NCG030240_2022 DMR_20220111

NCDEQ DIVision of Energy, ialineral and Lana Resources
Starlm ter Dischaa e Moriltaring Report (DMR) Form for N 030i)(]0
Metal Fabrication
Click here for instructions
Complete, siUn, scan and submit the DMR via the Storm wafter NPDES permit Data MOMW r ing Re rk I]MR I U pload form within
30 days of receiving samPiing results, Mail the original, sigrlecf hard copy of the DMR to the appropriate DEWR Regional office.
Certificate of Coverage No. NCG030 4Q Person Callecting Samples- NA
Facility blame.,Deere-Hiraf;N constrvach Corp - win&astCaropua Laboratory Name;
Fad IRY County: Forsyth Laboratory Cert_ No_:
Discharge during this period- Yes - No (if m, skip to signature d fore)
Has your facility implemented mandatory Tier response actions this 5arnkple period for any benchmarlk exceedances? Yes Lj No
If so, which Tier (I, 11, or III ?
A copy of this DWIR has been uploaded electrorjically via htt s; edocs_dg _nc_ ov `Forms/SW-DMR .� yes ryo
Date Llploa�ed:
Ana lytiraI Monitoring Requirements for Outfalls with Industrial ActWes — Benchmarks in {R4=-dI
Parameter
Code
Parameter
N/A
Receiving Stream Class
_ N/A
Date Sample Collected M M f D DIYYYY
46529
24-Haag Rainfall in inches
C0530
T5$ in mgf L (100 or 50*)
0040a
PH in standard units 16.D-9.p FW,
_
5.8-8.5 SVV]
01119
Copper, total recoverable in mg/L
(0.010 FW, 0.0958 SW)
01051
Le@d, total recoverable in Mg/ L
0.075 Hui, 0,22 SVV
01094
Zinc, total recoverable in mgf L (iJ.125
FW, 0.095 SW)
0340
Chemical Oxygen Demand (COD) is
D0552 I Non -Polar Oil & Grease in rngj�(15)
outfall01 J outfail.
WS-111
NA
Qutfall I Outfsll I Outfall
0utfafls to Outstanding Resource Waters (ORW}, High Quality Waters (HQVv), Trout WateI
rs (fir] ail Primary MrAj
have a bench ma rk t55 I imlt 9f 54 mg/L. All other water elassifirations h awe a benthma rk of 'Loo mgf i
FLV (Freshwaterl SW (Saltwater)
Notes No Flavor this period
°'I oertify by my signature below, under penalty of law, that this document and all attach rnants were prepared under my direction or supervision in
accordance with a system designed to assure that quallfied Personnel properly gether and evaluate the Information submitted_ Lased on my
Inquiry of the person or persons who rponage the system, orttiase persons directly responsible for gathering the information, the Information
s ubm itte d Is, to th a best of my knowledge and belief, true, accu rate, and com pl ete_ I aril aware that the re are significant PenaWes for submitting
false Information, indVDe(e&ted
offines and imprlsonmentfor knowingviarations.'"
Signature of PermitAtrtivrfxed Individual Gate
chase]dhcmc_oorn
Email Address
[phone]
Phone Number