NCG020007 DMR WW (3)

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) —WASTEWATER
SUBMIT TO CENTRAL OFFICE
General Permit No. N00020000
Calendar Year ;2 fl l
`Report ALL WASTEWATER monitoring data on this form (include"No Flow i'No Discharge"and Limit Violations)from
the previous calendar year to the DECkby; ARCl 1 oreach year.
Certificate of Coverage No. NCGO2 DODO C ��� *
Facility Name:
County:
Phone Number: (RI 0 ) I ((0 Total no. of outfalls monitored
Certified Laboratory Lab#
Lab#
Wastewater(WW) Discharge Outfall No.
Is this an industrial sand mine(See 40 CFR§436 Subpart D)? YesE No ❑
Does this outfall discharge WW to SA waters? Yes 0 No El
Does this outfall discharge WW to SB or PNA waters? Yes 0 No E!
Does this outfall discharge WW to HOW or ORW waters? Yes 0 No Lf
If so,what is the 7Q10 flow rate? or Tidally influenced waters,1Q10 not available ❑
Does this outfall discharge WW to Trout(Tr) designated waters? Yes ❑ NoR)
Were there any limit violations in the calendar year? Yes 0 No 2
Fecal
Outfall No. Daily Flow pH, TSS, SS, Discharge Upstream Downstream Coliform,
Rate, cfs SU mg/I mill Turbidity, (U)Turbidity, (D)Turbidity, col/100 ml
//applicable NTU NTU NTU (SA)
tnduslrial Sand
EffluentHnwor oRt'r freshwater 25145 KW,ORW, No Limit N/A N/A
50% of 6.0-9.0 HOW or ORW SA,SS,PHA,
Limitations 7Q10 sattwater 20/30 or any Trout Circlewater WaterQuahty Water Quality N/,4
that applies:
•
• 6.8-8.5 HOW or ORW 0.1/0.2 QuaatyStendard Standardappltes Standard applies
Mo.Ave/Sally Max. /nd��alpapNOblOW aradTrorPNA 50/25/10
10/15
Date Sample ,' .. ; : - -. k . ;
Collected, �;' �; .,9,,
mo/ddlyr ' - -� ,�--_ ' _
.L Vs
ICC: Q tti _ `i \ _ �.i �. tet.A 2©
MINEI-"1■' MEM(0
IBRLIMMilli.� � illijiMM !
1—t ri72
AN 1 8 2017
C NTRAL FILE
LVVI bhU HON
Permit Date 10/1/2015—9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCGO2 ®®Q®
Additional Outfall Attachment (make copies as needed for additional outfalls)
Wastewater(WW) Discharge Outfall No.
Is this an industrial sand mine(See 40 CFR§436 Subpart D)? Yost, No 0
Does this outfall discharge WW to SA waters? Yes 0 No Ej
Does this outfall discharge WW to SB or IRNA waters? Yes 0 No f .
Does this outfall discharge WW to HQW or ORW waters? Yes 0 No
If so,what is the 7Q10 flow rate? or Tidally influenced waters, 7Q10 not available 0
Does this outfall discharge WW to Trout(Tr) designated waters? Yes 0 Nola
Were there any limit violations in the calendar year reported? Yes 0 No g
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
EffluentHQWorORW freshwater` 25145 HQw.oRv,
50% of 6.0-9.0 How or OM SA,SS,PNA, No Limit N/A N/A
Limitations 7(110 saltwater 2010 -oranyTroutuClrcleWater IYaterQuahty Water Quality N/A
6.8-8.5 HOW or OM 0.1/0.2 Othatappliesard Standard applies Standardapplles
Mo.Ave/Dally Max. lndicaieNOFLOW aQd_TrorPNA 50/25/10
!/applicable 10/15
Date Sample ___= ,���� _ _ > _ t
Collected,
mo/dd/yr „=_ : , ' ; _ . I . _
Permit Date 10/1/2015—9/30/2020
Last Revised 10-2-2015

f
4
Certificate of Coverage No. NCGO2 cogpi
Additional Outfall Attachment (make copies as needed for additional outfalls)
Wastewater(WW) Discharge Outfall No.
Is this an Industrial sand mine(See 40 CFR§436 Subpart ID)? YesN No 0
Does this outfall discharge WW to SA waters? Yes❑ No`bJ
Does this outfall discharge WW to SB or PNA waters? Yes❑ No fit
Does this outfall discharge WW to HQW or ORW waters? Yes 0 No gl
If so,what Is the 7Q10 flow rate? or Tidally influenced waters, 7Q10 not available 0
Does this outfall discharge WW to Trout(Tr) designated waters? Yes❑ No E
Were-there any limit violations in the calendar year reported? Yes 0 No rt
Fecal
Outfall No Daily Flow pH, TSS, SS, Discharge Upstream Downstream Coliform,
Rate, cfs SU mg/1 mill Turbidity, (U) Turbidity, (D)Turbidity, col/100 ml
II applicable NTU NTU NTU (SA)
Industrial Sand
HOW or ORW freshwater ?5145 HQw,oRL^
Effluent oQ No Limit N/A NIA
50 Of 6.0'9•® HOWorORW SA,SB,PNA,
Limitations 7Q10 saltwaler 20130 or any Trout CtrcteWYater VlaterQualily Water Quality N/ft
6.8-8.6 HOW orORV! 0,110,2 Quality Standard Standard applies Standard applies r1
that applies:
Mo.Ave IDaily Max. Indicate
eNOF LO
>n Tr or PNA 50/25/10
10/15
Date,Sample ` _,::::-A, -, - - ,, ;
I= _i < Y,_=:-4 �. . _ --- i - _ :- - - �!f=-
-
i - - ir t-'. �w s , ;? ,Collected, - . t; _ 3;� :,:i.- r . - g _
moldd/ r t_ LL 'L _I - -i r; ,::,,I=,-_,::
Permit Date 1011/2015-9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 12111=1M
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 a d belief,true, accurate, and complete. I am aware that there are significant penalties for
submittingIf se inforr a '•n, including the possibility of fines and imprisonment for knowing violations."
(Required 1)3 4 CFR§1 : •) 1
1
Signature ,k_ P. I
___....,_
Date / /j/ �i � i
/ .
Mail Annual Summary Wastewater DMR to the NCDEQ Central Office:
Note the address is correct—Central Files is housed in DWR(no 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 1011/2015—9/30/2020
Last Revised 10-2-2015