NCG030061_2022 DMR_20221021

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 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. NCG030061 Person Collecting Samples:Jack Taylor
Facility Name:Moen Laboratory Name:Environment 1
Facility County:Craven Laboratory Cert. No.:10
Discharge during this period:Lj Yes Lvj No (if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? Yes U No
If so,which Tier(I, II,or III)?
A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.gov/Forms/SW-DMR ElYes UNo
Date Uploaded: 10/6/2022
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in(Red)
Parameter Code Parameter Outfall001 Outfall 002 Outfall Outfall Outfall
N/A Receiving Stream Class other Other
N/A Date Sample Collected MM/DD/YYYY
46529 24-Hour Rainfall in inches
C0530 TSS in mg/L(100 or 50*)
00400 pH in standard units(6.0—9.0 FW,
6.8-8.5 SW)
01119 Copper,total recoverable in mg/L
(0.010 FW,0.0058 SW)
01051 Lead,total recoverable in mg/L
(0.075 FW,0.22 SW)
01094 Zinc,total recoverable in mg/L(0.126
FW,0.095 SW)
00340 Chemical Oxygen Demand(COD)in
mg/L(120)
00552 Non-Polar Oil&Grease in mg/L(15)
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
,,. (Freshwater) (Saltwater)
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 s,to the best of m knowledge and belief,true,accurate,and complete.I am aware that there are significant penalties for submitting
ChatkyoWr�Wtee�r
infoMioncluding t e possibility of fines and imprisonment for knowing violations."
10/6/22
legated Authorized Individual Date
[e-mail] [phone] ext 6341
Email Address Phone Number