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HomeMy WebLinkAboutNCG060257_DMR_20211020NC Dartment of E v ronmental Quality Received NCDEQ Division of Energy, Mineral and Land Resources OCT 2 0 2021 Stormwater Discharge Monitoring Report (DMR) Form for NCG0W0fflon-S,j.2m Food and Kindred P,c_ional Gliice 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. NCG06 0257 Person Collecting Samples: See note below Facility Name: MOM Brands Laboratory Name: Facility County: Randolph Laboratory Cert. No.: Discharge during this period:0 Yes No (if no, skip to signature and date) Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances7 LjYes LjNo If so, which Tier (I, 11, or III)? A copy of this DMR has been uploaded electronically via httos://edocs.deg.nc.gov/Forms/SW-DMR Yes 0No Date Uploaded: Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red) Parameter Code Parameter Outfall Outfall Outfall Outfall Outfall N/A Receiving Stream Class See note below N/A Date Sample Collected MM/DD/YYYY 46529 24-Hour Rainfall in inches C0530 TS5 in mg/L (100 or 50•) 00400 pH in standard units (6.0-9.0 FW, 6.8 — 8.5 SW) 00556 Oil & Grease in mg/L (30) 31616 Fecal Coliform per 100 ml of freshwater (if required) (1000) 61211 Enterococci per 100 ml of saltwater if required) 500 00340 Chemical Oxygen Demand in mg/L (120) Additional parameters for outfalls in drainage areas that use>55 gallons per month of new hydraulic oil on average NCOIL Estimated New Motor/Hydraulic Oil Usage in gal/month 00552 Non -Polar Oil & Grease in mg/L (15) • 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): w. u..m.a m...ry.�p�m.baaW".Mwwon �rv,vrmi. in..a�+wervw�m..aammuw+.anw.�'+va. r...om......auro..�.e«mv.wwur�.ae�. s.w.m.r, mwe...mwa wo�..ra•�• "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 Individual 10/15/2021 Date 3?i9-(4cogs Email Address Phone Number