NCG080411_2022 DMR_20221110

T
NCDEQ Division of Energy, Mineral and Land Resources
5torrnwater Discharge Monitoring Report (aMR) Form for NCGO8OOOO
Transit and Transportation
Click here for instructions
Complete, sign, scan and submit the ❑MR via the 5tormwater NPDES Permit Data Monitorin Re vrt (DMR) Upload faun within
30 days of receiving sampling results. Mail the original, signed hard copy of the []MR to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NCGOS C?4{ 1,1
Person Collecting Samples:
Facility Name: IReu l 'lam CA
Facllity County: .6rM `r
Laboratory Name: A,l CO - -
Laboratory Cert. No,: CFp
Discharge during this period:
es
No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?1:1 Yes o
If so, which Tier (1, 11, or III)?
A copy of this DM has been uploaded electronically via htt s: /edo_cs.c1eq. ic.goy/Forms/5W-DMR Lgj<es 0 No
Date Uploaded:
Analytical Monitoring Requirements for Vehicle & Equipment Maintenance Areas — Benchmarks in (Red)
Pa ameter
Parameter
Outfall
Outfall;42
Outfall
Outfall
Outfall
Cod
N/A
Receiving Stream Class
N/A
Date Sample Collected MM/DD/YYYY
qj..3p _
_ p��Z
46529
24-Hour Rainfall in inches
Z
CO530
T55 in mg/L (100 or 50*)
91
00552
Non -Polar Oil & Grease in mg/L (15)
6
00400
pH in standard units (6.0 — 9.0 FW,
6. q
6.8-8.5SW)
1
NCOIL
Estimated New Motor/Hydraulic Oil
150
1sO
Usage in gal/month
'r ❑utfalls 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
FW (Freshwater) SW )Saltwater)
Notes (optional): T }
"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 id,
persons who anage the system, or those persons directly responsible for gathering the information, the information
submitted is, to, a bof my k edge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting
false infov n, i ng t ssibiIity of fines and imprisonment for knowing violations."
Signature of Permitte or Delegated Authorized Individual
UU i (Son I Z5a 4 @. @ ne-p V I; c_mrv.C.a co
Email Address
Date
9 to - 7,7-o - 3 1:L0
Phone Number