NCG140051_DMR SW_20220329

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) - STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year 2021
*Report ALL STORMWATER monitoring data on this form(include"No Flown/"No Discharge"and Benchmark
Exceedances)from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG14 ] ] 5❑ 1❑
Facility Name: DallA6
County: Gaston
Phone Number: 70( 4 )529-6364 Total no. of SDOs monitored 2
Certified Laboratory Waypoint Lab Lab# 402
Lab#
Stormwater Discharge Outfall (SDO) No. 001 VMA Outfall? Yes ❑ No ®✓
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No 0
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 ❑
Other ❑
Non-polar O&G
Total (EPA Method New Motor Oil
Outfall No.
Total Rainfall, Suspended pH, 1664 (SGT-HEM)), Usage (gal/mo.)
inches
oo, Solids (TSS), SU mg/l (VMA) liapplicable
m /I I/appliwble
Stormwater Circle Benchmark
Ru➢caro NO FLOW" 100/50 6.0-9.0 15 >55 gallm average
o.avege rtqulres TSS and
Benchmarks pp°caeln Nan-polar O&G monitoring
Date Sample
Collected, x--
mo/dd/yr
3/24/2021 NO FLOW
5/19/2021 NO FLOW APR 0 6 2022
6/1 712 0 21 NO FLOW D
9120/2021 NO FLOW
9130/2021 NO FLOW
12/62021 NO FLOW
12/142021 NO FLOW
Permit Date 8/1/2017—6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG 14 fl ] 5❑ 1❑
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. VMA Outfall? Yes ❑ No ❑
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 ❑
Other ❑
Non-polar O&G
Total (EPA Method New Motor Oil
Total Rainfall, Suspended pH, 1664es (SGT-HEM)), Usage (gal/mo.)
Outfall No. inches Solids (TSS), SU mgll (VMA) If applicable
mg/l flapplicabie
Stormwater circle Benchmark
lodiesto NO FLOW M 100150 6.0-9.0 15 >55 gallmo.average requires TBS and
Benchmarks applicable Non-polar O&G monitoring
Date Sample t'; a a ;_
Collected
f.
molddlyr
3/24/2021 NO FLOW
5/1 912 0 2 1 NO FLOW
9/30/2021 NO FLOW
12/14/2021 NO FLOW
Permit Date 8/1/2017—6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG14 EKE R
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§12 2J
Signature
Date ".Vv\
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 8/112017—6130/2022
Last Revised 8-22-2015