NCG140129_DMR_20191016

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE* II
General Permit No. NCG140000
Calendar Year Tat q
*Report ALL STORMWATER monitoring data on this form (include No Flow"t'No Discharge"and Benchmark
Exceedances)from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG14 DIME
Facility Name: !fit 65- Aux -li3
County: 1)%04I11.104
Phone Number: ( GI(01) S Lit{—1 L? Total no. of SDOs monitored 7--
Certified Laboratory Lab# 3
Lab#
Stormwater Discharge Outfall (SDO) No. I VMA Outfall? Yes❑ No1
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 E.
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 ❑
Other ❑
Non-polar O&G
Total (EPA Method New Motor Oil
Total Rainfall, Suspended pH, 1664(SGT-HEM)), Usage al/mo.
Outfall No. g (game.)
Inches Solids(TSS), SU mg/1(VMA) If applicable
mg/I
Stormwater Indicate
Benchmark
Mdicate no Flower 100/50 6.0-9.0 15 >66 oau MSnw.avenge requires s and
Benchmarks applicable Non-polar 01G°on ng
Date Sample
Collected,
mo/dd/ r
Ia I itI lei e 5 D vo 'L 2 RECEIVED
MA3 0 2 2020
(.:I,N ► AL i-ILtS
DWP SECTION
Permit Date 8/1/2017—6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG 14 :Dual
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall(SDO) No. - VMA Duffel'? Yes ❑ No[>1
Is this outfall currently in Tier 2 for any parameter? Yes 0 No j2
Was this outfall ever In Tler 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 0
Yes,received approval from DEMLR to reduce monitoring frequency ❑
Other 0
Non-polar O&G
Total (EPA Method New Motor Oil
Outfall No. Total Rainfall, Suspended pH, 1664(SGT-HEM)), Usage(gal/mo.)
inches Solids(TSS), SU mg/I(VMA) y
mg/I x, able applicable
Stormwater circle Benchmark
Indicate NO Frown 100/50 6.0-9.0 15 '66 oaWmo.average requires TIS and
Benchmarks applicable Hon-poler014Gmonllonng
Date Sample
Collected,
mo/dd/ r �y
14431L4 h.0 Pou
Permit Date 8/1/2017—6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG 14 []000
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 oy ki
Date ) 2n
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