NCG060174_2020 DMR_20201228

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG060000
Food and Kindred
Click here for instructions
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 a ro riate DEMLR Regional Office.
Part A: Analytical Monitoring Requirements for Outfalls with Industrial Activities— Benchmarks in (Red)
Parameter
CodeParameter
Outfall001
Outfall
Outfall
Outfall
Outfall
bps
003
N/A
Receiving Stream Class
C
e
e
N/A
Date Sample Collected MM/DD/YYYY
f 2.1q 616
2616
f �t-/y- Z6Z0
46529
24-Hour Rainfall in inches
6,93
d • % 3
6. g3
00556
Oil & Grease in mg/L (30)
.45
{ 5
.45
C0530
TSS in mg/L (100 or 50*)
-71 5
iv
00400
pH in standard units (6.0 — 9.0)
% (4
g. to
9 912
31616
Fecal Coliform per 100 ml of
freshwater (1000)
J b8
oZ 5` 0
ls{{D
61211
Enterococci per 100 ml of saltwater
(500)
00340 Chemical Oxygen Demand in mg/L
<
6 3 0.5
(120) 1 .5
Part B: Vehicle & Equipment Maintenance Areas — Benchmarks in
(Red)
Parameter
Code
Parameter
Outfall Ool
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
C
N/A
Date Sample CollectedMM/DD/YYYY
00552 7
Non -Polar Oil & Grease in mg/L (15)
15
NCOIL
New Motor/Hydraulic Oil Usage in
gal/month
p
* 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 that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for
knowing violations."
Signature of Permittee or belegated Authorized Individual
Date