NCG020150_MONITORING INFO_20190225

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V 0.)�
DOC TYPE
❑HISTORICAL FILE
6/, MONITORING REPORTS
DOC DATE
❑ �olj 03 a 5
YYVYMMDD

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
If SUBMIT TO CENTRAL OFFICE` II
General Permit No. NCG020000
Calendar Year z o 19
'Report ALL STORMWATER monitoring data on this form (incidde "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. N0002
Facility Name: !r rL, y1z _�57-N S.4.v0
County, _rsy41cpAr31 s„
Phone Number: ;Lc ) bgk- 3CI&I Total no. of SDOs monitored _
Certified Laboratory &LIZ Lab i# q_
Lab #
Stormwater Discharge Outfall (SDO) No. #-Z VMA Outfatl? Yes ❑
Is this outfall currently in Tier 2 for any parameter? Yes ❑
Was this outfall ever in Tier 2 during the past year? Yes ❑
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
J
FEB 2 5 2019
DIPIR SErTir )
Ou#fali No.
#
Total
Rainfall,
inches
TSS,
mgll
SS,
mill
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mg/1
(VMA)(gal/Mo.)
New
Motor` Oil
Usage
Stormwater
Benchmarks
lnrfrcafa NO
aFL karrlre
Circle
Benchmark
100I50
a.1
Circle
Benchmark
50r25110
N!A
sundara nw+as
N/A
Standard aPWater tity {71 e.
1
>55 uallmo,
Average require.
iO&G and
,writorl""
Date SampleEWAS
Collected,���,
mo/dd! r
,•,
.., r,t.�, �., fi
ti�
a '
a`;r rl, rtr t
N
.q
O
Igo
—�'Ve
lop
Permit Date 1011/2015 — 9130/2020
Last Revised 10-2-2015

Certificate of Coverage No. N0002 a❑1 ©0
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. tt j_ 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 outfail 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 ❑
Out#all No.
—�--
Total
Rainfall,
inches
TSS,
mgll
SS,
mlll
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
ORG, mgll
(VMA)
New
Motor Oil
. Usage
allmo.
Stormwater
Benchrrrarks
fnd(Crrrp N4
F&OW `'
J flCdll(p
"tire
Bunchrna r%
100150
0.1
rcle'S5Vleilul
`'line
BenclmlarM
50125/10
NIA
water Clualily
Standard applies
N/A
wear Quality
Standard Applies
15
aYerapu reymras
35 , and Non -polar
O&C +ponllorin
Date Sample
Collected,
Y1i alddl r
i r fj
drt.µf+
4
,,
a .r S
jM d{tt
1�� s�.r
;� E°
.� .�u
V ,
.r,A <
`
r
a +..
c .+ 1 }l pA `+
�� ; , ,
} i �n� t i r
fir. pr r.,
f ra'..4
iT
':+ k"l«�}fr
Mrrw „ i.,�,
�g "f i7P }r
:.+ a r
gilt ; t
tr"u»{
, ,F
. p
f
1
I
iv
s 9
2.7
r a
Permit Date 1011/2015 - 9/30/2020
Last Revised 10-2-2015

