NCG190094 DMR SW

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
Calendar Year ad' /.
General Permit No. NCG190000
Certificate of Coverage No. NCG 19 r©[ [
This monitoring report summary is due to the DWG Regional Office no later than 30 days from the dite
the facility receives laboratory sampling results from the final sample of the calendar year.
Facility Name: Y i/c-55 Co v Are-
County: _ .824
c�
Phone Number: ( 'Za /6/6 - 6 3e/ Total no. of SDOs monitored
• Outfall No. X0.6 3
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No or
Was this outfall ever In Tier 2 (monitored monthly) during the past year? Yes ❑ No Er`"
If this outfall was In Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other El
00530 00400 00556 01119 01104 01094 01114
Outfall Rain 8111 TSS, pH, Oil Copper, Aluminum, Lead,
Inches mg/L s.u. Gm mg/L mg/L Zinc, mg/L mg/L
Benchmark N/A 100 6.0—9.0 30 0.007 0.75 0.067 0.03
Date Sample �' , 4% . *N�
Collected, ° , y � �� � `y�
mo/dd/yr
9 3 7-t /5- '-• 9 1, .3 <-S ® 4/3 L ,SS-5- , 2.5 .u o 5.
S W U-250NCG 19-092309

"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
1 ■ 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."
Signature /1/:".--��
Date cl ;'
i
it
Mail Annual DMR Summary Reports to:
DWQ Regional Office Contact Information:
Asheville Office [phone] ;tr& } ,
Fayetteville Office [phone] , , ' ara ,
Mooresville Office [phone] °- �-^�` `0 � � „ � „, ,.i., •
Raleigh Office [phone] ,, __t-� 1.:„ � `,7
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Washington Office ...[phone] '""”' ` R��°� �1c ��Q`��t Icy � �� ��
• Wilmington Office [phone]
Winston-Salem [phone] r ttorit4 , '' ".`•",!�-i
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Central Office [phone] ;� f,
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ASHEVILLE REGIONAL,OF11CII FAVEtt'EVII.LE`REGIONAL OFFIC E 11100RESVILLE REGIONAL OFFICE ,
2090 US Highway 70 225 Green Street 610 East Center Avenue/Suite 301
' Swannanoa, NC 28778 Systel Building Suite 714 Mooresville, NC 28115 '`
[phone] Fayetteville, NC 28301-5043 [phone]
[phone]
T RALEIGH REGIONAL 0 I*-- Wp A" ' J 4Ar' f1 i te'�T7N REGIONAL(*FILE t..
•
3800 Barrett Drive 943 Washington Square Mall I 127 Cardinal Drive Extension '
Raleigh, NC 27609 Washington, NC 27889 Wilmington, NC 28405-2845
' [phone] [phone]f (910)[phone]
WII+IS'I'f�N- AI,NNI KRII3T� +.!_��— !
OFFICE 1617 Mail Service Center ..,--- —,-- f
585 Waughtown Street Raleigh, NC 27699-1617 ;rte
"To a preserve �' '
Winston-Salem, NC 27107 aril enhance
[phone] [phone] `-..:,,,ate ���11 Ca:n?:�►a s :.ales._•
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SWU-250NCG19-092309 1