NCG160085_2021 DMR_20211102

NCDEO, Division of Energy, Mineral and Land Resources
Stormwa`rer Discharge Monitoring Report (DMR) Form for NCG 60000
Asphalt Paving Mixtures and Blocks
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report DlViii Upload form within
30 days of receiving sampling results. Maii the original, signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Analytical Monitoring Requirements for Outfalls with Industrial Activities -- Benchmarks in (Red)
Parameter
Corse Parameter Outfail f Outfall Outfall Outfall Outfall
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY
46529 24-Hour Rainfall in inches 07
C0530 TSS In mg/L (i 00 or 50:1
Additional parameters for outfalls in drainage areas that use >55 gallons per month of new hydraulic oil on average
00552 Non -Polar Olt & Grease in mg/L(15)
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 T5S limit of SO mg/L. All other water classifications have a benchmark of 1100 mg/L
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. 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, including the possibility of fines and imprisonment for knowing violations."
of Permittee or @'eTegated Authorized Individual
Dave
Emall Address ['hone Dumber

aceAnalyf#rcal
wwwpacelabs,com
ANALYTICAL RESULTS
Project: W. RAL
Pace Project No.: 92568743
Pace Analytical Services, LLC
9800 Kincey Ave. Suite ion
Huntersviiie, NC 2807E
[phone]
Sample: OUTFALL 1 Lab ID: 92568743001 Collected: 10/26/21 08:35 Received: 10/26/21 12:20 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
2540D Total Suspended Solids Analytical Method: SM 2540D-2015
Pace Analytical Services - Eden
Total Suspended Solids 86.7 mg/L 9.3 1 10/27/21 12:18
REPORT OF LABORATORY ANALYSIS
Ws report shall not be reproduced, except in full,
Date: 11/01/2021 11:41 AM Wlhout the written consent of Pace Analytical Services, LLC. Page 4 of 10