NCG160085_2022 DMR_20220513

NCDF0 Division of Energy, Mineral and Land Resources
Stol'i11wate" Discharge Monitoring Report (©MR) Form for NCG160000
Asphalt Paving Mixtures and Blacks
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report (DMR1 upload form within
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the appropriate ❑EMI-11 Regional Office.
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Code Parameter Outfall Outfall outfall Outfall Outfall
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY
46529 24-Hour Rainfall In Inches
C0530 TSS in mg/L (100 or 5041
Additional parameters for outfalls in drainage areas that use>S5 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 (oltW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmarkTSs limit of 50 mg/L. All other water classifications have a benchmark of 100 rang/L
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, tothe bestof my knowledge and belief, true, accurate, and complete. I am aware that there aresignificant penaltiesfor submitting
false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Permittee or Delegated Authorized Individual
Date
Email Address Phone Number

aceAnalytical
www.pacclabi.com
ANALYTICAL RESULTS
Project: WEST PLANT
Pace Project No.: 92603364
Pace Analytical Services, LLC
9800KinceyAve. Suite100
Huntersville, NC 28078
[phone]
Sample: OUTFALL #1 TSS Lab ID: 92603364001 Collected: 05/09/22 07:00 Received: 05/09/22 10:35 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
2540➢ Total Suspended Solids Analytical Method: SM 254OD-2015
Pace Analytical Services - Eden
Total Suspended Solids ND mglL 2.5 1 05/10/22 22:23
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 05/1212022 08:57 AM without the written consent of Pace Analytical Services, LLC. Page 4 of 10