Certificate of Covorago No. NCG02 [29)U1 .l
Additional 4utfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. a 3 VMA Outfall? Yes ❑ No ❑
lc this outfall currently in Tior 2 for any parameter? Yes ❑ No El
Was this outfall over in Tler 2 during the past year? Yes [j No 0
It tins outfall was in -Pier 2 last year, was monthly monitoring discontinued?
Yes, onough consocutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
No, turbidity bonchmartc oxcacdanws did not require monthly monitoring ❑
Other ❑
f-
1
Uiatfaii Mo.
kt 3
`c• --�_ �--
'Total
Rainfall,
inches
TSS,
mgli
SS,
trti/i
Turbidity,'
NTU
Upstream
(U) Turbidity,
NTU
DoDownstreamnstream
(D) Turbidity,Motor
NTU
Non -polar
O&G, mgil
(VMA)
New
QII
Usage
(allmo.
St(lrrrrwatf'r
i3errchrrrark S
rndkwo NA
r'rI r.
d lrCJblu
Ci+tlu
fNmr;Imojk
1 d01S17
—
Q.1
�Clrrlc
11mich"I"t
�j�1251� Q
NIA
Warllr utolrty
Standard ar1111J45
NIA
Kim. OgAilit,
:ilandartl alopliO1
Jr
y5511A�m",.
.rver�KJa rbglnrrl;t
r6S "NJ firlm, 1"Aar
CIE,G ,rrurtltgr,n
Hate Sample
Collected,
ry
sly s.k
r'l
Mrs
I
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ❑❑❑❑
CERTIFICATION
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
[Required by 40 CFR §122.221
Signature .
Date .. I q
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in D WR (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

)A) . - a
ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year zy17
'Report ALL STORMWATER monitoring data on this form (include "No Flow"/"No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEO by MARCH 1 of each year.
Certificate of Coverage No. NCG02
Facility Name: j,Ar_i via oT 4,j, r4&V
County: d vvr...ru r
Phone Number: (fA�K ) LfL - 3fgy Total no. of SDOs monitored
Certified Laboratory &Cgs Lab # go
Lab #
Stormwater Discharge Outfall (SDO) No. Z VMA Outfall? Yes ❑ ' No
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No
Was this outfall ever in Ter 2 during the past year? Yes ❑ No © If this outfall was in Tier 2 last year, was monthly monitoring discontinued? RECF IVED
Yes, enough consecutive samples below benchmarks to decrease frequency ❑ JAN 2 4 Wt
Yes, received approval from DEMLR to reduce monitoring frequency ❑
No, turbidity benchmark exceedances did not require monthly monitoring ElCENTRAL FILES
pWR SECTION
Other ❑
Outfall No.
Total
Rainfall,
inches
TSS,
mgll
SS,
mill
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mgll
(VMA)
New
Motor Oil
Usage
allmoe
Stormwater
Benchmarks
fndlcata NO
FLOWY
apolkabla
`i"'°
Benchmark
100150
0.1
It
ncFhcm
Benchmark
50/25/10
N/A
Water Quality
Standard applies
N/A
Water Quality
Standard applies
15
era erequi
average requires
7S5 and Non -polar
O&C monitorin
Date Sample
Collected,Mmoldd! r
I
OR
��1stol
�,;
W
J
Permit Date 1011/2015 — 913012020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ❑❑❑❑
Additional Outfall Attachment (make copies as needed for additional outfalis)
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,
mgll
SS,
mill
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mgll
(VMA)
New
Motor Oil
Usage
allmo.
Stormwater
Benchmarks
Date Sample
Callected
moldd! r
fndfcare NO
F`ON''
a rJca6fa
k.rt'�
Circle
Benchmark
100150
���
0.1
• ,,j t
BencClrcthmark
Benchmark
50/25/10
o
NIA
water Quality
Standard applies
, a r a, ��1 �_t
NIA
Water Ouaflry
Standard applies
;3,1.-{,
.1 CJ
1
��n-r `r
�ss9aequi
areraye requires
755 and Npnpplar
O&G manitaln
,� ° ��,,i
Permit Date 10/1/2015 — 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 zr r 7
'Report ALL STORMWATER monitoring data on this'form (include "No Flovi'1"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: ii )QV r. s'Ti.✓i. SA.v✓l
r
County' _ 6 ✓1,r
Phone Number: -r}. `q� - 3� JAI_ Total no. of SDOs monitored
Certified Laboratory r,¢ur Lab # • +lo.
Lab #
Stormwater Discharge Outfall (SDO) No. 2 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 decease 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,
mg1l.
SS,
mill
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mgll
(VMA)
New
Motor Oil
Usage
allmo.
Stormwater
Benchmarks
indicate up
,F`fkeb a
Circrno
nch
Benchmark
100150
0.1
nchCircm
Benchmark
50/25/10
NIA
Water
Standard applies
NIA
Standard applWater ies
1 5
�a paequ1
awerape requires
TO&Gnmonitorlm ar
Date Sample
Collected,
mo/ddl r
Y•.ry
1 �:v dY
J•arl•„ rY.FM
'.M
ii
l }
t ?7
F•K
:t AV
9F
..�'-� W,
x�
I ,. 2 S. u�� \..'Kaw.
"�'
3
d
TV 0
1�2101?
1.7
d
Permit Date 101112015 — 9130/2020
Last Revised 10-2-2015

