NCG060099_2022 DMR_20220518

Click here for Instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data MonitorinngReeport (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. NCG06ovGidi
Person Collecting Samples: ,•//s
Facility Nan- e: F� .� v, , I;Z,� A, � Laboratory Name: -Fcx�•,w "lie
ia. ly
Facilii.ycouniy: Sz,ir-r'l Laboratory Cert. No.: efb
Discharge during this period: Yes DNo (if no, sop to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? ❑ Yes R No
If so, which Tier (I,11, or III)?
A copy of this DMR has been uploaded electronically via l7u s: (gdocs.de �nc,gav/Forms/SW-DMR yes ❑ No
Date Uploaded:/$/2Z
Analytical MonPoring RequireraerRs for Out- alls wbth Industrial AeNvRies -- Benchroarlcs in ( ki d)
Pararneter
€'ararneier
1
OU-001
Outfill
Ciaatfall
outfall
Code
N/A
Receiving Stream Class
a`n
N/A
Date Sample Collected MM/DD/YYYY
o f / /g lq
46529
24-Hour Rainfall in inches
. ,S'O
C0530
TSS in mg/L (100 or 50'')
11.4
00400
pH in standard units (6.0 -- 9.0 Foil,
`Ir
6.8 — 8. s c'N)
31616
Fecal Col iform per 100 ml of
freshwater (if required) (1.000)
N�lg
61211
Enterococci per 100 ml of saltwater
r44
(if required)
IV
00340
Chemical Oxygen Demand in mg/L
(jlli)
Additional parameters for outfalls 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
N Ik
00552
Non -Polar Oil & Grease in mg/L (15)
// /A
', Outfa Its to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of 5tl ing/2, All other water classifications have a henchmark of 100 mg/i.
RV (Freshwater) SVU (Saltwater)
Notes (optional):
"I certify by mysignature below, under penalty of law, that this document and all attachments were prepared under my direction orsupervision 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 hel€ef, 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
Email Address
.S /g - and 0,
Date
��,-. 94�, - 057
Phone Number