NCG030617_Monitoring Report_20211220

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG030000 r<
Metal Fabrication
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report(DM f' d witMn
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the appropriate DElXio al Office.
Certificate of Coverage No. NCG030617
Person Collecting Samples: Lanette Plyler
Facility Name: CORMETECH, Inc.
LaboratoryName: Pace Analytical
Facility County: Mecklenburg County
Laboratory Cert. No.: 329
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 exceedancesl Yes No
If so, which Tier (l, II, or III)?
A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.goy/Forms/SW-DMR Q Yes No
Date Uploaded: 12/15/2021
Analytical Monitoring Requirements for Outfalis with Industrial Activities— Benchmarks in (Red)
Parameter
Parameter
Outfall001
Outfall002
Outfall003
Outfall
Outfall
Code
N/A
Receiving Stream Class
Class C
Class C
Class C
N/A
Date Sample CollectedMM/DD/YYYY
11/22/2021
11/22/2021
11/22/2021
46529
24-Hour Rainfall in inches
0.25
0.25
0.25
C0530
TSSin mg/L(100 or50•)
<13
No Flow
<13
00400
pH in standard units (6.0-9.0 FW,
6.64
No Flow
6.57
6.8-8.5 SW)
01119
Copper, total recoverable in mg/L
<0.01
No Flow
<0.01
(0.010 FW, 0.0058 SW
01051
Lead, total recoverable in mg/ L
<0.01
No Flow
<0.01
(0.075 FW, 0.22 SW)
Zinc, total recoverable in mg/ L (0.126
01094
FW, 0.095 SW)
<0.02
No Flaw
<0.02
00340
Chemical Oxygen Demand (COD) in
<20.0
No Flow
23.0
mg/L(120)
00552
Non -Polar Oil & Grease in mg/L (15)
<5.3
No Flow
<5.3
` 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
FW (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 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 possibility of fines and imprisonment for knowing violations."
VIP -di k h 4 12/15/2021
of Permittee or DeleRaW Authorized Individual Date
[e-mail]
Email Address
980-722-1811
Phone Number

a �. - Stormwater NPDES Permit Data Monitoring Report
j3�
"""" (DMR) Upload
n.1 UNOu l
Enrlmnmenml QuNlry
Permit and Facility Information:
Please enter the Permit number and other details for this uplond.
IMPORTANT., Until the eDMR system is implemented for DEMLR Stormwater Program permits, an original
signed hardcopy of the DMR MUST be mailed to the address in your permit, in addition to this electronic
upload.
Fields marked with a red asterisk are required.
Permit Number* Enter COC or Individual Permit Number (NOT General Permit number with all O's)
NCG030617
Must begin with NCS or NCG
Facility Name:* CORMETECH, Inc.
County: * Mecklenburg
After uploading here, the original signed hardcopy must be mailed to:
DEQ Mooresville Regional Office
Attn: DEMLR Stormwater Program
610 East Center Avenue
Suite 301
Mooresville, NC 28115
Further contact details at https://deq.nc.gov/contacUregional-offices/mooresville
Monitoring Period Information:
Monitoring Period What is the YEAR or the sample date(s)?
Year:* 2021
Multiple DMRs from sampling periods within the same year can be uploaded together, but please upload different
years with a new submittal form.

Also, copies of the lab results and qualitative (visual) monitoring should NOT be submitted unless specifically
requested by DEQ staff. Only upload the completed and signed DMR forms.
DMR Upload* Click the upload button or drag and drop files here to attach document.
Q4 2021 Quarterly Stormwater Discharge Report... 915.52KB
Only PDFs are accepted.
Comments:
* By checking the box and signing box below, I certify that:
• I have given true, accurate, and complete information on this form;
• I agree that submission of this Data Monitoring Report (DMR) upload form is a "transaction" subject to Chapter 66,
Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act');
o I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the INC General
Statutes (the "Uniform Electronic Transactions Act');
• I understand that an electronic signature on this upload form has the same legal effect and can be enforced in the
same way as a written signature; AND
o I intend to electronically sign and submit this DMR upload form.
Full Name:* Lanette H Plyler
Name of person submitting this form
Email Address:* [e-mail]
Phone Number:* 9807221811
Signature:
16�4t-e RZci%ew
Date: * 12/15/2021