NCG020030 DMR SW

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year X41 S
"Report ALL STORMWATER monitoring data on this form (include "No Flow'?'No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG02 0❑l D❑051
Facility Name: Kn;gb -dale, Quairry
County: . Wake-
Phone
a!✓Phone Number: ( qlq
Certified Laboratory E N r 0 LA bS Lab # pyla-gb
Lab #
Total no. of SDOs monitored
Stormwater Discharge Outfall (SDO) No. 90 -) VMA Outfall? Yes ❑
Is this outfall currently in Tier 2 for any parameter? Yes ❑
Was this outfall ever in Tier 2 during the past year? Yes ❑
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
No LVJ
No z
NoR CEIV
FEB 11 2 c
CENTRAS. FILE.
DWR SECTIO
Outfall No.
-�
Total
Rainfall,
inches
-TSS,
mg/I
SS,
ml/I
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mg/I
(VMA)
New
Motor Oil
Usage
al/mo.
Stormwater
Benchmarks
Indicate NO
able
applWN icable
Circle
B chmark
00
O'1
nchmCircle
enchmark
25/10
N/A
S Standard applies
N/A
StWaterQuallty andard applater l s
15
> a e requires
average requires
TSS and O&&G m not ring
Date Sample
Collected,
ti
4S S
0,11
<0
S,
IA�0-tzls
0,1
<2.s
<0
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 0❑❑0 ❑S- OQ
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 §122.22]
Signature
Date )-/
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 [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT ,TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year V 15
ALL STORMWATER STORMWATER monitoring data on this form (include .'No Flow"P.No Discharge" and `Benchmark
Exceedances) from ahe previous calendar year to the: DEQ. by. MARCH 1 of each,.year.
Certificate of Coverage No. NCG02 D❑Q©[
Facility Name: Kr1 i AIS TLdQIje Q(AQ/'/)/
County: -Make-
Phone
kePhone Number: ( qtq 166-1100 Total no. of SDOs monitored _
Certified Laboratory _E N (' Lalbs Lab # My
Lab #
Stormwater Discharge Outfall (SDO) No.5 Q:;1 gQ-I VMA Outfall? Yes No ❑
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No 9
Was this outfall ever in Tier 2 during the past year? Yes ❑ No Rr
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 ❑
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 0K00 03 OQ
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 §122.22]
Signature
Date a/
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 [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015