.p C� _ Phone No. &2I? -A 464 - 70Of
Inspector: 0'r
Date of Inspection:
By this re, I certify that this report is accurate and complete to the best of my knowledge:
9;pb�� 16/(,113
(Si a o{Pe nittee or Designee) /�/ ` -
1. Outfall Description `" a
Outfall No. Structure (pipe, ditch, etc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
2. Color
Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium,
dark) as descriptors:
3. Odor
Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
etc.)
4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy:
1 2 3 4 5 6 7 8 9 10
Page 1
SWU-242-101599

M
5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids:
1 2 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where 1 is no solids and 10 is extremely muddy-
1 2 3 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yes No
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes No
9. Other Obvious Indicators of Stormwater Pollution
List and describe
Note: Low clarity, high solids, and/or the presence of foam or oil sheen maybe indicative of pollutant
exposure. These conditions may warrant further investigation.
SV*rU-242-101599
Page 2

9
ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) -- STORMWATER
SUBMITTO CENTRAL.OFF.ICE*
General Permit No. NCG020000
Calendar Year Z o13
- "Report ALL STORMWATER monitoring dbta on this form (include hW'Flow"Mo Discharge" and'Benchmark
Exceeda6ces).from the'oreyious calendar:year to the-DEQ by MARCH.1, of each year.. .
Certificate of Coverage No. NCG02 ®❑I EiAl
Facility Name: 1RaJ�vyj "rrt'es J-A6o 4%rry
County: Q
Prone Number: ($1$ 6 0 Total no. of SDOs monitored
Certified Laboratory W L _ Lab # .5H
Lab #
Stormwater Discharge Outfall (SDO) No. `� 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 ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑
Other ❑
■•
•: .
..
.. •
JENIM
N/A..
Standard applIes
:Collected,
LM1111111
rNar-
t�
Rer..t ksa� dvA� u �
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 [4Q©ff]
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. 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 ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑
Other ❑
Total
inches
Upstream
�.
Non-*pol
o:
_
Wateruality Q'Slandarda
�'
®
..
■
ol
1
ems'
ENOR
isiP+f'� �: •
_�+ �*;`•
y.�4- `�j '"�"`+1�
Permit Date 10t112015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ❑OELI©T
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. 1 am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Required by40 CFR §122.2ZLe--.,,
Signature
Date vikr
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in DWR (not DEMLR)
J� N.C. Department of Environmental Quality DEQ
� P Y( )
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMI_R Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 10/112015 — 9/30/2020
Last Revised 10-2-2015

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT -TO CENTRAL. OFFICE*
Genera! Permit No. NCG020000
Calendar Year Z 61.3
'Report ALL STORMWATER moriitoHng gate on this form (include `No Flow"Mo Discharge" and Benchmark
Exceeda66e's):from the pi, . obs calendar:year to the_DEQ by MARCH.1, of each year..: .
Certificate of Coverage No. NCG02 ®00F1j_1
Facility Name: R kJfov�_ &SAY4es _ &6a &4 f I'y
County: Q
Phone Number: 11r 26N' 70 D Ir Total no. of SDOs monitored 4
Certified Laboratory W_19 [� T ^ Lab # 5
Lab #
Stormwater Discharge Outfall (SDO) No. �_ VMA Outfall? Yes ❑ No ❑
Is this outfail 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 ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑
Other ❑
Upstream
�.
� : . tvm
..
..
• rmwater
Ben
I I 1
1 1
Water ",
� . r
Date Sample.
Collected,
...
MINI-,
Yi
�T
'
pAr,a°'
Permit Date 10/1/2015 — 9130/2020
Last Revised 10-2-2015

Certificate of Coverage No, N0002 [4511iffl
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. 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 ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑
Other ❑
MMot
NTUa
•
r0II--
•
Emu
MEE=
NIA
Water Quality
Standard applies
NIA
watirQuality
Standard applies
ate Sampi
pi
.
7-11'
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

STORMWATER DISCHARGE MONITORING REPORT (DMR)
Please Mail Original And One Copy To Mailing Address Below
GENERAL PERMIT NO. NCG020000
Part A: Facility Information
Samples Collected In Calendar Year: `0 1-L.- (all samples shall be reported within 30 days following monitoring period)
Certificate Of Coverage No. NCG02012 County of Facility wG6t
Facility Name �Qd Id b�.ar. (l�!!S _ Name of Laboratory �/� ! t fp�e4 l
Facility Contact j%? r; [ p _ Lab Certification # ��
Facility Contact Phone No. ( 2604 —7002
Part B: Land Disturbance and Process Area Monitoring Reouirements
Outfall
No
_.
Recernng Stream
A'amc. .. "
Date_'
50050
00530..:.
00076
00545
Sample
Collette
A.
~'
Total
Flow '
_
J:Total _
Suspended;
;Solids
Turbidity
Settleable:
Solids
-
F
,
mad .,,r.
_.' MG �,
1.
,I;,,.
:NTUs
In
Ak"Q.
t Iz
c
Part D: Storm Event Characteristics
Total Event Precipitation (inches): 1.0
Event Duration (hours): 2 S
Part E. Certification
Part C.• Vehicle Maintenance Monitoring Reauirements
Date
",So 5TI' ;
0055ti
`00530
,OOAOQr
Qutfall
Receiving Stream
Sample
`r
Name
" '
Collette
Total
O�i and
Sus code
pH'
_No '
�
Flow '
Grease
,p
Solidi:::{
:molddlyr
MG.,;
, mg/lr;
kni"
unit
Total Event Precipitation (inches):
Event Duration (hours): 4
(if a separate storm event is sampled)
"1 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 an 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 th rc significant penalties for submitting false Information,
including the possibility of fines and imprisonment for knowing violations.'
6llrz.
(Signatur of Per "ttee) (Date)
Part F• Mailing Address
Attn: Central Files, DENR, N.C. Division of Water Quality, 1617 Mail Service Center, Raleigh, NC 27699-I617
SWU-243-012005

