NCG140352_2021 DMR_20210310

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG140000
Ready -Mix Concrete
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 appropriate DEMLR Rcgionai Office.
Certificate of Coverage No. NCG140352
Person Collecting Samples: Pete Pelt
Facility Name: ST Wooten Winterville Concrete
Laboratory Name: Microbac
Facility County: Pitt
Laboratory Cert. No.: 11
Discharge during this period:❑✓ Yes ❑ No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? ❑ Yes 0 No
if so, which Tier (I, 11, or 111)?
A copy of this DMR has been uploaded electronically via l)gps://fidocs.deg.nc-Eov/Forms /5W-DMR ❑ Yes [D No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with industrial Activities — Benchmarks in (Red)
Parameter
Code
parameter
Outfall2
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
NSW
N/A
Date Sample Collected MM/DD/YYYY
02-19-2021
46529
24-Hour Rainfall in inches
3
C0530
TSS in mg/L (1.00 or 50*)
48.0 mgll
00400
1 pH in standard units (6.0--9,0)
7
Additional parameters for outfalls in drainage areas that use >55 gallons per month of new hydraulic oil on average
00552
Non -Polar Oil & Grease in mg/L (15)
NA
NCOIL
Estimated New Motor/Hydraulic Oil
Usage in gal/month
NA
* outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HOW), 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 posf bility 9f fines and imprisonment for knowing violations."
or Delegated Authorized individual
03/10/2021
Date
dress [e-mail] Phone Number 252-290-5912

OBAC'.
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K1 B0319
4nalytical Testing Parameters
Client Sample ID: Greenville OF 2
Sample Matrix: Stormwater Collected By: Client
Lab Sample 1D: K1 B0319-01 Collection Date: 02/19/2021 7:15
Inorganics Total Result RL Units DF Note Prepared Analyzed Analyst
SM 2540 D-2011
Total Suspended Solids 48.0 6.74 mg/L 3 02/24/21 1512 JDP
Batch Log Summary
r to ID Source ID......
SM 2540 D-2011 KB11286
KB11286-BS1
KIB0319-01 Greenville OF 2
KB11286-DUP2 KIB0366-01
KB11286-DUP1 KlB0312-01
K611286-BLK2
KB11286-BLK1
Batch Quality Control Summary: Microbac Laboratories, Inc. - Fayetteville
Spike Source %REC RPD
Inorganics Total Result
RL Units Level Result %REC Limits RPD Limit Notes
Batch KBI1286 - Wet Chem Aqueous - SM 2540 D-2011
PB W01 (KB 11286-B LK1)
Pre pared & Analyzed: 02/24/2021
Total Suspended Solids <2.50
2.50 mg/L
PBW02 (KB11286-BLK2) _ _
Prepared & Analyzed: 02/24/2021 ......... ............
Total Suspended Solids <2.50
2.50 mg/L
LCSW01 (KB11286-BS1)
Prepared & Analyzed: 02/24/2021
Total Suspended Solids 28.7
2.50 mg/L 30.1 95 95-105
Influent, compositeD (KB11286-DUP1) Source: K160312-01 Prepared & Analyzed: 02/24/2021
Total Suspended Solids 69.4
13.9 mglL 81.7 16 10
Influent, compositeD (KB31286-DUP2) Source: KIB0366-01 Prepared & Analyzed: 02I2412021
Total Suspended Solids 152
40.3 mglL 134 12 10
Definitions
mg/L-. Milligrams per Liter
RL: Reporting Limit
RPD: Relative Percent Difference
Cooler Receipt Log
Cooler ID: Default Cooler Temp:
1.2°C
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville, NC 28306 1910.864.1920 p I www.microbac.com I Page 3 of-5-1

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