NCG020716 DMR SW

` ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — ST RMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year ZoiS
*Report ALL STORMWATER monitoring data on this form (include "No Flow'T'No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of eat Ee:r
Certificate of Coverage No. Irl , -16
(t — MAR 21 Z016
Facility Name. r\/ 1 lam( 1. CENTRAL FILES
DVVR SECTION
County: Yet
Phone Number:(_) `32 9 1'G(, 7 (a(, 7V Total no of SDOs monitored
Certified Laboratory Lab #
Lab #
Stormwater Discharge Outfall (SDO) No. Lha at 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 ❑
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.
Ponn
Pon
Total
inches
TSS,
mg/I
SS,
ml/I
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mg/I
(VMA)
New
Motor Oil
Usage
(gal/mo.)
Storni water
Benchmarks
Indicate NO
FLOW �f
e"'
Circle
Benchmark
100/50
0.1
CircleN/A
Benchmark
50/25/10
Water Quality
Standard applies
NIA
Water Quality
Standard applies
1 5
>66 gal/mo
average requires
TSS and Non -polar
OaG monitoring
Date Sample
d
Collected,
/dd/
mo yr
��
_-
E
r
2►--I2-Is
L
��ll
z
Permit Date 10/1/2015 — 9/30/2020
Revised 11-16-2015 for Additional Monitoring Specific to this COC

%, Certificate of Coverage No cif C�Mn274
vz.v?/6
.rs:
Outfall No.
continued '
Total Al,
mg/I
Total Cu,
mg/I
Total Pb,
mg/l
Total Ni,
mg/l
Total Zn,
mg/I
Total
Chloride,
mg/I
Total
Fluoride,
mg/I
Total
Hardness,
mg/I
Stormwater
Benchmarks
0.75
0.010
0.075
0.335
0.126
860
6
N/A
Dat Sample e
p
Collected,
mo/ddlyr
�
F..
v
q
-
Permit Gate 10/1/2015 — 9/30/2020
Revised 11-16-2015 forAdditlonal Monitonng Specific to this COC

i
CERTIFICATION
Certificate of Coverage No N JC4)1 own
"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
[Required by 40 CFR §122 22]
Signature J C 4%rt
Date U
ility of fines and imprisonment for knowing violations."
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: DiNR 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
Revised 11-16-2015 for Additional Monitoring Specific to this COC