NCG140075_2021 DMR_20220221

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR) / SPPP Annual Update DATA REVIEW FORM
Calendar Year Z o 7,1
Individual NPDES Permit No. NCS❑❑❑❑❑❑ or
Certificate of Coverage (COC) No. NCG©Q❑©Q®
This monitoring report summary of the calendar year should be kept on file on -site with the facility SPPP.
Facility Name: C A Q.l I
County: h}# M
Phone Number: ( I i q ) 4& 1
C:�3
41)
Total no. of SDOs monitored
Outfall No. (
Is this outfall currently in Tier 2 (monitored monthly)?
Was this outfall ever In Tier 2 (monitored monthly) during the past year?
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 ET
Yes ❑ No [�
Yes❑ No13"'
Parameter, units
Total
Rainfall,
inches
-Irs 5
rti1 [r
Benchmark
N/A
IC6 r46-1 ,
Date Sample
Collected,I—
mmiddiyy
I
-
— f
_
Z Iz
-7 1'b tl
i 1 5
6 .o "if
bVVv-[04 - uenenu nnnuai urvu%
Last revised 510212018

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 ❑
Paiametei, (units)
Total
Rainfall,
inches
Benchmark N/A
Date Sample
Collected,
mmlddfyy
SWU-264 - Generic Annual DMR
Last revised 5102/2018

"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 2 /7144
For questions, contact your local Regional Office:
DWQ Regional Office Contact Information:
is-L
2090 US Highway 70
Swannanoa, NC 28778
[phone]
iiALVICU REGIONAL.0F
3800 Barrett Drive
Raleigh, NC 27609
[phone]
450 Hanes Mill Rd, Suite 3C
Winston-Salem, NC 27105
[phone]
a_
} A L daa
r
FAYIEMVII:.LE REC101iA OFFICE
225 Green Street
Systel Building Suite 714
Fayetteville, NC 28301-5043
[phone]
(<vngH���rU�_l�k;ulc�„_�tHH
943 Washington Square Mall
Washington, NC 27889
[phone]
C1E1-TPAG QFJWE
1617 Mail Service Center
Raleigh, NC 27699-1617
[phone]
610 East Center Avenue/Suite 301
Mooresville, NC 28115
[phone]
thGr 1ti ttE, ION L_aFFIA
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
[phone]
"To preserve, pnVed
and enhance
lNodh earomme s aerer...
SWU-264 - Generic Annual DMR
Last revised 5/02/2018