NCG140332_DMR_20200414

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year 2020
ATER monitoring data on this form (include"No Flow"/"No Discharge"and Benchmark
ec s)from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG14 0 3 3 2
Facility Name: POWELL'S READY MIX CONCRETE
County: HALIFAX
Phone Number: (252 )535-9717 Total no. of SDOs monitored 1
Certified Laboratory PACE ANALYTICAL Lab # 633
SWSG Lab# 5054
Stormwater Discharge Outfall (SDO) No. 001 VMA Outfall? Yes ❑ No ❑✓
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No ❑✓ RECEIVED
Was this outfall ever in Tier 2 during the past year? Yes ❑ No ❑✓
If this outfall was in Tier 2 last year, was monthly monitoring discontinued? APR 14 2020
Yes, enough consecutive samples below benchmarks to decrease frequency ❑ CEN I r(AL FILET
Yes, received approval from DEMLR to reduce monitoring frequency ❑ DWR SECTION
Other
Non-polar O&G
Total (EPA Method New Motor Oil
Total Rainfall, Suspended pH, 1664 Usage (gal/mo.)No. (SGT-HEM)), 9 (9 )
oo, inches Solids (TSS), SU mg/1 (VMA) If applicable
mg/I If applicable
Stormwater Circle Benchmark
Indicate NO FLOW it 100/50 6.0-9.0 15 >55 gal/mo.average requires TSS and
Benchmarks applicable Non-polar 08G monitoring
Date Sample
Collected,
mo/dd/yr
03/21/20 0.18" 335 7.67 N/A N/A
Permit Date 8/1/2017—6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG14 0 3 3 2
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
Date 04/03/20
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