NCG030511_2022 DMR_20221025

NCDEQ Division of Energy,Mineral and Land Resources
Stormwater Discharge Monitoring Report(DMR)Form for
NCG030000-Metal Fabrication
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. NCG030511 Person Collecting Samples: Johnson, Mark
Facility Name: Scott Safety Laboratory Name: Waypoint Analytical
Facility County: Union Laboratory Cert. No. 402
Discharge during this period: Q Yes ❑ No (if no, skip fa signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? ❑ Yes Ei No
If so,which Tier(I, II,or III)? NA
A copy of this DMR has been uploaded electronically via https://edocs.deq.nc.govlForms/SW-DMR 0 Yes ❑ No
Date Uploaded: Pending
Analytical Monitoring Requirements for Outfalls with Industrial Activities-Benchmarks in (Red)
Parameter Outfall Outfall Outfall Outfall Outfall
Code Parameter SDO-1 SDO-2 SDO-3 SDO-4 NA
NA Receiving Stream Class C C C C NA
NA Date Sample Collected MM/DD/YYYY 9/30/2022 9/30/2022 9/30/2022 9/30/2022 NA
46529 24-Hour Rainfall in inches 0.28 in. 0.28 in. 0.28 in. 0.28 in. NA in.
C0530 TSS in mg/L(100 or 50*) < 2.7 mg/L 29.2 mg/L 10.9 mg/L 14.2 mg/L < mg/L
0400 pH in standard units(6.0-9.0) 7.10 '*' 6.90 *** 7.30 ' 6.70 *** < ***
01119 Copper,total recoverable in mg/L(0.010) 0.004 mg/L 0.005 mg/L 0.004 mglL < 0.003 mg/L < mg/L
01051 Lead,total recoverable in mg/L(0.075) < 0.001 mg/L < 0.001 mg/L < 0.001 mg/L < 0.001 mg/L < mg/L
01094 Zinc,total recoverable in mg/L(0.126) 0.010 mg/L 0.029 mg/L 0.021 mg/L 0.019 mg/L < mg/L
00340 Chemical Oxygen Demand(COD)in rng/L(120) < 50 mg/L < 50 mg/L < 50 mg/L < 50 mg/L < mg/L
00552 Non-Polar Oil&Grease in mg/L(15) < 5.6 mg/L < 6.1 mg/L < 5.6 mg/L < 5.6 mg/L < mg/L
78141 Total Toxic Organics(TTO)in mg/L(1) < 0.00 mg/L < 0.00 mg/L < 0.00 mg/L < 0.00 mg/L < mg/L
*Outfalls to Outstanding Resource Waters(ORW), High Quality Waters(HOW),Trout Waters(Tr)and Primary Nursery Areas(PNA)have a benchmark TSS
limit of 5( -IL.All other water classifications have a benchmark of 100 mgii
Notes
"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 kn ing olations."
Paul Doron D /d(2 /Z 2
Signature of Permittee or Delegattedd Authorized Individual Date
Email Address [e-mail] Phone Number [phone]

1.Outfall Description:
Outfall No. SDO-3 Structure(pipe,ditch,etc.): Pipe
Receiving Stream: SWP3§2.1:"Stormwater discharges on the N and W sides are directed towards the City POTW(discharging into Bearskin Creek)."
Describe the industrial activities that occur within the outfall drainage area: Roof,parking areas and driveways runoff.
2.Color-Describe the color of the discharge using basic colors(red,brown,blue,etc.)as descriptors: clear
Describe the color of the discharge using tint(light,medium,dark)as descriptors: none
3.Odor:Describe any distinct odors that the discharge may have(i.e.,smells strongly of oil,weak chlorine odor,etc.): none
4.Clarity:Choose the number which best describes the clarity of the discharge,where 1 is clear and 5 is very cloudy: 1
5.Floating Solids-Choose the number which best describes the amount of floating solids in the stormwater discharge,where 1 is
no solids and 5 is the surface covered with floating solids: 1
6.Suspended Solids-Choose the number which best describes the amount of suspended solids in the stormwater discharge,
where 1 is no solids and 5 is extremely muddy: 1
7. Is there any foam in the stormwater discharge? none
8. Is there an oil sheen in the stormwater discharge? none
9.Is there evidence of erosion or deposition at the outfall? none
10.Other Obvious Indicators of Stormwater Pollution: not applicable
List indicators,or"Not Applicable"
1.Outfall Description:
Outfall No. SDO-4 Structure(pipe,ditch,etc.): Pipe
Receiving Stream: SWP3§2.1:"Stormwater discharge on the east side of the facility is directed towards the East Fork of Twelve Mile Creek."
Describe the industrial activities that occur within the outfall drainage area: Roof, parking areas and driveways runoff.
2.Color-Describe the color of the discharge using basic colors(red, brown,blue,etc.)as descriptors: brown
Describe the color of the discharge using tint(light, medium,dark)as descriptors: light
3.Odor:Describe any distinct odors that the discharge may have(i.e.,smells strongly of oil,weak chlorine odor,etc.): none
4.Clarity:Choose the number which best describes the clarity of the discharge,where 1 is clear and 5 is very cloudy: 1
5.Floating Solids-Choose the number which best describes the amount of floating solids in the stormwater discharge,where 1 is 2
no solids and 5 is the surface covered with floating solids:
6.Suspended Solids-Choose the number which best describes the amount of suspended solids in the stormwater discharge, 2
where 1 is no solids and 5 is extremely muddy:
7. Is there any foam in the stormwater discharge? none
8. Is there an oil sheen in the stormwater discharge? none
9. Is there evidence of erosion or deposition at the outfall? none
10.Other Obvious Indicators of Stormwater Pollution: not applicable
List indicators,or"Not Applicable"
Proposed Corrective and/or Preventive Actions
List action items here(EHS will record in the 3M Worldwide Incident Management System,WIMS)or"Not Applicable."