HomeMy WebLinkAboutNCG060356_2020 DMR_20210301IYCDEQ Division of Energy, Mineral and Land Re5ourres
Stormwater Discharge Monitoring Report (DMR) Form for NCGO60Oi1O
Food and Kindred
Click here for instructions
Complete, signr scan and submit the DMR via the Stormwater NPIDES Permit Data hionitorine Report 2DMRl uoloadfarm 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- NCG06 Person Collecti ng samples: Am Frev
FacilityName: HoMerietK Laboratory Name: 3acehn3rfxjf G
Facility Counity: Durtvn _ Laboratory Cert. No.: I aa, 633. saga
Discharge during this period: 0 Yes ❑ N.a ffno, skip rosrgnwvreanddote)
Has your facility implemented mandatary Tier response actions for any benchmark exceedances? E Yes ❑ hD
f sor which Tier �I, 11, or IIV I
Part A= Ana lytical Monito-ring Requi rements. %F outfalls with Industrial Activities— Benchmarks in I R =_
Parameter
Parameter
outfal1(5
outrall
outfall
otrfi311
o.rf311
Cade
WA
Receiving stream class
WSW. HSIN.CA
N A
Date Sample Cdkxted MM/DD&M
12P14M20
46529
24-Horn Rainfall in inches
1-34
C0536
oil & Grease in mgA f3A)
< 5.0
CO330
TSS in nTgiL (10O ar 5O111
48-0
CC4W
pH in standard units (&4-9A)
7-16
3M 16
Fecal Colifonn per IDD m! or
n
freshwater I IGM
ffa
61211
Enterococci per mo rN of saltwater
n{ca
500
Chemical oxygen Demand in OWL
34-6
120
Part 6: Vehicle & Equipmerrt Maintenance Areas —Benchmarks in fRedj
Parameter
Parameter
outfafl
outfall
Otit'al
o.rfall
o.rf311
Code
WA
Receiving Stream class
IAA
Date sample Collected MWDDP(m
OD552
Non -Polar oil & Grease in mg{L115)
New Matorf"raulic oil usage in
NCDIL
gaVmonth
* 4utFalls to- Outstanding Rtmurce Waters IOILW), tidh Quality Waters (HQWr Trwt Waters frr) and Primary Nu rxry Areas (PNA)
ham a benchmark T55limit of50 mSA. All other water daziliotions have a benchmark of 188ntigeL
Notes (opticinal:
"I certify by my signature below, under penalty of law, that this documentand all anachments were prepared under my direction or
supervision in accordance with a system deserted to assure that qualified personnel properly gather and evaluate the information
submitted- eased on my in qui ry 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 beliefr truer accurate, a nd rorn plete. I am
aware that there are sign ifica nt penalties for subm itting false i nformation, includ ing the possibility of fines a nd i m prison m ent for
knowing violations."
28 FEB 21
Signature of PermitteeOF Delegated Autliarixed Individual Date