NCG100199_2021 DMR_20210324

NCDEQ Division of Energy, Mineral and Land Resources
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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 Regianal Office.
Certificate of Coverage No. NCG10 0 1 1 9 Person Collecting Samples: George vagnieres
Facility Name: G&N Used Auto Parts Laboratory Name: Pace Analytical
Facility County: Nash Laboratory Cert. No.: 12
Discharge during this period: 0 Yes ❑ No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions for any benchmark exceedances? ❑ Yes ❑Q No
If so, which Tier (I, II, or III)?
Part A: Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Parameter
Outfall 1
Outfall
Outfall
Outfall
Outfall
Code
N/A
Receiving Stream Class
C
N/A
Date Sample Collected MM/DD/YYYY
02/15/2021
46529
24-Hour Rainfall in inches
2.5
00400
pH (-)
8.0
C0530
TSS in mg/L (100 or 50*)
5.1
01051
Lead, Total Recoverable in mg/L
<0.005
(.075)
78141
Total Toxic Organics in mg/L (1)
N/A
Ethylene Glycol in mg/L (any amount
77023
detected Tier One; 8,000 mg/L Tier
C 5.0
Two and Three)
00552
Non -Polar Oil & Grease in mg/L (15)
<5.0
NCOIL
New Motor/Hydraulic Oil Usage in
N/A
gal/month
* 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."
of Permittee°tir Delegated AuthorizeTlndividual Date