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 Ter 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 Cl
Yes, received approval from DEMLR to reduce monitoring frequency ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑
Other Cl
Outfall No.
Total
Rainfall,
inches
TSS,
mg/l
SS,
mlll
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
'Non -polar
O&G, mg/l
(VMA)
New
Motor Oil
Usage
ai/mo.
Stormwater
Benchmarks
rndicara NO
aFLOW H
kable
Olrcle
Benchmark
100150
0.1
Circle
Benchmark
50/25/10
NIA
Water
Standard appi es
NIA
ity
Standard apWater 1plles
15
nS5 gallma.
average requires
r 3G monand ltMn ar
Date Sample
Collected,
moldd/ r
'� Y,r'
,�� 3�
'a
4 >r , ::
lyy'7?�
` ,
r��
.:.J
,. r S,?,
}�.. ,� . "tx
}'�"� �i�!
t,''ti •�"� -Y . 36. �.
�.; •, �•;
�ii5.
�4Fr.i..'..'..If,{,.
, -,: a,
�5 i ;
r
g
�Wm
'4 vr{''tiY'Si
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 Qo 0 S0R
CERTIFICATION
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
[Required by 40 CFR §122.221
Signature
Date
.1
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

"r
ANNUAL. SUMMARY DISCHARGE MONITORING
REPORT (DMR) - STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
'Calendar Year 2v 1 ib
"Report ALL STORMWATER monitoring data on this form (include "No Flow"Mo Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each 04,
Certificate of Coverage No. NCG02-
Facility Name: &P V/.� r iSA Ald rr-►TRAL FILES
County: fj .✓cr.sz�S1L DWR SECTION
Phone Number: (!iQ) grt,- 3PY`t Total no. of SDOs monitored �-
Certified Laboratory Lab # q`
Lab #
Stormwater Discharge Outfall (SDO) No. -Z- VMA Outfall? Yes No
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No
Was this outfall ever in7ler 2 during the,,past year? Yes ❑ NoZ
If this outfall was In Tier 2 last year, was monthly monitoring discontinued?
Yes, enough oonsecutive 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 ❑
Upseaa`Downsream
(Um
�t
yTurbidlh►(D) TurbidttNn
1ar1Motor'Outfail'No
oil:
Ralnfatl;"'
" rngll:
iilN
NTU
111TU#
�'' r"YIVTU��
08�G; mgllx
Usage
x„,
Irtiches
' '
-t : '
J� :.'�;'s(VMA)i..,
i< allmo:
Starmwater
Circle
gift'°
NIA
NIA
ass gaup.
'
mdksto W
FLOW
Benctkmuk
50
0.1
Benchmark
25110
rsu-dar
shrd&W*
WauaPO
15
averago rogwree
monit�a`Benchmarks
0o
gDateSample
2: eCoi�e4iedj a
_
9.
q.11
`- -
Permit Date 10hl2015 — 9/30/2020
Last Revised 10-2-2015

