NCG060139_2022 DMR_20221122

NCDEQ Division of Energy,Mineral and Land Resources
Complete,sign,scan and submit the DMR via the __ — . within
30 days of receiving sampling results. Mail the original,signed hard copy of the DMR to the_pp,...
_- •
Certificate of Coverage No.NCG06lr; (3 _ /
Person Collecting Samples: %f'®� / ..-L✓m✓__,
Facility Name:5A4 , e(p� Fre.sk NA raga�;prl-CW A,>toN' Laboratory NameS •��ri; •e1,Q 1_ .Jll,rm�,k04mj chew-/,,.1-
Facility County: ,sa,vpso,+ Laboratory Cert. No.: LA)(C T p 116 / q''
Discharge during this period:cid Yes ❑No (if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?c,Yes ❑No
If so,which Tier(I,II,or III)? - —
A copy of this DMR has been uploaded electronically via ) _ ',-
' - pYes ❑No
Date Uploaded: _ - - - — -
Analytical Monitoring Requirements for Outfalls with Industrial Activities-Benchmarks in Red)
Parameter Parameter Outfall ,. Outfall Outfall Outfall Outfall
Code - — ____'
N/A Receiving Stream Class G,$YJ G).$ lAi
N/A Date Sample Collected MM/DD/YYYY /////!yy J7�///Lz
-
46529 24-Hour Rainfall in Inches 1./ / / K.
C0530 TSS In mg/L(100 or 50*) ir 6 4., 'S
pH in standard units(6.0-9.0 FW, 7•i"7 -2, b J
00400 6.8-8.5 SW) '
•
31616 Fecal Coliform per 100 ml of
freshwater(if required)(1000) Z/c24s2o ! . ./40/gJ
61211 Enterococci per 100 ml of saltwater _
(if required)(50C 1 - -
00340 Chemical Oxygen Demand in mg/L Z�
(120) 1
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) I
* Outfalls to Outstanding Resource Waters(ORW),High Quality Waters(HOW),Trout Waters(Tr)and Primary Nursery Areas(PNA)
have a benchmark T55 limit of 50 mg/L.All other water classifications have a benchmark of 00 mg/L
(Freshwater)SW{Saltwater) i
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 the best of my knowledge and belief,true,accurate,and complete.I am aware that there are significant penalties for submitting
false information,includin ossibility of fines and Imprisonment for knowing violations." M l
Signature of Permittee or Delegated Authorized Individual Date
*---PLOL,c->e°%/.. r_•) _(/1/.}:11);-e LeZo„4-- 4//./..-- sv J --42."."6
Phone Number
Email Address