NCG080792_2022 DMR_20220408

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG080000
Transit and Transportation
Click here for instructions
Complete, sign, scan and submit the DM via the Stormwater NPDES Permit Data Monitoring Report (DK4R) Upload_form within
30 days of receiving sampling results. Mail the original, signed hard Copy of the DM to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NCG08 0792
Person Collecting Samples: Ashton Gullickson
Facility Name: USF Holland - Charlotte 341
Laboratory Name: Pace Laboratories
Facility County: Mecklenburg
Laboratory Cert. No.: 633
Discharge during this period:QYes
11
No cif no, skip to signature and dare)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? El Yes Q No
If so, which Tier (I, 11, or 111)?
A copy of this D M R has been uploaded electronically via htts: /edocs.deg.nc. ov/Forms/SW-DMR Yes No
.P _/... d -- -
Date Uploaded:
Analytical Monitoring Requirements for Vehicle & Equipment Maintenance Areas —Benchmarks in (Red)
Parameter
Code
Parameter
Outfall002
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
C
N/A
Date Sampie Collected MM/DD/YYYY
0311612022
46529
24-Hour Rainfall in inches
0.26
C0530
T55 in mg/L (100 or 50*)
24
00552
Non -Polar Oil & Grease in mg/L (15)
1.33
pH in standard units (6.0 — 9.0 FW,
00400
6.8 — 8.5 SW)
8,8
Estimated New Motor/Hydraulic Oil
NCOIL
Usage in al/month
{1-800
* Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark T55 limit of 50 mg/L. All other water classifications have a benchmark of 100 mg/L
FW (Freshwater) 5W (Saltwater)
Notes (optional): pH is measured in the field as specified by General Permit NCGo80000. Outfalls 0011004 represent 0021003
"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, includingtl.g possi bi lipAof fines and imprisonment for knowing violations."
Signature of Permittee or delegated Authorized Individual
�ftF.4r� , Mo:" 0 JsFC . [pr4
Email Address
Date
Phone Number