NCG020235 DMR WW 20210216

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — WASTEWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCGO20000
Calendar Year a (9 (f)
'Report ALL WASTEWATER monitoring data on this form (include "No Flow f No Discharge' and Limit Violations) from
the previous calendar year to the DEQ by MARCH 1 of each year.
VFacilfty
te of Coverage No. NCGO2 00 003 0
Name: Hc�nSoy� r5csn,},�_ I�ou5CMb✓t u.g�j r)ra umber. (9t9 )3$O -A� Ll Total no. of ouNalis monitoredLaboratory BN g 6qyi; cal S, r. ; c&5 lab # 3 3 de o
�r �r " Lab # 1
Ctwrlol'iF
Wastewater (WW) Discharge Outfail No. 00
Is this an industrial sand mine (See 40 CFR §436 Subpart D)? Yes ❑ No
Does this outfall discharge W W to SA waters? Yes ❑ No IR
Does this outfall discharge WW to Se or PNA waters? Yes ❑ No
Does this outfall discharge W W to HQW or ORW waters? Yes ❑ No
H so, what is the 7070 now rate? or Tidally influenced waters, 7010 not available ❑
Does this outfali discharge W W to Trout (Tr) designated waters? Yes ❑ No
Were there any limit violatlons In the calendar year? Yes ❑ No b
Outfall No. Daily Flow pH, TSS,
Rate, cfs SU m9A
HOwaONW heanwkr u, eaa
Effluent 26/46
Limitations 50%of 6.0-8.r Hawc,oaw
7Q10 °'"""" 20130
6.8-8.6 Havwoaw
ea Aver Dfi4M&x ftil. WftOW =we.=m
aepps:"
Collected,
rV
o,l1 Il,401<2.
SS, Discharge Upstream Downstream COliform,
mul Turbidity, (U) Turbidity, (D) Turbidity, col/100 ml
sn,ss°wu,
No Limit NIA
NIA
pr.rry7mnt
aa.wbr wua
s� W�ppi NfA
50/2GI10
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015
IVFD
3 2021
�L FILE)
ECTIOPI

Certificate of Coverage No. NCG02 ❑o ®©©
Additional Outfall Attachment (make copies as needed for additional outfalls)
Wastewater (VVW) Discharge Outfall No. oc A
Is this an industrial sand mine (See 40 CFR §436 Subpart D)?
Yes ❑
No in
Does this outfail discharge WW to SA waters?
Does
Yes ❑
No pt
this outfall discharge WW to SB or PNA waters?
Does
Yes ❑
No�o)
this outfall discharge WW to HOW or ORW waters?
If
Yes ❑
No (�
so, what Is the 7010 flow rate? or Tidally Influenced waters,
7010 not available ❑
Does this outfali discharge WW to Trout (Tr) designated waters?
Yes ❑
No N
Were there any limit violations in the calendar year reported?
Yes ❑
No o
Outfall No.
Dail Flow
y
Rate, efs
pH,
TSS,
SS,
Discharge
Upstream
Downstream
Fecal
Coliform,
SU
mg/I
mill
Turbidity,
(U) Turbidity,
(D)Turbidity,
col/100 ml
"epp1AC0�
NTU
NTU
NTU
SA
Effluent
Limftatlons
How°rORW
60%of
trcMveur
6.0-9.0
ma m
25/46
HOwaORw
Now,oRw,
sA, sa PHA,
No Limit
N/A
N/A
7Q10
aHMI'�ee
a.4wehr
6.8-8.6
How0 onw
0.1/0.2
G��•
= w
sm�"m �
WA
Ya An/drj Yaa.
a0p10w
yng Trar PHA
10116
60/26✓10
Date Sample
Collected,
mo/dd/
r l
W
1,
S
u
M 9
L
13 90
p,b
d
c�,5
N A
I ! 10
0.0
<A.y
N/A
I,
Permit Date 10/1/2016 — 9/30/2020
Last Revised 10-2-2015

Certificate of coverage No. NCG02 [92Q©
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 §122.221
Signature o-t-o
Date_/IF/ao11
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