NCG020244_2021 DMR_20220121

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) —STORMWATER
SUBMIT TO CENTRAL OFFICE"
General Permit No. NCG020000
Calendar Year aoaI
'Report ALL STORMWATER monitoring data on this form (include "No Flow"r'No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. N0002
Facility Name: A A-(F L-C. Q.VASZ2
County: Ct:, A�
Phone Number: ( q22 ;A 5455 Total no. of SDOs monitored _3
Certified Laboratory L r Lab # 4o
Lab #
Stormwater Discharge Outfall (SDO) No. _00 VMA Outfall? Yes ❑ No d
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No o
Was this outfall ever in Tier 2 during the past year? Yes ❑ Nod
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
mlll
NTU
NTU
NTU
O&G, mgll
Usage
--��L
inches
(VMA)
allmo.
Stormwater
rndlcafeNO
BeCircle
nchmark
Circle
Benchmark
NIA
NIA
>56gaUmo.
average requires
Benchmarks
Ftowif
a xebre
DU U
0.1
( 2619 0
Standard appll s
ale r Quality
Standard applies
15
lar
To30 monitoringSS and o
Date Sample
Collected,
moldd! r
W:Lala!
40.0
c Q ti
41
/0A
NIA
AJA
IV A
1 t a%
t.
,-0-1
ti. a
NiA
NJ
�
DG , --S)c e
N o Fuw
Permit Date 10/1/2016 — 9/30/2020
Last Revised10-2-2015
'VIA SK3•MALIZ

Certificate of Coverage No. NCG02 U®00
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. oo a VMA Outfall? Yes ❑ No El
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.
Od a
Rainfall,
mgll
mill
NTU
NTU
NTU
O&G, mgll
Usage
Inches
(VMA)
allmo.
Stormwater
lndlcateNO
Circle
B-inAmark
Cfrcle
Benchmadt
NIA
NIA
>65 gatlmo.
average requires
Benchmarks
FLOWNWaterQuallty
applicable
�'
�2511 Q
Slandard applies
WaterQuallty
Standard applles
15
TSS andNon.polar
0&0 monftodn
Date Sample
`
Collected,
'
molddl r
Co!'aaIa
0.r..:
a9.4 1
40.1
7
NIA,
NrA
N/A
Q_
- bFc I ft Fc.wv
ff#MW���
Permit Date 10/1/2016 - 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No.
NCG02 ❑a ®©©
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. VMA Outfall? Yes ❑
Is this outfall currently in Tier 2 for any parameter? Yes ❑
Was this outfall ever in Tier 2 during the past year? Yes ❑
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
NJ
No 1�
No E9
No L;�
Outfall No.
Total
Rainfall,
Inches
TSS,
mgll
SS,
mill
i(VMA)(gal/Mo.)
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mgli
New
Motor Oil
Usage
Stormwater
Benchmarks
Indicate
OWfflar
yFlkeble
Circle
Benchmark
DO O
0.1
circle
Benchmark
(R25110
N/A
Standard applialerQualltes
NIA
Water Qualit
Standard applies
15
>56 gallmo.
average requires
monitoring
�0&0m nSS and riing
Date Sample
Collected,
molddl r
Cp/aa 3.1
Q.
4.
40, 1
6
n1 A
/\)/A
AJIA
Q ( I l a
1. 3
1
1
N A
A) A
A) A
N Pc
OC.' — TDae
o Y
Permit Date 10/1/2015 — 9/3012020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 U(M-4 ❑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 t )
Mall 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 Date 10/112015 — 9/30/2020
Last Revised 10-2-2015