NCG020235 DMR SW 20210216

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — S70RMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year aoa
ALL STORMWATER monitoring data on this form (include 'No Flow"PNo Discharge' and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each veer.
Certificate of Coverage No. NC602
Facility Name: (in5DY1 AgCCOgo.'Se5-. Rmuo�emor)- Q�Uarq
County. 'Du.r hra,m /rl2r onu,,
Phone Number. 19 3 an- as y cam_ Total no. of SgOs monitored 3
Certified Laboratory pdee A„a .h;v ieS �l 6& clab #
v Lab# Ia,.0L,.. LWv
Stormwater Discharge Outfall (SDO) No. _J_ VMA Outfall? Yes ❑ No,J
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 exceedanoss did not require monthly monitoring ❑
Other
Outfall No. I Total I Tg , I SS, I Turbi
5 0o- Rainfall, m /1 ml/I NTU
Inches
100/50 L 0.1 1 50/2W10
Upstream Downstream
(U) Turbidity, (D) Turbidity, Non -polar
NTU NTU O&G, mg/i
(VMA)
Permit Date 10/1/2015 — 9/30/2020
Lasl Revised 10-2-2015
It
New
Motor Oil
Usage

Certificate of Coverage No. N0002 Kj®®ffj
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SS-0) No. 1-4_ VMA Outrall? Yes ❑ No
Is this outfall currently In Tier 2 for any parameter?
Was this outfall ever in Tier 2 duringthe past Yes ❑ No
p 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 exceedanoes did not require monthly monitoring ❑
Other
Upstream
Ouffall No. Total TSS, Spo--� IR in sl,I mg I mill I
Tu�1ty,l(U) NTUd1ty,
Collected,
0-1 1 50/25/10
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015
Downstream
New
(D) Turbidity,
Non -polar
Motor Oil
NTU
O&G, mg/l
Usage
(�1HA)
aymo.
N/A
> 6w
Shn�EaNOe�
16
own
i35 a. No"-p aar
ow monHor
N/h!
� s r

Certificate of Coverage No. NCG02 ❑O 5]E ❑5
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. 3 VMA Outfall? Yes ❑ No
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No rR
Was this outfall ever in Tier 2 during the past year? Yes ❑ No 14
If this otttfalI was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval tom DEMLR to reduce monitoring frequency ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑
Other ❑
:rr r
r
r r
Permit Date 101112015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 O 1®13 05
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 --=/I6/ op k (
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 10/1/2015 — 9/30/2020
Last Revised 10-2-2015