NCG060105_2021 DMR_20211220

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG060000
Food and Kindred
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. N00060105
Person Collecting Samples: Mark Poythress
Facility Name: Glaxosmithkline
Laboratory Name: Microbac
Facility County: Wake
Laboratory Cert. No.:11
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? ®Yes [E] 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 E]No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Parameter
Outfall1
Outfall5
Outfall7
Outfall8
Outfall
Code
N/A
Receiving Stream Class
NSW, WS-V
NSW, WS-V
NSW, WS-V
NSW, WS-V
N/A
Date Sample Collected MM/DD/YYYY
12/08/2021
12/08/2021
12/08/2021
12/08/2021
46529
24-Hour Rainfall in inches
0.5
0.5
0.5
0.5
C0530
TSS in mg/L (100 or 50*)
24.4
4.08
12.0
8.89
00400
pH in standard units (6.0-9.0 FW,
8.4
6.9
6.7
6.2
6.8 — 8.5 SW)
00556
Oil & Grease in mg/L (30)
ND
ND
ND
ND
Fecal Coliform per 100 ml of
31616
freshwater (if required) (1000)
n/a
n/a
n/a
n/a
61211
Enterococci per 100 ml of saltwater
n/a
n/a
n/a
n/a
(if required) (500)
Chemical Oxygen Demand in mg/L
00340
(120)
24.5
38.0
37.0
26.5
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
n/a
n/a
n/a
n/a
Usage in gal/month
00552
Non -Polar Oil & Grease in mg/L (15)
n/a
n/a
n/a
n/a
* 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):
"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 manag5#tcr system, or those persons directly responsible for gathering the information, the information
submitte is, tInAcluding
tbest of my knowle nd belief, true, accurate, and complete. I am aware that there are significant penalties for submitting
false inf r tithe_qpsiribility of fines and imprisonment for knowing violations."
or Delegated Authorized Individual
[e-mail]
Email Address
Date
91q 6301 9y
Phone Number