HomeMy WebLinkAboutNCG020351 DMR SW (3)is ANNUAL SUMMARY DISCHARGE MONITORING
REPORT DMR — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year
*Report ALL STORMWATER monitoring data on this form (include "No Flow"Mo Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year. V®
Certificate of Coverage No. N0002 ®® AN
Facility Name: Ca -,, I t, � X4 ,"h -P 8. '1016
County:CENTRAL FILES
Phone Number: (%C*) j 3 7 � Total no. of SDOs monitored �AW SECTION
a .
Certified Laboratory O,as.e, r, -;k -e Lab # *
Lab #
Storrnwater Discharge Outfall (SDO) No. J— VMA Outfall?
Yes ❑ No
Is this outfall currently in Tier 2 for any parameter?
Yes ❑ No Nr
Was this outfall ever in Tier 2 during the past year?
Yes ❑ Noiz
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
❑
No, turbidity benchmark exceedances did not require monthly monitoring
❑
Other
❑
Upstream Downstream New
Total TSS, V SS, ` 'Turbidity, (U) Turbidity, (D) Turbidity, .Non -polar. Motor Oil ,
Outfall No. Rainfall, mg/I . NTU
mill NTU , NTU ' O&G,•mgA Usage
inches (V MA) al/mo.
OMARCi,ck >S5 gellmo.
Stormwater &,diwm
h No Benchark Benownark N/A N/A average requires
Benchmarks F`g°" 100150 0.1 50/25/10 Standard pWes �e Quality a 15 oao mai ��"
FDC—ate Sample s � Iollected,mom
2 —q - i6-1 6,72.1 y, I
Permit Date 1011/2015 — 913012020
Cast Revised 10-2-2015
Certificate of Coverage No. NCG02�[g�
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 §11. 22]
Signature
Date /-- lC,
Mail Annual Summary Stormwater 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 (919) 807-6300
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
(919) 707-9220
Permit Date 101112015 — 913012020
Last Revised 10-2-2015