NCG080720_2021 DMR_20211006

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCGO80000
Transit and Transportation
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report (DMR) Upload forth 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. NCG08 07 Zt7
Person Collecting Samples: DAv/S
Facility Name: jk 06 AVkaAVAW
Laboratory Name: �Q j2
Facility County: ^4t'l,"6AY
Laboratory Cert. No.: Ae 2 D
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 No
If so, which Tier (I, II, or Ill)? 77LJe j
A copy of this DMR has been uploaded electronically via https:Z/e_docs.deg.nc.gov/Forms/SW-DMR ,® Yes ® No
Date Uploaded:
Analytical Monitoring Requirements for Vehicle & Equipment Maintenance Areas — Benchmarks in (Red)
Parameter
Code
Parameter
Outfall f
Outfall .2.
Outfall .j
Outfall
Outfall
N/A
Receiving Stream Class
N/A
Gate Sample Collected MM/DD/YYYY
9 ,i1 ,Z/
AZ J,
OF AZ -V
46529 I
24-Hour Rainfall in inches
, let
G
• 24
,126
C0530
TSS in mg/L (100 or 50*)
f 7
126
00552
Non -Polar Oil & Grease in mg/L (15)
7.7
[ �,
[ (�,
< 7. f/
00400
pH in standard units (6.0 — 9.0 FW,
N/�`
/
Nf�
(�
�/.�/
6.8-8.5SW)
[�•g?
NCOIL
Estimated New Motor/Hydraulic Oil
Usage in gal/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 50 mg/L. All other water classifications have a benchmark of 100 mg/L
FW (Freshwater)SW (Saltwater)
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. Rased 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 ofPermittee or Delboted Authorized Individual
Email Address
/�eo_e-
Phone Number