NCG080156 DMR SW (3)

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR)/ SPPP Annual Update DATA REVIEW FORM
Calendar Year a 0/s -
Individual NPDES Permit No. NCS❑❑❑❑❑❑ or ���I��®
Certificate of Coverage (COC) No. NCGQF1❑O ❑j 0©
JAN 2 5 2016
This monitoring report summary of the calendar year should be kept on rile on-site with the facility SPPP.
CENTRAL FILES 17
Facility Name: Fir C.. ?rr, h, n s Ce, A4cr SWR SECTION .....
County: Wu I"- r
Phone Number: (91g ) V16- S-777 Total no. of SDOs monitored 1
Outfall No. 00.1
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No S
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
SWU-264 - Generic Annual DMR
Last revised 5/17/2013
Parameter;
(units)
Total.
Rainfall;:
inches .
e c mark '
.yM -.
. .'
mpledy.firCollected#
N A.
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N
NO Q1S*c1j"A'jf%L"
SWU-264 - Generic Annual DMR
Last revised 5/17/2013

"I certify-, under penalty of law, that this document and al} 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 rnyj inquiry of the person
manage the system; or those persons .directly responsible for gathering the- information, the"information submitted is, to the
or persons who
best of my knowled e a d belief, true,_accurate, and -complete. V'
aware,that there are, significant penalties for.submitting false information,
including the pos il't of fines and imprisonment for knowing violations."
Signator
Date -
For questions, contact your local Regional Office:
DWQ Regional Office Contact Information:
y
SHEVILLE REGIONAL OFFICE
FAYETTEVILLE, REGIONAL_ OFFICE "
MbORESVILLEREGIONAL'OFFKE
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
(704) 6634699
[phone]
2ALEIGH REGIONAL,OFFICE
WASHINGTON.REGIONAL OFFICE
WILMINGTON REGIONAL„OFFICE ,
3800 Barrett Drive, .I
943 Washington Square Mall
127 Cardinal Drive Extension
,Raleigh,. NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
(9,19) 791-4200
(2 -2) 046.-6481
(91"0) 796 _7215
_ _-...
3TON,'=SALEIVI,REGI0NAL OFFICE
- - - - - --_
CENTRALOFFICE,
585 Waughtown Street
Winston-Salem, NC 27107 '
1611 Mail Service` Center -
- Raleigh, NC 27699-1617
g ,
- - - -
1 1_,Prese” Protec.I
! and enhance ..
(336):771=5000 _..
[phone]
.
r North CsrcV�rra's water
SWU-264 - Generic Annual DMR
Last revised 5/17/2013