NCG140031_DMR_20240108

NC Department of
NCDEQ Division of Energy, Mineral and Land Resources Envi, : nment:al Quality
reived
Wastewater Discharge Monitoring Report (DMR) Form for NCG140000Q1
Ready-Mix Concrete
Click here for instructions
Complete,sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report(DMR) Upload form within
30 days of receiving sampling results. Mail the original,signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NCG140031 Person Collecting Samples:Fred Gibson
Facility Name:MV Development, Inc dba Piedmont Ready Mix Laboratory Name: Pace Analytical
Facility County:Randolph Laboratory Cert. No.: 927053343001
Discharge during this period:❑✓ Yes ❑ No (if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?❑Yes No
If so,which Tier(I, II, or III)?
A copy of this DMR has been uploaded electronically via https://edocs.deq.nc.gov/Forms/SW-DMR ® Yes ErNo
Date Uploaded:1-4-24
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Effluent Limits in (Red)
Parameter Parameter Outfall Outfall Outfall Outfall Outfall
Code
N/A Receiving Stream Class 1
N/A Date Sample Collected MM/DD/YYYY 12/22/23
Daily Flow Rate in cfs(50%of 7Q10
82220 12
for HQW/ORW)
C0530 TSS in mg/L(30,20,or 10*) 5.6
pH in standard units(6.0-9.0
00400 7.4
freshwater,6.8-8.5 saltwater)
Settleable Solids In HQW,ORW,SA,
00545 SB,Tr&PNA(5 mL/L) ND
Non-Polar Oil&Grease in mg/L(N/A,
00552 but samples above 15 require tiered N/A
responses)
* Outfalls to Outstanding Resource Waters(ORW),High Quality Waters(HQW)have a TSS limit of 20 mg/L,outfalls to Trout Waters(Tr)and
Primary Nursery Areas(PNA)have a TSS limit of 10 mg/L.All other water classifications have a benchmark of 30 mg/L.
Notes(optional):
"I certify by my signature below,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 informatio ,including the po sibility of ines and imprisonment for knowing violations."
1-4-24
Signature of Permittee or Delegated Authorized Individual Date
Email Address [e-mail] Phone Number 336-672-0957

Pace Analytical Services,LLC
1377 South Park Drive
ace® Kernersville,NC 27284
[phone]
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Laboratory Report
Patty Perry Report Date: 01/02/2024
Piedmont Ready Mix Date Received: 12/22/2023
524 W. Bailey St.
Asheboro, NC 27203
Project: Piedmont Ready Mix
Pace Project No.:92705343
Sample: OF 1 Lab ID: 92705343001 Collected: 12/22/23 09:40 Matrix: Water
Method Parameters Results Units Report Limit Analyzed Qualifiers
SM 2540D-2015 Total Suspended Solids 5.6 mg/L 2.5 12/26/23 11:12
SM 2540E-2015 Total Settleable Solids ND mL/L/hr 0.10 12/22/23 15:00
leeokt
Reviewed by: ceru� J
Stephanie Knott
704-977-0981
[e-mail]
Pace Analytical Services Eden
205 East Meadow Road Suite A,Eden,NC 27288 North Carolina Wastewater Certification#:633
North Carolina Drinking Water Certification#:37738 VirginiaNELAP Certification#:460025
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