NCG160116_2022 DMR_20220311

NCDEEi Division Of Energy, Minerai and Land Resources
Stormwater Discharge Monitoring Report (DMR) Forth for NCG160000
Asphalt paving Mixtures and Blocks
Click here for instructions
Complete, sign, scan and suhmit 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 ❑EMLR Regional Office.
Analytical Monitoring Requirements for 0utfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Code Parameter Outfall f Outfail Z Ouifiall Outfall Outfall
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY Z
46529 24-Hour Rainfall in inches N
C0530 TSS in mg/L (100 or 50T) *,
Additional parameters for outfalls in drainage areas that use>55 gallons per month of new hydraulic oil on average
00552 Non --Polar Oil & Grease in mg/L(IS)
NCOIL Estimated New Motor/Hydraulic Oil
Usage in gal/month
Outfalls Co Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr} and Primary Nursery Areas (PNA)
have a benchmarkT55 limit of 50 mg/L. All other water classifications have a benchmark of 100 mg/L.
Notes (optional).
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inquiry of the persorti or persons who manage the system, or those persons directly responsible for gathering the information, the information
submitted is, to the best -of soy 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 imprisonmentfor knowing violations."
sign ure or' Pernlitte or Delegated Authorized Individual Date
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