NCG020869_MONITORING INFO_20190225

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V C& ojO b�
DOC TYPE
[I/ HISTORICAL FILE
C� MONITORING REPORTS
DOC DATE
o jol ti b) a s
YYYYMMDD

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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 Floyd'/"No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 9 of each year.
Certificate of Coverage No. NCG02 L�L�
Facility Name: �i �. �• �_ uJ o- -t M
County: (-� o b C, e.
Phone Number: (-?Oq 2? 1 — S30Total no. of SDOs monitored
Certified Laboratory Lab #
Stormwater Discharge Outfall (SDO) No. L_ VMA Outfall? Yes ❑ No [v]'
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 RECEIVED
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?'
Yes, enough consecutive samples below benchmarks to decrease frequency ❑ FEB 2 b ZQ b
Yes, received approval from DEMbR to reduce monitoring frequency ❑ 'GEN-i RA
No, turbidity benchmark exceedances did not require monthly monitoring ❑ DVVR 5-EGTIO •j
Other ❑
Outfall No.
Total
'Rainfall;
inches
TSS, .
mgli
SS,,
mlll
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstrearr>i
(D) Turbidity,
NTU
Non -polar
O&G, mgll
(VMA)
New
Motor Oil:
Usage
allmo.
Stormwater
Benchmarks
.;,dicey No
FLOW!(
a licabla
Circle
Benchmark
100150
- 0.1
Circle
Benchmark
50/25/10
NIA
Water Quality'
Standard applies
NIA
Water Quality
Standard applies
1 $
>55 gallmo.
average requires "
TSS and Non -polar
OSG monitorlr
Date Sample
p
Collected,
molddl rs�l,�;�•�'�
' ^r = tt� ��
�: if Y' - ���1
s�,�{),,E�At,,
4
MA
'1tt '�
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y�t,,J
f •E;� s}
:«,,,s r, a
V 1
, k 1 h �t, � ���
r j•�'i 'i i
t y jr
�:��<K ya�g� -
ITSkir
f 1Tt 14.i`,L� i'A
is f H X
. i a
� �,
7 �s.
� �
I
V
Permit Date 10/1/2015 - 9/30/2020
Last Revised 10-2-2015

L Certificate of Coverage No. NCGN ❑0 ®©Fj]
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 benchmark exceedances did not require monthly monitoring ❑
Other ❑
OutfalI No.
Total
Rainfall,
inches
TSS,
m 1l '
g
SS,
mill
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
0&G 'rri 11
9
(VMA)(gal/Mo.),
New' `.
Motor!0il
' '
Usage
Sf.• -
ormwater,
Benchmarks
Date Samples,
Collected,
molddlyr
rndfcare No
applicableF
w, s ^� c
Circle,-
Benchmark
100150
�
-
0.1
iF - � ink
- circle
Benchmark
50/25/10
r.•, y
NIA'
Standard appli s
r ,�- Y
NIA
Standard appli 5
iR v"'
15
^xr -.
>ssgalfma. -
average requlres
7 &G monit ring
Y ��'Hs
Permit Date 10/112015 — 9/3012020
Last Revised 10-2-2015

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Certificate of Coverage No. NCG02 [�d®®[%
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
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 — 9130/2020
Last Revised 10-2-2015