NCG060326_2022 DMR_20220929

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG060000
Food and Kindred
Click here far instructions
Complete, sign, scan and submit the DMR 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. NCG06 c;3
Person Collecting Samples: Su,�
Facility Name: I ,„j1,,, PrK
Laboratory Name: C-JVf�3r'v^vlatflZ, cthG�., si
Facility County: &)P t rJ
Laboratory Cert. No.: ;bvj (; �q q4 ba-14 3 7-;�'9
Discharge during this period: ❑ Yes 10 No (if no, skip to signature and date)
Has your facility implemented mandatoryTier response actions this sample period for any benchmark exceedances? ❑ Yes P1 No
If so, which Tier (1, 11, or I11)?
A copy of this DMR has been uploaded electronically via hops:]/edocs.deg. nc-gov/Fors/SW-DMR 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
Date Sample Collected MM/DD/YYYY
46529
24-Hour Rainfall in inches
C0530
TSS in mg/L (100 or SO")
00400
pH in standard units (6.0 — 9.01
00556
Oil & Grease in mg/L (30)
31616
Fecal Coiiform per 100 ml of
freshwater (if required) iwo
61211
Enterococci per 100 ml of saltwater
(if required) 500
00340
Chemical Oxygen Demand in mg/L
(120)
Additional parameters for outfalls in drainage areas that use >55 gallons per month of new hydraulic
oil on average
NCOIL
Estimated New Motor/Hydraulic Oil
Usage in gal/month
00552
Non -Polar Oil & Grease in mg/L (15)
x Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark T55 limit of so mg/t . All other water classifications have a benchmark of 100 mg/1
Notes (optional):
"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 Ike best of ri)y knowledge and belief, ti ue, accif a1c and complete i am aware that There are signif+can� penahies for submitting
9-a
=[, n1c7 r11u r11LC
t v - ' s d- -