NCG160085_MONITORING INFO_20181019

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE,
❑ HISTORICAL FILE
❑MONITORING REPORTS
DOC DATE
❑ l7 I �5 i) I (�
YYYYM M D D

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING %E(PORT�DMR�
®, Calendar Year 20/f CDeptof nvlron entalQuality
Revised 911712014
OCT 19 2018
General Permit No. NCG160000
Certificate of Coverage No. NCG16❑Dd®1310
Raleigh Regional Office
This monitoring report summary is due to the DEMLR Regional Office no later than November 1 of
each year.
Facility Name: AlKS7 A6X,
County: A114X,e
Phone Number: ( 17W ) Y,#
Total no. of SDOs monitored
Part A. Outfall No. (use multiple sheets for multiple outfalls)
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 In
Outfall /
Total Rainfall,
inches
00530
TSS m /L
� 9
Benchmark
N/A
501100
Date Sample Collected,
mo/dd/yr
I.
2 ?O g
p
13a/ L
,f71n L
•
Yes ❑ No 91
Yes ❑ No
Page j 1

Part B. On -Site Vehicle Maintenance Outfall 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 T.ier,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, m IL
9.
Non -polar Oil &
Grease, mglL.
Benchmark
N/A
501100
15
Date Sample Collected,
moldd/yr
-
-
i
I
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 information, including the possibility of fines and imprisonment for knowing violations."
Signature
Date
!I,
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
MOORESVILLE REGIONAL OFFICE '
2090 US Highway 70
225 Green Street
610 East Center Avenue/Suite 301
Swannanoa, NC 28778
Systel Building Suite 714
Mooresville, NC 28115
[phone]
Fayetteville, NC 28301-5043
[phone]
[phone]
RALEIGH REGIONAL OFFICE
WASHINGTON REGIONAL OFFICE
W7LMINGTON REGIONAL OFFICE
3800 Barrett Drive
943 Washington Square Mall
127 Cardinal Drive Extension
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
I
[phone]
[phone]
WINSTON-SALEM REGIONAL
OFFICE
585 Waughtown Street
Winston-Salem, NC 27107
[phone]
Page13

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
© Calendar Year —"O/ol
Revised 9I 712014
General Permit No. NCG160000
Certificate of Coverage No. NCG 16 O11�1®O�❑
This monitoring report summary is due to the DEMLR Regional Office no later than November 1 of
each year.
Facility Name: 44ho rl ZAX-e- A,, L7e;0r A1d �l!
County: ' �c% 4!, _
Phone Number: (-A�) xr, yor Total no. of SDOs monitored
Part A. Outfall No. 1 (use multiple sheets for multiple outfalls)
Is this outfall currently in Tier:2•(monitored morithly)? ''
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 n
00530
Outfall Total Rainfall,
inches TSS, mg/L
Benchmark N/A 501100
Date Sample Collected, f
mo/dd/yr
Ye's❑ No®
Yes ❑ No
Page I 1

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,,mgIL •.
Non-polar Oil &
Grease, mglL
Benchmark
N/A
501100
15 .
Date Sample Collected,
molddlyr
Z /8
ff
AID o
Yes ❑ No ❑
Yes ❑ No ❑
2AID '4LZ"?I'r
sv,r4>Z4,eal
yet
C
0
Page12

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."
Signature
Date
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
MOORESVILLE REGIONAL OFFICE
I 2090 US Highway 70
225 Green Street
6] 0 East Center Avenue/Suite 301
Swannanoa, NC 28778 i
Systel Building Suite 714
Mooresville, NC 28115
[phone]
Fayetteville, NC 28301-5043
[phone]
[phone]
RALEIGH REGIONAL OFFICE
WASHINGTON REGIONAL OFFICE
WILMINGTON REGIONAL OFFICE
3800 Barrett Drive
943 Washington Square Mall
127 Cardinal Drive Extension
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
I
[phone]
[phone]
,
I WINSTON-SALEM REGIONAL �
OFFICE
585 Waughtown Street
Winston-Salem, NC 27107
[phone]
----
Page 13

