NCG030714_Monitoring Report_20220127

NCDEQ Division of Energy, Mineral and Land Resources
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Stormwater Discharge Monitoring Report (DMR) Form for NCG03000o
Metal Fabrication
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Click here for instructions
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Complete, sign, scan and submit the DM via the Stormwater NPDES Permit Data M on itoring
Re Dort DMR L 'ad form within
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the appropriate
DEMLIT Regional Office.
Certificate of Coverage No. NCG03 0714
Person Collecting Samples: Clinton Rayfield
Facility Name:CORMETECH, Inc.
Laboratory Name: Pace Analytical
Facility County: Cleveland
Laboratory Cert. No.: 329
Discharge during this period:Ej
Yes
13
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, 11, or III)? Tier 11
A copy of this DMR has been uploaded electronically via hh>tps://edocs.deg.nc.gov/Forms/SW-DMR • Yes No
Date uploaded: 1/24/2022
Analytical Monitoring Requirements for Outfalls with Industrial Activities— Benchmarks in (Red)
Parameter
Parameter
Outfall004
Outfail006
outfail
Outfall
Outfall
Code
N/A
Receiving Stream Class
Class C
Class C
N/A
Date Sample Collected MM/DD/YYYY
12/29/2021
12/29/2021
46529
24-Hour Rainfall in inches
0.25
0.25
C0530
TSS in mg/L (100 or 50•)
24
98
00400
PH in standard units (6.0-9.0 FW,
8.67
6.02
6.8-8.5 SW)
01119
Copper, total recoverable in mg/L
0.016
0.078
(0.010 FW, 0.00S8 SW)
01051
Lead, total recoverable in mg/ L
0.0011
0.0034
(0.075 FW, 0.22 SM
01094
Zinc, total recoverable in mg/ L (0.126
0.072
0.420
FW, 0.095 SW)
00340
Chemical Oxygen Demand (COD) in
52
67
mg/L (120)
00552
Non -Polar Oil & Grease in mg/L (15)
<5.8
<6.1
• Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HOW), 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 100 mg/L
FW (Freshwater) SW (Saltwater)
Notes (optional): December 2021 Monthly Sampling Results(Tier 11 Response for Outfafls
"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, orthose 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."
of Permittee or Delellated Authorized Individual
I. [e-mail]
Email Address
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Date
980-722-1811
Phone Number

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NOP111 CAfl LINA
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Permit and Facility Information:
Please enter the permit number and other details for this upload.
IMPORTANT. Until the eDMR system is implemented for DEMLR Stormwater Program permits, an original
signed hardcopy of the DMR MUST be mailed to the address in your permit, in addition to this electronic
upload.
Fields marked with a red asterisk are required.
Permit Number* Enter COC or Individual Permit Number (NOT General Permit number with all 0's)
NCG030714
Must begin with NCS or NCG
Facility Name:* CORMETECH,Inc.
County:* Cleveland
After uploading here, the original signed hardcopy must be mailed to:
DEQ Mooresville Regional Office
Attn: DEMLR Stormwater Program
610 East Center Avenue
Suite 301
Mooresville, NC 28115
Further contact details at https:Hdeq.nc.gov/contact/regional-offices/mooresville
Monitoring Period Information:
Monitoring Period What is the YEAR of the sample date(s)?
Year:* 2021
Multiple DMRs from sampling periods within the same year can be uploaded together, but please upload differe
years with a new submittal form.

Also, copies of the lab results and qualitative (visual) monitoring should NOT be submitted unless specifically
requested by DEQ staff. Only upload the completed and signed DMR forms.
DMR Upload* Click the upload button or drag and drop files here to attach document.
CORMETECH Tier II Dec 2021 (Outfalls 004 & 0... 742.79KB
Only PDFs are accepted.
Comments: Tier II Response DMR Submission (December 2021 Monthly Sampling for Outfalls
004 & 006)
NOTE: This is the first submission of Tier II Response monthly sampling data for
the CORMETECH, Inc. facility located in Kings Mountain, NC.
* By checking the box and signing box below, I certify that:
• I have given true, accurate, and complete information on this form;
o I agree that submission of this Data Monitoring Report (DMR) upload form is a "transaction" subject to Chapter 66,
Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act');
o I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General
Statutes (the "Uniform Electronic Transactions Act');
o I understand that an electronic signature on this upload form has the same legal effect and can be enforced in the
same way as a written signature; AND
o I intend to electronically sign and submit this DMR upload form.
Full Name:* Lanette H Plyler
Name of person submitting this form
Email Address: * [e-mail]
Phone Number:* 9807221811
Signature: *
Date: * 01 /24/2022