NCG030657_2020 DMR_20210610

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NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG030000
Metal Fabrication
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. NCG03 0 6 5 7 Person Collecting Samples: Paul w. Spangenberg
Facility Name: Matlab, Inc. - Plant 14 Laboratory Name: Con -Test
Facility County: Randolph Laboratory Cert. No.: 652
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 ❑ No
If so, which Tier (I, II, or III)? 1
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Outfall 1
Outfall 2
Outfall
Outfall
Outfall
Receiving Stream Class
C
CDate
Sample Collected MM/DD/YYYY
11/11/2020
11/11/2020
24-Hour Rainfall in inches
2.53
2.53
Non -Polar Oil & Grease in mg/L (15)
<4.0
<4.0
XParameter
TSS in mg/L (100 or 50*)
24
10
pH in standard units (6.0-9.0)
6.9
6.3
New Motor/Hydraulic Oil Usage in
gal/month
N/A
N/A
Copper, total recoverable in mg/L0,0080
0.010 FW 0.005 SWLead,
0.0062
total recoverable in mg/ L
t0.075 FW, 0.220 SW)
0.0017
0.0041
01094 Zinc, total recoverable in mg/ L (0.126
FW, 0.095 SW
0 38
Q_ 17
78141 Total Toxic Organics (TTO) in mg/L(1)
N/A
N/A
* Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TS5 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�lnforation, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am
aware that th significan enalties for submitting false information, including the possibility of fines and imprisonment for
knowing v'
of Perm itteeV-zbDelegat uthoriz Ip Iv dual
12/10/2020
Date