NCG140273_Monitoring Report_20220629

Stormwater NPDES Permitischar %
Monitoring Report (®MR) Upload 04�
Permit and Facility Information:
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Please enter the permit number and other details for this upload.
IMPORTANT Until your stormwater permit is registered in the eDMR system, an original signed (not digitally
signed) hardcopy of the DMR must be mailed to the address in your permit, in addition to this electronic
upload.
Permit Number* Enter COC or Individual Permit Number (NOT General Permit number with all 0's)
NCG140273
Must begin with NCS or NCG
Facility Name: * Stevenson-Weir/Southern- Salisbury
County: * Rowan
After uploading here, the original signed hardcopy must be mailed to:
DEQ Mooresville Regional Office
Attn: DEMLR Stormwater Program
610 East Center Avenue
Suite 301
Mooresville, NC 28115
Further contact details at https:Hdeq.nc.gov/contact/regional-offices/mooresville
Monitoring Period Information:
Multiple DMRs from sampling periods within the same year can be uploaded together, but please upload different
years with a new submittal form.
Monitoring Period What is the YEAR of the sample date(s)?
Year:* 2022
Copies of the lab results and/or qualitative (visual) monitoring should NOT be submitted unless specifically
requested by DEQ staff. Only upload completed and signed DMR forms.
**DMR forms should have original signature (not digital) to comply with requirements in 40 CFR 122.22**

DMR Upload* Click the upload button or drag and drop files here to attach document.
NCG14-SWDMR-Salisbury 5.25.2022-SW.pdf 161.24KB
Only PDFs are accepted.
Comments:
* By checking the box and signing box below, I certify that:
o I have given true, accurate, and complete information on this form;
o I agree that submission of this Discharge Monitoring Report (DMR) Upload form is a "transaction" subject to Chapter
66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
a I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General
Statutes (the "Uniform Electronic Transactions Act');
o I understand that an electronic signature on this upload form has the same legal effect and can be enforced in the
same way as a written signature; AND
o I intend to electronically sign and submit this DMR Upload form.
Full Name:* Shannon S. Houck
Name of person submitting this form
Email Address: * [e-mail]
Phone Number:* 8643635615
Signature: *
Date: * 06/27/2022

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140273 SAMPLE COLLECTION YEAR: 2022
FACILITY NAME: Stevenson-Weir/Southern-Salisbury SAMPLING PERIOD: ❑ July -December ❑ January -June
SAMPLE COLLECTOR: Gary Barnhardt COUNTY Rowan
CERTIFIED LABORATORY: Waypoint Lab # 402 PHONE NO. ( )
Lab # 90740- ADD TO LISTSERVE? ❑YES ®NO EMAIL:
Waypoint OPTIONAL INFO:
Part A: Stormwater Monitoring Requirements
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ®Trout ❑Other,
Outfall No.
Date Sample
Collected
( mm/dd/yr OR
NO FLOW)'
pH
(Standard Units)
TSS
(mg/L)
Total
Rainfall a
(in)
In Tier 2
Monthly Monitoring?
(y/n)
# of Months in Tier 2
Z
Sampling
-
-
6-92
1002,3
-
1
5-25-2022
7.5
52.6
0.62
no
2
No Flow
no
' If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
s If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HOW, Trout, and PNA waters where they are 50 mg/l.
For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 8/1/2017-6/30/2022 Last Revised 07/27/17
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Dirt R- Wakh-la RAnintonnnro ertiwitw nnnnitnrina Ran„rramantc fnr farilitips using > 55 Pal of new motor oil/month — averaeed over a calendar vear.
Outfall
No.:
Date Sample
Collected
(mo/dd/yr)1
H
Standard
Units)...
Non -Polar
- .
Orl;&Grease us�n
method .1664
SGT-NEM
tmg/�)
Total
Suspended
Solids
� '!9A)
Total
Rainfall 4
(in)
-
New Motor Oil Usage
(gal/month)
In Per Z.
Monthly
Monitoring?
(Y/n)
# of Months. in Tier 2
Sampling 2
6-92
152
1002,3
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFACE (INCLUDING VEHICLE MAINTENANCE)? YES [:] NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copy of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitoring period
in case of "No Flow") to:
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"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."
Shannon S. Houck 6/25/2022
(Signature of Permittee) (Date)
Permit Date: 8/1/2017-6/30/2022 Last Revised 07/27/17
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