NCG160053_MONITORING INFO_20180627

A (-JA r\L /17 a,
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V uc,
DOC TYPE,
HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ ab �o
YYYYM M DD

A,,
:;T(3RIV1WA T ER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year o?o/tS
Revised 9/172014
General Permit No. NCG160000
Certificate of Coverage No. NCG16❑O O❑❑5 3❑❑
This monitoring report summary is due to the DEMLR Regional Office no later than November 1 of
each year.
Facility Name: Ci
County: W/c.sa
Phone Number: (.252) a90- 59/2
Total no. of SDOs monitored .2—
Part A. Outfall No. (use multiple sheets for multiple outfalls)
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No jH
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
3 `Outfall'y
€4
Total Rainfall
�x=
inches'{�c,,,
fTSSrmgIL,E#i.
Benchmark
N/A.:
501106 `
�1� HF Date=Sample Collected„
,
.
a3",5A4Ile-
NC Dept of Environmenial Qualm
JUN 21 21118
--- Raleigh-Regional-0ffiee--
Page I 1

i'ait 8. On -Site 'vehicle Maintenance-oudall•No:
Is this outfall currently in Tier 2 (monitored monthly)?
Was this outfall ever in Tier 2 (monitored monthly) during the past year?
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
�Outfall i.��
.... w7 r... •.. ,' 0., 4„"
'-
Total Rainfall,
,�, inch"es
.. Acw i, :si_. '
00530
00556
;.
• 1. ':s l
Non polar Oil &
:I Grease, mg/L #•E,
,... r T ai , 'i3in
Benchmark
N/A
501100
15
rDate'�Sample Collected•
o iIMI
�
� ;�_
HA
Yes ❑ No ❑
Yes ❑ No ❑
0
Page 12

STORMWATER DISCHARGE OUTFALL (SDO)- 1
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year a0/8
Revised 911712014 ,
General Permit No. NCG160000
Certificate of Coverage No. NCG16❑O QII ©❑
This monitoring report summary, is due to the DEMLR Regional Office no later than November 1 of
each year.
Facility N
County:
Phone Number: S2 0290- 59/Z
Total no. of SDOs monitored
Part A. Outfall No. (use multiple sheets for multiple outfalls)
Is this outfall currently in Tier 2 (monitored monthly)? "' Yes ❑ No
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ NoR
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DEMLR to reduce monitoring frequency ❑
Other ❑
4 wis e f �e
i Outfall
1 n
Totaliirall
mchesE
005 .��•
t"1a 30
L� t+1"4
TSS, mg �i/J
Benchmark
NIA.
5&10l) '' .'
m Idlsa ple
+ 17`O s
Collected
z
0261.3 L
Page I 1

Part Li. On -Site -Vehicle Maintenance Outfail No.
Is this outfall currently in Tier 2 (monitored monthly)? Yes • ❑ No ❑
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No ❑
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DEMLR to reduce monitoring frequency ❑
Other
$ t tfall ,
r •.
�
Total Rainfall
nches 7
t 00530
�:00556
4.ik�1 (� �y��. �f i
k T3S, mglL Y a
F
N nP olan Oif &a
ease IinglL{3
Ben mar
1A
0/100
15',
6Date Sample 'Ile�cted�
mo/dd/yr y xi
vswl
s
Page 12

°'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 igfeirmation, including the possibility of fines and imprisonment for knowing violations."
Signature
Date l -
Mail Annual DMR Summary Reports to:
DEMLR Regional Office Contact Information:
Asheville Office ......
[phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
(919) 791A200
Washington Office ...
[phone]
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
ASHEUILL'EREGIONAL'°?OFFICE
jFAYETrTEVILL'rrREG10NA'IsOFFICE
MOORF.SVIliLERGG►ONAL'OFF,ICE
2090 US Highway 70
i 225 Green Street
610 East Center Avenue/Suite 301
Swannanoa, NC 28778
Systel Building Suite 714
Mooresville, NC 28115
[phone]
I Fayetteville, NC 28301-5043
[phone]
[phone]
R'ALEIGH¢REGIONAL**•OFFICE
WASH INGTON REGIONACyOFF,ICE
WILMINGT, CF
BarretfDiive ---
943-W5s}iington Square Mail--127-Cardinal'Drive
Extension
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
[phone]
[phone]
W INSTON=SAliEM •R EGIOMk ,
OFFICE
i
585 Waughtown Street
Winston-Salem, NC 27107
[phone]
Page 13