NCG140074_DMR_20191118

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE* m
General Permit No. NCG140000
Calendar Year Zo I et
*Report ALL STORMWATER monitoring data on this form (include'No Flow"PNo Discharge"and Benchmark
Exceedances)from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG 14 FUNK
Facility Name: yl + S &GS a
County:
Phone Number: ( 't 15 ) y)'8 Total no. of SDOs monitored I
Certified Laboratory ce.c e Lab#
Lab#
Stormwater Discharge Outfall(SDO) No. I 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 Br RECEIVED
If this outfall was In Tier 2 last year, was monthly monitoring discontinued? MAR 0 2 2020
Yes,enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑ GEN I r[ML. FILES
Other 0 DWR SECTION
Non-polar O&G
Total (EPA Method New Motor Oil
Total Rainfall g
Outfall No. Inches Suspended pH, 1664(SGT-HEM)), Usage(gal/mo.)
Solids(TSS), SU mg/I(VMA) "applicable
mgll if applicable
Circle Benchmark
Stormwater
indleale No FLowu 100/50 6.0-9.0 15 >es g+umo.average requires TSB end
Benchmarks applicable Non-polarO&O monitoring
Date Sample
Collected,
mo/dd/yr
D l9//o/;g ' 251` 413,7 7 Af A to A
lJll811, , �� n1 D 6,7 NA fa>Q
Permit Date 8/1/2017—6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG1 4 nQO4
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 ,2._____PL
Date zjj.7/zo
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 8/1/2017—6/30/2022
Last Revised 8-22-2015