STORMWATER DISCHARGE OUTFALL (SDO)
® ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year ,2011'?
Revised 9/17/2014
L L
0
General Permit No. NCG160000
Certificate of Coverage No. NCG16❑D MWFI
This monitoring report summary is due to the DEMLR Regional Office no later than November 1 of
each year.
Facility Name:
County:
Phone Number
lJ�� si.� w4r- ,%CsWT
Total no. of SDOs monitored Y
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
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/dd/yr
,2A'� fia ,&/9
Vhtllc ,1r)A4*11k7-
Page I I

Part B. On -Site Vehicle Maintenance Outfall 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 ❑
Outfall
Total Rainfall,-
inches
00530
00556
;TSS, mg/L:-`.
° Non -polar Oil &
Grease;;mglL
Benchmark
N/A
501100
Date Sample Collected,
molddlyr
C
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 information, including the possibility of fines and imprisonment for knowing violations."
Signature
Date /O•L7-Ity
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]
0
ASHEVILLE REGIONAL OFFICE .FAYETTEVILU REGIONAL OFFICE MOORESVILLE REGIONAL OFFICE
2090 US Highway 70 225 Green Street 610 East Center Avenue/Suite 301
Swannanoa, NC 28778 i Systel Building Suite 714 Mooresville, NC 28115
[phone] Fayetteville, NC 28301-5043 [phone]
[phone]
RALEIGH REGIONAL OFFICE WASHINGTON REGIONAL OFFICE i
3800 Barrett Drive 943 Washington Square Mall
Raleigh, NC 27609 Washington, NC 27889
[phone] [phone]
i
I
I WINSTON-SALEM REGIONAL j _"- " "'
i
OFFICE
585 Waughtown Street
Winston-Salem, NC 27107
[phone]
WILMINGTON REGIONAL OFFICE
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
[phone]
i
Page 13

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
® Calendar Year
Revised 9/17/2014
General Permit No. NCG160000
Certificate of Coverage No. NCG16 EPTNqD
This monitoring report summary is due to the DEMLR Regional Office no later than November 1 of
each year.
Facility Name: AeA AS A*7- q�j
County:
Phone Number: ( %O Total no. of SDOs monitored 3
Part A. Outfall No. A_ (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
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 ❑
00530
Outfall Total Rainfall, inches TSS, mg/L
Benchmark N/A 501100
Date Sample Collected, I
mo/dd/yr
,?•*v '",10/y
Aa Vk X ' y,Ata4lyeT
PageII

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
TS$, mglL
Non-polar Oil &
Grease, mg/U..
Benchmark
N/A
501100
15
Date Sample Collected,
mo/dd/yr
I
1
-
1.
Yes ❑ No ❑
Yes ❑ No ❑
•
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 information, including the possibility of fines and imprisonment for knowing violations."
Signz
Date
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
MOORESVILLE REGIONAL OFFICE
2090 US Highway 70
225 Green Street
610 East Center Avenue/Suite 301
Swannanoa, NC 28778
s Systel Building Suite 714
Mooresville, NC 28115
[phone]
Fayetteville, NC 28301-5043
[phone]
[phone]
RALEIGH REGIONAL OFFICE
3800 Barrett Drive
WASHINGTON REGIONAL OFFICE
943 Washington Square Mall
N7LMINGTON REGIONAL OFFICE ?
127
Raleigh, NC 27609
Washington, NC 27889
Cardinal Drive Extension
Wilmington, NC 28405-2845
[phone]
[phone]
[phone]
WINSTON-SALEM REGIONAL
OFFICE
585 Waughtown Street
Winston-Salem, NC 27107
[phone]
i
0
Page 13

