NCG210402_2021 DMR_20210504 (2)

Page 2
NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG210000
Timber Products
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 Regional Office.
Certificate of Coverage No. NCG210402
Person Collecting Samples: Kenneth Elliott, Elliott Consulting
Facility Name: J.W. Jones Lumber Company, Inc. - Chip Mill
Laboratory Name: Environmental Chemists, Inc.
Facility County: Pasquotank
Laboratory Cert. No.: DWQ 94, DLS 37729
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 ✓❑ No
If so, which Tier (I, II, or III)?
A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.gov/Forms/SW-DMR ❑✓ Yes ❑ No
Date Uploaded: May 04, 2021
Analytical Monitoring Requirements for Clutfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Code
Parameter
Outfall #1**
Upstream #3
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
C;Sw
N/A
Date Sample Collected MM/DD/YYYY
03/18/2021
46529
24-Hour Rainfall in inches
0.23
C0530
TSS in mg/L (100 or 50*)
NA
00340
Chemical Oxygen Demand (120)
73
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)
NCOIL
Estimated New Motor/Hydraulic Oil
Usage in 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):** Upstream & downstream samples are comparison samples for information only.
"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 knowledg- ­b 9,�Ij?f;gt6uey pK4urae, and complete. I am aware that there are significant penalties for submitting
false inforrrayOn, inc in r�iibiO��DN
Rea n jMP��b�icuracyandj'9enowingviolations."
`K`�Qj I Reason: I attest to the accuracy and integrity of this
document
Location: Elliott Consulting May 04, 2021
Signature of Permittee or Delegated Authorized Individual Date
Email Address [e-mail] Phone Number 252-339-9021