NCG050412_2021 DMR_20210603

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG050000
Apparel, Printing, Rubber, Etc.
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDM
ES Permit Data Monitoring Report (DR) U! ad 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. NCG05 0412
Person Collecting Samples_ Pau) Spangenberg
Facility Name: Wellmark, LLC
Laboratory Name: Corr -Test
Facility County: Randolph
Laboratory Cert. No.: 652
Discharge during this period: R] 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 [Z] No
If so, which Tier (1, II, or III)?
A copy of this DMR has been uploaded electronically via https://edocs deg.nc,gov/Forms/5W-DMR Q Yes ❑ No
Date Uploaded: 3/5121
Analytical Monitoring Requirements for Vehicle & Equipment Areas—Bendhmarlm in (Red)
Parameter
Code
Parameter
Outfalll
Outfall2
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
C
C
N/A
Date Sample Collected MM/DD/YYYY
2/18/21
2118/21
46529
24-Hour Rainfall in inches
1.5
1.5
C0530
TSS in mg/L (100 or 50*)
24
16
00552
Non -Polar Oil & Grease in mg/L (15)
<0 33
0.70
NCOIL
Estimated New Motor/Hydraulic Oil
Usage in gal/month
300
300
vuUaus to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TS5 limit of 5o mg/L. All other water dassificatiorts 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
ant accord"th a system designed to assure that alified personnel properly gather and evaluate the information submitted. Based on my
inquiry the p rson or persons whom age the s stem, or those persons directly responsible for gathering the information, the information
submi ed is, to he best of my kn wled a and beli f, true accurate, and complete. I am aware that there are significant penalties for submitting
false formatio , in i th i�bil o�ffines mpris nmentfor knowing violations_"
Individual
CC
Date
Phone Number