NCG080683_2021 DMR_20210506

NCDEQ Division of Energy, Mineral and land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG080000
Transit and Transportation
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. NCG08F0_F6_F8_F3_j Person Collecting Samples:
Facility Name: High Point Fleet Maintenance/Environmental Services Laboratory Name: City of High Point Water Qualify
Facility County: Guilford Laboratory Cert. No.: 55
Discharge during this period: ❑ Yes 0 No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions for any benchmark exceedances? 9 Yes ❑ No
If so, which Tier (1, II, or 111)? 11
Part A: Vehicle & Equipment Maintenance Areas — Benchmarks in (Red)
Parameter
Code
Parameter
Outfall
Outfall
Outfall
Outfall
Outfa11
N/A
Receiving Stream Class
N/A
Date Sample Collected MM/DD/YYYY
46529
24-Hour Rainfall in inches
00552
Non -Polar Oil & Grease in mg/L (15)
C0530
TSS in mg/L (100 or 50*)
00400
pH in standard units (6.0--9.0)
NCOIL
New Motor/Hydraulic Oil Usage In
gal/month
Part B: Oil/Water Separators & Secondary Containment Areas at Bulk Stations & Terminals — Benchmarks in (Red)
Parameter
Code
Parameter
Outfall
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
N/A
Date Sample Collected MM/DD/YYYY
46529
24-Hour Rainfall in inches
00552
Non -Polar Oil & Grease in mg/L (15)
C0530
TSS in mg/L (100 or 50*)
00400
pH in standard units (6.0-9,0)
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."
�J
Signature of PeWnittee or Delegated Authorized Individual
5-G-z)
Date