Y
Certificate of Coverage No. NCG02 ❑]0❑
Additional Outfall Attachment (make copies as needed for additional otitfalls)
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 exceedences did not require monthly monitoring ❑
Other ❑
°OutfallrNo:,Totaf�T55,,�f
^Rainfall;°kmgll
...-� ';inches
777..�
�
Gr. s:c
�: {
r
< as ��
..Circle,
r
f SS, r,
wim111`'�
Wz.
'Turtiidi ty,
'.
f
Upstreamk r
' r
�'(U) Turbidity,
NTU " 'f'
...>„
f 'ri;i9M �J.
Downstream
':,
i(D)°*Turbidity;
AIVTU�
C
Non h�olar
P
OGm811
i�w New;
fMbtor�4fl'
�Usa e
Sb.
Stormwater �
Benchmarks
Milt" Sam"�,
p
��tCoilected;+�'�
m /dd<.
• /,�r�lwo
FLOW 11 _ ,
,�„m
r r,:
:..
�*•'
. �
100150
k
.''R. `k a
0 1
•. `r r
''Circle
.. - ..
� 5 10 25110
1
NIA
Wefx ouailb,
sw.dud appNa ,
x
brs.a,i , '.i _ 'y1z,
NIA
- Water ouality
$hodard
4 .6+x- '?
'- ..
._ ..
s
s55Pik".
_.,,.-„e,,.qwf..
TSS and Mn-War
oac
w
.::yle .S r�-'.
J
I
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. N0002 QE]Rro-]
CERTIFICATION
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Required by 40 CFR §122.221
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—9/3012020
Last Revised 10-2-2015

ANNUAL SUMMARY DISCHARGE MONITORING
I
REPORT (DMR) -STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year 21P1 b
*Report ALL STORMWATER monitoring data on this form (include "No Flo►a�'/`No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH epch-y_ r.
Certificate of Coverage No. NCG02
FEB 2 3 2017
Facility Name: b ff,(Viz srr,,r,z + SA&a r�T,n �L M1 .,
County: KvNl.r m .str —�� DWR SECTION
Phone Number:( $2,1)_ AU - I MI Totai no. of SDOs monitored _ - Certified Laboratory Laboratory N1*L1z Lab # Vv�
Lab #
Stormwater Discharge Outfall (SDO) No. L7=— VMA Outfall? Yes No ❑
Is this outfall currently in *nor 2 for any parameter? Yes ❑, No.N
Was this outfalI ever In Ter 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 exceedences did not require monthly monitoring- ❑
Other ❑
�F S rZ}1 1W r � k
j 1-
.<
,Outfaila�No ,
��
r�
Tbl'��r
Ram#all6
,;
Ais
1.1
,TSS,E
;, mg1l�
-
}ASS,?
mlli
rTurbtd�ty,;
�
Upstream ,'
i(1J)Turbidity;
?NTU F ° ;
Downstream
'(D}Turbttli�ty;
` NTU -
Non polar
1O&G;�irigli
',New
Motor.OR'
} Usa e
9
Stormwater. x
Benchmarks
nwk,ro,,0
.FLO; ,
Circle
Mwhrnark
100150
0.1
C�'O
Benchmark
50125I10
NIA
swat" �.e
NIA
ity
swtandaardaater ppi
15
y gaurno.
everaQe mqulre.
TSosGmn Non -polar
M1n�ate�Sample�
- - L
d
Sao
7- l6
6
4
!
1--
Perinit Date 10/1/2015—9/3012020
Last Revised 10-2-2015

Certificate of Coverage No. NCG021:]Elr—F
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge.Outfall (SDO) No. VMA'Outfall? Yes'[D ' No M
Is this outfall currently in 'nor 2 for any parameter? Yes ❑ No E)
Was this outfall ever In 11or 2 during the past year? Yes ❑ No E]
If this outfall was In Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency 1-1
Yes. received approval from DEMLR to reduce monitoring frequency El
No, turbidity benchmark exobedances did net require monthly monitoring
Other ❑
�J
ji'S�
Total
�-a,Wk
4
"TS
V
SS7ftbldltyj�
rmill
A
i&iyTqrbidit�r
N
,Downstream stroam
,
4 � NjRXO&G3
_ofa G
V M
50.
tMaop!MRM
galhii& :t
stoimwatb?
Benchmar*s
FLO
0cft"
-
0-
Cktu
50/25/10
NIA
suwndamapptun
wat"Quau
Su2rd &P"
15
TGS M konvWar16/50
n a & .­app.(kLa.,bou
Collected,A
.
i4
Permit Date 1011/2015 — 9130/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 Do 0 5[]7,9
CERTIFICATION
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
[Required by 40 CFR §122.221
Signature '
Date
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in D WR (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 ' 9/3012020
Last Revised 10-212015

