NCG020097_DMR_20210218

ANNUAL SUMMARY DISCHARGE MONITORING
— WASTEWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year z e:z t2
`Report ALL WASTEWATER monitoring data on this form (include "No Flow'Y"No Discharge" and Limit Violalions) hom
the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG02
Facility Name. 2III ri Nv�t4"IAn V a,111,1 /
County: _ _)j,,, I/ /
Phone Number: CZ,, t g%2 7 - q, 1} ?,p Total no. of outfalls monitored _
Certified Laboratory P-ACIi Lab # 9 a
Lab #
Wastewater (WW) Discharge Outfall No. r- ; T
Is this an industrial sand mine (See 40 CFR §436 Subpart D)?
Does this outfall discharge WW to SA waters?
Does this outfall discharge WW to SB or PNA waters?
Does this outfall discharge WW to HQW or ORW waters?
If so, what is the 7010 flow rate?
Yes ❑
No ❑-
Yes ❑
No (3
Yes ❑
No
Yes ❑
No ❑
or Tidally influenced waters, 7Q10 not available ❑
IN this outfall discharge WW to Trout (Tr) designated waters? Yes F1
Were there any limit violations in the calendar
Yes
NOR
Nof9
E
Dail Flow
y
Rate, cfs
PH,
SU
TSS,
mg/1
SS,
ml/t
dapppcabt°
Discharge
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Fecal
Coliform,
col(SA) mt
SA
Effluent
Limitations
Mn. Ave / pally Max.
Date Sample
Collected,
mo/dd/ r
HOW"r ORW
50°/p of
7Q10
InA1ra,a NO FLOW
Iraypllcaply
nuhwatar
6.0-9.0
aallwaM,
6.8-�•5
IntlualrMl Santl
25/45
NOWprORW
20/30
HOW pr ORW
a-d Tr nr PNA
10/15
�W ,PN.
s SBT,
a,ap
Y0.2
0.1/U.2
No Limit
Ohnla Wall,
pualitY9alwam
taal applloa:
50/25/10
N/A
Water Qualityi
Standards pWlee
N/A
W"°iOua1py
SwntlarU apWlp.
N/A
PA
7, `
0AXA
v
A-7
,vt
7•
o v
Ir. 1-1,41
9, t
u
r GP.-vt
7
fJ
33.
ezA
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 EEO 0 7❑
Additional Outfall Attachment (make copies as needed for additional outfalls)
Wastewater (WW) Discharge Outfall No.
Is this an industrial sand mine (See 40 CFR W6 Subpart D)? Yes ❑ No ❑
Does this outfall discharge WW to SA waters? Yes ❑ No ❑
Does this outfall discharge WW to SB or PNA waters? Yes ❑ No ❑
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 ❑ No ❑
Were there any limit violations in the calendar year reported? Yes ❑ No ❑
Outfall No. I Daily Flow
Rate, cfs
PH,
SU
TSS,
mg/i
SS,
ml/1
nappncaere
Discharge
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Fecal
Coliform,
col/100 ml
SA
Effluent Irowo, oew
50%of
Limitations 7Q10
N.. 4v.rltlaily MdR ! In"I'dlO NO now
It dlt,.hh"
voamyael
6.0-9.0
.dlObdOt>,
6.8-8.5
IuduaNlal sand
25/45
N7W ,30;W
20/30
NOW o, ORIN
PRdTI OI PNA
10/15
NOW. ORW.
SA.S8.PNA.
a.ddynddt
0.1 /0.2
No Limit
UalitySwMIard
that aWllea:
50/25/10
N/A
StandardaFPllaa
N/A
StanOrdiddllaa
NIA
Date Sample
Collected,
mo/dd! r
t:d
Permit Date 101112015 — 9/3012020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 [j1F±1EE
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 z o z
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