NCG020022_DMR_20210301 (1)

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year ;40 O_
"Report ALL STORMWATER monitoring data on this form (include "No Flow"I"No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG02®®®
FacilityName: L/ n.rJ Cr b i I'+ ✓� i Jt ��� �)— L <—
County: Mbo (L�i
Phone Number: (ALP) 9qV - A"6 Total no. of SDOs monitored y _
Certified Laboratory �tc mCft�.-\ TeSfi^q Lab # 69- L/
Lab #
Stormwater Discharge Outfall (SDO) No.56'L VMA Outfall?
Yes ❑ NOK
Is this outfall currently in Tier 2 for any parameter?
Yes ❑ No 01,
Was this outfall ever in Tier 2 during the past year?
Yes ❑ Nokl�
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
❑
No, turbidity benchmark exceedances did not require monthly monitoring
❑
Other
❑
�
•
.fir
-
.. .
MO M
N ME
I mla
Fes- r�C�7L��
� • +
�_-���
Permit Date 10/1/2015-9/30/2020 CENTRALFILc.
DWR SECTIOi
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 0[][E®5,
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. VMA Outfall?
Yes ❑
No
Is this outfall currently in Tier 2 for any parameter?
Yes ❑
N04-
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?
Yes, enough consecutive samples below benchmarks to decrease frequency
❑
Yes, received approval from DEMLR to reduce monitoring frequency
❑
No, turbidity benchmark exceedenoes did not require monthly monitoring
❑
Other
❑
Ou fall No.
Total
Rainfall,
inches
TSS,
mg/I,
SS,
ml/I
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
l mg/1
(VMA)
New
MotorOil
Usage
ailmo.
Stormwater
Benchmarks
Indl<xlo NO
FLOV'Ir
oDl<
""'°
Bonchmerk
100/50
0.1
G"'0
BoncM1merk
50/25/10
N!A
standard applies
N!A
standard eoouas
15
'55pa°m.
avar... rOpulms
TO&Gm n<t Pnlef
Date Sample
molddlyr
�,
livo ROW
F .,t.
sx{f
:n-�
u}:;l,
a�
ii,
x- O
o• a
+o
O,/
O
•
- o
111
Lodoo
O
we ow
+
•00
5
I
•0 '�t'
.3
e•100
0
oirloly
-2JV0
F10w
-D
Net, Flow
0-a.o
NOFIcd
,-
00
1171
p
0 P100
Permit Date 10MI2015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ❑O©©
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. II p< 6-,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
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 ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑
Other ❑
..
..
a ..
...
.. o
�=Roomr
r
®
'.•.'..;
M" IM41'!
n, R*,
VTMM��������
r
Permit Date 10/1 /2015 — 9130/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ®01;[a].
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 CPR §122.22]
Signature
Date o3•o�-z1
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 10/112015 — 9/30/2020
Last Revised 10-2-2015