NCG020467_MONITORING INFO_20190225

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V 0309�
DOC TYPE
❑HISTORICAL FILE
C� MONITORING REPORTS
DOC DATE
❑
YYYYMMDD

i
ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year z o 1 g
`Report ALL STORMWATER monitoring data on this form (incldde "No Flow"r`No Discharge" and Benchmark
Exceedances) frorn the previous calendar year to the DEO by MARCH 1 of each year.
Certificate of Coverage No. N0002
Facility Name: _SoyrH !_t'lL2,fjdra iP✓gnrt%I _ .-----
County: Aft g 6a -cam
Phone Number: fx r) f6 - 3 f y `t Total no. of SDOs monitored
Certified Laboratory Lab # q tP
Lab #
Stormwater Discharge Outfali (SDO) No. *t&d..La2zi 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? RECEIVED
Yes, enough consecutive samples below benchmarks to decrease frequency ❑ FEB 2 5
Yes, received approval from DEMLR to reduce monitoring frequency El2�ig
_
No, turbidity benchmarkexceedances did not require monthly monitoring ❑ CENTPAL FJIFr,.,
Other ❑!•t�f `'�:C? IO�.j
1
OutfalTotal
'Marti No.
2J<.IIV
Rainfall,
inches
TSS,
mgll
SS,
mlll
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mgll
(VIVIA)
New
Motor Oil
Usage
allmo.
Stormwater
Benchmarks
fudfcata NO
FLOW"'
a !lcahfu
nCl cr,c
Born;Nmark
100150
0.1
Circle
Benchmark
50/25/10
NIA
water Quality
standard a1 01as
NIA
water quality
Standard appllos
5
'S5 pa1lmo
,roatRQe rayulr'ac
f35 anti Nowpnlar
OJFG munitor!
Date Sample
Collected +
molddl r
r ..� .IBM
rill,
irsyE
iF, •
G' .ro.1
!
! '�' rd
'" r r � +rr,
fi=�.tn
K � r
4 f , tx •.t�,':
#
#,.L�,
r ,k
JirY h.ruw y I.:i
n. ikw.af...s„
6_
1
d
►� o
Permit Date 10/112015 — 9/30/2020
Last Revised 10-2-2015

to
Certificate of Coverage No. NCGO2 0N©©
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 samplos below benchmarks to decroaso frequency ❑
Yes, received approval from DEMLR to reduco monitoring frequency ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑
Other T^� _ ❑
Outfall No.
Total
Rainfall,
inches
TSS,
mgll
SS,
mi/i
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
-
Non -polar
O&G, mg11
(VMA)
New
Motor Oil
Usage
al/mo.
5torrnwater
Benchmarks
ledknr0 NO
F`4tN"
a lrcable
circle
Bune;lururk
100/50
0.1
"`�
denGnlnarh
rJ{I125110
NIA
w,fRl Qe.111ry
S=andard applies
NIA
Wafer Quality
Standard appiles
1 5
'S'9'gtji
average /eltelrc9
TSS and Ndniwtar
pRG nwnitann
Date Sample
p
Collected,
y"
molddl r
rf
+ ,� ,�
_ Si TrI
„ Tr
f t
z �
i
} ��
i�.4t'7,'s .�
,17 -i[.i
It , , r
rf'
-,., • .-
ux _°
't.r `U IX'T,
1 :.,� , fin"
s;f� .
f ��.
u i%i?r�.,a t..+,
h{ - x
s.d� °i ' ,
4 r r
ta��r*
Permit Date 101112015 — 9/30/2020
Last Revised 10-2-2015

_i
Certificate of Coverage No. NCG02 ❑D H[ j7
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 &1 ii 1 tT, a
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

