NCG160148_2022 DMR_20220822

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) l=c°3rm for NCG160000
Asphalt raving Mixtures and Blocks
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report (DMA) U load, „_. d form within
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the a_p.pr jgriato DEMLRRegional Office.,
Certificate of Coverage No. NCG1.60148
Person Collecting Samples: Kevin Poole
Facility Name: S.T. Wooten Pea Ridge Asphalt
Laboratory Name: Cameron Testing
Facility County: Chatham
Laboratory Cert. No.: 654
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 (1, II, or II1)?
A copy of this DMR has been uploaded electronically via https://edoc:s.dpg.nc.goviForms lSW-f}MR ❑✓ Yes ❑ No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Code
Parameter
Outfall 1
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
WS-IV
N/A
Date Sample Collected MM/DD/YYYY
4-21-2022
46529
24-Hour Rainfall in inches
.32
C0530
TSS in mg/L (1.00 or 50*)
20.8mg/I
Additional parameters for outfal€s in drainage areas that use >55 gallons per month of new hydraulic oil on average
00552
Non -Polar Oil & Grease in mg/L (15)
NA
NCOIL
Estimated New Motor/Hydraulic Oil
Usage in gal/month
NA
* 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);
1 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, orthose persons directly responsible for gathering the information, the information
submitted is, e est f my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting
false infor anon, includ Ag the possiljilityof fines and imprisonment for knowing violations."
08-22-2022
Signature ofgermittee orbelegated Authorized Individual Date
Email Address [e-mail] Phone Number 252-290-5912