NCG100031_2022 DMR_20220615

41
dL-
NCDEQ Division of Ene
AL
.r„
Stor water Discnarge
Complete,, sign., scan and submit the D
30 days of receiving sampling results.
Analytical Mon
itoring Requir
Mineral and
onitoring Repo
sed
otnr Vehicles
Click here forinstructions
nd Resources
Rj Form for
CG100000
li4 oil
ORMY
IR via the StormwaterNPDES Permit Data Monitoring Report (DMR) Upload fo0--ow
rm w
tail the originalsigned hard copy of the DMR to the as�gropriate DEMLR Regional 01
ements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter parameter Outfa11001 Outfali Outfall Outfall Outfall
Code
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY 05123/2022
46529 24-Hour Rainfall in inches 1.2
C0530 TSS in mg/L (100 or 50*) 52.9
00400PH in standard units (6.0-9.0 FW, 7786.8 — 8.5 SW)
IV
00340 Chemical Oxygen Demandin mg/L 65.0A
(12001051 Lead,totalrecoverable(asPb)in 0.00988
mg/ L (0.075 FW, 0.22 SW)Ethylene Glycol in mg/ L (any amount
77023 detected Tier One; 8,000 mg/L Tier <1.0
Two and Three)
00552 Non -Polar Oil & Grease in mg/L (15) 2.83
NCOIL Estimated New Motor/Hydraulic Oil
Usage ingal/month
* Outfa I Is to Outstanding Resource Waters (0RW), H igh Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS II&I't of 54 mg/L. AEI other wader classfficati.ans have a benchmark of 100 mg/L
FW (Frashwaterl SW (Saltwater)
ithin
ffice.
ify bv my signature below, under Penaltv of law, that this document and all attachments were prepared under my direction ar supervision in
accordance with a system designed to assure that quaiMea personnei properly gather and evaluate the information submiited. Based on my
inquiry of the person or persons who manage the system, or those persons direct[y�epsbforgh�the iaEng nformatan., the information
submItTed Is, t4 the wcl
be�fi o� my kno��e and belie#, true., accurate, and complete,. I am aware that there are 5igr�ificant penalties fnr submitting
false intormation, including t e-,ossibilit f fines an imprisanment for knowing violations."
Signature of Pe' it(ee or Delia
samsdustyparts
SS
Email Addre
il.co
c
e uthorized Individua
KAP_.-WM
[phone]
Phone Number
r
4:
{
W1
A