ANNUAL SUMMARY DISCHARGE MONITORING
' REPORT (DMR) — STORMWATER .
SUBMIT TO CENTRAL OFFICE'
General Permit No. NCG020000
Calendar Year 2017
'Report ALL STORMWATER monitoring data on this form (include "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: S/✓rH Ad'VP61ja _ xuAgmy
County: _ 4f,_ m L✓,. L_
Phone Number: (!U 4) 6 s k - 3 d y+f Total no. of SDOs monitored _
Certified Laboratory "dAcir _ _ Lab # Y o
Lab #
Stormwater Discharge Outfall (SDO) No. VMA Outfall? Yes ® No ❑
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No X❑
Was this outfall ever in Ter 2 during the past year? Yes ❑ No [M
If this outfall was in Tier 2 last year, was monthly monitoring discontinued? RECEIVED
Yes, enough consecutive samples below benchmarks to decrease frequency ❑ BAN 2 4 2018
Yes, received approval from DEMLR to reduce monitoring frequency ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑ CENTRAL FILES
DWR SECTION
Other ❑
Outfall No.
AAr?kr%%1
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.
Benchmarks
fnalcafa NO
FLOW +/
a 1leable
CirStormwater nchni
Bent:hmatk
100150
0.1
BencCirclehmark
$enchmarN
50/25/10
NIA
water Ouallry
Standard apptiea
NIA
Water Quality
Standard applies
1 5
eZVerlmo.
average re4ulrsa
755 and Nonpolar
O&G monluxin
Date Sample
Collected,�
w S
rwel
,t
V, y
A
Hf' �.
d
1 Opp
S
/p
- ctlif
Permit Date 1011/2015 — 9/3012020
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 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 I>onchmark exceedances did not require monthly monitoring ❑
Other _ ❑
Outfall Na.
Total
Rainfall,
inches
TSS,
mg/l
SS,
mill
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mgll
(VMA)
New
Motor Oil
Usage
al/mo.
Benchmarks
!ndlcaro NO
- aFr ka"
MteStormwater nchpe
Benchmark
100/50
0.1
Benchmark
nchCircrn
50/25/10
NIA
StandarrQuality
apples
NIA
Standard applies
15
eraw requires
average repuire!
T06G m nnorinSS and iar
Date Sample
Collected,
molddl r
1 i 1
f °`
+ ia,\Y?1►rlki
:„v$5`
o- Y
,,,
.j., fC -E
0+
5 F11 ..iV L
�; ! _ . r b
k,`
`xl '�
f:i'Y
r � s- -�."p
"�,f;
,�.,-
' •3%t--' tfs
dd
a�
4
'3��c r
��� �r
r r <
�nf
s
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

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 Flow"rNo 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: f y-rJ4 AteeFL/i=Rs.. &Llhaarwy
County: ,M,ye h./Ek L_
Phone Number:( !2 ir) if& - 34br1 Total no. of SDOs monitored
Certified Laboratory ✓/4'Glz Lab # f—
Lab #
Stormwater Discharge Outfall (SDO) No. ,g Li- - -- VMA Outfall? Yes ❑ No
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No ❑X
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.
K y
Total
Rainfall,
inches
TSS,
mgll
SS,
mlll
Turbidity,
NTU
I
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mgll
(VMA)
New
Motor Oil
Usage
allmo.
Stormwater
Benchmarks
indicate NO
FLOW it
a lkahfe
Circle
Banchmark
100/50
0.1
Circle
Benchmark
50/25/10
NIA
Standard applies
NIA
ity
Standard applies
15
.55 Baumo.
aZager ""$
Toacnr� i or on -polar
Date Sample
moldd! r
`" -
x61��,
,
11ilyl
r t yto
"�„w4will
i
r�5,
r fi�¢{iY�
rCollected,_t,ll
'�L.i7.: 7121'nJ r
r1
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

