NCG020248_2021 DMR_20220121

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) -- STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No, NCG020000
Calendar Year a b5 ;L \
'Report ALL STORMWATER monitoring data on this form (include "No Flow" I" No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG02 ®®5®
Facility Name:
County: 1A `i w vn O
Phone Number: X1 ) 5 ak 54 55 Total no. of SDOs monitored
Certified Laboratory P P,C"G Lab # 40
Lab #
Stormwater Discharge Outfall (SDO) No. Ott 1 VMA Outfall? Yes ❑ No [.7�
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No [v(
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 ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑
Other ❑
Upstream Downstream New
Outfall No. Total TSS, SS, Turbidity, (U) Turbidity, (D) Turbidity, Non -polar Motor Oil
Rainfall, mgll mlll NTU NTU NTU O&G, mgll Usage
inches (VMA) (oallmo.)
Stormwater
JndfcaleNO
nchm
Benchma
C1Ce
Benchmark
NIA
NIA
'°° a requires
averdgerequlrea
Benchmarks
FLown
applkable
144!
0.1
501251S
standard eppl[es
aLerQuallty
Standard applies
15
olar
T0&0monitorSS and ing
Date Sample
Collected,
moldd! r
(n/teaja►
('}.Cn
G�.S
L0.I
LI•O
A/[A
NiA
111f/�
N._1�
Dee,
Ca. 5 I Z-0. l 1 1.
Permit Date 101112015 — 9/30/2020
Last Revised 10-2-2015
_�,K Com-(TZO ,LlaC�� v 71P�

Certificate of Coverage No. N0002 ❑O ®4❑®
Additional Outfall Attachment (make copies as needed for additional ouifalls)
Stormwater Discharge Outfall (SDO) No. 00(o VMA Outfall?
Yes ❑
No [v�
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
❑
No, turbidity benchmark exceedances did not require monthly monitoring
❑
Other
❑
Upstream
Downstream
New
Total
TSS,
SS,
Turbidity,
(U) Turbidity,
(D) Turbidity,
Non -polar
Motor Oil
Outfall No.
Rainfall,
mgll
mill
NTU
NTU
NTU
O&G, mg/1
Usage
Inches
(VMA)(gal/Mo.)
Sformwvater
rndleale No
Circle
Benchmark
Circle
nchmark
NIA
NIA
>66 galrmo.
average requires
Benchmarks
FLOWif
applicable
100/ f�
�C�
0.
Standard applies
Standard appliWater es
`5
TSS and O&G monitoring
Date Sample
Collected,
L60/26&
molddlyr
:n.
'
Wg'g' a I.
&
L,2. S
LD , 1
1.0
01A
N A
N A
5 I/ -
Permit Date 101112015 — 9/3012020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ❑O ®©®
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. OQ3_ VMA Outfall? Yes ❑ No L4
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 ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑
Other ❑
Upstream Downstream New
Outfall No. Total TSS, SS, Turbidity, (U) Turbidity, (D) Turbidity, Non -polar Motor Oil
Rainfall, mgll mill NTU NTU NTU O&G, mgll Usage
DD inches (VMA) (gal/Mo.)
Stormwater
Benchmarks
IndiraleNO
aF1 k8b
Benchmark
100,�
0.1
Senchma
501251�
Date Sample
Collected,
molddl r
A ttl Jv rN IIV
n Ft
NIA
N/A
>aa gaumo.
average requires
Water Quality
WaterQuallty
1
TSS and Non -polar
Standard applies
Standard applies
v
0&0 monitoring
r
4 I tlaI T i.3 ILa. S IZ-o.1 1 I.to 1 A[A I N1A I A)1k I MfA
Permit Date 10/112015--913012020
Last Revised 10-2-2015
C6tv-S�0t,t�ji;:- 1_F LF�S�

Certificate of Coverage No. N0002 ❑8 ®❑4
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 §122.22)
Signature
Date 1 /ao �a
Mail Annual Summary Stormwater 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 Cate 101112016--9130/2020
Last Revised 10-2-2015