NCG020313 DMR SW (2)

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
-r, -•-•-....-,-:--,..,_ ,.-z -µms•L, ! '.x, ,1 -_ .�_ _ .. x •- -
General Permit No. NCG020000
Calendar Year `ZO I (o
ike"ort ALL STOWili!'_St ER morsit igilpdagto;n�this form nc uta o Flow1, o:��sc3 a g:aid B_h,74rnark °; ,,,1
.t.. _ -F ceedlal;>ces)iforvi=fl;ieiprevious�dalendar}.ye_artoithe DEQ b.,$.'A%MAi 0t741,o,se ehcyear. ,..44 , = ,..,
Certificate of Coverage No.` NC--602'4F-I,'on JAS 12) 2011
Facility Name: K I I-t-+t2. tlL& I'M z- --.%1-5.-
County:
•• ��
County: La.lz c,-i-,( �.._5 Ci.C`S-CR-_,:r-.‘
C�-`1C\I
Phone Number: (76 L) ) Z1�1- 5 36 9 4Otai no. of SDOs monitored 2-
Certified Laboratory c7i'a '-S vile-AN 41 y I-►CAN I Lab# q't/v
Lab#
Stormwater Discharge Outfall (SDO) No. O t VMA Outfall? Yes ❑ No [e]'
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No EY
Was this outfall ever in Tier 2 during the past year? Yes ❑ No IL
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 0
Other 0
Upstream Downstream New
Total TSS, SS, Turbidity, (U)Turbidity, (D)Turbidity, Non-polar Motor Oil
Outfall No. Rainfall, mgll mi/I NTU NTU NTU O&G, mg/I Usage
inches (VMA) (gal/mo.)
Stormwater C'�1e Circle N/A N/A >55 gal/mo.
Indicate NO Benchmark Benchmark average,reguires
F@OW if, •WaterQuaip Wafei•iluaiity 1,5 TSS and Nonpolar"
Be/7C/]I7)a�k5 applrca6fe 100/50 ®'1 50/25/10 Standard applies standardiapplies ABG monitoring
Date Sample
Collected,
mo/dd/yr }
0c)/%11 6 (90 Z J i2 c b , ( ID N1ra NfA N/✓a N 114
12-j1 'jttto 4 ' h'D 43. 2 <0. ' 1. 3 1.111K NIA 14/A- NIA
Permit Date 10/1/2015—9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCGO2 o I s I i Imo.
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. lJ 2.- VMA Outfall? Yes ❑ No [
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No &K.
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 D
Other ❑
Upstream Downstream New
Total TSS, SS, Turbidity, (U)Turbidity, (D) Turbidity, Non-polar Motor Oil
Outfall02- Rainfall, mg/I mill NTU NTU NTU O&G, mg/I Usage
inches (VMA) (gal/mo.)
StOl7ritfl/c�tef Circle Circle era a galtme.
Indicate NO Benchmark Benchmark N/A N/A average requires
Benchmarks apPnWni 100/50 0.1 50/25/10 sty .tiara apps s tiara aPPu 1-- T sG m nht ring r
Date Sample
Collected,
mo/dd/yr
vsl)S//1, 0a2. S 4 , 3 a, l 5 !J/� N /A N/A /l11-
12-1 141( 1 Ca d , /v b . Co <0., I . 4 iv/A A �A N/A A✓% -
Permit Date 10/1/2015-9/30(2020
Last Revised 10-2-2015

Certificate of Coverage No. NCGO2 F1® 1131
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 )r £. ~�1'r''�'
Date 31/7
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