NCG140140_2023 DMR_20230124

BENCHMARK EXCEEDANCE or TIER 2 DISCHARGE MONITORING REPORT (DMR) — STORMWATER
SUBMIT TO REGIONAL OFFICE*
General Permit No. NCG140000
*Use this form if any stormwater samples have EXCEEDED A BENCHMARK or if the facility is in TIER 2 MONITORING for any parameter.
Send sample results to the DEMLR Regional Office within 30 days of receipt from the laboratory.
Certificate of Coverage No. NCG14 0 1 4 0
Facility Name: Williams Ready Mix Products, Inc. Sample Collection Period: Period 1 ❑ Period 2 ❑■ Calendar Year 2022
County: Union For Monthly Monitoring: Month December
Phone Number: (704 )283-1173 Person Collecting Samples: Richard Harmon - Harmon Environmental, PA
Certified Laboratory: Pace Analytical Services, LLC Lab# 12
Lab #
Has this facility had 4 or more benchmark exceedances for any single parameter, at any one SW discharge outfall (SDO)? Yes ❑ No
Have you contacted the Regional Office? Yes n No Li
Whom at the Region did you speak with? Lily Kay
Stormwater Monitoring Requirements
Does this SDO Total Non-polar O&G
include Vehicle Suspended pH, (EPA Method 1664 New Motor Oil
Outfall Date Sample Total Is this SDO in Maintenance Solids (TSS), SU (SGT-HEM)), mg/I Usage (gal/mo.)
No. Collected Rainfall Tier 2? Activities (VMA)? mg/I (VMA) If applicable
If applicable
100 >55 gal/mo.average
mo/dd/yr inches Y/N Y/N 6.0-9.0 15 requires TSS and Non-polar
50 (ORW,HQW,Tr,PNA) 08G monitoring
or "NO FLOW"
02 No Flow Y N
03 No Flow Y N
Permit Date 8/1/2017—6/30/2022 Last Revised 8-22-2017
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Certificate of Coverage No. NCG14 FIE 4 n
CERTIFICATION
"I certify, 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 knowing violations." [Required by 40 CFR§122.22]
Signature
Date J-24- 2O2-3
Mail Benchmark Exceedance/Tier 2 DMR to Your DEMLR Regional Office Land Quality Section:
ASHEVILLE REGIONAL OFFICE FAYETTEVILLE REGIONAL OFFICE MOORESVILLE REGIONAL OFFICE
2090 US Highway 70 225 Green Street 610 East Center Avenue/Suite 301
Swannanoa, NC 28778 Systel Building Suite 714 Mooresville, NC 28115
[phone] Fayetteville,NC 28301-5043 [phone]
[phone]
RALEIGH REGIONAL OFFICE WASHINGTON REGIONAL OFFICE WILMINGTON REGIONAL OFFICE
3800 Barrett Drive 943 Washington Square Mall 127 Cardinal Drive Extension
Raleigh, NC 27609 Washington, NC 27889 Wilmington, NC 28405-2845
[phone] [phone] [phone]
WINSTON-SALEM REGIONAL CENTRAL OFFICE
OFFICE Questions for The Central Office lail= �
450 Hanes Mill Road, Suite 300
Winston-Salem,NC 27103 Stormwater Permitting Program? ✓` ,� rf\l. gh
[phone] [phone] �✓ / - �,.�, _
•riis4pit41.1111144
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Permit Date 8/1/2017-6/30/2022 Last Revised 8-22-2017
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