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
®' Calendar Year A91
Revised 911712014
General Permit No. NCG160000
Certificate of Coverage No. NCG160K®F4❑
This monitoring report summary is due to the DEMLR Regional Office no later than November 1 of
each year.
Facility Name:
County:
Phone Number:
Total no. of SDOs monitored y
Part A. Outfall No. J (use multiple sheets for multiple outfalls)
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 r-1
Outfall�
Total Rainfall,
inches
00530
TSS, mg/L
Benchmark
N/A
501100
Date Sample Collected,
mo/dd/yr
Yes ❑ No
Yes ❑ No E
j3jl-�Ze 4/v7 ;s,041 fie%
Paget

Part B. On -Site Vehicle Maintenance Outfall 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 ❑
Outfall Total Rainfall, 7SSmg Non -polar Oil &
inches , IL drease, mglL
Benchmark N/A 501100 15
Date Sample Collected,
mo/dd/yr
J
01
Page12

I certify, under penalty of law, that this document and all attachments were prepared under my direction or
0 supervision in accordance with a system designed to assure that qualified personnel properly gather and
i 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 _
Date /61
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]
9
ASHEVILLE REGIONAL OFFICE
2090 US Highway 70
FAYETTEVILLE REGIONAL OFFICE
MOORESVILLE REGIONAL OFFICE
Swannanoa, NC 28778
225 Green Street
Systel Building Suite 714
610 East Center Avenue/Suite 301
[phone]
Fayetteville, NC 28301-5043
Mooresville, NC 28115
[phone]
[phone]
RALEIGH REGIONAL OFFICE
3800 Barrett Drive
WASHINGTON REGIONAL OFFICE
943 Washington Square Mall
WILMINGTON REGIONAL OFFICE
Raleigh, NC 27609
Washington, NC 27889
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
[phone]
[phone]
[phone]
i
WINSTON-SALEM REGIONAL
OFFICE
585 Waughtown Street
Winston-Salem, NC 27107
[phone]
•
J
Page13

y,
STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING RROWAMR)nentalQuality
QCalendar Year . V/8
Revised 9/17/2014 OCT 19
2018
General Permit No. NCG160000
Certificate of Coverage No. NCG16[�O®QFI
Raleigh Regional Office
This monitoring report summary is due to the DEMLR Regional Office no later than November 1 of
each year.
Facility Name:
County:
Phone Number:
Total no. of SDOs monitored
Part A. Outfall No. (use multiple sheets for multiple outfalls)
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
TSS, m /L
9
Benchmark
N/A
501100
Date Sample Collected,
mo/dd/yr
2 •20 8
. D
?Sill G
A7 -/8
flit?
Yes ❑ No 91
Yes ❑ No Fkj
Page I 1

Part B. On -Site Vehicle Maintenance Outfall 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 ❑
Outfall
Total Rainfall,,
inches
00530
00556
TSS, mglL
Non -polar Oil &
Grease, mg/L.
Benchmark
N/A
50/100
15
Date Sample Collected,
mo/ddlyr
i
I
c
.w, _
0
E
Page12

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
i 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
Date A
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]
ri
ASHEVILLE REGIONAL OFFICE
2090 US Highway 70
Swannanoa, NC 28778
[phone]
RALEIGH REGIONAL OFFICE
3800 Barrett Drive
Raleigh, NC 27609
[phone]
I
i
WINSTON-SALEM REGIONAL
OFFICE
585 Waughtown Street
Winston-Salem, NC 27107
[phone]
•
FAYETTEVILLE REGIONAL OFFICE MOORESVILLE REGIONAL OFFICE
225 Green Street 610 East Center Avenue/Suite 301
Systel Building Suite 714
Fayetteville, NC 28301-5043
[phone]
Mooresville, NC 28115
[phone]
- -- --
N'ASHINGTON REGIONAL-OFFICE-_..WiLMINGTON REGIONAL OFFICE
943 Washington Square Mall 127 Cardinal Drive Extension
Washington, NC 27889 Wilmington, NC 28405-2845
[phone] a(910)796-7215
Page 13

