NCG140305_MONITORING INFO_20190226

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
IV Cc,
DOC TYPE
%HISTORICAL FILE
ONITORING REPORTS
DOC DATE
❑ vvlC� �� � ���
YYYYMMDD

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — WASTEWATER
SUBMIT TO CENTRAL OFFICE*
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General Permit No. NCG140000
Calendar Year 2019
"Report ALL WASTEWATER monitoring data on this form (include "No Flow"/"No Discharge" and Limit Violations) from
the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG I 4F21 3❑00
Facility Name: ScoKesoale
County: Guilford
Phone Number: 70( 4 ) 529-6364
Certified Laboratory Prism Lab
Lab # 402
Lab #
Total no. of outfalls monitored 1
Wastewater (WW) Discharge Outfall No. 001
Does this outfall discharge WW to SA waters? Yes ❑ No �✓
Does this outfall discharge WW to SI3 or PNA waters? Yes ❑ No ✓❑
Does this outfall discharge WW to HQW or ORW waters? Yes ❑ No 0
If so, what is the 7010 flow rate? or Tidally influenced waters, 7Q10 not available ❑
Does this outfall discharge WW to Trout jr) designated waters? Yes ❑ No 0
Were there any limit violations in the calendar year? Yes ❑ No Q
Outfall No.
Daily Flow Rate,
pH,
TSS,
SS,
Non -Polar O&G (EPA Method 1664
cfs
SU
mg/1
mill
(SGT-HEM)), mgll
it applicable
Standard
Effluent
HOW or ORW
50% of 7Q10
froahwater
6.0-9.0
'30
HOW, ORIN, SA,
No Limit
Limitations
HOW
ZD
SB, PNA, or any
Trove
indicate NO FLOW if
saltwater
a
5
Samples above Benchmark
applicable
6.8-.5
8a
HOW I ORIN and Tr, or
subject to Tiered Reaponaea
Daily Ma.lmum
10
15
Date
'
Sample;
Collected,
molddl r
2/13/2019
001 NO FLOW
HQ 2 b ZOIS
6/28/2019
001 NO FLOW
r^. nlrl Ci:('i r1Al
8/28/2019
001
7.3
<5
y -
9/19/2019
PW 001 NO FLOW
12/2/2019
001 NO FLOW
Permit Date 8/1/2017 — 6/3012022
Last Revised 8-22-2017

Certificate of Coverage No. NCG14 ®3❑® 5❑
1y :4:4919WIN#Leik,I
"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 6y 40 CFR §122.
Signature
Date
ZKls'7--
Mail Annual Summary Wastewater 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 8/112017 — 6130/2022
Last Revised 8-22-2017