NCG020721_DMR_20230110 (1)

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) - WASTEWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year a Oo'lQ
*Report ALL WASTEWATER monitoring data on this form (include"No Flow'T No Discharge"and Limit Violations)from
the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. hNCG02 ®©�
Facility Name: ���111�� NI CL Al
County: to tYl
Phone Number: (2.5a ) ayy-,'�730S Total no. of outfalls monitored
Certified Laboratory ()AV.T.�. Lab #I—
o Lab# .
Wastewater (WW) Discharge Outfall No. 001 _
Is this an industrial sand mine (See 40 CFR§436 Subpart D)? Yes❑ No[a
Does this outfall discharge WW to SA waters? Yes❑ No
Does this outfall discharge WW to SB or PNA waters? Yes❑ No[�
Does this outfall discharge WW to HQW or ORW waters? Yes❑ No[�
If so, what is the 7Q10 flow rate? or Tidally influenced waters, 7Q10 not available ❑
Does this outfall discharge WW to Trout jr) designated waters? Yes❑ No
Were there any limit violations in the calendar year? Yes❑ No a
Fecal
Outfall No. Daily Flow pH, TSS, SS, Discharge Upstream Downstream Coliform,
( Rate, cfs SU mg/I mI/I Turbidity, (U)Turbidity, (D) Turbidity, col/100 ml
i/applicable NTU NTU NTU SA
Industrial Sand
HOW or ORIN freshwater 25145 HOW,ORW,
Effluent 50% of 6.0-9.0 HQW or ORW SA,Se,PNA, No Limit N/A N/A
Limitations 7Q10 saltwater 20/30 or any Trout Circle Water Water Quality Water Quality N/A
6.8-8.5 HOW or ORIN 0.1/0.2 Q that appllesard Standard applies Standard applies
Mo.Ave/Daily Max. Indicate NO FLOW and Tr or PNA 50/25I10
if
applicable 10/15
Date Sample
Collected,
mo/dd/yr a
OOD -1. Q's
a - d. 5 ► 0 4 17 202
- a - a t a . 5 _ �-,,
DAIR SECTION
-z -9.-1-
Permit Date 10/112015—9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 O❑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§122.22]
Signature_11*1?fi15&1e)a-1
Date
Mail Annual Summary Wastewater 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 10/1/2015—9/30/2020
Last Revised 10-2-2015