NCG020124_DMR WW_20210216

ANNUAL SUMMARY DISCHARGE MONITORING
14
- WASTEWATER
11 SUBMIT TO CENTRAL OFFICE* 11
General Permit No. NCG020000
Calendar Year ci. OaD
'Report ALL WASTEWATER monitoring data on this form (include "No Flow/"No Discharge" and Limit Violations) from
f the previous calendar year to the DEQ by MARCH 1 ofeach year.
Certificate of Coverage No. NCG02
Facility Name:
County: _
�I V1ce�-0n][:Quac'f
Phone Number. (119 ) 380 -Al y r Total no. of outfalls monitored
Certified Laboratory Tp 0 nal yti cal Se r i ceS tab # Qde✓�
` ' Lab# a
Wastewater (WW) Discharge Outfall No. ®®
Is this an industrial sand mine (See 40 CFR §436 Subpart 0)? Yes ❑ No C3
Does this outfall discharge WW to SA waters? Yes ❑ No 154
Does this outfall discharge WW to S8 or PNA waters? Yes ❑ No
Does this outfall discharge WW to HQW or ORW waters? Yes ❑ No�
If so, what is the 7Q70 flow rate? or Tidally influenced waters, 7010 not available ❑
Does this outfall discharge WW to Trout (Tr) designated waters? Yes ❑ NorR
Were there any limit violations In the calendar year? Yes ❑ No
outfall No.
Daily Flow
pH,
TSS,
SS,
Discharge
Upstream
Downstream
Fecal
Coliform,
©o� I
Rate, cis
SU
mg/l
mUl
Turbidity,
(U) Turbidity,
(D) Turbidity,
col/100 mi
"°'pMca°°
NTU
NTU
NTU
SA
Effluent
XGW .rORW
60°/,of
tr°ahunor
w 9a
26/46
xoworoRW
H,,W.oxw,
sass,
No Limit
N/A
N/A
Limitations
7Q70
eidnK'
faft9r
20130
rXa,
way
L
WA
6.8-8.6
Xow.rMW
0.1/0°•'
0.1/0.2
f, rd
"Ma
9w4fidapp
'^^"•
s d• d• 404
x..nveioaiyxu
mdmanNoriow
"nwr<mw
ngTforPM
10116
60/25/10
Date Sample
Collected,
mold r
u
1
�
r
03/ o a
o.
'70
16,a
o.ln
39,E
11.3
19.1
N/A
o Ro 1�
1. 11
9.
I1.0
N/A
G
14.IR I
N/A}
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. N0002 0O91©
CERTIFICATION
"1 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 § 122.221
Signs
Date
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 [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015