NCG160200_MONITORING REPORT_20201116

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR) / SPPP Annual Update DATA REVIEW FORM
Calendar Year ;ih
Individual NPDES Permit No. N
Certificate of Coverage (COC) No. N
Call
This monitoring report summary of the calendar year should be kept on file on -site with the facility SPPP.
Facility Na ne'. F4i P? -we _ w cJ(a� loJ SE
County:
Phone Number: (�ilxi) S�3� Total no. of SDOs monitored
Outfall No.
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No)�
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No x
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 DEMLR to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No
Parameter, (units)
Total
Rainfall,
inches
q-
L ,v��
f 1
Benchmark
N/A
i Off,
Date Sample
Collected,
mm/dd/y
ovvu-Lo4 - uenenG Nnnual uivim
Last revised 61062018

Additional Outfall Attachment
Outfall No.
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ Nog
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No%
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 DEMLR to reduce monitoring frequency ❑
Other ❑ ��,{
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No L�
Parameter, (units)
Total
Rainfall,
inches
�Sc)
gN°�
Benchmark
N/A
ADO
Date Sample
Collected,
mm/dd/yy
NO rt4>.j
l 7
SWU-264 - Generic Annual DMR
Last revised 8/06/2018

" 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."
Date
For questions, contact your local Regional Office:
DEMLR Regional Office Contact Information:
ASHEVILLE REGIONAL OFFICE
2090 US Highway 70
Swannanoa, NC 28778
[phone]
RALEIGH REGIONAL OFFICE
3800 Barrett Drive
Raleigh, NC 27609
[phone]
WINSTON-SALENIREGIONAL OFFICE.
450 Hanes Mill Rd, Suite 300
Winston-Salem, NC 27105
[phone]
w inston.SaIem
~y
Rolcigh
w wlhmcton
FAYETTEVILLE REGIONAL OFFICE
225 Green Street
Systel Building Suite 714
Fayetteville, NC 28301-5043
[phone]
WASHINGTON REGIONAL OFFICE
943 Washington Square Mall
Washington, NC 27889
[phone]
CENTRAL OFFICE
1617 Mail Service Center
Raleigh, NC 27699-1617
[phone]
MOORESVILLE REGIONAL OFFICE
610 East Center Avenue/Suite 301
Mooresville, NC 28115
[phone]
WILMINGTON REGIONAL OFFICE
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
[phone]
SWU-264 - Generic Annual DMR
Last revised 81062018