NCG140451_MONITORING INFO_20190224

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STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V
DOC TYPE
❑HISTORICAL FILE
C�MONITORING REPORTS
DOC DATE
❑ �C� I V � `^ y
YYYYMMDD

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STORMWATER DISCh:-.RGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year ?.
Individual NPDES Permit No. NCS❑❑❑❑❑❑ or
Certificate of Coverage (COC) No. NCG❑/ [f©10©1P FEB 24
This monitoring report summary of the calendar year should be kept on fife on -site with the facility SPPP. ��'CVy#� AL CT1j;
Facility Name: � 9�� ������ -� d !
County: FNWKL1
Phone Number:LqLg�, �Q i7 Total no. of SDOs monitored l
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 DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No [
SW U-264-Generic-1 Mec2012

I certify,_ A -der penalty of law, that this document and all attachments U.-_; e`prepared under my direction or supervision in accordance min 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
Signature
Date 44Z AU
and imprisonrr}ent for knowing violations."
'For questions, contact your local Regional Office:
©WO Regional office Contact Information:
W8EWVff.,LK,REGI0, NAL.fl F , �E
Erb ',E' ::AEGIONAL
i11rIQQRE9VKJ�,E'REGI0?4ALOMCE
225 Green Street
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]
if3ALEIGII REGIONAL OFMCE
IL VASIUNOTOIO itl'L'[D"KE
8i'�MiVMGTQNREGIQNAL QFMCE
3800 Barrett Drive
943 Washington Square Mall
127 Cardinal Drive Extension
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
[phone]
[phone]
jWW8'I'ON�St),LEIVIf RE,G1Q AL
lCrEiNITIRAL OMCE-
1617 Mail Service Center
Raleigh, NC 27699-1617
'ioArr+ipatti';
n
585 Waughtown Street
Winston-Salem, NC 27107
[phone]
[phone]
SW U-264-Generic-13Dec2012