NCG020157 DMR SW

y ANNUAL SUMMARY DMR - STORMWATER
SEND TO CENTRAL OFFICE.*.
RECEIVED
J STORMWATER DISCHARGE OUTFALLS (SDO)
GENERAL PERMIT NO. NCG020000 MAR. f 0 2016
*Report ALL STORMWATER Monitoring Data on this form (including No Flow and No Discharge and Permit Limit Violations) by MARCH 1 of eacQ_
CERTIFICATE OF COVERAGE NO p
NCG02
12'.
�
FACILITY NAME: rye � , ?ro
PERSON COLLECTING SAMPLES
CERTIFIED LABORATORY Muer.* �e.clh Lab
Lab #
?art A: Stormwater MonitorinLy Reauirements
SAMPLE COLLECTION YEAR: aO 15
COUNTY OraAsa-
PHONE NO. (q 19 _23j.- 3981
ADD TO LISTSERVE? YES ❑ NO IN EMAIL:
Date Sample In Tier. 2
Outfall Collected Monthly
No. (mo/dd/yr OR Mon�torin
# of Months m'
-
Tier 2
Total Suspended
Total Flow,
Turbidity;
'Settleable
Total
Event
t g
NO FLOW) _ (Y /n)
z
Sampling
Solids:
(MG)
(mgll).
(NTU )
Solids ml/,I
( )
Rainfall
(m)'
Duration
(minutes)
-' -
-1003
4'
See Footnote3 s
0 13
3/ -3 0.1
14
1 40.1
0.0�
3
Seco
No -b�5B
&\t_
If "NO FLOW" or "NO DISCHARGE_ Enter "Nn FI,OW" or "Nr) M.04 PAWW" fnr -Ph n ffon 1P-. -4 t6A n�fo n.,., o
Per NCG02: Tier 2 Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range
3 If a value is in`excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit.
4 TSS benchmark values are 100 mg/1 except in ORW,.HWQ' trout, and PNA waters where they are 50 mg/I.
5 The discharge shall not cause an instantaneous measurement of the turbidity of the receiving water to exceed: 10 NTU for freshwater streams, lakes, and reservoirs designated
as trout waters; 25 NTU for all lakes and reservoirs, and all salt waters; 50 NTU for all other streams and surface waters. Turbidity may be monitored at the SDO.
Alternatively, the permittee may choose to monitor turbidity in the receiving water, directly upstream and downstream of the SDO.
Permit Date: 1/1/2010-12/31/2014 Last Revised 02-02-11
Page I of 2

rant u: ven►cie iviaintenance Act►vity ivionitor
Outfall
Date Sample
In Tier 2
#
No.
Collected
Monthly
(mo/dd/yr OR
Monitoring?
Si
NO FLOW)
(Y►►)
uirements for facilities using > 55 gal of new motor oil/month on
I
HAS YOUR FACILITY HAD 4.011 MORE BENCHMARK EXCEEDENCES
AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES 0 NO [4-
WHO
4..WHO AT THE REGION HAVE YOU SPOKEN WITH?
G ALL "NO FLOW", "NO DISCHARGE" &
I OF EACH YEAR TO:
:vent
iration—
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN THIS CERTIFICA TION FOR ANY INFORMA TION REPORTED:
"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
violat'ons.
3 �3--1
(Signature of Permittee) (Date)
Permit Date: 1/1/2010-12/31/2014 Last Revised 02-02-11
Page 2 of 2