NCG140352_2022 DMR_20220324

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (13MR) Form for NCG14€30€ 0
Ready -Mix Concrete
ick 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 a.ppropriatc_uEMLR_Repianal ice.
Certificate of Coverage No. NCG140352
Person Collecting Samples: Pete Pelt
Facility Name: ST Wooten Winterville Concrete
Laboratory Name: Microbac
Facility County: Pitt
Laboratory Cert. No.: 11
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 ❑✓ No
If so, which Tier (I, 11, or I11)?
A copy of this DMR has been uploaded electronically via ❑ Yes ❑✓ No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities -- Benchmarks in (Red)
Parameter
Code
parameter
Outfall 1
Outfall 2
Outfall
Outfall
outfall
N/A
Receiving Stream Class
C;Sw;NSW
C;Sw;NSW
N/A
Date Sample Collected MM/DD/YYYY
3-10-2022
3-10-2022
46529
24-Hour Rainfall in inches
2"
2"
C0530
I TSS in mg/L (100 or 50*)
111.5mg/I
4.63mg/I
00400
1 pH in standard units (6.0— 9.0)
7.8
6.8
Additional parameters for outfalls in drainage areas that use >55 gallons per month of new hydraulic oil on average
00552
Non -Polar Oil & Grease in mg/L (15)
NCOIL
Estimated New Motor/Hydraulic Oil
Usage in gal/month
" Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HOW), 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/I.
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 informoo ,-including the possibi�ty of fines and imprisonment for knowing violations."
3-24-2022
Permittee or Delegated Authorized Individual Date
Email Address [e-mail] Phone Number 252-290-5912