NCG030308_2021 DMR_20220110

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. NCG03C_1308
Person Collecting Samples: 'n
Facility Name:& -Awn eo.
Laboratory Name: EC�o ttiw)
Facility County:
Laboratory Cert. No.: r'1
Discharge during this period:
MYes No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? Elyes No
If so, which TierQ ll, or III)?
A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.gov/Forms/SW-DMR 173yes No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Code
Parameter
OutFall�
Outfallla
Outfall -03
Outfall
Outfall
N/A
Receiving Stream Class
(�
(s ..j Lv
c 0
N/A
Date Sample Collected MM/DD/YYYY
�a p� j
1 (2p�)
fr370rZ
46529
24 Hour Rainfall in inches
��a ''
[
C0530
T55 in mg/L (100 or 50*)
a ,5
r f
, I
00400
pH in standard units (6.0-9.0 FW,
�f5
_
7,5
6.8-8.5 SW)
=S
01119
Copper, total recoverable in mg/L
(0.010 FW, 0.0058 SW)
D-00 .1 i
�� C�3�R
CO(fG�7
01051
Lead, total recoverable in mg/ L
(0.075 FW, 0.22 SW)
D- Du,3 fb
i
D • G� 1 D
01094
Zinc, total recoverable in mg/ L (0.126
FW,0.095SW)
�y 7xr7
0.06J f
D, jDl
D• i I0
00340
Chemical Oxygen Demand (COD) in
1 oZ
D
) D
mg/L (120)
00552
Non -Polar Oil & Grease in mg/L (15)
I ,q
p
I -SO
Outfails 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 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 intion, including the possibility of fines and imprisonment for knowing violations."
//7 Z4,
Signature of Perm' ee or Delegated Authorized Individual D to
ux�`cCl [C gxnAVu� Q E O 107 C) j
Email Address Phone Number