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NCG140380_2021 DMR_20210621
NCDEQ Division of Energy, Mineral and Land Resources Stormwater Discharge Monitoring Report (DMR) Form for NCG1 fD000 Ready -Mix Concrete Click here for instructions Complete, sign, scan and submit the DMR via the 5torrnwater NPDES Permit Data Monitoring Re art DMR Upload form within 30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the jjppLqp late L)%MLR Regional Office. Certificate of Coverage No. NCG140380 Person Collecting Samples: Brandon Joyner Facility Name: ST Wooten Corporation Goldsboro Concrete Laboratory Name: Microbac Facility County: Wayne Laboratory Cert. No.: 11 Discharge during this period: © Yes ❑ No (if no, skip to signature and date) Has your facility implemented mandatory Tier response actions this sam pie 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 17tt s: edoc:s.d!s .tic. ov Farms SW-DMR ❑✓ Yes ❑ No Date Uploaded:06-21-2021 Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red) Parameter Code Parameter Outfall 2 Outfall Outfall Outfall Outfall N/A Receiving Stream Class C;NSW N/A Date Sample Collected MM/DD/YYYY 06-04-2021 46529 24-Hour Rainfall in inches 3.75 C0530 TSS in mg/L (100 or 50*) 28.0rng/I 00400 pH in standard units (6.0-9,0) 7.5 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) NA NCOIL Estimated New Motor/Hydraulic Oil Usage in gal/month NA * 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, orthose persons directly responsible for gatheringthe information, the information submitted is,_#o-tile best of my kn�wledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false iryfoi nation, S cludir/the p ssibijity of fines and imprisonment for knowing violations." 06-21-2021 of Permittee or Delegated Authorized Individual Date Address james.washburn@stwcorp.com Phone Number 252-290-5912