NCG020007 DMR WW (2)

1
,1
ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — WASTEWATER
ra SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year ?©1:S7
*Report ALL WASTEWATER monitoring data on this form (include"No Flow"/"No Discharge"and Limit Violations)from
the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG02s.®0®0r;' o
Facility Name: 1,r,AA,4 .An.ti,. C C f — kr rc n., REC NED
County: W,i c(,t..t y„,C, JAN 1 1 2O1
Phone Number: (q k 0 ) S 2.-c(.S j f (- Total no. of outfalls monitored --
Certified Laboratory Lab# CENTRAL FILES
DWR SECTION
Lab#
Wastewater(WIN) Discharge Outfall No.
Is this an industrial sand mine(See 40 CFR§436 Subpart D)? Yes ►AL No ❑
Does this outfall discharge WW to SA waters? Yes ❑ No J
Does this outfall discharge WW to SB or PNA waters? Yes ❑ No RI
Does this outfall discharge WW to HQW or ORW waters? Yes ❑ No I
If so,what is the 7Q10 flow rate? or Tidally influenced waters, 7Q10 not available ❑
Does this outfall discharge WW to Trout(Tr) designated waters? Yes ❑ No
Were there any limit violations in the calendar year? Yes ❑ No 0
_ - - , - , -Fecal .
- _
'0utfaII No. - „ Daily Flow pH, TSS, , S, ' Discharge - `Upstream - Downstream-. Coliform,
-- - .- - , ;Rate,cfs: SU - 'mg/I -; ,-mIll ' Turbidity;-,—(U)-Turbidity; (D) Turbidity, col/100 ml
- - - _ - -- ,ifappbcable ; 'NTU NTLI `, , _. NTU. ' . -(SA) -
Industrial Sand
HQW 50%orORWf freshwater 25/45 HQW,ORW, No Limit N/A N/A
Effluent of 6.0-9.0 HQW or ORW SA,SB,PNA,
Limitations - 7Q10 saltwater 20/30 or any Trout Circle Water Water Quality Water Quality N/A
6.8-8.5 HOW orORW 0.1/0.2
Quality Standard Standard applies Standard applies
thatapplies:
Mo.Ave/Daily Max. Indicate//app�cabO LOW and Tr or PNA 50/25/10
10/15
Date,Sam pl e ,3, :° _ g k�.m":„ ,s > ,. f�= i;;:5'2.;':;,'4;;;-:' :"` i- 1
Collected,- -r"'rA'�'�:'�,u , t,r's,�,;,. ., F;�£, ' �I~,=,>e " ( �,. .
m dd/Vr' ~° - _ „I";T- .,}€-;.°W°: ',1.iV f., , a; -i f° }[p
of 'J' - �� _;�° xFt . w� i�': _. � � m.,. xLL6xa wt,, �a;rs ,��J �tw..., , .d.. l'., .-, .nm , A<, ,,,,,,::::::::n�
'261,S—
Alia a c l"�" ,, f 1 s FL,,-"_' ,1�°Sir°`L A 1 J 2-4)i A"Aso -�I a.AI A�1 zoo:"
A( b tks(- Ll< I AAN c z ,ce(,,, 0� tx-- ,2: a.\-- - De—e_a".t..4-- Azi A.---
Permit
Permit Date 10/1/2015—9/30/2020
Last Revised 10-2-2015

1,
Certificate of Coverage No. NCGO2 ®[Q® �✓
Additional Outfall Attachment (make copies as needed for additional outfalls) ,
t
i
Wastewater(WW) Discharge Outfall No.
Is this an industrial sand mine(See 40 CFR§436 Subpart D)? Yes 'i1 No ❑
Does this outfall discharge WW to SA waters? Yes ❑ No ►!
Does this outfall discharge WW to SB or PNA waters? Yes ❑ No 0
Does this outfall discharge WW to HQW or ORW waters? Yes ❑ No [VII
If so,what is the 7Q10 flow rate? or Tidally influenced waters, 7Q10 not available ❑
Does this outfall discharge WW to Trout(Tr) designated waters? Yes ❑ No NJ
Were there any limit violations in the calendar year reported? Yes ❑ No 1p
''Daily3Elow,,'_- ,.pH,. , TSS;, . =: ..,SS,' . ' Discharge; ".Upstream:'',':Downstream -Coliform..
, =
:

�^ Certificate of Coverage No. NCGO2 nEi®2
(tel '
�' —,. -ent (make copies as needed for additional outfalls)
WasI. .,charge Outfall No.
Is this an I.. ,Arra/
.. sand mine (See 40 CFR§436 Subpart D)? Yes1 ] No ❑
Does this outfall discharge WW to SA waters? Yes ❑ No`j
Does this outfall discharge WW to SB or PNA waters? Yes ❑ Nd J
Does this outfall discharge WW to HQW or ORW waters? Yes ❑ No']
If so,what is the 7Q10 flow rate? or Tidally influenced waters, 7Q10 not available ❑
Does this outfall discharge WW to Trout(Tr) designated waters? Yes ❑ Nos]
Were there any limit violations in the calendar year reported? Yes ❑ No 0
Fecal
Outfall No. 'Daily Flow pH, TSS; SS, Discharge Upstream Downstream, Coliform,
- - - Rate, cfs SU mg/I ml/I Turbidity,, (U) Turbidity, (D)' Turbidity, col/100 ml
if applicable :NTU - -NTU NTU,_ ' (SA),
Industrial Sand
HQW Effluent 50% RW 6.0-9.0 freshwater 25/45 HQW,ORW,
HQW or ORW SA,SB,PNA, No Limit N/A N/A
50�0 of
Limitations7Q10 saltwater 20130 or any Trout Circle Water Water Quality Water Quality NIA
Quality Standard Standard applies Standard applies
6.8'8.5 HQW or ORW 0.1/0.2 that applies:
Mo.Ave I Dally Max. Indicate NO FLOW and Tr or PNA 50/25/10
if applicable 10/15
Date Sample C` : " ` If:H-- » ,I4 __ -,d'� ,
Collected, - ,,' °II•: x. i.,. Ii• .i, - --i"- - _
.mo/dd/yr , , _ '3, _ -`} .�.�:. _i. � .�..�_ .L__' ---- •- ' f_� �� _. i L. - , - ,, ,
Ja_ l_._.. .__ a�_ i
Permit Date 10/1/2015—9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCGO2
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 falh.e information, including the possibility of fines and imprisonment for knowing violations."
[Required by 0 CFR§122.
r
Signature
Date 31
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
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