HomeMy WebLinkAboutNCG240004_2021 DMR_20210707NCDEQ 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. NCG�4 Person Collecting Samples:
Facility Name: ��-/// l C/( ��{ Laboratory Name:
Facility County:Laboratory Cert. No.:
Discharge during this period: ❑ Yes VNo (if no, skip to signature and date)
rif
as your facility implemented mandatory Tier response actions for any benchmark exceedances? ElYes ❑ No
so, which Tier (I, II, or III)?
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
46529
24-Hour Rainfall in inches
C0530
TSS in mg/L (100)
00340
Chemical Oxygen Demand (COD)
(120)
31615
Fecal Coliform in colonies per 100 ml
(1000)
600
Total Nitrogen in mg/L (30)
665
Total Phosphorus in mg/L (2)
400
pH in standard units (6.0-9.0)
01119
Copper, total recoverable in mg/L
(0.010)
01051
Lead, total recoverable in mg/ L
(0.075)
01094
Zinc, total recoverable in mg/ L
(0.126)
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 r significant p�nalties for submitting false information, including the possibility of fines and imprisonment for
knowing violatjns n
Signature of Permittee or Oelegated Authorized Ind
D to