NCG030027_2021 DMR_20211207

Andrew Short
Plant Director
[phone] (phone)
[phone] (fax)
and rewbshort(a,eaton.com
December 7, 2021
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Attn: DWQ Central Files
RE: November 2021 Monthly Tier III Discharge Monitoring Report
Attached are the analytical results and associated chain of custody for the November 2021, monthly Tier
III stormwater outfall sampling event, submitted in accordance with Section D of the NPDES Stormwater
General Permit No. NCG030000 and Certificate of Coverage No. NCG030027 issued to our facility.
Additionally, attached is the applicable Discharge Monitoring Report (DMR) Form provided by the North
Carolina Division of Water Quality (NCDWQ).
I certify under penalty of law that this document and all attachments were prepared under my direction or
supervision in accordance with the 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 other 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 fine and imprisonment for knowing violations.
Sincerely,
0j, K&
Andrew Short
Plant Manager
Attachments

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG030000
Metal Fabrication
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. NCG03 0027
Person Collecting Samples: Chris Fuller
Facility Name: Eaton Roxboro
Laboratory Name: Pace Analytical
Facility County: Person
Laboratory Cert, No.: 375
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? MYes ED No
If so, which Tier (I, 11, or III)? Ili
A copy of this DMR has been uploaded electronically via htt s: edocs.de .nc, ov Forms SW-DMR El Yes No
Date Uploaded: 11/05/2021
Analytical Monitoring Requirements for Outfalls with Industrial Activities —Benchmarks in (lied)
Parameter
Parameter
Outfall001
Outfall005
Outfall
Outfall
Outfall
Code
N/A
Receiving Stream Class
NIA
NIA
N/A
Date Sample Collected MM/DD/YYYY
NIA
NIA
46529
24-Hour rainfall in inches
NIA
NIA
C0530
TSS in mg/L (100 or 50*)
NIA
NIA
00400
PH in standard units (6.0-900 FW,
NIA
NIA
6.6-&S $W)
Copper, total recoverable in mg/L
01119
(0.010 FW, 0.005E SW)
NIA
NIA
Lead, total recoverable in mg/ L
01051
(0,075 FW, 0.22 SW)
NIA
NIA
Zinc, total recoverable in mg/ L (0.1.2b
01094
FW, ii 095 5W)
NIA
NIA
Chemical Oxygen Demand (COD) in
00340
mg/L (120)
NIA
NIA
00552
Non -Polar Oil & Grease in mg/L (15)
NIA
NIA
* 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 €erg/L
FW (Freshwater) SW (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
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 inform
at'on, including the ossibility of fines and imprisonment for knowing violations."
12/07/2021
Signature of Permittee or Delegated Authorized Individual Date
[e-mail]
Email Address
336-503-6536
Phone Number