NCG020716_MONITORING INFO_20200121

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STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
IV U& b a b- N l
DOC TYPE
❑ HISTORICAL FILE
1� MONITORING REPORTS
DOC DATE
❑ 90 D 0 I i
YYYYM M D D

DOC TYPE 1 ❑ HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE I ❑
YYYYM M DD

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year Z 01 9
'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. N0002027--4 O 7 I
Facility Name: 'V z L_ A W 5 O ti t r) k
County: M t cCA I
Phone Number: ( )yZJ q6 % /t)03 Total no. of SDOs monitored
Certified Laboratory t 1S /) C /, e v/ ; I I P Lab #
Lab #
Stormwater Discharge Outfall (SDO) No. eLM 01 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 ❑
O tfall N ..
Total
Rainfall,
inches
TSS,
mg/I
SS,
ml/I
Turbidity,
NTU
Upstream
(0)Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mg/I
(VMA)
New
Motor Oil
Usage
al/mo.
Stormwater
Benchmarks
Indicate NO
appo able
Circle
Benchmark
100/50
0.1
Benchmark
`hm
50/25/10
NIA
Wat.rO li
Standard applies
N/A
Water QualitySS
Standard applies
15
eas. q.i
average require°
and �lar
TOtto monslop
itoring
Date Sample
Collected,
moldd/ r
Wmmm�---
Ol 19
Z5
Loi
(o,
o
u i
25
I
3
Z 111
Al i) P/10
In%
�,EN (RAI F
it FS
DWR SEC"10N
1Is
L c�
Permit Date 10/1/2015 — 9/3012020
Revised 11-16-2015 for Additional Monitoring Specific to this COC

Certificate of Coverage No. NCG020274
Supplemental parameters:
06tfaliNdmF7
Permit Date 1011 /2015 — 9/30/2020
Revised 11-16-2015 for Additional Monitoring Specific to this COC
Permit Date 1011 /2015 — 9/30/2020
Revised 11-16-2015 for Additional Monitoring Specific to this COC

Certificate of Coverage No. NCG020274
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 5..i
Date 0l /0 2-
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]
G
Permit Date 10/112015 — 9/30/2020
Revised 11-16-2015 for Additional Monitoring Specific to this COC