NCG030538_2021 DMR_20211123

NCDEQ Division of Energy, Mineral and Land Resources
5tormwater Discharge Monitoring Report (DMR) Form for NCG030000
Metal Fabrication
Click here for instructions
Complete, sign, scan and submit the DMR via the 5tormwater NPDE5 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. NCG030538
Person Collecting Samples: Jessica Clark
Facility Name:CVG
Laboratory Name: PAR Labs
Facility County: Cleveland
Laboratory Cert. No.:20
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? 0 Yes � No
If so, which Tier (I, II, or III)?
A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.gov/Forms/SW-DMR Yes LjNo
Date Uploaded:11/23/2021
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Parameter
Outfall
Outfall
Outfall
Outfall
Outfall
Code
N/A
Receiving Stream Class
1
N/A
Date Sample Collected MM/DD/YYYY
11 /4/21
46529
24-Hour Rainfall in inches
2.5
C0530
TS5 in mg/L (100 or 504)
<5
00400
pH in standard units (6.0 — 9.0 FW,
5.94
6.8-8.5 SW)
Copper, total recoverable in mg/L
01119
(0.010 FW, 0.0058 SW)
0.01
01051
Lead, total recoverable in mg/ L
<•002
0.075 FW, 0.22 SW)
Zinc, total recoverable in mg/ L(0.126
01094
FW, 0.095 SW)
245
00340
Chemical Oxygen Demand (COD) in
12
mg/L (120)
00552
Non -Polar Oil & Grease in mg/L (15)
<5.2
Outfalls to Outstanding Resource Waters (ORWI, 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
F W (Freshwater) - (Saltwater)
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
qui of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information
submi ed 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, includinge passibility of fines and imprisonment for knowing violations.
11/23/2021
of Permittee o� Delegated Authorized Individual Date
[e-mail] 704-937-4434
Email Address Phone Number