NCG020715_DMR_20220301

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year o
"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 ]777❑/ El
Facility Name: err'a�g,6 8r,L-AC
County:
Phone Number: 7( 0yY Al r— AIY26 Total no. of SDOs monitored 3
Certified Laboratory_, 62_ ru /`i r�/ Lab#
Lab#
Stormwater Discharge Outfall (SDO) No.�_ VMA Outfall? Yes ❑ No R
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No 2�
Was this outfall ever in Tier 2 during the past year? Yes P-� 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 L�
Other ❑
Upstream Downstream New
Total TSS, SS, Turbidity, (U)Turbidity, (D) Turbidity, Non-polar Motor Oil
Outfall No. Rainfall, m /I ml/l NTU O&G, mg/I
g NTU NTU Usage
inches (VMA) ( al/mo.)
Stormwater Satchel rehipciree N/A N/A enserequi
Intlicafe NO Benchmark BencM1mark avenge rngWms
Benchmarks FLOWpplie.be 100/50 0.1 50/25/10 5ntlartlapplies Stter Quality a�naaraaater rppllea 15 oacndNo�nolar
ng
Date Sample
Collected,
m idd/ rall
"753/1
N P./7 .� / /tom 7•yy / 6. 2
M
GE
Permit Date 10/1/2015-9/3012020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ❑❑❑❑
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. 74 VMA Outfall? Yes ❑ No ^/
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No L�
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
OutfallNo. Rainfall, mg/1 mI/I NTU NTU NTU O&G, mg/I Usage
inches (VMA) al/mo.
Circle OIrNe average
requires
Indicate NO Benchmark Benchmark N/A NIA avmgallon
Stormwater lres
Benchmarks FL0 ae 100150 0.1 50/25/10 Standardapplles Standard apples 15 Water Quality og�em netoo„near
Date Sample
Collected,
mo/dd/ r
Ila-
3 /S
9 i /ate
Id ,i / /ew
i2 �a ai F/
Permit Date 10/1/2015—9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 © 21Efl RJ
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. 3 VMA Outfall? Yes ❑ No RJ
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 L"
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 exceedarl did not require monthly monitoring ❑
Other ❑
Upstream Downstream New
Outfl No. Total TSS, SS, Turbidity, (U) Turbidity, Non-polar, (D)Turbidity, Motor Oil
Rainfall, z gll n 'arl NTU NTU NTU O&G, mgll Usaae
inches (VMA) (gal/Mo.)
Circle Circle N/A NIA >55 gaunt
Stormwater Indicate NO Benchmark Benchmark average requires
0.
FLOWif Water Quality Water Quality 15 TSS and Non-polar
Benchmarks app,Kahle 100150 0.1 50/25/10 Standard applies Standard applies O&G monitoring
Date Sample
Collected,
m /d / r
6 fAle w
Permit Date 10/1/2015—9/30/2020
Last Revised 10-2-2015

v .
Certificate of Coverage No. NCG02 ®�0[
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§1 .22]
Signature
, / /.
Date F / 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 Date 10/1/2016—9/3012020
Last Revised 10-2-2015