NCG020749 DMR SW (2)

ANNUAL S UMMARR Y DMR - STORM. AT'ER
L-SEN�
D �"C' CENTRAL W''ICE * _
ST'OIiMWAT'ER DISCHARGE OUTFALLS (SIDO)
GENERAL PERMIT NO. NCG020000
'Report ALL STORMWATER Monitoring Data on this form (including No Flow and No Discharge and Permit Limit Violations) by MARCH !
CERTIFICATE OF COVERAGE NO. NCG02j -
FACILITY NAME: A© Ir ' I ,
PERSON COLLECTING AMPLES tri
CERTIFIED LABORATORY ab #
#
Part A: Stormwater Mnnitnrina Run..,, n,.. a Lab
Date Sample
Outfall Collected
No. (mo/dd/yr OR
NO FLOW)l
In Tier 2 # of Months in
Monthly
Monitoring? Tier 2 2 Total Flow
Wnl Sampling (MG)
SAMPLE COLLECTION YEAR:
COUNTY 49A4A(6!6-
PHONE NO. (�I� )�2 _ffl(0S
ADD TO LISTSERVE?YES ENO EMAIL: ', 4f atae►1er
Total Suspended
Solids Turbidity
(mg1l) (NTLI)
100, See Fontnnto
Settleable Total Event
Solids (mill) Rainfall Duration
(minutes)
0.1 _....._ __
4--
I
FNFOW" or "NO DtSCHARGEEnter "NO FLOW" or"NO DISCHARGE" foreach outfall here and theDate Range.
s2: Tier 2 Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark ranges'inexcessofthebenchmark, or outside the benchmark range (for pH), you must implement the Tier I or'tier 2 responses in the Genered Permit.
mark vahies are 100 mg/Iexcept in OR.W, HWQ, troutand PNA waters where they are 50 myl.
"rge shall not cause an instantaneous measurement of the turbidity of the receiving water to exceed: l0 NTU far freshwater streams, lal;e;,, and reservoirs desig��au;
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 SIX),
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 Revisod 02••02-1 t
rj—. I -a,

Outfall
No.
=•■W■,■•�•■A■•«
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
<+�.��� ,nun,wrm ne uarements for facilities
In Tier 2 # of Months New m6tor
Monthly
Monitoring? � Tjer 2 Oil Usage
(y/n� SamplingZ al/month .
-
usin >
Total Flow
(11RG)
55 gal of new motor oil/month
TPH usin method
g
1664A.SGT-HEM
m /1
on averse
Total Suspended
pe
Solids
m I
pH
(Standard
Units
Total
Rainfall
in
+
Event
Duration
minutes
15
100
6-9
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES
AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO e
HAVE YOU CONTACTED THE REGION? YES ❑ NO
Fer
WHO AT THE REGION HAVE YOU SPOKEN WITH?
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN TIIIS CERTIFICATION FOR ANY INFORMATION 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 wlao masa& 1114:
system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge .and belief, true, accucaie,
and complete. I ay,aware that t� arsignificant en for submitting false information, including the possibility of fines and imprisonment fur Ijuowin;;
violations."
Y -O -A t nC cr r
.(Signature of P mittee) (Date)
Permit Date: 1/i/2010-12/31/2014
Last Revised 02-02-11
Paget oft