NCG140242_DMR_20191112

RFCFIVED
MAR 0 2 2020
CEN l r(AL FILES
DWR SECTION
STORMWATER DISCHARGE OUTFALL(SDO)
ANNUAL SUMMARY DATA MONITORING REPORT(DMR)/SPPP Annual Update DATA REVIEW FORM
Calendar Year loll
Individual NPDES Permit No. NCS❑❑❑❑❑❑ or
Certificate of Coverage(COC)No. NCG©®❑O®®r
This monitoring report summary of the calendar year should be, kept on file on-site with the facility SPPP.
Facility Name: P1avt+ )�,v�g kjldo k
County:
Phone Number:( ) Z/-7 - ?g00 Total no.of SDOs monitored
Outfall No.
Is this outfall currently in Tier 2(monitored monthly)? Yes❑ No I^Y/
Was this outfall ever in Tier 2(monitored monthly)during the past year? Yes❑ No LV
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 fk
Parameter,(units)
Total
Rainfall,
Inches
Benchmark N/A /00/a �..-
Date Sample Y'
Collected,
mmlddlyy r
.06/ln/1 ,75`r 23
//f/ J1 -Sod 4JP 9.2
SWU-264-Generic Annual DMR
Last revised 5/02/2018

"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."
Signature 6 --
Date Z- /1 f ZoZO
For questions,contact your local Regional Office:
DWQ Regional Office Contact Information:
apor.rirY�rr if , �w
iir
LP-1 t "%Ai )
lite
-- -
ASHEVILLE
REGIONAL OFFICE FAYETTEVILLE REGIONAL OFFICE MOORESVILLE REGIONAL OFFICE--
2090 US Highway 70 225 Green Street 610 East Center Avenue/Suite 301
Swannanoa,NC 28778 Systel Building Suite 714 Mooresville,NC 28115
[phone] Fayetteville,NC 28301-5043 [phone]
— — — — [phone]
II RALEIG REGIONAL OFFICE WASHI7VGTON REGIONAL OFFICE VVILMINGTON REGIONAL OFFICE
3800 Barrett Drive 943 Washington Square Mall 127 Cardinal Drive Extension
Raleigh,NC 27609 Washington,NC 27889 Wilmington,NC 28405-2845
[phone] [phone] [phone]
WINSTON-SALEM REGIONAL OFFICE CENTRAL OFFICE
450 Hanes Mill Rd,Suite 300 1617 Mail Service Center "ropteae►v+�,pd'ect
Winston-Salem,NC 27105 Raleigh,NC 27699-1617 iS r` Xenh
`_ [phone] [phone] North Carolinas water..."
SWU-264-Generic Annual DMR
Last revised 5/02/2018

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year 0 1 O
*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 yew-.
Certificate of Coverage No. NCG 14 DO ®©® RECIFIVFO—
Facility Name: Pia,_+' I Kv t5 1r4-ci MAR 0 2 2020
County: W )<
Phone Number: ( cj i S ) all - T1 crDO CEN I rtf.�L FILES
Total no. oflS¢Rg IBINibl'4✓d 1
Certified Laboratory Pc<c e Lab#
Lab#
Stormwater Discharge Outfall(SDO) No. r VMA Outfall? Yes ❑ No Er
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No Er
Was this outfall ever in Tier 2 during the past year? Yes ❑ No Er
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 0
Other 0
Non-polar O&G
Total (EPA Method New Motor Oil
Total Rainfall, Suspended )), Usage(gal/mo.)
Outfall No. Inches p pH, 1664(SGT-HEM)),
( Solids(TSS), SU mg/I(VMA) „ate
mg/i walkable
Cede BOnclawrk
Stormwater
Indicate NO FLOWN 100/50 6.0-9.0 16 >as a•srm.avenge requires MS and
Benchmarks applicable Not►pOUrOtemw,OAnp
Date Sample
Collected,
mo/dd/ r
6 f ro/y ,?S 9.3 Al ta
ii /zhc' .50" jJ2' 2 r1 Ng
Permit Date 8/1/2017-6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG 14 non
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§122.22J
Signature f
Date 01//77A O
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&22-2015