NCG020171 DMR SW (2)

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
• - `[ SBM! ,CENTRALOFFICE*-
General Permit No. NCG020000
Calendar Year 2016
*Report AUL STORMWATER monitoring data on this form(include No Flow/"No Discharge andgB,enchrr ark
-- - 'E ceedances)from the previous calendar year to the DEQ,by MARCH 1.of each year -1 _----
PEeN
Certificate of Coverage No. NC,0021)171 - ` JAN 2 3 2017
Facility Name: _Clarks Quarry
County: _Craven DWRiAL SECTION
Phone Number: (252)_633-5308_ Total no. of SDOs monitored 1
Certified Laboratory_Pace Analytical Services, Inc. Lab#_67
Lab#
Stormwater Discharge Outfall (SDO) No. _SDO1 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 /1
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency 0
Yes, received approval from DEMLR to reduce monitoring frequency ❑
No,turbidity benchmark exceedances did not require monthly monitoring 0
Other ❑
Upstream. Downstream New
Outfall No. Total TSS, SS, Turbidity, (U) Turbidity, (D) Turbidity, Non-polar Motor Oil
SDO 1 Rainfall, moml/I NTU NTU NTU O&G, mg/I Usage
inches - (VMA) (gal/mo.)`
Circle Circle N/A N/A >55 gallmo.
Stormwater Indicate NO Benchmark Benchmark average requires
Benchmarks FLOW it 100/50 0.1 50/25/10 Water Quality Water Quality 15 TSS and Non-polar
applicable Standard applies Standard applies o&o monitoring
Date Sample
Collected,
mo/dd/yr
No discharge
for 2016
Permit Date 10/1/2015—9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCGO2 0171
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§122.22]
•Signature .�w�.1
Date 1/16/17
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