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ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — WASTEWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year 2019
*Report ALL WASTEWATER monitoring data on this form (include "No Flow'/"No Discharge" and Limit Violations)from
the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG14 0 4 3 7
Facility Name: Mebane
County: Orange
Phone Number: (336 )996-2841 Total no. of outfalls monitored 1
Certified Laboratory Lab#
Lab#
Wastewater (WW) Discharge Outfall No. 001
Does this outfall discharge WW to SA waters? Yes ❑ No ❑✓
Does this outfall discharge WW to SB or PNA waters? Yes ❑ No ❑✓
Does this outfall discharge WW to HQW or ORW waters? Yes ❑ No 0
If so, what is the 7Q10 flow rate? or Tidally influenced waters, 7Q10 not available ❑
Does this outfall discharge WW to Trout(Tr) designated waters? Yes ❑ No ❑✓
Were there any limit violations in the calendar year? Yes El No 0
Outfall No. Daily Flow Rate, pH, TSS, SS, Non-Polar O&G (EPA Method 1664
oo, cfs SU mg/I mill (SGT-HEM)), mg/I
if applicable
Standard
HQW or ORW freshwater 30 HQW,ORW,SA,
Effluent 50% of 7Q10 6.0-9.0 HQW SB,PNA,orany No Limit
Limitations 20 Trout
Indicate NO FLOW if saltwater Samples above Benchmark
6.8-8.5 RP
applicable HQW/O and Tr,or 5 subject to Tiered Responses WNA Daily Maximum 15
10
Date
Sample
Collected,
mo/dd/yr
3/25/19 001 7.1 6.4 <0 1 SM 2540 0-1997
6/28/2019 NO FLOW _
9/27/2019 NO FLOW REC D
\1
12/18/2019 NO FLOW APR 16 '6a
OWP sc CT10^;
Permit Date 8/1/2017—6/30/2022
Last Revised 8-22-2017
Certificate of Coverage No. NCG14 0 4 3 7
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, cluding the possibility of fines and imprisonment for knowing violations."
[Required by 40 CFR 122.22]
Signature
Date /3/2cz6
Mail Annual Summary Wastewater 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 (919) 807-6300
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
(919) 707-9220
Permit Date 8/1/2017—6/30/2022
Last Revised 8-22-2017