NCG140136_DMR_20210302

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR) / SPPP Annual Update DATA REVIEW FORM
Calendar Year Ze zo
Individual NPDES Permit No. NCS❑❑❑❑❑❑ or
Certificate of Coverage (COC) No. NCG©Q 0❑©©®
This monitoring report summary of the calendar year should be kept on File on -site with the facility SPPP.
Facility Name: lk POL14
County: W 0.4
Phone Number: _IL_) I b 7 - 85L Total no. of SDOs monitored
Outfall No. I
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? REC EI\117_�
Enough consecutive samples below benchmarks to decrease frequency ❑ MAR S 2�21
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑ CENTR/\L
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No ■❑
ow
R S[GT!OC!
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
srzsl�e
, f
n 4
SW U-264 - Generic Annual DMR
Last revised 5/02/2018

Additional Outfall Attachment
Outfall No. Z�
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No [�j
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 N
Parameter, (units)
Total
Rainfall,
inches
�.}al Sod
s el tc I
p µ
Benchmark
N/A
loo(ea
6 .o -1.0
Date Sample
Collected,
mmlddlyy
511V0 U70
S
17.(oCl
11-7 2n
SWU-264 - Generic Annual DMR
Last revised 5/02/2018

"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."
Signature
Date
IVAI -
For questions, contact your local Regional Office:
DWQ Regional Office Contact Information:
ASHEVILLE REGIONAL OF.
2090 US Highway 70
Swannanoa, NC 28778
[phone]
RALEIGH REGIONAL OF
3800 Barrett Drive
Raleigh, NC 27609
[phone]
STUN-SALEM REGIONAL OFFICE
450 Hanes Mill Rd, Suite 300
Winston-Salem, NC 27105
[phone]
FAYETTEVILLE REGIONAL OF
225 Green Street
Systel Building Suite 714
Fayetteville, NC 28301-5043
[phone]
6HINGTON REGIONAL OFFICE
943 Washington Square Mall
Washington, NC 27889
[phone]
1617 Mail Service Center
Raleigh, NC 27699-1617
[phone]
40ORESVILLE REGIONAL OFFICE
610 East Center Avenue/Suite 301
Mooresville, NC 28115
[phone]
WILMINGTON REGIONAL OFFI4
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
[phone]
"ro preserve, Protect
and enhance
North CardinaS water..."
SW U-264 - Generic Annual DMR
Last revised 5/02/2018