NCG080198_2021 DMR_20211101 (2)

NCDEQ Division of Energy, Mineral and Land Resources
Storrnwater 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 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. NCG08 0198
Person Collecting Samples: James W. Willard II (INENCO, INC.)
Facility Name: LISK TRUCKING, INC.
Laboratory Name: Pace Analytical Services, LLC & Con -Test
Facility County: Anson
Laboratory Cert. No.: 12, 40, 37706, 37712 & 652
Discharge during this period: ]Yes E] 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 (1, 11, or III)?
A copy of this DMR has been uploaded electronically via htt s: edacs.deg. nc.gov/Forms/SW-DM R Yes No
Date Uploaded: 11/01/2021
Analytical Monitoring Requirements for Vehicle & Equipment Maintenance Areas —Benchmarks in (Red)
Parameter
Code
Parameter
Outfall1
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
C
N/A
Date Sample Collected MM/DD/YYYY
09/21/2021
46529
24-Hour Rainfall in inches
1.04
C0530
TSS in mg/L (100 or 50*)
114
00552
Non -Polar Oil & Grease in mg/L (15)
< 2.4
pH in standard units (6.0 —9.0 FW,
00400
6.8—&5 SW)
6.80
Estimated New Motor/Hydraulic Oil
NCOIL
Usage in gal/month
230
* 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/I.
FW (Freshwater) SW (Saltwater)
Notes (optional): pH sample collected and analyzed by James W. Willard II of INENCO, INC., North Carolina Field Services Certification #: 5540
"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 pers ns who manage the system, orthose persons directly responsible for gatheringthe information, the information
submitted is, t e best o y kno �Olffi
elief, true ccurate, and complete. I am aware that there are significant penalties for submitting
false informa o , inclu gthe osai ilis and i, " risonmentfor knowing violations."
t /t/�✓ \ /»_/� ( _ 11/01/2021
of Permittee or`6eQateO/A"utharized Individual Date
[e-mail]
Email Address
704-272-6101
Phone Number