NCG030061_2022 DMR_20220412

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG030000
Metal Fabrication
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. NCG030061
Person Collecting Samples: Jack Taylor
Facility Name: Moen
Laboratory Name: Environment 1
Facility County: Craven
Laboratory Cert. No.: 10
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? Lj Yes U No
If so, which Tier (I, Il, or III)?
A copy of this DMR has been uploaded electronically via littps://edocs.dg_q.nc.gov/Forms/SW-DMR r Yes LjNo
Date Uploaded: 4/5/2022
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Code
Parameter
Outfall001
Outfall 002
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
other
other
N/A
Date Sample Collected MM/DD/YYYY
46529
24-Hour Rainfall in inches
C0530
TSS in mg/L (100 or 50*)
00400
pH in standard units (6.0-9.0 FW,
6.8-8.5 SW)
Copper, total recoverable in mg/L
01119
(0.010 FW, 0.0058 SW)
Lead, total recoverable in mg/ L
01051
(0.075 FW, 0.22 SW)
01094
Zinc, total recoverable in mg/ L (0.126
FW, 0.095 SW)
Chemical Oxygen Demand (COD) in
00340
mg/L (120)
00552 i
Non -Polar Oil & Grease in mg/L (15)
* Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), 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/L
(Freshwater) SW (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 whqAanage the system, or those persons directly responsible for gathering the information, the information
submitted is, tot,
o the best of kn ledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting
false infor t' , to ossibility of fines and imprisonment for knowing violations."
4/5/22
5igfldtuYe16f_Permittee/4r Delegated Authorized Individual Date
katie.fritzler�
Email Address
[phone] ext 6341
Phone Number