HomeMy WebLinkAboutNCG020883_DMR_20240111STORMWATER DISCHARGE OUTEALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT PMR)
Calendar Year 202-3—
Individual NPDES Permit No. NCS"LJLJULILJ or
Certificate of Coverage (COC) No. NCGQ99$9__
This monitoring report summary of the calendar year should be kept on file on -site with the fatuity SPPP.L
Facility Name: _ �� ice" jSk CL FY(e M I K)G
County: T �'A-TkWBA
Phone Number: ( 76
V) a G - L 3 % Totai no. of SDOs monitored
Outfall No.
Is this outfall currently in Tier 2 (monitored monthly)? Yes El No [�
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 u
JAN 17 20�y
CENT
Parameter, units
Total
Rainfall,
Inches
�%� l
/ J
T(', b) j
s
Benchmark
Date Sample
Collected,
mmlddlyy
N/A
+ V
N (
LTG
l "
f V
SW U-264-Generic-13 Dec2012
STORM `JAT1 11 DISCHARGE MONITORING REPO T (MR)
1 Please Mail Original And One Copy To Mailing Address Below 11
GENERAL PERMIT NO. NCGO20000
Part A: Facilio) Information
Samples Collected In Calendar Year; . Vj zo Z 3 (all samples shall be reported within 30 days following monitoring period)
Certificate Of Coverage No. NCG02 3 County of Facility
Facility Name ti c /mod 07 r'y a Name of Laboratory
Facility Contact _�j-f-�ui!{ jG H'—� �,.. l,aa`, C eatl;ioation iE
Facility Contact Phone No. (1�y> C� y 7
Part B: Land Dinlurbance and Process Area Monitoring Requirements
Date1.
50050 005�0 `. OOOY6 : 005A5:'-
0,ntfall Receiving stveaem goon 8o II'otaH rot; t
. Nm e R . - 1setIYls9bl'c;
Nlo. Q.'ollceted Plow saspendeoi, Tnrbt�iity Solide
--LIB/tifT VI oCC�C[
Part D: Storm Event Characteristics n
Total Event Precipitation (inches): _--. W �AN 1 7
Event Duration (hours): -- -- —
Part E: Certification CENTRAL
Precipitation (inches):
ion (hours):
storm event is sampled)
"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 informations submitted. Eased 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, truc, accurate, and complete. I am aware that there are signiileant penalties for submitting false information,
including file possibility of fines and imprisonment rot, knowing violations.
fgnaeure of Permittee) - (FDate)
Part F: Mailing Address
Attn: Central Files, IDENR, N.C. Division of water Quality, 1617 Mill Service Center, Riieigh, NC 27699-1617