NCG070161_2024 DMR_20240625

NCDEQ Division of Energy,Mineral and Land Resources
Stormwater Discharge Monitoring Report(DMR)Form for NCG070000
Stone,Clay,Glass,&Concrete Products
Click here for instructions
Complete,sign,scan and submit the DMR via the Stormwater NPUES 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 DE MLR Regional Office.
Certificate of Coverage No.NCGo70(W I Person Collecting Samples: fitmunaitifino
Facility Name: fi r') 1(As I Laboratory Name: k u{PS
Facility County: (1). ��QYU (+ laboratory Cert.No.: 11 IZ
Discharge during this period:M 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 grNo
If so,which Tier(I,II,or III)? i
A copy of this DMR has been uploaded electronically via Mips://edocs.dei.nc.gov/Forms/SW•DMR [ Yes gi No
Date Uploaded:
Analytical Monitoring Requirements for Vehicle&Equipment Areas—Benchmarks in(Red)
Parameter —
Code Parameter ()Wall Outfall Outfall Outfall Outfall
tIIrM bmtn��
N/A Receiving Stream Class rd N/A Date Sample Collected MM/DD/YYYY v5111124
46529 24-Hour Rainfall in inches a 21
C0530 TSS in mg/L(100 or 501 ,11 11 i
00552 Non-Polar Oil&Grease in mg/L(15) V
NCOIL Estimated New Motor/Hydraulic Oil
Usage in gal/month ?-• a s.
awaits to Outstanding Resource Waters(ORW),High Qualityy 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/I.
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.lam aware that there are significant penalties for submitting
false inf rmation,including the sibility of fines and imprisonment for knowing violations.'
A
ature of Perrnittee or Delegated Authorized Individual Pate/
Email Address Phone Number