NCG020795 DMR WW

ANNUAL SUMMARY MSCHA GE MOMT RI G
REPORT (DMR) ®z -'XS T ,rVf € EP
SUBMI ' PO CENTRAL OFFICE*
Gerneral Permit No. MCGO20000
Calendar Year 2 D S
-Report ALL WASTEWATER monitoring data on this form (include `'No Flow"Mo Discharge'' and Limit Violations) from
the previous calendar year to the DEQ by MARCH 1 of each year.
CertMicate of Coverage No.
Facility Name: VI n i m(��ar bf 10 ✓l -'---)CK 001 I\ 0 (4y.. 1
County: —AV46
11r�z
Phone Number ( 2 -7-5 1 Total no. of outfalls monitored �
Certit�ed Lat�oraionj irh � 00 0� {� Lala # SSS
Lab
Wastewater (WM Discharge Outfall leo. 00
Is this an industrial sand mine (See 40 CFIi §436 Subpart D)? ales ❑ ago ❑
Does this outfall discharge M to Sig waters? 'Iles ❑ R'02—
Does this outfali discharge WW to SB or PMA waters? yes ❑ No []
Dares this oufifall discharge WVtlr to l"`OW or f2RW inraters? Y,, ❑ ' No ❑
if so: alai is the 7.10 floe rate`? or i ldally influenced haters; 7010 not available ❑
l Does £his ouffall discharge MV to Trout (Tr) designated waters? Yes ❑ fIo Q
Were there any iirnit violations in the calendar year? Yes ❑ MO ❑
i�et-ii'=.ic Daze sE3/1/�O E� G �/30i2�2�
Last Revised 10-2-2015
!
Fecal
outfall 40.
!ail Flow
cfs
�H7
Ss
Tss7
Mg/i
589
i�i
Discharge
Turbidity,
Upstrearn
(€)Trbildity,
Dovnst�4Q
(D)Turbidity,
��pYforr$g
col/100m
loLiRate,
drappiicakla
MTX
NTU
MTU
(A.j
'
Industrtat sand
t
Effluent
3iGlY or ORV!
50% Qf
freshwater
6.0-9.0
25/45
l-tQ1Y. ORVJ.
No la. reit
I
N/A
N/A
Limitations
Q 10
salhrrater
HQVd or ORW
20/30
$A 513, Pw&
oranyTrout
Circle Water
Water Quality
Water Quality
NIA%�•
-�•
HQW or ORVd
0. .
Quality standard
that standard
Standard applies
Standard epplirs
Mo. Ave l Daily Max.
rrdreato NO FLOP➢
W applicable
and Tr or PHA
� 0/1 �
;t7 F2�/,g0
5f0 f
Date Sample
frkofddlyr
3 I m 1,5
0, !
ID - I
LI.
4 15
• I
42 .
<o -1
0 -7 C>
( ��B 2 F Z!016
q ZS jS
!
7•y
i X2.5
< 0.1
1 2•�
1 }
2z
q M0
! <2.5
I q.'z
!
! CENTUVVR
7.5
<0.1
5E%-.#
----
i�et-ii'=.ic Daze sE3/1/�O E� G �/30i2�2�
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ®?Q®®
a
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 §122.221
Signature
Date 2 r7 20( b
Mail Annual Summary Wastewater 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
Aitn: 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 10/112015 — 9/30/2020
Last Revised 90-2-2095