*a STAt(
Stormwater Discharge 4utfall (SD4)
Qualitative Monitoring Report
Permit No.: NIC/O121d l 0 0/fl/ / or Certificate of Coverage No.: N/C/GIQ/ZId/ 1 l2191
Facility Name: 196tdfdvd &tjwr ;e s
County: r 0+0 4A 0. Phone No. 6 — 2 toy `" 700 T
Inspector: A�ajq To wve&...... o-
Date of inspection:
By this ure, I certify that this report is accurate and complete to the best of my knowledge:
611A`t
(Si re o1'Pe ittee or Designee)
1. OutfH11 Description L
Outfall No. Structure (pipe, ditch, etc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
2. Color
Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium,
dark) as descriptors: t 4 zo, LO S%
3. Odor
Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
etc.) NO V-,A-
4. Clarity
Choose the number which best describes the clarity of the discharge where I is clear and 10 is very
cloudy:
1 3 4 5 b 7 S 9 10
Page I
S WU-242-101599

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
l is no solids and 10 is the surface covered with floating solids:
2 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where 1 is no solids and 10 is extremely muddy:
�1 2 3 4 5 6 7 8 9 10
7, Foam
Is there any foam in the stormwater discharge? Yes Rio J
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes Y
9. Other Obvious Indicators of Stormwater Pollution
w
List and describe [ 10 _5-A"ft 1 .�
Note: Low clarity, high solids, and/or the presence of foam or oil sheen may be indicative of pollutant
exposure. These conditions may warrant further investigation.
Page 2
Sw[_7-242-101599

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT -'TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year 2 o t * —
Report ALL STORMWATER monitoring data on this form (includo"No Flow/"No Discharge" and Benchmark.
Exceedances) from the. previous calendar year to the DEQ by MARCH 1. of each year.
Certificate of Coverage No. NCG02
Facility Name: 9AJ(V
County: R
.Phone Number:c
Certified Laboratory W&V
I I
Lab # 5H
Lab #
Stormwater Discharge Outfall (SDO) No. I 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 ❑
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,-
rngll
5S,
ml/l '
Turbidity,
NTU-
Upstream: A
(U) Turbidity,
NTU
Downstream.
(D):Turbidity,
NTU -
Non -polar
O&G, m ti
g
(VMA)
i iNew
Motor,0i.1,.
:: Usage.. ,
galltno.
. - 5tormwafer.
Benchmarks
. Indicate No
tet%
C'"'°
-Benchmark
100150-
- 0.1...50/25110--..-..Sw��;rraapplfes
�'"`°
Benchmark
NIA
... ......_
NIA
...__ . _.
5andardappuaitty Water iis
_ .
15
>6t;gaf7m°'
averaga.raqulres .
TOSOrnaSS and npnpn'ar
Date Sample
Collected�
MINM77
S
' It
-
0.
N
�_..
a •ram'
(P
t
Permit Date 10/1/2015 — 913012020
rTNISM NAT Last Revised 10-2-2015

Certificate of Coverag'e'No. NCG02 0©®�
Additional Outfall Attachment (matte copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. 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 outfalt was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from aEMLR to reduce monitoring frequency ❑
No, turbidity benchmark exceadances did not require monthly monitoring ❑
Other ❑
Outfall No.
Total
Rainfall,
inches
TSS,
mgll ��
SS,
; mill'
Turbidity,
NTU .; :
. " _
Upstream
(U.)'Turbidity,
� NTU
Downstream;
,(D) furpidity,
-
� NTU
Noes -polar,
O&GL,-mg)
(VMA)
New...
. Motor Oil
Usage.:.
g.
ailmo...
Stormwvater
Benchmarks
IndkatA NO
aF ,kable , .
nchnn le
Benchmark
100150
0.1
Beneh�nark
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Permlt Date 101112015 — 9130/2020
Last Revisod 10-2-2015 4

Certificate of Coverage No. NCG02 ❑0 [Oag
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)
Signature
Date AR 4 .
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
69 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 Maill'Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 101112015 — 9/30/2020
Last Revised 10-2-2015

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