NCG060101_DMR_20210204

2/Z/2021
New Submission
Stormwater NPDES Permit Data Monitoring Report
(DMR) Upload
Permit and Facility Information:
Please enter the permit number and other details for this upload.
NC Department of
Environmental Quality
Received
FEB 0 4 2021
Winston-Salem
Regional Office
IMPORTANT.- Until the eDMR system is implemented for DEMLR Stormwater Program permits, an original
signed hardcopy of the DMR MUST be mailed to the address in your permit, in addition to this electronic
upload.
Fields marked with a red asterisk* are required.
Permit Number* Enter COC or Individual Permit Number
CCGO60101
Must begin with NCS or NCG
Facility Name:* DyStar LP
County: * Rockingham
After uploading here, the original signed hardcopy must be mailed to:
DEQ Winston-Salem Regional Office
Attn: DEMLR Stormwater Program
450 West Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
Further contact details at https://deq.nc.gov/contact/regional-offices/winston-
salem (https://deq.nc.gov/contact/regional-offices/winston-salem)
Monitoring Period Information:
Monitoring Period What is the YEAR of the sample date(s)?
Year:* 12020
Multiple DMRs from sampling periods within the same year can be uploaded together, but please upload different
years with a new submittal form.
https://cdoes.deq.ne.gov[Forms/SW-DMR 0

2/2/2021
New Submission
DMR Upload* Click the upload button or drag and drop files here to attach document.
Upload
Annual Stormwater Inspection 12 13 20.pdf (/For... 309.28KB X
2020 DMR DyStar LP Reidsville.pdf (/Forms/han... 984.62KB X
Only PDFs are accepted.
Comments:
Annual Summary Data Monitoring Report (DMR) for 2020. Also included is the
Dnsite inspection report.
* ® By checking the box and signing box below, I certify that:
o I have given true, accurate, and complete information on this form;
agree that submission of this Data Monitoring Report (DMR) upload form is a "transaction" subject to Chapter 66,
Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
o I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General
Statutes (the "Uniform Electronic Transactions Act");
• I understand that an electronic signature on this upload form has the same legal effect and can be enforced in the
same way as a written signature; AND
• I intend to electronically sign and submit this DMR upload form.
Full Name: * Charlie Stroman III
Name of person submitting this form
Email Address: * [e-mail]
Phone Number:* 3363426631
Signature: * X
Date: * Date captured on form submission
I'm not a robot
reCAPTCHA
Privacy - Terms
Submit Save as Draft
littps://edocs.deq.nc.gov/Forms/SW-DMR 2/3

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR) / SPPP Annual Update DATA REVIEW FORM
Calendar Year 2.020
Individual NPDES Permit No.
Certificate of Coverage (COC) No.
or
This monitoring reportsummary of the calendar year should be kept on file on -site with the facility SPPP.
Facility Name: DyStar LP
County: Rockingham
Phone Number: 3( 36 ) 342-6631 Total no. of SDOs monitored
Outfall No. 001
Is this ouffall currently in Tier 2 (monitored monthly)?
Yes ❑ No nN
Was this outfall ever in Tier 2 (monitored monthly) during the past year?
Yes ❑ No M
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 DWO to reduce monitoring frequency
❑
Other
❑
Was this SDO monitored because of vehicle maintenance activities?
Yes ❑ NOR
Parameter, (units)
Total
Rainfall,
inches
TSSmg/L
pH
COD mg/L
Oil & Grease
mglL
Benchmark
N/A
100 or 50
6.0 to 9.0
120
30
Date Sample
Collected,
mm/ddlyy
08/31/20
0.5
18.7
6.97
113
5
12/14/20
0.95
14.3
6.9
25.2
<5
SWU-264 - Generic Annual DMR
Lastmmed5wa 18

Additional Outfall Attachment
Outfall No.
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 ❑
Total
Rainfall,
Inches
N/A
Date Sample
Collected,
SWU-264 - Generic Annual DMR
Last revised Y022016

"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 02/02/21
For questions, contact your local Regional Office:
DWO Regional Office Contact Information:
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Raleigh
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ASHEVILLE REGIONAL OFFICE
2090 US Highway 70
Swannanoa, NC 28778
[phone]
RALEIGH REGIONAL OFFICE
3900 Barrett Drive
Raleigh, NC 27609
[phone]
WINSTONSALEM REGIONAL OFFICE
450 Hanes Mill Rd, Suite 300
Winston-Salem, NC 27105
[phone]
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FAYETTEVILLE REGIONAL OFFICE
225 Green Street
Systel Building Suite 714
Fayetteville, NC 28301-5043
[phone]
WASHINGTON REGIONAL OFFICE
943 Washington Square Mall
Washington, NC 27889
[phone]
CENTRAL OFFICE
1617 Mail Service Center
Raleigh, NC 27699-1617
[phone]
s
MOORESVILLE REGIONAL OFFICE
610 East Center Avenue/Suite 301
Mooresville, NC 28115
[phone]
W ILMINGTON REGIONAL OFFICE
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
[phone]
������ To preserve, prolect
( and enhance
Noah Cardina's water_."
SWU-264 - Generic Annual DMR
Last revise 5VZW18