NCG140138 DMR WW 20210311

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — WASTEWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year
'Report ALL WASTEWATER monitoring data on this form (include "No Flow"PNo Discharge" and Limit Violations) from
the Drevious calendar vear to the DEQ by MARCH 1 of each vear.
Certificate of Coverage No. NCG140138 ° _
Facility Name: Greystone Concrete Products, Inc. MAR 15 2021
County: Vance CENTRAL FILE;_
Phone Number: 252-438-5144 Total no. of outfalls monitored DWR SECTION
Certified Laboratory %� AG/7 G Lab#
Lab #
Wastewater (WW) Discharge Outfall No. 00 /
Does this outfall discharge WW to SA waters?
Yes ❑
No
Does this outfall discharge WW to SB or PNA waters?
Yes ❑
No
Does this outfall discharge WW to HQW or ORW waters?
Yes ❑
No
If so, what is the 7Q10 flow rate? or Tidally influenced waters,
7Q10 not available ❑
Does this outfall discharge WW to Trout (Tr) designated waters?
Yes ❑
No ❑
Were there any limit violations in the calendar year?
Yes ❑
No ❑
Outfall No.
Daily Flow Rate,
cfs
pH,
SLI
TSS,
mg/I
SS,
ml/I
7/applicable
Non -Polar O&G (EPA Method
1664 (SGT-HEM)), mg/l
Effluent
Limitations
Qally Maximum
HOW or ORW
50% of 7Q10
Indlca(e NOPLOWff
applicable
er
C6O!9;.0
saitvrater
6.8 $ 5
Stand
3U
xow
20
HQW10RNan Tr,or
PA
10
HQW, ORW, SA, SB, PNA,
or aprr oat
5
No Limit
Samples above Benchmark
subject to Tiered Responses
15
Date
Sample
Collected,
mo/dd/yr
Not Applicable
for Greystone
Not Applicable
for Grey=tone
r7
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2017

Certificate of Coverage No. N CG 140138
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.
Signature
Date
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
,..� A_ ttn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
P�
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2017