NCG020209 DMR SW

11
77
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STORMWATER
General Permit No. NCG020000
CalendarYear a O E S
aRepoit ALL STORMWATER monitoring data on this,fbnn (include L"iso'-Flov l,NoDipeharg�" and;Benchmark
'Exceedances),from the previous,c alendaryearto the QEQ 0y,W.6RCH,1 of each year.
Certificate of Coverage No. NCG02 Q® O❑®
Facility Name: - hcx n5o n G r� a �eS - G1 e i ��'3 Q u-kcAr
County: '�Cike�-
Phone Number: (q i q ) 3 8C3 - ?-'I y a Total no. of SDOs monitored
Certified Laboratory T a r1 e- A ria (v+i cc�I tab # W'W 007
�-k:n n & 5 q ac s Lab # 5312
2
Story` water Discharge Outfall (SDO) No. �M -1 VMIA Outfall? Yes Dfl No ❑
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No V9
Was this outfall ever in Tier 2 during the past year? Yes ® No ig
If this outfall was in Fier 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 exceedanoes did not require monthly monitoring ❑
Other ❑
outfall No.
SRS _
Total
Rainfall,
inches
TSS,
mg1l
SS,
mill
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&O, mgil
(VMA)
New
Motor oil
Usage
aUmoo
e Ixabrn
�O/ �i� ®
Wbwr a .rrr Wareen�»
$tarrdardapplin �t adardsppli®a
ass ®om Wo"wee
oBtGrt€anitorira
Date Sample
Collected,
(0,99
232.5
L50
NZA
^309' ,
1az).0
<506
>55
�n
a
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a
l
e
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S_
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e
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Q
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o
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tl
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Permit Date 10//12015 ® 9/30/2020
Last Revised 10-2-2095

Certificate of Coverage No. NCG02 ❑©OQ®
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. 5 pb- A VMA Outfall? Yes ❑ No;'
Is this outfall currently in Tier 2 for any parameter? Yes ❑ NoN
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 ❑
Outfall No.
Total
Rainfall,
inches
TSS,
mg/I
SS,
mill
•
Turbid,'¢���7r
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mg/I
(VMA)
New
Motor Oil
Usage
aVmo.
St®rm afer `
Benchmarks.
Indicate NO
e
sircle __
Benchmark
1 0rouaf
,0160 ;
0
Benchmark Benchmark
501251'10
N/A
uality
Stand rd app
N/A
; Standabap'prl es
1
>SSgeVmo
everage�requlres
O G mordto�rlo r
Date Sample
Collected,
mo/dd/yr
�2
Permit Date 1 011/201 5 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ❑® ®©g
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
Sign,
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