NCG090032_MONITORING INFO_20191220

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
�/CG o I no3�
DOC TYPE
❑ HISTORICAL FILE
CYMONITORING REPORTS
DOC DATE
❑ 3019 / a c)' t
YYYYMMDD

STOR,MWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS NCG090032
FACILITY NAME Sieqwerk EIC
PERSON COLLECTING SAMPLE(S) Lee Kearson
CERTIFIED LABORATORY(S) Blue Ridge Labs Lab #275
Lab #
Part A: Specific Monitoring Requirements
SAMPLES COLLECTED DURING CALENDAR YEAR: 2019
(This monitoring report shall be received by the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
COUNTY Burke
PHONE NO. 8( 28 )391-2314
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
Outfall
Date
50050
a -
I\ {- t )
No.
Sample
Collected
Total
Flow ifa
Total
Rainfall
Cd
Cr
Pb
TSS
mo/dd/ r
MG
inches
1
11/12/19 _
0.16
0.0001
0.0005
0.005
5
\L FILc0
2
11/12/19—_
0.16
0.0001
0.0005
0.005
5
rnA1S2:EC
Ilv
3
11/12/19
0.16
0.0001
0.0005
0.005
5
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Oyes Ono
(if yes, complete Part B)
Part Re Vehicle Maintenance Activiry Monitoring Reuuirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow
(if applicable)
Total
Rainfall
Oil & Grease
(if appl.)
Non -polar
O&G/TPH
(Method 1664
SGT-HEM), if
appl.
Total
Suspended
Solids
pH
New Motor
Oil Usage
mo/dd/ r
MG
inches
m /I
mg/1
unit
al/mo
Form SWU-247, last revised 611212015
Page I of 2

STORM EVENT CHARACTERISTICS:
Date 11/12/19
Total Event Precipitation (inches): 0.16
Event Duration (hours): (only if applicable — see permit.)
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see permit.)
Mail Original and one copy to:
Division of Energy Mineral and Land Resources
Attn: Central Files
1617 Mail Service Center
Raleigh. North Carolina 27699-1617
"I certify, 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 that there are significant penalties for submitting false information,
including the pos�lity of fines and imprisonment for knowing violations."
- --gz� rZl /7/i9
Permittee) (Date)
Form SWU-247, last revised 611212015
Page 2 of 2