NCG060414_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 0414
Person Collecting Samples: Parker Cliatt
Facility Narne. _ , n
I Laboratory Na!re. EurOffins TestAmerica Sava a)�
Facility County: Henderson
Laboratory Cert. No.: 269
Discharge during this period: PJC 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 ❑x No
If so, which Tier (►, il, or 111)?
A copy of this DMR has been uploaded electronically via https:/Iedocs.deg.nc.gov/Forms/SW-DMR 0 Yes ❑ No
Date Uplcraded. 1/20/2022
Analytical Monitoring Requirements for outfails with Industrial Activities — Benchmarks in ,
Parameter
Code
Parameter
Qutfall OO2
Outfall003
I Outfall004
Gutfall005
O-..,tfall
N/A
Receiving Stream Class
B
B
B
B
N/A
Date Sample Collected MM/DD/YYYY
12/30/2021
12/30/2021
12/30/2021
12/30/2021
46529
24-Hour Rainfall in inches
0.24
0.24
0.24
0.74
C0530
TSS in mg/ L (100 or 50*)
<25
00400
PH in standard units (6.0- 9.0 FW,
,�
8.06
6.8-8.5SW)
a
07
31616
Fecal Coliform per 100 ml of
L
+J
N/A
freshwater (if required) (1000)
_
—
—
61211
Enterococci per 100 ml of saltwater
(if required) ='`::_
a
N/A
o
0
Chemical Oxygen Demand in mg/L
00340
(120)
v
9.6
.!
Additional parameters for outfalls in drainage are° that use >55 gallons per month cTnew hydraulic d3Fon average
NCOiL
Estimated New Motor/Hydraulic Oil
N
N/A
N
Usage in gal/month
o
o
a
00552
Non -Polar Oil .& Grease in mg/
z
<03S
0
0
outtalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of All other water classifications, have a benchmark of
(Freshwater) w' (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 infArmatiork inclucVng.the possibility of fines and imprisonment for knowing violations."
Signature of Permiftee or Delegated Authorized Individual
[e-mail]
Email Address
1 b Z,
Date
951-445-7785
Phone Number