NCG060126_2021 DMR_20211229

NCDEQ Division of Energy, Mineral and Land Resources
Storm►rrater Discharge Monitoring Report JDfi Ri Form for NCG060000
Food and Kindred
Click here for instructions
1 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 DEIYILR Regional Office.
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter Parameter
Code
Outfall
Outfall Outfall
Outfall Outfall
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY
46529 24-Hour Rainfall in inches
C0530 TSS in mg/L (1DD or 50*)
pH in standard units (6.0 _ 9.0 Fw,
00400
6.8 - 8.5 SW
Fecal Coliform per 100 ml of
31616
freshwater (if required) 1000
Enterococci per 100 ml of saltwater
61211
(if required) 500
Chemical Oxygen Demand in mg/L
00340
120
Additional parameters for outfalls in drainage areas that use >55 gallons per month of new hvdraulir
nil nn ap�aeo
NCOIL
Estimated New Motor/Hydraulic oil
Usage in gal/month
00552
Non -Polar Oil & Grease in mg/L (15)
* Outfalls to Outstanding Resource Waters (ORW), high Quality Waters (iHQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of so rng/t.. Ali other water classifications have a benchmark of 100 mg/t
FW (Freshwater) 5w (Saltwater)
Notes (optional): 'Alorf ' - r 5 „y� jc iw
"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 property 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,�aTfie Y -di
of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting
false info ation, inc ding the possibility of fines and imprisonment for knowing violations."
Permittee od Delegated Authorized Individual
Email Address
Date
- 13 1551
Phone Number