NCG030513_2021 DMR_20210929

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG030000
Metal Fabrication
Click here for instructions
Complete, sign, scan and submit the DMR via the Storrnwater 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. NCG03 0513
Person Collecting Samples: Nicholas Fugitt
Facility Name: Goodyear Statesville
Laboratory Name: Pace Analytical
Facility County: Iredell
laboratory Cert. No.: Charlotte: 1215342/37706 Asheville: 40/3771
Discharge during this period: E]Yes ® No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? EJ Yes No
If so, which Tier (I, Il, or III)?
A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.gov/Forms/SW-DMR M Yes No
Date Uploaded: 9/29/2021
Analytical Monitoring Requirements for Qutfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Parameter
Outfall
Outfall
Outfall
Outfall
Outfall
Code
N/A
Receiving Stream Class
Class C
N/A
Date Sample Collected MM/DD/YYYY
8/16/2021
46529
24-Hour Rainfall in inches
.75"
C0530
TSS in mg/L (100 or 50*)
4.1 mg/L
00400
pH ]n standard units (6,0 — 9,0 FW,
6.78
6.8.8.5 SW)
01119
Copper, total recoverable in mg/L
<.005 mg/L
(0,010 FW, 0,0058 SW)
01051
Lead, total recoverable in mg/ L
<.005 mg/L
(O.Oi5 FW, 0.22 SW)
Zinc, total recoverable in mg/ L (0.126
01094
FW, 0.095 SW)
< 010 mg/L
00340
Chemical Oxygen Demand (COD) in
< 25.0 mg/L
mg/L (120)
00552
Non -Polar Oil & Grease in mg/L (15)
< 4.8 mg/L
* 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
FW (Freshwater) SW (Saltwater)
Dotes (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 properlygather 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."
Signature df Permittee or joelegated Authorized Individual
UUZfn'i l IR d OJAA 000 C-.0 . CA r^
Email Address
Date
t7©t-t "ZS 4503
Phone Number