NCG020274 DMR SW (3)

'y
ANNUAL SUMMARY DISCHARGE MONITORING
REPORT DMR — STORfiNVVAI'ER
SUBMIT TO CENTRAL OFFICE"
General Permit No. NCG020000
Calendar Year iA0 /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 --0000 //��
Facility Name: e �l/r%Z t��/ /?Sf1 - / A 1YI67V,1 74y lit /A Ir 0
County:
Phone Number: U 7&5 %a2-/ Total no. of SDOs monitored
Certified Laboratory ji!!�:T--S' Lab # 600
Ae a w7z. CorP. 4�s !/Lt,, &Lab # 19.7
Stormwater Discharge Outfall (SDO) No. -aj / VMA Outfall? Yes No ["
Is this outfall currently in Tier 2 for any parameter? Yes No
Was this outfall ever in Tier 2 during the past year? Yes[ No Q'
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑ RECEIVED
Yes, received approval from DEMLR to reduce monitoring frequency ❑ FEB.16 20%
No, turbidity benchmark exceedances did not require monthly monitoring ❑ CENTRAL FILES
Other ❑ R SECTION
outfoll No.
Total
Rainfall,
inches
TSS,
mg/I
SS, :.
ml/I .
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
08G, mg/1
(VMA)
New .
Motor Oil
Usage
(gal/mo.)
StormwaterCircle
Benchmarks
Indicate NO
FLOW if
a iica6le
Bench
10 50
0.1
Circle
Benchmark—
5012 10
NIA
"later Quality
Standard applies
NIA
water Qualit,,
Standard applies
15
>65 gallam.
average requires
TSS and Non -polar
OSG monitoring
Date Sample
Collected, .
mold . yr ;e
(o ?o/
D 3
/q
0.3
600
jLq
AlA.-
I
15
7,4
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 MQ 7❑Q
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. 2 VMA Outfall? Yes ❑ No [�
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No []'
1Uas this outfall ever in Tier 2 during the past year? Yes ❑ No
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 ❑
Outfall No.
�/h 'VZ
Total
Rainfall,
inches
TSS,
SS, '
mUl
Turbidity,r
TUNTU
Upstream-
(U) Turbidity,D
Downstream
( ) turbidity,
NTU
O&G, m g/I
A)
New
MotoOil
Usage
(al/mo.)
Stormwater
Benchmarks
Indicate NO
FLOW if
a
Circle
Benchmark
100/50
0.1
Circle
Benchmark
50/25/10
N/A
Water Quality
standard applies
N/A
Water Quality
standard applies
15
>55 e
averagea requires
TSS and Non -polar
O&G monitorin
Date Sample
Collected,
mo/dd/yr=
/5
0. 113
613
0
36
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 O❑❑z ]ER]
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. ^ b3 VMA Outfall? Yes ❑ No H`
Is this outfall currently in Tier 2 for any parameter? Yes ❑ 'No [>�
Was this outfall ever in Tier 2 during the past year? Yes ❑ No [
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 ❑
Ou all `No.
Total
Rainfall,mg/I
inches
TSS,,
SS,
mill
Turbidity,
NTU
Upstream,
(U) Turbidity,.
NTU ."
Downstream.
(D) Turbidity,
NTU
Non -polar
O&G, m9/I
(VMA)
New,
Motor Oil.
Usage
(gal/ mo.)
Stormwater
Benchmarks
Indicate NO
applicablepL
Circlenchm
Benchmark
100/50
0.1
Benchma
50/25(40
N/A
sWatertand pies
N/A
swndardr Quality
15
>55 gal/mo.
average requires
TSS and Non -polar
O&G monitoring
Date Sample
Collected,
mo/dd/yr
p
lv l Za /S
y3
32b/
0, 6
3 3 d
3 6
z
A.%
1,3
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 Q©F7
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 Z
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