NCG030711_2022 DMR_20220712

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 DM via the Stormwater NPDES 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 0711
Person Collecting Samples: Jordie Promislow
Facility Name: Robert Bosch Tool Corporation
Laboratory Name: Pace Analytical
Facility County. Lincoln
Laboratory Cert. No.: 92458016
Discharge during this period:
Ej Yes
0 No (if no, skip to signature and dare)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?EYes LjNo
If so, which Tier (I, 11, or Ill)?
A copy of this DMR has been uploaded electronically via htt s: edocs.deg. nc. ov Forms SW-DMR Yes No
Date Uploaded:
Analytical Monitoring Requirements for OutfaIIs with Industrial Activities — Benchmarks in (Red)
Parameter
Parameter
Outfall2
Outfall
Outfall
Outfall
Outfall
Code
N/A
Receiving Stream Class
WS-Iv
N/A
Date Sample Collected MM/DD/YYYY
6/2312022
46529
24-Hour Rainfall in inches
0.2 inches
C0530
TSS in mg/L (100 or s0')
16.0 m91L
00400
PH in standard units (6.0 — 9.0 FW,
7,6
6.8-8.5 5W)
Copper, total recoverable in mg/L
01119
(0.010 FW, 0.0058 SW)
0.0167 mg/L
Lead, total recoverable in mg/ L
01051
(0.075 FW, 0.22 SW)
c 0.005 mg1L
Zinc, total recoverable in mg/ L(0.126
01094
FW, 0.095 SW)
0 242 m91L
Chemical oxygen Demand (COD) in
00340
mg/L (120)
277 mg/L
00552
Non -Polar Oil & Grease in mg/L (15)
c 5.0 mg/L
* 0utfails to Outstanding Resource Waters (0RW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TS5 limit of 50 mg/L. All other water classifications have a benchmark of 100 mg/L
FW (Freshwater) 5W (Saltwater)
Notes (optional): Tier monitoring relief has been granted for copper and zinc.
"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 information, including the possibility of fines and imprisonment for knowing violations."
Signature of Per R tt ori5`elegated Authorized Individual Date
Pedro. Fondevi[[e-mail]
Email Address
7 i22.
[phone]
Phone Number