NCG060386_Monitoring Report_20220119

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG060000
Food and Kindred
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report IDMR) 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. NCGO6G3$G
Person Collecting Samples: /yieygEf. L. ,tPaT2rc
Facility Name: jjjbws ti/p"r &YE E e., C'
Laboratory Name: ,qe.- ANA4megL
Facility County:
I Laboratory Cert. No.: .3Z61
Discharge during this period: ❑✓ Yes ❑
No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? ❑ Yes No
If so, which Tier (I, II, or III)?
A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.gov/Forms/SW-DMR ❑ Yes o
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities— Benchmarks in (Red)
Parameter
Code
Parameter
Outfall
4001 Ad'"rrf
Outfall
AlmcrJ4
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
N/A
Date Sample Collected MM/DD/YYYY
/ p pg 011
lee) p$ 21
46S29
24-Hour Rainfall in inches
9 2
O, 2-
00530
TSSin mg/L(100or50')
1g
all
00400
PH i n standard units (6.0 — 9.0)
(„$
G.6
00556
Oil & Grease in mg/L(30)
AID
NO
31616
Fecal Coliform per 100 ml of
freshwater (if required) (1000)
144
AtA
61211
Enterococci per 100 ml of saltwater
�P
WA-
NA
(if required) SOO
00340
Chemical Oxygen Demand in mg/L
23.0
79
(120)
1
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
00552
Non -Polar Oil & Grease in mg/L(1S)
Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of50 mg/L. All other water classifications have a benchmark of 100 mg/L
Notes (optional):
"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 qualrfied personnel properly gather and evaluate the information submitted. Based on my
inquiry of t e person or persons who manage the system, or those persons directly responsible for gathering the information, the information
submitte i ,tot be of nowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting
false iqf ation tj iingh possibility of fines and imprisonment for knowing violations."
of Permittee or Delegated Authorized Individual
Email Address 6,4Vt. deeWV Ca V. d0AI
/2 - /-Zl
Date
Phone Number 764