NCG100084_2021 DMR_20211021

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NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG100000
Used Motor Vehicles
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. NCG10 0084
Person Collecting Samples: Dale Bevels
Facility Name: Wayne Auto Salvage
Laboratory Name: ALS Houston, US
Facility County; Wayne
Laboratory Cert. No.: 624-2021
Discharge during this period:
Yes
11
No (if no, skip to signature and dote)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?❑ Yes Q No
If so, which Tier (I, il, or III)?
A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.pov/Forms/SW-DMR Yes ®No
Date Uploaded: OCt. 21, 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
N/A
Date Sample Collected MM/DD/YYYY
46529
24-Hour Rainfall in inches
C0530
TSS in mg/L (100 or 50*)
pH in standard units (6.0-- 9.0 FW,
00400
6.8 — 8.5 SW)
Chemical Oxygen Demand in mg/L
00340
1xo)
i
Lead, total recoverable (as Pb)in
01051
mg/ L (0.075 FW, 0.22 SW)
Ethylene Glycol in mg/ L (any amount
77023
detected Tier One; 8,000 mg/L Tier
Two and Three)
r
00552
Non -Polar Oil & Grease in mg/L (15)
Estimated New Motor/Hydraulic Oil
1
NCOIL
Usage in al/month
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)
Notes (optional): r
"I certify by my signature belt , under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system igned to assure that qualified personnel properly gather and evaluate the information submitted. Based on my
inquiry of the persgn or rsons who manage the system, or those persons directly responsible for gathering the information, the information
submitted is, to the b of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting
false informati n, i I g the possibility of fines and imprisonment for knowing violations,"
An/
Signature of Permittee or Delegated Authorized Individual Date
r
[e-mail] 919-734-3958
Email Address Phone Number