NCG140478_DMR SW 3rdQ_20220329

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG140000
Calendar Year 2021 - 3rd Quarter
*Report ALL STORMWATER monitoring data on this form (include "No Flow" P`No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG 14 0❑®7❑® G1 V
Facility Name: LANE TEMPORARY CONCRETE PLANT-STATESVILLE APRR 0 6 ?o??
County: IREDELL
Phone Number: (336
Certified Laboratory
518-4671
Lab #
Lab #
CENTRAL FILES
TRM;PP t%> monitored 1
Stormwater Discharge Outfall (SDO) No. 1 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 ❑
outfall No.
Total
Total Rainfall, Suspended
inches Solids (TSS),
m /I
pH,
SU
Non -polar O&G
(EPA Method
1664 (SGT-HEM)),
mg/I (VMA)
Ifapplicable
New Motor Oil
Usage (gal/mo.)
ffapplicable
Stormwater
Benchmarks
Date Sample
Collected,
mo/dd/yr
Circle Benchmark
Indicate NO FLOW if 100/50
applicable
No Flow
6.0-9.0
15
>55 al/mo. requires TSS and
g average g q
Non -polar O&G monitoring
Permit Date 8/1/2017 — 6/30/2022
Last Revised 8-22-2015

Certificate of Coverage No. NCG14 U®1i1®
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
gather
system, or
evaluate the information submitted. Based on my inquiry of the person persons who manage the
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 §122.221
6(Aa paTVo
Signature
Date < t /=
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct -- Central Files is housed in DWR (not DEMt_R)
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 811/2017 — 6/30/2022