NCG160055_MONITORING INFO_20180627

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STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v C� I u CJ ej
DOC TYPE.
❑ HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ D I �6 a�
YYYYMMDD

�• STORMWATER UIJ-,,oARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year A-70JB
r Revised 911712014
General Permit No. NCG160000
Certificate of Coverage No. NCG16 0❑❑2 S❑©❑
This monitoring report summary is due to the DEMLR Regional Office no later than November 1 of
each year.
Facility Name: ,'>. /, 00007M L.g M
County: LEE
Phone Number: ( S2)
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 N
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No o
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
Total Rainfall,
inches
00530
TSS, mg/L
Benchmark
N/A
501100
Date Sample Collected,
mo/ddlyr
a,
x k
t
4
r _
S
L
NC Dept ofEnvironmemal Quality
JUN 21 2018
Raleigh Regional Office
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Part B. On -Site Vehicle Maintenance Outfall 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
Total Rainfall,
inches
00530
00556
TSS, mglL
Non-polar Oil &
Grease, mg/L
Benchmark
N/A
501100
.15
Date.Sample Collected,
molddlyr
r
,
Yes ❑ No ❑
Yes ❑ No ❑
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" 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 ipfetmation, including the possibility of fines and imprisonment for knowing violations."
Signature
Date 6
Mail Annual DMR Summary Reports to:
DEMLR Regional Office Contact Information:
Asheville Office ......
[phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
[phone]
Washington Office ...
[phone]
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
ASHEVILLE REGIONAL OFFICE
FAYETTEVILLE REGIONAL OFFICE
225 Green Street
M_OORESVILLE REGIONAL OFFICE_
610 East Center Avenue/Suite 301
2090 US Highway 70
Swannanoa, NC 28778
Systel Building Suite 714
Mooresville, NC 28115
[phone]
Fayetteville, NC 28301-5043
[phone]
[phone]
RALEIGH�REGIONALOFFICE
WASHIN_GT_O_NREGIONALOFFICE
WILMINCTONRF,GIONALOFFICE
127 Cardinal Drive Extension
3800 Barrett nrive
943 Washington Square Mall
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
[phone]
[phone]
WINSTON-SALEM REGIONAL
OFFICE
585 Waughtown Street
Winston-Salem, NC 27107
[phone]
I
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