NCG030261_2022 DMR_20220413

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG030000
Metal Fabrication Page 1 of 2
Click here for instructions Dec. 2021
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitorin 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. NCG03 0261
Person Collecting Samples: Sharnetta Simmons (LS Cable)
Facility Name: LS Cable & System USA, Inc.
Laboratory Name: Environment 1, Inc.
Facility County: Edgecombe
Laboratory Cert. No.: DW # 37715, WW # 10
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)? Tier One
A copy of this DMR has been uploaded electronically via https.Iledocs.deQ.nc. ov/Forms/SW-DMR __ Yes Lvlj No
Date Uploaded: email & us Mail only
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in
Parameter
Code
Parameter
Outfall SDO-1
Outfall SDO-2
Outfall SDO-3
Outfall SDO-4
Outfall SDO-5
N/A
Receiving Stream Class
WS-IV
WS-IV
WS-IV
WSW
WS-IV
N/A
Date Sample Collected MM/DD/YYYY
12/08/21
12/08/21
12/08/21
12/08/21
12/08/21
46529
24-Hour Rainfall in inches
Not Measured
Not Measured
Not Measured
Not Measured
Not Measured
C0530
TSS in mg/L (100 or 50*)
3.1
48
11
24
119
00400
pH in standard units (6.0-9.0 FW,
6.4
7.4
7.1
6.7
6.6
6.8-8.5 SW)
01119
Copper, total recoverable in mg/L
0.006
0.065
0.018
0.032
0.041
(0.010 FW, 0.0058 SW)
01051
Lead, total recoverable in mg/ L
(0.075 FW, 0.22 SW)
<0.005
<0.005
<0.005
<0.005
<0.005
01094
Zinc, total recoverable in mg/ L ,_.
FW, 0.095 SW)
0.057
0.061
0.021
0.027
0.175
00340
Chemical Oxygen Demand (COD) in
mg/L (120)
Not Analyzed
<5.0
Not Analyzed
<5.0
Not Analyzed
<5.0
Not Analyzed
<5.0
Not Analyzed
<5.0
00552
Non -Polar Oil & Grease in mg/L
Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of . All other water classifications have a benchmark of
FW (Freshwater) SW (Saltwater)
Notes (optional): LS Cable is in process of replacing rain gauge, will collect rainfall data in future events after March 2022
77
"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 information, including the possibility of fines and imprisonment for knowing violations."
Signature of Permittl"r Delegated Authorized Individual
ed. h ardv cbo-h
Email Address
V °— /.2. 2a22
Date
252 92-q 3 2— S—
Phone Number

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG030000
Metal Fabrication Page 2 of 2
Click here for instructions Dec. 2021
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring.Report (DMR) U loaa wi Fr . within
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the appropriate DEMLR Regional L.rice.
Certificate of Coverage No. NCG03 0261
Person Collecting Samples: Sharnetta Simmons (LS Cable)
Facility Name: LS Cable & System USA, Inc.
Laboratory Name: Environment 1, Inc.
Facility County: Edgecombe
Laboratory Cert. No.: DW # 37715, WW # 10
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)? Tier One
A copy of this DMR has been uploaded electronically via -Etps://edocs.deg.nc.gov/Forms/SW-DM Ej Yes No
Date Uploaded: email & us Mail only
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
i Parameter
Code
Parameter
Outfall SDO-6
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
WS-IV
N/A
Date Sample Collected MM/DD/YYYY
12/08/21
46529
24-Hour Rainfall in inches
C0530
TSS in mg/L (200 or 50*)
00400
pH in standard units (6.0-9.0 FW,
6.8-8.5 SW)
01119
Copper, total recoverable in mg/L
(0.010 FW, 0.0058 SW)
01051
Lead, total recoverable in mg/ L
(0.075 FW, 0.22 SW)
01094
Zinc, total recoverable in mg/ L (0.126
FW, 0.095 SW)
00340
Chemical Oxygen Demand (COD) in
mg/L (120)
00552
Non -Polar Oil & Grease in mg/L
Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of . All other water classifications have a benchmark of DO mg/L
FW (Freshwater) (Saltwater)
Notes (optional): No discharge at SDO-6.
"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 information, including the possibility of fines and imprisonment for knowing violations."
Signature of Permittee or Delegated Authorized Individual Date
ed , hard P L 5 c5 v 5A � Cori,
Email Address
_25a. -23525-
Phone Number

