NCG030061_2022 DMR_20220520

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 5t2LMVatrr b!PDES 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. NCG03 0061 r
Person Collecting Samples: Jack Taylor
Facility Name; Moen
Laboratory Name: Environment 1
Facility County: Craven
Laboratory Cert. No.: 10
Discharge during this period:
✓ Yes Ej No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceed ances? Yes ✓ No
If so, which Tier (I, II, or III)?
A copy of this DMR has been uploaded electronically via https:Uedocs.deaa nc.RoyjForm fSW-DMR ✓ Yes IJo
Date Uploaded: 4/9/2022
Analytical Monitoring Requirements for Dutfalls 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
4118/22
4/18/22
46529
24-Hour Rainfall in inches
0.73
0.73
C0530
TSS in mg/L (100 or 50*)
16
20
pH in standard units (6.0 — 9.0 FW,
00400
6.8-8.5 SW)
7.3
7.2
Copper, total recoverable in mg/L
01119
(0.010 FW, 0.0058 SW)
0 123
0.015
Lead total recoverable in mg/ 1.
01051
(�0.075 FW, 0.22SW)
0.006
0,002
Zinc, total recoverable in mg/ 1_ (0.126
01094
FW, 0.095 SW)
0.098
0.272
Chemical Oxygen Demand (COD) in
00340
mg/L 120
N/A
NIA
00552
Non -Polar Oil & Grease in mg/L (15)
<5.0
<5.0
* Outfalls to Outstanding Resource Waters (ORW), High Quallty Waters (HOW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a barichmark TSS limit of 50 mg/L All other water classifications have a benchmark of 100 mg/L
FW (Freshwater) SW (Saltwater)
Notes (sptionao:
"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 esigned to rssure that qualified personnel properly gather and evaluate the information submitted, Based on my
inquiry of the person orillifrsons who manage the system, or those persons dire ly responsible for gathering the information, the information
submitce is. to a 6es f my knowlec belie , an complete. I am aware that there are significant penalties for submitting.
false :o iu gthe 5ityoffinesandImprisonmentforknowingviolations."
re of Perm
katie.fritz lerCG
Email Address
or Delegated Authorized Individual
5/9/22
Date
[phone] ext 6341
Phone Number