NCG030213_2021 DMR_20220104

NCDEQ Division of Energy, Mineral and Land Resources
Storrinwater 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 Monitorin Re ort DMR U load form within
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the alopropriate DEMLR Re ional Office*.
Certificate of Coverage No. NCG03 0213
Person Collecting Samples: Mark Phelps
Facility Name: MiTek Industries
Laboratory Name: Environmental Chemists, Inc.
Facility County: Chowan
Laboratory Cert. No.: DWQ #94, DLS #37729
Discharge during this period: ✓0 Yes ❑ No (if no, skip to signature and date}
Has your facility implemented mandatory Tier response actions this saml2le period for any benchmark exceedances? ❑ Yes ✓❑ No
If so, which Tier (I, II, or III)?
A copy of this DMR has been uploaded electronically via https://c--doLs.deg.nc.gov/FormsJSW--DMR ✓❑ Yes ❑ No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities-- Benchmarks in (Red)
Parameter
Code
Parameter
Outfall
Outfall
Outfal!
Outfall
Outfall
N/A
Receiving Stream Class
SB
N/A
Date Sample Collected MM/DD/YYYY
12/8/2021
46529
24-Hour Rainfall in inches
.85
C0530
TSS in mg/L (100 or 50*)
4.8 mg/L
00400
pH in standard units (6.0— 9.0)
6.4 units
01119
Copper, total recoverable in mg/L
007 mg/L
(a.010)
01051
Lead, total recoverable in mg/ L
010 mg/L
(n.n7s}
01094
Zinc, total recoverable in mg/ L
.050 mg/L
(0.126}
78141
Total Toxic Organics (TTO) in mg/L(1)
N/A
(if required)
00552 1
Non -Polar Oil & Grease in mg/L (15)
<5.0 mg/L
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 1 gallon
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 TSS limit of 50 mg/L. All other water classifications have a benchmark of 100 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 personnei 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, in4ud6g the possibility of fines and imprisonment for knowing violations."
1 /4/2022
Signaturejof Permittee or Delegated Authorized Individual Date
Email Address rcook@mii,com Phone Number 252-368-3060

Total Toxic Organics Certification;
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring
requirement for total toxic organics (70),1 certify that to the best of my knowledge and belief, no leak, spill, or dumping of
concentrated toxic organics into the stormwater or onto areas which are exposed to rainfall or stormwater runoff has occurred since
filing the last discharge monitoring report. I further certify that this facility is implementing all the provisions of the Solvent
Management Plap included in the Stormwater Pollution Prevention Plan.°
Signature of Permittee or Delegated Authorized Individual
Email Address [e-mail]
1 /4/2022
Date
Phone Number 252-368-3060