NCG060099_2022 DMR_20221130

���:1 r 'l�I.�l1;?#}:I; �I'o .'I:I I�it!.•�,` {�tjiii li':'.:`f1 i,':I1:+ ,:; I+,r�i�tii':ai til l'i?..
I` i�I'',.'' fi;;(rl,tj
Fvvd ,arwl Kindred
Click here for instructions
Complete, sign, scan and submit the DMR via the Starmwater NPDES Permit Data Monitoring Report {AMR Uj2load 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. NCC06opGjei
Person Collecting Samples:
Facility Name, P eed.1,C Ir--V ;
Laboratory Name:�C
Laboratory Cert. No.: yp
Facility County; cr P't
Discharge during this period; WrYes EjNo fit no, skip to si_gj)atule and date)
Has your facility implemented mandatory Tier response actions this sample period for any henchmark exceedances? ❑ Yes [vMo
It so, which Tier (I, II, or Ill)?
A copy of this DMR has been uploaded electronically via htt s; edocs.deq^nc,gov/Forms/5UU-DMR v Yes ❑ No
Date Uploaded:
Analytical Monitoring Requiremertts for Outfalls with Inclus'.:r1al Activities l3enchnmaNcs i1'L 1
t�aiarneter
Code
Parameter
outfall
Oufifall
Ontfatl
N/A
Receiving Stream Class
A ��
N/A
Date Sample Collected MM/DD/YYYY
46529
24-Hour Rainfall in inches
?s'
C0530
TSS in mg/L (100 or 50:-')
1�14
00400
pH in standard units (6.0 — 9.0. EInr;
G'Fi ",.s 5W)
31616
Fecal Coliform per 100 ml of
freshwater (if required) f 10001.
61211
Enterococci per 100 ml of saltwater
,VIA
(if required) (500)
00340
Chemical Oxygen Remand in mg/L
5Z
Additional parameters for outfalls in drainage areas that use >55 gallons per month of new hydraulic
oil on average
NCOIL
Estimated New Motor/Hydraulic oil
Usage' in gal/month
%VId
00552
Non -Polar Oil & Grease in mg/L (15)
NIjf
r.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 100 mg/L
F4#V (Freshwater) (Saltwater)
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 qualified personnel properly gather and evaluate the information submitted. eased on my
inquiry of the person or persons who manage the system, or those persons directly responsible forgathering 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 Delegates! Authorized Individual
AcEtdju,e.,�v,v
Email Address
/I -3a 2oa R
Date
_2-31,--,346--259/
Prone Number