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HomeMy WebLinkAboutNCG060126_2021 DMR_20211229 (2)NCDEQ Division of Energy, Mineral and Land Resources Stormwater Discharge Monitoring Report (DMR) Forth for NCG060000 Food and Kindred 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 ajpropriate DEMLR Regional Office. Certificate of Coverage No. NCG06 � , Person Collecting Samples: fYTj Facility Name: „ ,�i i e)e). Re5k i4 e,,b Cry Laboratory Name: �_ ti ,rU _L A,, Facility County: �j �, de . Laboratory Cert. No.: Discharge during this period: ❑ Yes a 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 (1, II, or III)? A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.gov/Forms/SW-DMR Yes ❑ No Date Uploaded: Analytical Monitoring Requirements for putfalls with Industrial Activities — Benchmarks in (Red) Parameter Parameter Outfall Outfall Outfall Outfall Outfall Code N/A Receiving Stream Class N/A Date Sample Collected MM/DD/YYYY 46529 24-Hour Rainfall in inches C0530 TSS in mg/L (100 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 putfalls in drainage areas that use >55 gallons per month of new hydraulic oil on average Estimated New Motor/Hydraulic Oil NCOIL Usage in gal/month 00552 Non -Polar Oil & Grease in mg/L (15) * Outfalls to Outstanding Resource waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA) have a benchmark TSS limit of 50 mg/L. All other water classifications have a benchmark of loo mg/t. FW (Freshwater) sw (Saltwater) Notes (optional): "I certify by my signature beiow, 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`rtFe b st of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false inforZtion, inc ding the possibility of fines and imprisonment for knowing violations." Signatur oe f Permittee od Delegated Authorized individual (-IVM,5 (�Ai,d \�e0 (,VV\— Email Address Date Phone Number