r '
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 outfaII 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 ❑
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.
5tormwater
Benchmarks
fndlca[o NR
aDj74kable
Circle hm
Benchmark
001 0
n
Q'
Benchmark
egen�cfhcmarkA
��a12`��� V
NIA
S andard applies
NIA
Standard applies
C
`�
aSSe equi
average requires
lar
r dG monitorSS and ing
Date Sample
Collected,
E
3jr.
`
T"
T
ry
t -
c
E
�n
it
r�y:�•
.4 L" ✓qq
4 y
is
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year 2111--
'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: r
County' _ .>#, t7o 6&- Lt.-
Phone Numbor: ( Ake ) 6 4L= 31sK t-I Total no. of SDOs monitored 6
Certified Laboratory _- -- , l z Lab # ct o
Lab #
Stormwater Discharge, 0utfall (SDO) No. MA Outfall? Yes ❑ No © ^f35
Is this outfall currently In Tier 2 for any parameter? Yes ❑ No © 6
Was this outfall ever in Ter 2 during the past year? Yes ❑ No © 13 y
If this outfall was in Tier 2 last year, was monthly monitoring.discontinued? 131
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 ❑
051 AG, L3 7
A 8
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.
Benchmarks
6ulicam NO
stowa
a lfcadla
c1ruoStormwater nchm
Benchmark
100150
0.1
nchniCircl
Benchmark
50/25/10
N/A
Water°ia1t'
Standard applies
N/A
waterauaut„
Standard apples
15
's`ereq I
avereyo regalrus
rnsant'Nt,nim''a,
OdG "w Otacl"jj
Date Sample
Collected,
molddl r
A
I
�,�
t;t"`::
w.r r.n+
��, r3
`�
Lb' Ja !
yA
r `'-�i'
0Z ,414.�,,
ax €fi
.�x,
.Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ❑❑❑❑
Additional Cluffall 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, onough consecutive samples below benchmarks to decrease frequency ❑
Yes, roreivod approval from DEMLR to reduce monitoring frequency ❑
No, turbidity benchmark exceodances did not require monthly monitoring ❑
Other ❑
Outfall No.
Total
Rainfall,
inches
TSS,
mg/I
SS,
ml/!
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mg/l
(VMA)
New
Motor Oil
Usage
allmo.
Benchmarks
fndlGarII NO
��ow it
a flCabl¢
CircStormwater ncti re
k!¢ncnrnarb
100150
0.1
nclIntCircle
B¢nchmarN
5012511 p
N/ A
/`1
avatar Quality
standard applies
N/ 1t
M
Water Quality
Standard appltes
15
e$S gapma.
averaQ¢ requlrEe
TSS and Nonvtar
ipOSG nronftodn
Date Sample
CalleCollected,
ma/dd1Yr
' }"�/ #P .
S �.
t4 "�
G3`"` : {�
333 a
,�
e.
` t
6
V
�F rx �A�4g;�
y iG1Y
R•Jj,S
,,;:>� 'y�; ' a�
;ter
�? �; r,
��y a;`"
r
44
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 29®E�
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 ell,ltfli P
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 1011/2015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 0©®Q
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 4XI/Ir r
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 1011/2015 — 9/30/2020
Last Revised 10-2-2016

4
ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) - STORMWATER•
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year ge i b
"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 year.
Certificate of Coverage No. NCG02
Facility Name: Sign VAdor y
County: d& bOw,,.L1-
Phone Number: ( 4ig-) Lg+c- 3rgq Total no. of SDOs monitored
Certified Laboratory GlLab # zt o
Lab #
Stormwater Discharge Outfall.(SDO) No. #f Roil* VMA Outfal!? Yes ® No ❑
Is this outfall currently in Tler'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? RECEIVED
Yes, enough consecutive samples below benchmarks to decrease frequency ❑ FEB 2 3 2011
Yes, received approval from DEMLR to reduce monitoring frequency ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑ CENTRAL FILES
DWR SECTION
Other ❑
�•�" �4�Jr 1 i
'
Y T #�
OutfallNo ,; a
-fLi o' t
�1 .1
' ;�T,otalr,;p
�:
Rainfallf',
v w .a
Al
V
� TSS;4 F
ti mgll
i
i f SS
mul
•
4Turbidity,,
lVTU
'
f�
"Upstream,. •
,{U)fTurb�dity y
NTLl�
iL M1I •�' R�M'�-
Downstream',
'{D) Turb�d�ty
N, n , +�
' NTtJ� ,,� ,
`r -
s iVon polar
O&G mgl!
VMA
New
x Motor 0i1
Usa e
9_.
' allmo'
Stormwater
Benchmarks
6W1cam M0
FL°, ;ff„
Circle
I3anehmar%
100150
0.1
Circle
6onchmadC
50/25/10
NIA
" ;
ter
NIA
Water Quality
s�naa p ile,
15
>68gallm.•
airarage requires
G&G `"
rMonitoring
DateSample
�C`oliected ���s
S %
e 15
12-4
AV!�
/
O
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

