NCG030139_2021 DMR_20210722

NCDEQ Division of Energy, Mineral and Land Resources
5tormwater Discharge Monitoring Report (DMR) Form for NCG030000
Metal Fabrication
Click here for instructions
Complete, sign, scan and submit the DMR via the 5tormwater NPDE5 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 0139
Person Collecting Samples: Kaitl nn Bryan-Scaggs
Facility Name: Mueller Systems
Laboratory Name: Waypoint Analytical
Facility County: Rowan
Laboratory Cert. No.: 402
Discharge during this period: [Z] 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 (I, II, or Ill)?
A copy of this DMR has been uploaded electronically via htts: edocs.de .nc. ov Forms 5W-DMR ✓❑ Yes []No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Code
Parameter
Outfall01
Outfall02
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
Class C
Class C
N/A
Date Sample Collected MM/DD/YYYY
07/2/2029
07/2/2021
46529
1 24-Hour Rainfall in inches
0.76
0.76
C053D
T5S in mg/L (100 or 50*)
23
5.2
00400
1 pH in standard units (6.0 — 9.0)
7.01
7.21
01119
Copper, total recoverable in mg/L
0,0140
0.0345
(0.010)
01051
Lead, total recoverable in mg/ L
a0.0010
0.0028
(0.075)
01094
Zinc, total recoverable In mg/ L
0.024
0.047
0.126)
78141
Total Toxic Organics (TTO) in mg/L(1)
N/A
N/A
(if required)
00552
Non -Polar Oil & Grease in mg/L
Additional parameters for outfalls in drainage areas that use >55 gallons per month of new hydraulic oil on average
New Motor/Hydraulic Oil
__F
NC01L2Estimated
sa a In eaUmonth
NIA
NIA
1.
" Outfalls to Outstanding Resource Waters (ORWI, High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of 50 mg/ 1. 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 forgathering 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 inform, inSluding th"ossibilitypflines and imprisonment for knowing violations."
07/22/2021
of Permittee or Delegated Authorized Individual Date
Email Address )[e-mail] Phone Number 704-278-5334

Total Toxic Organics Certification:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring
requirement for total toxic organics (TTO), I certify that to the best of my knowledge and belief, no leak, spill, or dumping of
concentrated toxic organics into the stormwater or onto areas which are exposed to rainfall or stormwater runoff has occurred since
filing the last discharge monitoring report. I further certify that this facility is implementing all the provisions of the Solvent
ManagemeWlan included in the SWrmwater Pollution Prevention Plan."
07-22-202 1
of Permittee or Deleeated Authorized Individual Date
Email Address [e-mail] Phone Number 704-278-5334