NCG060421_2021 DMR_20220118

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG060000
Food and Kindred
Click here for instructions
0 Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report (DMR) Upload form within
Z5v uayn vi lee giving sampling results. Mail the original, sighed hard c opy of the DMR to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NCG06 0421 Person Collecting Samples: John Haffner i
Facility Name Amazorixom services LL - RD 1 laboratory Name: Rirof ns TestA nerica l
Facility County: Alamance Laboratory Cert. No.: 269
Discharge during this period: IJ 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 © No
if so, which Tier (1, jj, or 111)? I
A copy of this DMR has been uploaded electronically via https:/Zedocs.deg.nc.gov/Forms/SW-DMR_ © Yes ❑ No
Date Uploaded: 1/18/2022
Analytical: Monitoring Requirements for Outfaiis with Industrial Activities — Benchmarks in (Red)
Parameter
Code
I Para
�alpmeter
I r%..a#-11 �
ii 4f Lf 01
Outf..11 102
I iiYal pll
1 HULL. 1
I ��.LIGL
I
I .i iiaiczll
I .,u�lcsll
N/A
Receiving Stream Class
I WS-V
` S v
I
I
I I
N/A
Date Sample Collected MM/DD/YYYY
12/19/2021
12/19/2021
46529
124-Hour Rainfall in inches
1 0.61
0.67
C0530
TSS in mgjL ,!100 or 50*)
59
71
00400
pH in standard units (6.0-9.0 FW,
02
7.21
I
6.8-8.5SW)
Fecal Coliform per 100 ml of
31616
I
I freshwater (if required)
I N/A
( N/A
I
f
61211
I Enterococci per 100 ml of saltwater
I
I (if required) (500)
N/A
N/A
L 00340
Chemical Oxygen Demand in mg/L
24
19
Additional parameters for outfalls in drainage areas that use >55 gallons per month of new hydraulic oil on average
i Estimated New Motor/Hydraulic Oil l 1 I
f NCOIL I Usage in gal/month N/A IN/A
I nQrj5Non-Polar2 Non -Polar (ail R Crease in ma, L ll I lai! A I AT/ A I j
I I 'gI 1V/t1 I 1Vltl I I
I 1
Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TCC limit of A11 `ether Ater classific-at.ons have a benchmark of
(Freshwater) (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."
C� V N
Signature of Permittee or Delegated Authorized Individual
nickensanamazon. com
Email Address
t t G/&z
Date
[phone]
Phone Number