NCG060175_Monitoring Report_20220531

5/27/22, 7:58 AM .. _, , .,,,,,,,,,,Submission Completed:", . —.,
Stormwater NPDES Permit Discharge
Monitoring Report (DMR) Upload 11�
boo 11 ry.
Permit and Facility Information:
Please enter the permit number and other details for this upload. °c
IMPORTANT: Until your stormwater permit is registered in the eDMR system, an original signed (not digitally
signed) hardcopy of the DMR must be mailed to the address in your permit, in addition to this electronic
upload.
Permit Number* Enter COG or Individual Permit Number (NOT General Permit number with all 0's)
NCG060000 V C U O( 01 7 S
Must begin with NCS or NCG
Facility Name:* FRITO-LAY 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/contact/regional-offices/mooresviIle
Monitoring Period Information:
Multiple DMRs from sampling periods within the same year can be uploaded together, but please upload different
years with a new submittal form.
Monitoring Period What is the YEAR of the sample date(s)?
Year:* 2022
Copies of the lab results and/or qualitative (visual) monitoring should NOT be submitted unless specifically
requested by DEQ staff. Only upload completed and signed DMR forms.
**DMR forms should have original signature (not digital) to comply with requirements in 40 CFR 122.22**
https://edocs.deq.nc.gov/Forms/Form/Submit 1/2

5/27/22, 7:58 AM:
DMR Upload*
Comments:
Q2 DMR FORM SIGNED.pdf
Only PDFs are accepted.
* By checking the box and signing box below, I certify that:
� . Submission -Completed- :---
Click the upload button or drag and drop files here to attach document.
'148.25KB
♦
nNGi p2 rrn.:
A
�0
t 9
,0
O
nfi
o I have given true, accurate, and complete information on this form;
• I agree that submission of this Discharge 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 NC General
Statutes (the "Uniform Electronic Transactions Act");
o 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
e I intend to electronically sign and submit this DMR Upload form.
Full Name:* Bryant Michael
Name of person submitting this form
Email Address: * [e-mail]
Phone Number:* 7043698576
Signature:*
�'tyawt- eIW,- AqW
Date: * 05/27/2022
https://edoes.deq.ne.gov/Fors/Form/Submit 212

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number NCS NCG060000
SAMPLES COLLECTED DURING CALENDAR YEAR: 2022
(This monitoring report shall be received by the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
Xj
FACILITY NAME Frito-Lav Inc.
COUNTY Mecklenburg
PERSON COLLECTING SAMPLE(S) David Morris
-oz
PHONE NO. 5( 15 )608-2904
CERTIFIED LABORATORY(S) WavPoint Analytical
Lab #98935 Td?s
((j
Lab# Z�M
c rn SIGNATURE OF PERMITTEE OR DESIGNEE
00
N O REOUiRED ON PAGE 2.
Part A: Specific Monitoring Requirements
n
----------
----------
----------
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? (Dyes Ono
(if yes, complete Part B)
Part B: Vehicle Maintenance Activitv Monitoring Requirements
Outfall
Date
50050
00556
00530
00400
Total Flow
Total
Oil & Grease
Non -polar
Total
pH
New Motor
No.
Sample
Collected
(if applicable)
Rainfall
(if appl.)
O&G/TPH
Suspended
Oil Usage
(Method 1664
Solids
SGT-HEM), if
appl.
mo/dd/ r
MG
inches
m
MgA
unit
al/mo
1
4/18/2022
1.58
5.4
38.0
6.42
2
4/18/2022
1.58
5.8
11.8
6.29
3
4/18/2022
1.58
5.5
4.7
6.18
Form SWU-247, last revised 611212015
Page I oft

s
STORM EVENT CHARACTERISTICS: Mail Original and one copy to:. ,
Division of Energy Mineral and Land Resources
Date 4/18/22 Attn: Central Files
Total Event Precipitation (inches): 1.58 1617 Mail Service Center
Event Duration (hours): 10 (only if applicable — see permit.) Raleigh, North Carolina 27699-1617
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see permit.)
"I certify, 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, accuLUbtpand complete. I am aware that there are significant penalties for submitting false information,
including the possib' 'ty of fines and ' ment for knowing violations."
5/26/2022
(S' re of Permittee) (Date)
Form SWU-247, last revised 611212015
_ Page 2 of 2