NCG030626_2021 DMR_20211007 (2)

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Permit and Facility Information:
Reese enter the perrrit nurrber and other details for this upload.
..................................................................................................................................................................................................................................................................................................................................
IMPORTANT: Until the eDMR system is implemented for DEMLR Stormwater Program permits, an original signed
hardcopy of the DMR MUST be mailed to the address in your permit, in addition to this electronic upload.
Fields marked with a red asterisk are required.
Permit Number* Enter 00CorIndividual PerrritNurrber(NOT General Perrritnurrberwithall 9s)
NCG030626
Mast begin with NCS or NOG
Facility Name:* Cleveland -Cliffs Piedmont
County:* Catawba
After uploading here, the original signed hardcopy must be mailed to:
DEQ Mooresville Regional Office
Attn: DEMLR Stormwater Program
610 East Center Avenue
Suite 301
Mooresville, NC 28115
Further contact details at https://deq.nc.gov/contact/regionaI-offices/mooresville
Monitoring Period Information:
.....................................................................................................................................................
Monitoring Period What is the YEAR of the sarrple date(s)?
Year:* 2021
Multiple DMRs from sampling periods within the same year can be uploaded together, but please upload different ,years
with a new submittal form.
Also, copies of the lab results and qualitative (visual) monitoring should NOT be submitted unless specifically
requested by DEQ staff. Only upload the completed and signed DMR forms.
DM R Upload* Oick the upload button or drag and drop files here to attach docurrent.
Piedmont Fall 21'.pdf 176.14KB
Only FDFs are accepted.
Comments:
* rJ By checking the box and signing box below, I certify that:
o I have given true, accurate, and complete information on this form;
o I agree that submission of this Data Monitoring Report (DMR) upload form is a "transaction" subject to Chapter 66,
Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
o I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes
(the "Uniform Electronic Transactions Act");
o I understand that an electronic signature on this upload form has the same legal effect and can be enforced in the
same way as a written signature; AND

o I intend to electronically sign and submit this DMR upload form.
Full Name:* David Hedrick
f brre of person subrritting this form
Email Address:* [e-mail]
Phone Number:* 18284649214
Signature:*
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Date: * 09/29/2021