NCG060410_2021 DMR_20220120

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG060000
Food and Kindred
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. NCG06 0410
Person Collecting Samples: Parker Cliatt
Facility Name:AMaZon.COMLaboratory
dame: Eur€>f1ns TestAmeTica Savannah
Facility County: Guilford
Laboratory Cert. No.: 269
Discharge during this period: M Yes ❑ No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceeciances? ❑ Yes 0 No
If so, which Tier (1, ii, or ill)?
A copy of this DMR has been uploaded electronically via https:%/edocs.deg.nc.gov/Forms/SW-DMR Q Yes [—]No
Date Uploaded: 1/20/2022
Analytical Monitoring Requirements for Outfalls with industrial Activities —Benchmarks in (Red)
Parameter
Code
Parameter
Out€al# 001
Out€all 002
Out€all
Out€all
Outfa!!
N/A
Receiving Stream Class
WS-IV
WS-IV
N/A
Date Sample Collected MM/DD/YYYY
12/30/2021
12/30/2021
46529
24-Hour Rainfall in inches
0.5
0.5
C0530
TSS in mg/L y100 or 50*)
11
7.5
00400
pH in standard units (6.Q,-9.0 FW,
7.13
7.13
6.8 — 8.5 SW)
31616
Fecal Coliform per 100 ml of
N/A
N/A
freshwater (if required) (1000)
61211
Enterococci per 100 ml of saltwater
N/A
N/A
(if required) (50K's'
Chemical Oxygen Demand in mg/L
00340
i 1213?
9.6
12
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
N/A
N/A
Usage in gal/month
I 00552
Non -Polar Oil & Grease in
<0.77
<0.75
Outtalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of L Ali other water classifications have a benchmark of i' mg,?.
tfv` (Freshwater) S ."'rf" (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 property 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 infor tion,' cluding the possibility of fines and imprisonment for knowing violations."
VIA]V\ e9 zZ--
Signature of Permittee or Delegated Authorized Individual Date
[e-mail]
Email Address
951-445-7785
Phone Number