NCG020285 DMR SW

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)
- Calendar Year 7_ o i5_ 15+ Gla f -P
Individual NPDES Permit No. NCS❑❑❑❑❑❑ or
Certificate of Coverage (COC) No. NCG®OID] QFEE]
This monitoring report summary of the calendar year should be kept on file on-site with the facility SPPP.
Facility Name: C 19 A.y- u' -k+ey X
County: ro wu v,
Phone Number: C22YJ &31 Z Y I Total no. of SDOs monitored
Outfall No. I
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ Noe
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No
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 ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No.❑
RECEIVED
JUL 0 6 ZU15
CEN*rF?AL FILES
DWR SECTION
SW U -264 -Generic -13 Dec2012
Total
inches
Parameter;: (units)
3
Benchmark
N/A
Date Sample
Collected,
� mmlddlyy
1 of>_..
`�.' y?' '.r.
K .' . t : rbj :S:.s `✓. 's% M.
,:. w4 3 33-.d 'Sha9`d fi....
9 Z .:i f Amy Pt.Y h'��.''^
k %" Y''+i
4
1-.
SW U -264 -Generic -13 Dec2012

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 pof fines and imprison
Signature ossibility 0
, e) J,__1
Date 2 / S
DWQ Regional Office Contact Information:
for knowing violations."
For questions, contact your local Regional Office:
ASHEVILLE REGIONAL OFFICE
FAY_ ETTEVILLE REGIONAL OFFICE
MOORESVILLE 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]
RALEIGH REGIONAL OFFICE
WASHINGTON REGIONAL OFFICE
iWILMINGTON REGIONAL OFFICE
3800 Barrett Drive
943 Washington Square Mall
127 Cardinal Drive Extension
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
[phone]
[phone]
yWINSTON-SALEM REGIONAL OFFICE
CENTRALOFFICE;
1617 Mail Service Center
f' "ToOresenre, protect
585 Waughtown Street
Winston-Salem, NC 27107
Raleigh, NC 27699-1617
and enhawe
(336) 7.71-5000
[phone]
ntorth Carolina's tiater:_."'
SW U-264-Generic-13Dec2012