NCG020157_DMR_20220111

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year a Do 1
*Report ALL STORMWATER monitoring data on this form (include"No Flow"/"No Discharge"and Benchmark
Exceedances)from the previous calendar year to the DEQ by MARCH 1 of each year
Certificate of Coverage No. NCG02 ❑o ©❑S Q FEB 2 3 Z022
Facility Name: R 25 w Pr OGI.tA CTS I n r- ci FILES
Icc�ES
r—
County: 0 ra.ye­ DWR SECTION
Phone Number: qt9 ) -131-398 I Total no. of SDOs monitored
Certified Laboratory Lab#
Lab#
Stormwater Discharge Outfall (SDO) No. 1 VMA Outfall? Yes ❑ No N
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 El
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, mg/I ml/I NTU NTU NTU O&G, mg/I Usage
inches (VMA) gal/mo.
Stormwater Circle N/A N/A >ssgae
Indicate NO Benchmncher ark Benchmark average requires
s
Benchmarks
FLOWIr Water Quality Water Quality 15 TSS and Nonpolar
applicable 100/50 0.1 50/25/10 Standard applies Standard applies O&G monitoring
Date Sample
Collected,
mo/dd/yr
-SCL ryxMeo No iz-3 'r oal
Permit Date 10/1/2015—9130/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ED]5❑ 2]
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§122.24
Signature J C.,W
Date l)�I.Ax
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 Date 10/1/2015—9/30/2020
Last Revised 10-2-2015