NCG140138 DMR SW 20210311

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year ;L220
*Report ALL STORMWATER monitoring data on this form (include "No FloyVTNo Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. N CG 140138
Facility Name: Grevstone Concrete Products, Inc.
County: Vance
Phone Number: 252-438-5144 Total no. of SDOs monitored
Certified -Laboratory - V��_ Lab #
Lab #
Stormwater Discharge Outfall (SDO) No. VMA Outfall? Yes ❑ No
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 ❑
Other ❑
Non -polar O&G
Total (EPA Method New Motor Oil
Total Rainfall, Suspended pH, 1664 SGT-HEM , Usage (gallmo.)
690 Ouifall No. inches ( ))
Solids (TSS), SU mg/I (VMA) If applicable
mall If applicable
Stormwater cr ncnMarK
lndiaare nto Ftow if 1 � � 6.0-9.0 15 >ss gatlmo. average regolres rss and
Benchmarks applicable Non -polar O&G rnonitoring
Date Sample
Collected,
mo/dd/yr
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2015

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year k ;�2
*Report ALL STORMWATER monitoring data on this form (include "No Flow"/"No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG140138
Facility Name: Greystone Concrete Products, Inc.
County: Vance
Phone Number: 252-438-5144 Total no. of SDOs monitored
Certified Laboratory %✓ Lab #-
Lab #
Stormwater Discharge Outfall (SDO) No. VMA Outfall? Yes ❑ No14
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No W
Was this outfall ever in Tier 2 during the past year? Yes ❑ No Pj
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 ❑
Other ❑
Non -polar O&G
Total
(EPA Method
New Motor Oil
Outfall No.
Total Rainfall,
Suspended
pH,
1664 (SGT-HEM)),
Usage (gal/mo.)
inches
Solids TSS
( ),
SU
mgll (VMA)
If applicable
m g/1
If applicable
Stormwater
Indicate NO FLOW IF
ci chmark
10 0
6.0-90
.
15
>55 gaUmo. average requires TSS and
Benchmarks
applicable
Non -polar O&G monitoring
Date Sample
�- N; a
.n r
.
Collected
7-:
moldd/yr
Permit Date 8/1 /2017 — 6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG140138
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 §122.22]
Signature
Date -F,
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 81112017 — 6/30/2022
Last Revised 8-22-2017