NCG020761_DMR_20200412

STORMWATER DISCHARGE MONITORING REPORT (DMR)
Please Mail Original And One Copy To Mailing Address Below
GENERAL PERMIT NO. NCG020000
Part A: Facility Information
Samples Collected In Calendar Year: i� a` (all samples shall be reported within 30 days following monitoring period)
Certificate Of Coverage No. NCG02- t�1 j County of Facility L 2 e
Facility Name Name of Laboratory e
Facility Contact �-�.kSu l / � t/ }� Lab Certification # �!�/17
Facility Contact Phone No. c , )
P rt B • Land Disturbance and Process Area Mo 'toring Requirements
i Outfalll .I'`
I' 1 Diif�100016.'
Sample
NO.1
TotalFldw
Sus' `ended
P
Turliititt •'
Y
! prN." b e' bli
;!
"Collected:
Solids.
.1 ti„�+��;"H�y�E;
+•
mo/dd/ r
MG
m
NTUs
3I b
y,326
Footnote 1 Identify the receiving stream: W Y R EC E I U E L..,°
Part D: Storm 7»ent Characteristics '
Total Event Precipitation (inches): • / v
Event Duration (hours): 7 VAS
Part E: Certification
APR 2 0 2020
vnrr C- Vphiclp Maintenance Monitoring Reauirements
fJutfali� '
` 'Date',
,KI
't!'
{;t+�F!'
�;�, •tlr, ,;sE
4ioil hd'
a
A •,h; Hlllu
ri5ample,; Iotat
FIbW
{
Grease
Sttspeniled`
, pH
Collected'
I ,1 m� ��_ ,�'
4
r Solids
•
`
aNl tl 1'
r I
,
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tnoJddJ
rMG�I to
tihit.
CENTRAL FILES Total Event Precipitation (inches):
DWR SECTION Event Duration (hours):
(if a separate storm event is sampled)
"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 ere are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations. '��
(Signature of Permittee) (Date)
/ Part F: Mailing Address
Attn: Central Files, DENR, N.C. Division of Water Quality,1617 Mail Service Center, Raleigh, NC 27699-1617
SWU-243-120199

Analytical Results�rT�s�l� w
ANALY i iCAL
,cesville Brick Company
J Box 471
Statesville, NC 28687
Receive Date: 03/31 /2020
Reported: 04/02/2020
For:
Comments:
Sample Number
Parameter
Sample ID
Result
Unit Method
Analyzed
Analyst
200331-29-01
Settleable Solids
Plant OF 1
<0.1
ml/L SM2540E-2011
03/31/2020
WC
200331-29-01
TSS
Plant OF 1
4.328
mg/L SM254OD-2011
04/01/2020
CJE
200331-29-01
Turbidity
Plant OF 1
8.7
NTU EPA 180.1
04/01/2020
MD
Respectfully submitted,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
PO Box 228 • Statesville, NC 28687 • 704/872/4697
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