NCG020260_2021 DMR_20220118

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG020000
Active and Inactive Mining Sites
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. NCG020,zt7 r
Person Collecting Samples: �n
Facility Name:
Laboratory Name:
Facility County: ^/ i� Laboratory Cert, No.:
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 Qil No
If so, which Tier (1, II, or III)?
A copy of this DMR has been uploaded electronically via htt s:ZZedocs.deg.nc.gov/Forms/­`SW-DMR Yes ❑ No
Date Uploaded: f r A 1_
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Code
Parameter
Outfall
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
N/A
Date Sample Collected MM/DD/YYYY
46529
24-Hour Rainfall in inches
00545
Settleable Solids (SS) (0.1 mg/1)
C0530
TSS in mg/L (100 or 50*)
00070
Turbidity of discharge**
Turbidity downstream of discharge**
Turbidity upstream of discharge**
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
Usage in gal/month
00552
Non -Polar Oil & Grease in mg/L (15)
Additional parameters for Clay Mines
01105
Aluminum, total in mg/L (0.75 FW,
0.24 SW)
01092
Zinc, total (as Zn) in mg/L (0.126 FW,
0.095 SW)
00951
Fluoride, total in mg/L (6.0)
00900
Hardness, total
00400
pH, in standard units (6.0-9.0 FW,
6.8-8.5 SW)
01097
Antimony, total in mg/L (0.34 FW,
N/A SW)
01002
Arsenic, total in mg/L (0.15 FW, 0.069
5W)
C0034
Chromium III in mg/L (0.905 FW, N/A
SW)
Additional parameters for Feldspar Ore Mines
01105
Aluminum, total in mg/L (0.75 FW,
0.24 SW)
01092
Zinc, total (as Zn) in mg/L (0.126 FW,
0.095 SW)

—Igjl� .V VUlsLdf1U1[16 Resource waxers {uKvvi, reign 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
** See F-5 of the NC6020000 General Permit for turbidity requirements.
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 information, including the possibility of fines and imprisonment for knowing violations."
of Permittee or Delegated Authorized Individual
Email Address
Date
9�, - /;U , .3 g it al
Phone Number