ANNUAL SUMMARY DNJ R - STORMWATER
II SEND TO CENTRAL OFFICE * II
STORMWATER DISCHARGE OUTFALLS (SDO)
GENERAL PERMIT NO. NCG020000
RECEIVED
FEB 2 3 2O16
CENTRAL FILES
DWR SECTInni
*Report ALL STORMWATER Monitoring Data on this form (including No Flow and No Discharge and Permit Limit Violations) by MARCH 1 of each year.
CERTIFICATE OF COVERAGE NO. NCG02`70"-t -5 D SAMPLE COLLECTION YEAR: �v►5
FACILITY NAME: (•rtavI; STD r : sN.✓,? COUNTY 13✓,..c•,•c,ty,2
PERSON COLLECTING SAMPLES ]�#L,*,cV 4APtr PHONE NO. (T2r) 9y4- 3gy��
CERTIFIED LABORATORY 10,4cr Lab # 1,10 ADD TO LISTSERVE? YES ❑ NO ❑ EMAIL:
Lab #
Part A: Stormwater Monitoring Requirements
Outfall
No.
Date Sample
Collected
(mo/dd/ r OR
NO FLO�I
In Tier 2
Monthly
Monitoring?
(yIn )
# of Months in
Tier 2
Sampling2
Total Flow
(MG)
Total Suspended
Solids
(mg/0
m1;/)
Turbidity
(NTU)
Settleable
Solids (ml/
Total
Rainfall
(in) ( )
Event
Duration
(minutes)
-
-
-
-
-
1003•'
See Footnote3. 5
0.13
b S .Z
. d
Z
i s
•XLl
2-6
4
0
' If "NO FLOW" or "NO DISCHARGE; Enter "NO FLOW" or "NO DISCHARGE" -for each outfall here and the Date Range.-
2 Per NCG02: Tier 2 Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range
} If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier I or Tier 2 responses in the General Permit.
' TSS benchmark values are 100 me except in ORW, HWQ, trout, and PNA waters where they are 50 mg/l.
s The discharge shall not cause an instantaneous measurement of the turbidity of the receiving water to exceed: 10 NTU for freshwater streams, lakes, and reservoirs designated
as trout waters; 25 NTU for all lakes and reservoirs, and all salt waters, 50 NTU for all other streams and surface waters. Turbidity may be monitored at the SDO.
Alternatively, the permittee may choose to monitor turbidity in the receiving water, directly upstream and downstream of the SDO.
Permit Date: 1/l/2010-12/31/2014 Last Revised 02-02-I1
Page I of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month on average
Out -fall
No
Date Sample
Collected
(molddlyr OR
NO FLOW)'
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months
in Tier 2
Sampling 2
New Motor
Oil Usage
g
allmonth
Total Flow
(MG)
)
TPH using method
1664A SGT-HEM
m
Total Suspended
Solids
m
pH
(Standard
Units
Total
Rainfall
in
Event
Duration
minutes
-
-
153
1001,4
6-93
ps
o V
..
b
�. r
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES
AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO [jr
HAVE YOU CONTACTED THE REGION? YES ❑ NO [�
WHO AT THE REGION HAVE YOU SPOKEN WITH?
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW". "NO DISCHARGE" & LIMIT
VIOLATIONS) BY MARCH 1 OF EACH YEAR TO:
Division of Water Quality
Attn; DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617 ' .
[phone]
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."
O*c of Permittee)
Date: I / 1 /20 t 0-12/31 /2014
A1104
(Date)
Last Revised 02-02-1 1
Page 2 of 2

