NCG140437_DMR_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 Flow"1"No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG14 00® 3❑ 70
Facility Name: Mebane
County: Orange
Phone Number: (336 ) 996-0326 Total no. of SDOs monitored 1
Certified Laboratory Research and Analy. Lab Lab #
Lab #
Stormwater Discharge Outfall (SDO) No. 001 VMA Outfall? Yes ❑ No
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No Q
Was this outfall ever in Tier 2 during the past year? Yes ❑ No 0
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 ❑
Outfall No.
Total Rainfall,
inches
Total
Suspended
Solids (TSS),
mg/1
pH,
SU
Non -polar O&G
(EPA Method
1664 SGT-HEM ,
( ))
mg/1 (VMA)
1/applicable
New Motor Oil
Usage (gal/mo.)
lrapplicable
Stormwater
Benchmarks
Indicate NO FLOW if
applicableNon-polar
Circle Benchmark
100/50
6.0-9.0
15
>55 allmo. average requires TSS and
g g
O&G monitoring
Date Sample
Collected,
mo/ddlyr
3/30/2021
NO FLOW
INZEC
6/29/2021
NO FLOW
9/20/2021
NO FLOWPIT
R ti
i
AIR
12/7/2021
NO FLOW
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG14 0❑® 30 7❑
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.
Signature
Date
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 8/1/2017 — 6/30/2022
Last Revised 8-22-2015