NCG140129_DMR_20210302

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR) / SPPP Annual Update DATA REVIEW FORM
Calendar Year L o z o
Individual NPDES Permit No.
Certificate of Coverage (COC) No.
or
This monitoring report summary of the calendar year should be kept on file on -site with the facility SPPP.
Facility Name:
County: Dj,;
Phone Number:
Total no. of SDOs monitored 1
Outfall No. i
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No W
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No W
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 DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No ❑■
REcOVEC,
MAR U 6 Z021
.'CP1TfV\L FR.E:_�
DTIR SLCTION
Parameter, (units)
Total
Rainfall,
inches
Total
Suspended
Solids MG/L
PH
Benchmark
N/A
100/50
6.0-9.0
Date Sample
Collected,
mm/ddlyy
b 2Uzc
SW U-264 - Generic Annual DMR
Last revised 5102/2018

Additional Outfall Attachment
Outfall No. Z
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
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 DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No 5j
Parameter, (units)
Total
Rainfall,
inches
Benchmark
N/A
iro 5 v
6 D - °'r.0
Date Sample
Collected,
mmlddlyy
L-40
.So
Al,, FLO,,)
nl A
SW U-264 - Generic Annual DMR
Last revised 510212018

"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."
Signature
Date __3/
For questions, contact your local Regional Office:
DWQ Regional Office Contact Information:
ASHEVILLE REGIONAL OFFICE
2090 US Highway 70
Swannanoa, NC 28778
[phone]
AGH REGIONAL OI
3800 Barrett Drive
Raleigh, NC 27609
[phone]
450 Hanes Mill Rd, Suite 300
Winston-Salem, NC 27105
FAYETTE VILLE REGIONAL, OFF:
225 Green Street
Systel Building Suite 714
Fayetteville, NC 28301-5043
[phone]
WASIIINGTON REGIONAL OFFI
943 Washington Square Mall
Washington, NC 27889
[phone]
1617 Mail Service Center
Raleigh, NC 27699-1617
[phone]
V100RESVILLE REGIONAL OFFICI
610 East Center Avenue/Suite 301
Mooresville, NC 28115
[phone]
WILMINGTON REGIONAL OFFII
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
[phone]
7o preserve, protect
and enhance
North Carolina%, water...
SW U-264 - Generic Annual DMR
Last revised 510212018