NCG240019_2021 DMR_20210628 (2)

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG240000
Compost Operations
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. NCG24 001 �
Person Collecting Samples: ` .-
Facility Name: Mealeptav, r n ,,+ j r _
Laboratory Name: r U,
Facility County:
P(( bur^
Laboratory Cert. No.:
Discharge during this period: Yes ❑ No (if no, skip to signature and date)
Has your facility implemented-mmandatoryTier response actions this sample period for any benchmark exceedances? myes ❑ No
If so, which Tier (I, II, or III)? tier I
A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.gov/Forms/SW-DMR ❑ Yes ❑ No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Code
Parameter
Outfall '
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
N/A
Date Sample Collected MM/DD/YYYY
G6ll7�ro10�1
46529
24-Hour Rainfall in inches
C0530
TSS in mg/L (100)
00340
Chemical Oxygen Demand (120)
l
31615
Fecal Coliform in colonies per 100 ml
61 ox
(1000)
600
Total Nitrogen in mg/L (30)
665
Total Phosphorus in mg/L (2)
r '�
400
pH in standard units (6.0-9.0)
01119
Copper, total recoverable in mg/L
006 '>
(0.010)
tOV
01051
Lead, total recoverable in mg/ L
or 01�
(0.075)
01094
Zinc, total recoverable in mg/ L
(0.126)
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)
G ,
COIL
Estimated New Motor/Hydraulic Oil
Usage in gal/month
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."
of Permittee or Delegated Authorized Individual
Email Address
�(. ril h s`�@ �`h / •° /f A� C C. (G /� n J i J 6 C7 L`�4 G. 5 C7 l<
CA q /z(
Date
Phone Number
c��o JiY- �FJ-5