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
®i Calendar Year Xala'
Revised 9IT712014
General Permit No. NCG160000
Certificate of Coverage No. NCG 16©1�1®OO D
This monitoring report summary is due to the DEMLR Regional Office no later than November 1 of
each year.
Facility Name: 614.QP.J IAN LA.(K9
County:
Phone Number: (Af—) ' f f3s7 Total no. of SDOs monitored
Part A. Outfall No. 1 (use multiple sheets for multiple outfalls)
Is this outfall currently in TierZ(mohitored monthly)? Yes ❑ No
51
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 ❑
00530
Outfall / Total Rainfall, TSS, m /L
inches g
Benchmark N/A 501100
Date Sample Collected,
mo/dd/yr l(
1
0
Page I 1

Part B. On -Site Vehicle Maintenance Outfall 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 ❑
Outfall
Total Rainfall,
inches ': '
00530
00556
m 9IL -
TSS, ..
Non -polar Oil &
Grease, mglL
Benchmark
N/A
501100
15 .
Date Sample Collected,
mo/dd/yr
i .k.
AID 45�O
yet
A
•
Page12

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."
Signature
Date
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
MOORESVILLE REGIONAL OFFICE
2090 US Highway 70
225 Green Street
6] 0 East Center Avenue/Suite 301
Swannanoa, NC 28778
Systel Building Suite 714
Mooresville, NC 28115
[phone]
Fayetteville, NC 28301-5043
[phone]
[phone]
RALEIGH REGIONAL OFFICE 7
WASHINGTON REGIONAL OFFICE
W'ILMINGTON REGIONAL OFFICE
3800 Barrett Drive
943 Washington Square Mall
127 Cardinal Drive Extension
Raleigh, NC 27609 j
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
[phone]
[phone]
WINSTON-SALEM REGIONAL ,
.... _ _._..._.__.....:
- .---- _
OFFICE
585 Waughtown Street
Winston-Salem, NC 27107
[phone]
Page 13

STORMWATER DISCHARGE OUTFALL (SDO)
® ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year .20/1'
Revised 9/1712014
0
General Permit No. NCG160000
Certificate of Coverage No. NCG 113R ❑D ®©❑
This monitoring report summary is due to the DEMLR Regional Office no later than November 1 of
each year.
Facility Name: Lo4r- �O"1/7—
County:
Phone Number: ( 7oy )_3py' &!. Y Total no. of SDOs monitored
Part A. Outfall No. _ f (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
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 n
Outfall /
Total Rainfall,
inches
00530
TSS, mg/L
Benchmark
N/A
501100
Date Sample Collected,
molddlyr
17
,2hlp kAa a2mi8
SPAA11. ,(10r)%4*a1e7-
Page I 1

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: '...'''Grease;,
Non -polar Oil &
""' L•.
Benchmark
N/A
501100
Date Sample Collected,
mo/dd/yr
Yes ❑ No ❑
Yes ❑ No ❑
C
0
e
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
Oevaluate 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 —�—
Date
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
i 2090 US Highway 70
.FAYETTEVILLE REGIONAL OFFICE
225
MOORESVILLE REGIONAL OFFICE
Green Street
610 East Center Avenue/Suite 301
Swannanoa, NC 28778
Systel Building Suite 714
Mooresville, NC 28115
[phone]
Fayetteville, NC 28301-5043
[phone]
[phone]
RALEIGH REGIONAL OFFICE
3800 Barrett
VIASHINGTON REGIONAL OFFICE
WILMINGTON REGIONAL OFFICE
Drive
943 Washington Square Mall
127 Cardinal Drive Extension
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
[phone]
[phone]
i
I WINSTON-SALEM REGIONAL
OFFICE
j585 Waughtown Street
Winston-Salem, NC 27107
[phone]
Page13

