NCG030429_2020 DMR_20201101

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG030000
Metal Fabrication
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Mon itoring 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. NCG03 I7 3 0 0 Person Collecting Samples: Lacy Harris
Facility Name: GKN Driveiine_North America fnc_.._ L baratory,Name. _Me_ritech Inc- _ -
Facility County: Person Laboratory Cert. No.: 165
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? El Yes ❑ No
If so, which Tier (I, II, or III)?
Analytical Monitoring Requirements for Outfalls with Industrial Activities -- Benchmarks in (Red)
Parameter
Parameter
Outfall
Outfall
Outfall Outfall Outfall
Code
N/A
Receiving Stream Class
N/A
Date Sample Collected MM/DD/YYYY
46529
24-flour Rainfall in inches
00552
Non -Polar Oil & Grease in mg/L (15)
C0530
TSS in mg/L (100 or 50*)
00400
pH in standard units (6.0-9.0)
New Motor/Hydraulic Oil Usage in
NCOIL
gal/month
Copper, total recoverable in mg/L
01119
(0.010 FW, 0.005 Sw)
Lead, total recoverable in mg/ L
01051
(0.075 FW, 0.220 SW)
Zinc, total recoverable in mg/ L (0.126
01094
FW, 0,095 SW)
78141
Total Toxic Organics (TTO) in mg/L(i)
* 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): No samples collected due to no storm water run-off
"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 that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for
knowing violations."
1' Io 1 /2020
Signature o0ermittee or Delegated Authorized Individual Date