NCG140140_Tier 2 Monitoring Report_20210816 (2)

BENCHMARK EXCEEDANCE or TIER 2 DISCHARGE MONITORING REPORT (DMR) — STORMWATER
SUBMIT TO REGIONAL OFFICE*
General Permit No. NCG140000
*Use this form if any stormwater samples have EXCEEDED A BENCHMARK or if the facility is in TIER 2 MONITORING for any parameter.
Send sample results to the DEMLR Regional Office within 30 days of receipt from the laboratory.
Certificate of Coverage No. NCG14
Facility Name: Williams Ready Mix Products, Inc. Sample Collection Period: Period 1 ❑ Period 2 Al Calendar Year 2021
County: Union For Monthly Monitoring: Month July
Phone Number: 7( 04 ) 283-1173 Person Collecting Samples: Richard Harmon - Harmon Environmental, PA
Certified Laboratory: Pace Analytical Services, LLC Lab # 40
Lab #
Has this facility had 4 or more benchmark exceedances for any single parameter, at anyone SW d�charge outfall (SDO)? Yes ❑ No W
Have you contacted the Regional Office? Yes ❑■ No ❑ o y C
Whom at the Region did you speak with? Lily Kay �N'o°, L
I.l
Stnrmwater Monitorina Reauirements a
Outfall
No.
aeam
Date Sample
p
Collected
Total
Rainfall
Is this SDO in
Tier 2?
Does this SDO
include Vehicle
Maintenance
Activities (VMA)?
Total
Suspended
Solids (TSS),
mg/I
0;5
pH,
SU
Non -polar O&G
(EPA Method 1664
(SGT-HEM)), mg/I
(VMA)
Iiapplicable
New Motor Oil
Usage (gal/mo.)
napprcabre
-
mo/dd/yr
or "NO FLOW"
inches
Y/N
Y/N
100
50 (ORW, HOW, Tr, PNA)
6.0-9.0
15
>55 galfmo. average
requires T55 and Non -polar
O&G monitoring
01
No Flow
N
N
NA
NA
02
No Flow
Y
N
NA
NA
03
No Flow
N
N
NA
NA
Permit Date 8/1/2017 — 6/30/2022 Last Revised 8-22-2017
Page 1 of 3

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Certificate of Coverage No. NCGU 0 1❑®0
CERTIFICATION
" 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, 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." [Required by 40 CFR §122.22]
Sign
Date
Mail Benchmark Exceedance/Tier 2 DMR to Your DEMLR Regional Office Land Quality Section:
ASHEVILLE REGIONAL OFFICE
2090 US Highway 70
Swannanoa, NC 28778
[phone]
RALEIGH REGIONAL OFFICE
3800 Barrett Drive
Raleigh, NC 27609
[phone]
WtNSTON-SALEM REGIONAL
OFFICE
450 Hanes Mill Road, Suite 300
Winston-Salem, NC 27103
[phone]
FAYETTEVILLE REGIONAL OFFICE MOORESVILLE REGIONAL OFFICE
225 Green Street 610 East Center Avenue/Suite 301
Systel Building Suite 714 Mooresville, NC 28115
Fayetteville, NC 28301-5043 [phone]
[phone]
WASHINGTON REGIONAL OFFICE WILMINGTON REGIONAL OFFICE
943 Washington Square Mall 127 Cardinal Drive Extension
Washington, NC 27889 Wilmington, NC 28405-2845
[phone] [phone]
CENTRAL OFFICE
Questions for The Central Office
Stormwater Permitting Program?
[phone]
Permit Date 8/1/2017 — 6/30/2022 Last Revised 8-22-2017
Page 3 of 3

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