0 . %,
Certificate of Coverage No. NCG02 ❑[)[]D
Additional Ouifall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No., VMA'Outfali? 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 . ❑
i
. rt -
OutfallNo
7
t
rTotal
.. s
Rainfaii;
Ar
l
.
-r5s
a.
r 9 a
f`
51�.
a.
7 SS,
milt
.$
Turitiidi ,.
, h►
'N'nJ
Upstream �
, ` t u
U Tur'bidi
(. ? ri
NTU
0, nstrearri
r �r ��
1 D Turbidi
'F M
( ri
M , Ram
x fNTU
k,
��R� �� R
�
j Non,poiarMotor�
�O8�G �m li
.r 9 ,
A �
Y New
oi! ,
,.�
< sage.
_ �.
5torrrrwater,
Benchmarks
.
,,d�;,,o '
Ftown _
a !cable -
100150
'.: 4.1
, •: ,
501251i0
NIA
staro .r,w ..
WA
Water Quallb
star�ard +�PPIi•+-.OdG
- ;: 15. ..
Tavdr�pe .
monitor!
�Date�Sample=;
0
M
Permit Date 1011/2015 - 9130/2020
Last Revised 10-2-2015

1
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 §122.22]
Signature '
Date 21Js]1-7
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

ANNUAL SUMMARY DMR - STORMWATER I
SEND TO CENTRAL OFFICE * 11
STORMWATER DISCHARGE OUTFALLS (SDO)
GENERAL PERMIT NO. NCG020000
*Report ALL STORMWATER Monitoring Data on this form (including No Flow and No Discharge and Permit Limit Violations) by MARCH I of each year.
CERTIFICATE OF COVERAGE NO. NCG02 O= 1
FACILITY NAME: 5PVT-11 ,AeQjVV&4L _fjj&jjjgX
PERSON COLLECTING SAMPLES Tr,y y t,/ AS j;A
CERTIFIED LABORATORY c Lab #!� p
Lab #
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: g rrj S k Ee E I V E
COUNTY-,!&VpI..n1j_
PHONE NO. (ya.f) if;- lbryg FEB 2 3 201fi
ADD TO LiSTSERVE? YES ❑ NO ❑ EMAIL:
I. EIN i r AL' - ES
DWR SECTION
Outfall
No.
Date Sample
Collected
(mo/dd1'yr OR
NO FLOW)1
In Tier 2
Monthly
Monitoring.
(yln)
# of Months in
Tier 2
Sampling 2
Total Flow
(MG)
Total Suspended
Solids
Turbidity
(NTU)
Settleable
Solids (m1/l)
Total
Rainfall
(in)
Event
Duration
(minutes)
-
-
-
-
-
1003, 4
See Footnote3, 5
0.13
Y 7 es
All0
1
S!
- r*i
s -
r = r
.AAJELVW
9
V.
133
Alf lag
' if "NO FLOW" or `NO DISCHARGE, Enter "NO FLOW" or `NO DISCHARGE" for each outfall here and the Date Range.
Per NCG02: Tier 2 Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range
3 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 mg/l.
'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 02-02-11
Page 1 of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month on average
Outfall
No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months
in Tier 2
Sampling Z
New Motor
Oil Usage
g
(gal/month)
Total Flow
(MG)
TPH using method
1664A SGT--HEM
m
Total Suspended
Solids
m 1
pH
Standard
Units
Total
Rainfall
in
Event
Duration
minutes
-
-
153
1001,4
6-9'
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
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]
YOUMUST SIGN THIS CERTIFICATION FOR ANYINFORMATIONREPORTED:
"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."
.Z 1
(Signat of Permittee) (Date)
Permit ate: 1/l/2010-12/31/2014 Last Revised 02-02-1 1
Page 2 of 2

