NCG020001 DMR SW (4)

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT DMR—STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year a 01 S
*Report ALL STORMWATER monitoring data on this form (include "No Flow'? No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG02
Facility Name:
County: Wo
Phone Number:( III ja& - 1100 Total no. of SDOs monitored
Certified Laboratory NC 0 LA b g Lab # pwd"q 6
Lab #
3
Stormwater Discharge Outfall (SDO) No. S 0-3 EQ -I VMA Outfall? Yes [�f No ❑
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No If
Was this outfall ever in Tier 2 during the past year? Yes ❑ NoRECEIVED
If this outfall was in Tier 2 last year, was monthly monitoring discontinued? FED 11 2016
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
❑ CENTRAL FILES
❑ DWR SECTION
4 Al °_1
Total
Rainfall,
inches
TSS,
mg/I
SS,
mUl
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mg/I
(VMA)
New
Motor Oil
Usage .
gal/mo..
Stormwater
Benchmarks
Indicate NO
applicable
�'"'e
B ehmark
0050
0.1
Circle
enehmark
5 25/10
N/A
Quality
Standard applies
N/A
Stter ter QualityC
andard applies
15
>55 a requires
average requires
TOSG monitoringSS and Non-polar
Date Sample
Collected,
mo/dd/yr
Permit Date 10/1/2015 - 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ©0®
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
Date q
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

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT DMR — STORMWATER
` SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year a 0 1 S
*Report.ALL STORMWATER monitoring data on thisform(include"'No Flow"/"No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH',1: of each`.year.
Certificate of Coverage No. NCG02Q❑ 00 0 — �- r V
FEB � 1 2016
Facility Name: Tf'Iana�Q QUO{'/'y
County: Wake_ CENTRAL FILES
Phone Number: Ctu DwR SECTION
Ta
otno. of SDOs monitored 3
Certified Laboratory �- NC D Lab g Lab # awd"g6
Lab #
Stormwater Discharge Outfall (SDO) No. SP0-5 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 Q�
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
S�
Total
Rainfall,
orches
a
TSS
mg/I .
SS
mtLl
Turbidity,`
NTU ''
Upstream
U Turbidi
O . it -,j,
NTU
K
Downstream
(D) Tub�dity
NTU
Non polar
OCG; mg%I
P
f
New .
Motor Oil,:
` Usage
,Stormwater
Benchmarks
Indicate NO
FcowH
_.. applicable
circle
Benchmark
1:00/50
0.1"
Circle
Benchmark;
50/25/10
N/A
Water Quality
Standard applies
N/A
Water Cuailty
Standard applies
15 .
>u gaymo.
average requires
TSSer and requires
a d Non-monitoIn
Date Sample:.
Collected,
'mo/dd/yr,'
-.
-
.
,
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ©OQ©
CERTIFICATION
N 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
Date �,/
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