NCG030213_2021 DMR_20211011

NCDEQ Division of Energy, Mineral and Land Resources
Storrnvvater Discharge Monitoring Report (DMR) Form for NCG030000
Metal Fabrication
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NP DLS Permit Data Monitorin Report DMR Upload form within
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the appropriate DEMLR Rogional Office.
Certificate of Coverage No. NCG03 0213
Person Collecting Samples: Mark Phelps
Facility Name: MiTek Industries
Laboratory Name: Environmental Chemists
Facility County: Chowan
Laboratory Cert. No.: DWQ #94 DLS#37729
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 III)?
A copy of this DMR has been uploaded electronically via htt s: edocs.deg. nc. ov Form sJSW-DMR ✓❑ Yes ❑ No
Date Uploaded: 10s11/2021
Analytical Monitoring Requirements for outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Parameter
Outfall
Outfall
Outfall
Outfall
Outfall
Code
N/A
Receiving Stream Class
SB
N/A
Date Samp e Collected MM/DD/YYYY
9/23/21
46529
24-Hour Rainfall in inc-ies
.75
C0530
TSs in mg/L (100 or 50*)
7.6 mg/L
00400
pH in stancard units (6.0— 9.0)
7.6
01119
Copper, total recoverable in mg/L
<.007 mg1L
(0.010)
01051
Lead, total recoverable in mg/ L
01 mg/L
(0.075)
01094
Zinc, total recoverable in mg/ L
<.067 mg/L
(0.126)
Total Toxic Organics (TTO) in mg/L(1)
NIA
78141
(if required)
00552
Non -Polar Oil & Grease in mg/L (15)
<5.0 mg/L.
Additional parameters for outfalls in drainage areas that use >55 gallons per month of new hydraulic oil on average
Estimated New 1 ot'I I Hydraulic Oil 1 gal
NCOIL
Usage in gal/month
* Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout waters l irl ano Primary Nursery Areas 1PLIAi
have a benchmark TSS limit of 50 mg/L. All other water classifications have a benchmark of 100 mg/L
Notes (optional):
1 certify by my signature below, under penatty 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 information, in Joinjthe possibility of fines and imprisonment for knowing violations."
Signature if I5ermittee or Delegated Authorized Individual
Email Address r-oo��® 11 , c6,�v>L
/a rl Zoz l
Date
Phone Number Z5Z-3606

Total Toxic Organics Certification;
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring
requirement for total toxic organics (TTO), I certify that to the best of my knowledge and belief, no leak, spill, or dumping of
concentrated toxic organics into the stormwater or onto areas which are exposed to rainfall or stormwater runoff has occurred since
filing the last discharge monitoring report. I further certify that this facility is implementing all the provisions of the Solvent
Management Plan inq(uded in the Stormwater Pollution Prevention Plan."
Signature df Permittee or Delegated Authorized Individual
Email Address f`Coo' © in1� ,a(V\
/a 1 2oZ l
Date
Phone Number 25Z- 3i96' &&0