I ANNUAL SUMMARY DNYR - STORMWATER
SEND TO CENTRAL OFFICE REC
STORMJVATER DISCHARGE OUTFALLS (SDO) 0 ��
GENERAL PERMIT NO. NCG020000 1S FEB 2 2015
*Report ALL STORMTVA TER Monitoring Data on this form (including No Flow and No Discharge and Permit Limit Violations) by MARgTffDojeach }ear. DWR 3ECT1rfj
CERTIFICATE OF COVERAGE NO. NCG02 o 7 SAMPLE COLLECTION YEAR: aI �jo
COUNTY _ it(i:avwi't L
FACILITY NA11IE: _S'Q v�1.1 ,rr{.��yt..�,-�,t„ 4 yA��2,I � c
PERSON COLLECTING SAMPLES A it /' z� ��'L PIIONE NO. c 92y l & Q'd-_ 3,S q i
CERTIFIED LABORATORY ✓fi`Gi� _ Lab # `I C1 ADD TO LISTSERVE? YES ❑ NO ❑ EMAIL:
Lab #
Part A: Stormwater Aionitoring Requirements
Outfall
` Date Sample",
Collected
(tnoldd/ r OR.
Y I
NO FLOW)
In Ties:2"
Monthly
Monitorin
- g'`'�
..(YIP)-
# of Months in
Tier.2,
' "':SiimplItig?'
_
Total Flow
(1VIG)' "
I
Total Suspendedr
-Solids
_..:, .(mom)
,
Turbidity
(NTU)"
_
Settleable
"Solid$ (ml/l)'
Total -
Rainfall_
(in)
--Event
Duration
(minutes)
'nut
-
-
-
-
3 100
See Footnote
0.-1: " .
3 110 q
Zvi
17,b
wAnkir
N
,
0,66
S
is 6
re
e7
�.
5
! C AqK f'
' If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here and the Date Range.
Z Per NCG02: Tier 2 Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range
s 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 mgll except in ORW, HWQ, trout, and PNA waters where they are 50 mg/l.
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 water, directly upstream and downstream of the SDO.
Permit Date: 1 / 1 /2010-12131 /201 d Last Revised 0 1 -2 1 -11
Page I of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oit/month on average
i
Outfall� ;
c r
s..`Dafe Sam lel`',
; - a p
h 'C611&ted .
(moldd/yr•OR
'-'NO-FLOW).
;.Tier 2,'
In' r,
'Mon thly
Monitoring? -
i ' ;(y!n)
f '= -
# of Months
-
tn;Tier 2 ~
Sam. pliflgZ'
New 11lator
.,
Oil Usage
aUmonth
::'^
Total'Flow
(11IG) .,
,�.
TPH using method
j 1664A SGT HEM•
__ m
,•
Total Suspended'' .
' Solids f
m 5 ' '
; pH
{Standued'
>.:Units ` _
Total
` ,Rainfall .
' _ in . ;
Event '
',Duration-
minutes _
-
a
".x --1 "'.`
°
100 ...
y6-9
y._.. S
-i - rhif
2�O
�!Z
Z
.✓
9
/1,
7! t
o.6
HAS YOUR FACILITY HAD 4 OR MORE BENCITMARK EXCEEDENCES
AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES [:]NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO
WHO AT THE REGION HAVE YOU SPOKEN WITH?
MAIL ORIGINAL. AND ONE COPY OF THIS ANNUAL SUI%IAIARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE" & LI-NIIT
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 INFOR41ATI0fV REPORTED:
"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."
(Signature,4fPermittee )
Permit D e: 1 / 1 /2010-12/31 /2014
z LS Jis
(Date
last Revised 0 1 -21 -11
Page 2 of 2