I ANNUAL SUMMARY DNR - STO1 MWATER
11 SEND TO CENTRAL OFFICE * II
STORMIYA TER DISCHARGE OUTFALLS (SDO)
GENERAL PERIMIT NO. NCG020000
*Report ALL ST"ORMTVATER Monitoring Data on this form (including No Flow and No Discharge and Permit Limit Violations) by MARCH 1 of each year.
CERTIFICATE OF COVERAGE NO. NCG02 © _L ,_p-
FACILITY NAME: (Ifo VIZ_S%,1JZ w S l _&d _
PERSON COLLECTING SAMPLES J�ytvurtd
CERTIFIED LABORATORY Lab #
Lab #
Part A: Stormwater Monitoring Requirements
SA1%IPLE COLLECTION YEAR: R 2 r) i RECEivEr)
COUNTY _ sSi/.✓t�.til�Sl: �-�
PHONE NO. { S2g) 6f6' 3TIM FEB 12 2015
ADD TO LISTSERVE? YES LINO[:]
DWR SECTION
Outfall
No:"
Date Sample'
- Collected
(mo/ddlyr OR,'
NO FLOC
`1Vlonthly -
Monitoring?
(Y/n}
# of Months in
Tier:2
Ssm lin 2
p. g
Total Flow
`(111G)
'
Total Suspended
-Solids
{mgll).
� 4
'Turbidtty
{NTU}'
�
Settleable
'Solids iitlll '
( } .
Total �
Rainfall.
-: (in)•
-Event
Duration;
(minutes)-
-
1003,4See
Footnote
o.1
tx7-
9, P
G, `I'
.? �'!
LA
t
__2_1
It
A,
3, 8
-3,
1
!T
,
If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here and the Date Range.
2 Per NCG02: Tier 2 Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range
' If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit.
TSS benchmark values are 100 mg/l except in ORW, HWQ, trout, and PNA waters where they are 50 mgll.
5 The discharge shall not cause an instantaneous measurement of the turbidity of the receiving water to exceed: 10 NTU for freshwater streams, lakes, and reservoirs designated
as trout waters; 25 NTU for all lakes and reservoirs, and all salt waters; 50 NTU for all other streams and surface waters. Turbidity may be monitored at the SDO.
Alternatively, the permittee may choose to monitor turbidity in the receiving eater, directly upstream and downstream of the SDO.
Permit Date: 1/1 /2010-12/31 /2014 Last Revised 0 1 - 2 1 - I
Page l of 2

Part B: Vehicle Alaintenance Activity Alo itoring Re uirements for facilities using > 55 gal of new motor oil/month on average
'Outfall"
No-
I Date Sample.,;
r• , Collected , _,:
moldd/ r•OR ,
NO FL0�1�t
_` Injrier42' -'
1VIonthly ,
g�
(}/n}`
#i of 1<Ionth"s
in! 2
Sampling',
New Motor
Oil Usage
ai/month
Total Floiv
(AIG)
-TPH using method
I664A1SGT HEM
m 1
Tvfal Suspended'
Solids
_, m <<
; pH
(Standard
Units
r Total
Rainfall'
�n >
Event
i:Duration
minutes
S
I
Ivy
44113
1
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES
AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO W
WHO AT THE REGION HAVE YOU SPOKEN WITH?
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW". "NO DISCHARGE" & LIMIT
VIOLATIONS) BY MARCH I OF EACH YEAR TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN THIS CERTIFICATIOeV FOR ANY INFORiVATION 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."
t6re of Permittee)
Date: 1 / l /2010-12131 /2014
{Da e)
Last Revised 0 1 -21 -11
Page 2 of 2