NCG210432_Monitoring Report_20220201

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for
Timber Products
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitorir
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the
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Upload°Orttt within
Certificate of Coverage No. NCG210432
Person Collecting Samples: NA
Facility Name: CHEP-Charlotte
Laboratory Name: NA
Facility County: Mecklenburg
Laboratory Cert. No.: NA
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 exceedances? ❑ Yes ❑✓ No
If so, which Tier (I, 11, or II1)?
A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.gov/Forms/SW-DMR 0 Yes ❑ No
Date Uploaded:
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 (see note)
N/A
Date Sample Collected MM/DD/YYYY
n/a (see note)
46529
24-Hour Rainfall in inches
n/a (see note)
C0530
TSS in mg/L (100 or 50*)
n/a (see note)
00340
1 Chemical Oxygen Demand (120)
n/a (see note)
Additional parameters for outfalls in drainage areas that use>55 gallons per month of new hydraulic oil on average
00552
Non -Polar oil & Grease in mg/L (15)
n/a (see note)
NCOIL
Estimated New Motor/Hydraulic Oil
Usage in gal/month
n/a (see note)
* 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
Notes (optional): Released from monitoring by DEMLR Regional Office
"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 irjWmation, including the possibility of fines and imprisonment for knowing violations."
of Permittee or Delegated Authorized Individual
Email Address c5ko,un.W rlkcr-son Q-ej .C-6,
Date
Phone Number
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