NCG140416_DMR_20240606

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NCDE Division of Energy, Mineral and Land Resources %I-V late
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Stormwater Discharge Monitoring Report (DMR) Form for NCG140000 jUN 0 6 2024
Ready-Mixed Concrete
5 Click here for instructions Winston-Salem
Regional Office
Complete,sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring 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. NCG141 0 14 1 116 1 Person Collecting Samples: Chris Garrison
Facility Name: Gobble Concrete Laboratory Name: Enthalpy Analytical
Facility County:Davidson Laboratory Cert. No.:495
Discharge during this period: ■❑Yes ❑■ No (if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions for any benchmark exceedances?❑Yes X No
If so, which Tier(I, 11,or III)?
Part A:Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in (Red)
Parameter Parameter Outfall Outfall Outfall Outfall Outfall
Code
N/A Receiving Stream Class 1
N/A Date Sample Collected MM/DD/YYYY 05/14/24
46529 24-Hour Rainfall in inches 0.25
C0530 TSS in mg/L(100 or 50*) 61.2
00400 pH in standard units(6.0—9.0) 6.6
Non-Polar Oil&Grease in
00552 mg/L(15)for drainage areas that use>55 NA
gal/mo of new hydraulic oil on average
NCOIL Estimated New Motor/Hydraulic Oil NA
Usage in gal/month
* 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.
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. 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 t rhere are s' iificant penalties for submitting false information, including the possibility of fines and imprisonment for
knowing'violations." '
6/23/2024
Signature of P4r ' tee or De egated orized Individual Date