NCG060209_2022 DMR_20220414

Nill Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG060000
Food and Kindred
ck here for instructions
Complete, sign, scan and submit the DN1R 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. NCG060209
Person Collecting Samples:
Facility Name: Warsaw Mill
Laboratory Name:
Facility County: Dupiin
Laboratory Cert. No.:
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, II, or lli)?
A copy of this DMR has been uploaded eiectronicaliy via htt s: edocs.de .nc. ov Forms SW-DMR ® Yes ❑ No
Date Uploaded: 4/14/2022
Analytical Monitoring Requirements for Outfalls with Industrial Activities - Benchmarks in (Red)
Parameter
Code
Parameter
Outfall1
Outfall2
Outfall3
Outfall
Outfall
N/A
Receiving Stream Class
C 5w
C,Sw
C,S"w
N/A
Date Sample Collected VIM/DD/YYYY
46329
24-Hour Rainfall in inches
C0530
TSS in ni (100 or 50*)
PH in standard units (6.0 - 9.0 FW,
00400
6.8 - 8.5 SW)
Fecal Coliform per 100 ml of
31616
freshwater (if required) (1000)
Enterococci per 100 ml of saltwater
61211
(if required) (500)
Chemical Oxygen Demand in mg/L
00340
(120)
.Additional parameters for outfalls in drainage areas that use >55 gallons per month of new hydraulic oil on average
Estimated New Motor/Hydraulic Oil
NCOIL
Usage in gal/month
00552
Non -Polar Oil & Grease in 1 (15)
* Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HOW), Trout Waters (Tr) and Primary Nursery Areas (PNAJ
have a benchmark TSS limit of 50 mg/L. All other water classifications have a benchmark of 100 mg/L
FW (Freshwater) SW (Saltwater)
Notes (optional): No flow was reported for Jan -March sampling period
"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, including the 1yossibility of fineVnd imprisonment for knowing violations."
4/ 14/2022
Signature of ermittee or Delegated Authorized individual Date
[e-mail] 910-293-3434
Email Address
Phone Number