NCG060030_2021 DMR_20211001

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG060000
Food and Kindred
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. NCG060030
Person Collecting Samples: Stephen Gouge
Facility Name: Baxter Healthcare Corporation
Laboratory Name: Baxter WWTP Lab, Environmental Testing Solutions
Facility County: McDowell
Laboratory Cart. No.:935, 600
Discharge during this period: 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 n No
If so, which Tier (I, II, or III)?
A copy of this DMR has been uploaded electronically via https:J/edocs.deQ.nc.&ovfForms lSW-DMR Yes Lj No
Date Uploaded:10/01/2021
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter ; Parameter
Code
Outfall ST01
Outfall ST02
Outfall ST04
Outfall NA
Outfa11 NA
N/A
Receiving Stream Class
Tr
Tr
Tr
NA
NA
N/A
Date Sample Collected MM/DD/YYYY
08/31/2021
08/31/2021
08/31/2021
NA
NA
46529
24-Hour Rainfall in inches
1.7
1.7
1.7
NA
NA
C0530
TSS in mg/L (100 or 50')
9.4
31.6
7.8
NA
NA
00400
pH in standard units (6.0-9.0 FW,
7.04
6.62
6.77
NA
NA
6.8 — 8.5 SW)
00556
Oil & Grease in mg/L (30)
<5
<5
<5
NA
NA
Fecal Coliform per 100 ml of
31616
freshwater (if required) (1000)
NA
NA
NA
NA
NA
61211
Enterococci per 100 ml of saltwater
NA
NA
NA
NA
NA
(if required) (500)
00340
C 20) ical Oxygen Demand in mg/L
41
54
38
NA
NA
Additional parameters for outfalls in drainage areas that use >55 gallons per month of new hydraulic oil on average
NCOIL
Estimated New Motor/Hydraulic Oil
NA
NA
NA
NA
NA
Usage in al/month
INA
00552
Non -Polar Oil & Grease in mg/L (IS)
NA
NA
NA
NA
Outfails 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
(freshwater) S (Saltwater)
Notes (optional): Received Oil and Grease results on 09/20/2021
"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 irggrmation, inc)qing the possibility of fines and imprisonment for knowing violations."
Signature of Permittek o� Delegated Authorized individual
[e-mail]
Email Address
IOII1102)
Date
828-756-6608
Phone Number