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG030000
Metal Fabrication Page 1 of 2
Click here for instructions Feb. 2022
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitorin 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. NCG03 0261
Person Collecting Samples: Sharnetta Simmons (LS Cable)
Facility Name: LS Cable & System USA, Inc.
Laboratory Name: Environment 1, Inc.
Facility County: Edgecombe
Laboratory Cert. No.: DW # 37715, WW # 10
Discharge during this period:
✓_
Yes
El
No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? ✓ Yes 17 No
If so, which Tier (I, II, or III)? Tier Two
A copy of this DMR has been uploaded electronically via https://edocs.de .nc.FovzForms/SW-DMR U Yes ✓ No
Date Uploaded: email & US Mail only
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Code
Parameter
Outfall SDO-1
Outfall SDO-2
Outfall SDO-3
Outfall SDO-4
Outfall SDO-5
N/A
Receiving Stream Class
WS-IV
WS-IV
WS-IV
WS-IV
WS-IV
N/A
Date Sample Collected MM/DD/YYYY
02/07/2022
02/07/2022
02/07/2022
02/07/2022
02/07/2022
46529
24-Hour Rainfall in inches
Not Measured
Not Measured
Not Measured
Not Measured
Not Measured
C0530
TSS in mg/L (100 or 50*)
<2.5
115
33
119
22
00400
pH in standard units (6.0 — 9.0 FW,
5.7
7.2
6.9
6.8
6.0
6.8-8.5 SW)
01119
Copper, total recoverable in mg/L
0.004
0.091
0.032
0.062
0.008
(0.010 FW, 0.0058 SW)
01051
Lead, total recoverable in mg/ L
<0.005
0.008
<0.005
0.011
<0.005
0.075 FW, 0.22 SW)
01094
Zinc, total recoverable in mg/ L (0.126
0.042
0.093
0.044
0.093
0.141
. W, 0.095 SW)
00340
Chemical Oxygen Demand (COD) in mg/L (120)
Not Analyzed
Not Analyzed
Not Analyzed
Not Analyzed
Not Analyzed
00552
Non -Polar oil & Grease in mg/L (15)
<5.0
<5.0
<5.0
<5.0
<5.0
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 i00 mg/L
FW (Freshwater) (Saltwater)
Notes (optional): LS Cable is in process of replacing rain gauge, will collect rainfall data in future events after March 2022
"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 information, including the possibility of fines and imprisonment for knowing violations."
Signature of Permittee or Delegated Authorized Individual
ell I Aai-dly P LS GS u SA . CAm
Email Address
�-6z2
Date
Phone Number

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG030000
Metal Fabrication Page 2 of 2
Click here for instructions Feb. 2022
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report I DMRJ 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. NCG03 0261 Person Collecting Samples: Sharnetta Simmons (LS Cable)
Facility Name: LS Cable & System USA, Inc. Laboratory Name: Environment 1, Inc.
Facility County: Edgecombe Laboratory Cert. No.: DW # 37715, WW # 10
Discharge during this period: MYes No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? .✓ Yes UNo
If so, which Tier (I, II, or III)? Tier Two
A copy of this DMR has been uploaded electronically via ems://edocs.deg.nc.gov/Forms/SW-DI, Yes _i✓_j No
Date Uploaded: email & us Mail only
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Code
Parameter
Outfall SDO-6
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
WS-IV
N/A
Date Sample Collected MM/DD/YYYY
02/07/2022
46529
24-Hour Rainfall in inches
Not Measured
C0530
TSS in mg/L (100 or 50*)
7.7
00400
pH in standard units (6.0-9.0 FW,
6.3
6.8-8.5 SW)
01119
Copper, total recoverable in mg/L
0.014
(0.010 FW, 0.0058 SW)
01051
Lead, total recoverable in mg/ L
<0.005
(0.075 FW, 0.22 SW)
01094
Zinc, total recoverable in mg/ L (0.126
0.030
FW, 0.095 SW)
00340
Chemical Oxygen Demand (COD) in
Not Analyzed
mg/L (120)
00552
Non -Polar Oil & Grease in mg/L ' S)
<5.0
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 300 mg/L
(Freshwater) SW (Saltwater)
Notes (optional): LS Cable is in process of replacing rain gauge, will collect rainfall data in future events after March 2022
"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 information, including the possibility of fines and imprisonment for knowing violations."
Signature of Permittee or Delegated Authorized Individual
P-d, A,
Email Address
Date
25-a F-ay 35a�
Phone Number