NCG190050_2021 DMR_20210921 (2)

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG190000
Marinas and Shipbuilding
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDi_S_Permit Data Monitoring Report COMR} 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. NCG19 c>O Person Collecting Samples: ,x {
Facility Name: "e _if-e m Laboratory Name: _
Facility County: Laboratory Cert. No.: y
Discharge during this period: ❑ Yes ff No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? ❑ Yes ❑ No
If so, which Tier (I, 11, or Ill)?
A copy of this DMR has been uploaded electronically via httos://edocs.deci.nc.gov/Forms/SW-DMR ❑ Yes ❑ No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Parameter
Outfall
Outfall
Outfall
Outfall
Outfall
Code
N/A
Receiving Stream Class
N/A
Date Sample Collected MM/DD/YYYY
46529
24-Hour Rainfall in inches
C0530
TSS in mg/L (200 or 50*)
00552
Non -Polar Oil & Grease in mg/L (15)
00340
Chemical Oxygen Demand in mg/L (220)
00400
pH in standard units (6.0 — 9.01
Aluminum, total recoverable in mg/ L
01105
(0.75 FW, 0.24 SW)
Chromium III, total recoverable in mg/L
01027
at certain facilities" (0.905 FW, none
SW)
Chromium VI, total recoverable in mg/L
C0034
at certain facilities** (0.016 FW, 1.1
SW)
Copper, total recoverable in mg/L
02042
(0.010 FW, 0.006 SW)
Lead, total recoverable (as Pb) in mg/ L
01051
(0.075 FW, 0.22 5W)
Nickel, total recoverable in mg/L (0.335
C0034
FW, 0.074 SW)
Zinc, total recoverable in mg/L (0.126
01092
FW, 0.095 SM
Estimated New Motor/Hydraulic Oil
NCOIL
Usage in al/month
*Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of SO mg/L. All other water classifications have a benchmark of 100 mg/L
"Only required for Snip and Boat Building and Repairing [SIC 373] facilities that perform metal fabrication In areas that could potentially be
exposed to stormwater
FW (Freshwater) SW (Saltwater)
Notes (optional): Ale) /�-'IAW LYik'/.rrC �zz/'V'K i' A4*Zok" S60 %d
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"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 hest of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting
false information, including the possibii;ty of fines and imprisonment for knowing violations."
Sig ure of Permitt or uthorized
Email Address
Individual
'(jt I
Date
Phone Number