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year 120/8
Revised 911712014
General Permit No. NCG160000
Certificate of Coverage No. NCG16 EFYIPPF�
This monitoring report summary is due to the DEMLR Regional Office no later than November 1 of
each year.
Facility Name: AWFE Q.iVIWT 41AV7'
County: 4/144E
Phone Number: ( %Oy) Total no. of SDOs monitored 3
Part A. Outfall No. (use multiple sheets for multiple outfalls)
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No
CP
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 ❑
00530
Outfall Z Total Rainfall, inches TSS, mg/L
Benchmark N/A 501100
Date Sample Collected,
mo/dd/yr
Page I 1

Part B. On -Site Vehicle Maintenance Outfall 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 ❑
00530
00556
TSS, mglL
Non -polar Oil &
Outfall
Total Rainfall,
_
inches
Grease, mglU .
Benchmark
N/A
501100
15
Date Sample Collected,
mo/dd/yr
1 ,
•I
Page 12

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."
Sign
Date
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]
is
ASHEVILLE REGIONAL OFFICE
FAYETTEVILLE REGIONAL OFFICE MOORESVILLE REGIONAL OFFICE
2090 US Highway 70
225 Green Street
.
610 East Center Avenue/Suite 301
Swannanoa, NC 28778
Systel Building Suite 714
Mooresville, NC 28115
[phone]
Fayetteville, NC 28301-5043
[phone]
[phone]
RALEIGH REGIONAL OFFICE -
3800 Barrett Drive
VI ASHINGTON REGIONAL OFFICE-
943 Washington Square Mall
WILMINGTON REGIONAL OFFICE
127
Raleigh, NC 27609
Washington, NC 27889
Cardinal Drive Extension
Wilmington, NC 28405-2845
[phone]
[phone]
[phone]
WINSTON-SALEM REGIONAL
'OFFICE
585 Waughtown Street
Winston-Salem, NC 27107
[phone]
Page13

STORMINATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
® Calendar Year
Revised 9/77/2074
General Permit No. NCG160000
Certificate of Coverage No. NCG16Z0®O1
This monitoring report summary is due to the DENILR Regional Office no later than November 1 of
each year.
Facility Name:
County:
Phone Number:
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)?
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
O
Outfall
Total Rainfall,
inches
00530
TSS, mg/L
Benchmark
N/A
501100
Date Sample Collected,
mo/dd/yr
tv e
0.8
7.
Yes ❑ No 29
Yes ❑ NoE
"mod Az'x, a2/A
S�Zl .f%v7 raid /%T.
Page d

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 ❑
00530
00556
, m /L
TSSg
Non -polar Oil &
drease, mglL
Outfall
Total Rainfall,
inches
Benchmark
N/A
501100
15
Date Sample Collected,
molddlyr
Yes ❑ No ❑
Yes ❑ No ❑
•
140
Page12

" 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 thprp nm �i, ,a,,..,.,,
submitting false information, including the possibility of fines and imprisonment for knowing violations."
Sigm
Date
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 ._(252)
946-6481
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
0
ASHEVILLE REGIONAL OFFICE
2090 US Highway 70
Swannanoa, NC 28778
[phone]
FAYETTEVILLE REGIONAL OFFICE
225 Green Street
Systel Building Suite 714
Fayetteville, NC 28301-5043
[phone]
MOORESVILLE REGIONAL OFFICE
610 East Center Avenue/Suite 301
Mooresville, NC 28115
[phone]
RALEIGH REGIONAL OFFICE WASHINGTON REGIONAL OFFICE WILMINGTON REGIONAL OFFICE
3800 Barrett Drive 943 Washington Square Mall 127 Cardinal Drive Extension
Raleigh, NC 27609 Washington, NC 27889 Wilmington, NC 28405-2845
[phone] (252) 946 648
i
WINSTON-SALEM REGIONAL
OFFICE
585 Waughtown Street
Winston-Salem, NC 27107
[phone]
1 [phone]
Page 13