NCG060099_2023 DMR_20230405

Complete,sign,scan and submit the DIM.via the G within
30 days of receiving sampling results. Mail the original,signed hard copy of the DMR to the � �.
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I + rI.Ii r „_�Ir .ij_d f'
110 if ',.i."''1 s.r' SOH
Fad Ill i 1 ; ` r f
3
e �� +
Discharge during this
'is period: Yes
._.� (if
no,skip to signature and date)
Has your facility implemented mandatory Tier response actions this sain le period for any benchmark exceedancesi Yes [1 No�
If so,which Tier(l,ll,or Ill)?
A copy of this DMR has been uploaded electronically via :'< ''es r
Date Uploaded: e4--
Analytical itllo'nilitorkg egi.iremeiir s'i'c€'a'i'alls with;1,-,45.usYa AL'e ifrde s—l3enehvarics
Code
N/A rO€F'call I at/L*4i Outfall Cu fail Vaal
l
N/A Receiving Stream Class Voct+,y}
N/A Date Sample Collected MM/DD/YYYY 3 -2 -?.3
46529 24-Hour Rainfall in inches
C0530 TSS in mg/L i3>;10 r`<.;;+` 7 2-
00400 pH in standard units(6.0-,9':t"!:
31616 Fecal Colifiorm per 100 ml of h I��
freshwater(if required) X,C1
61211 Enterococci per 100 ml of saltwater /AM'
(if required)
00340 Chemical Oxygen Demand in mg/L
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 I __
Usage in gal/month
00552 Non-Polar Oil&Grease in mg/L t;t`{ N/A-
Outfalis to Outstanding Resource Waters(ORW),High Quality Waters(HQW),Trout Waters(Tr)and Primary Nursery Areas(PNA)
have a benchmark Tss limit of SOmelt.All other water classifications have a benchmark of''.ro-::-n g,,'
I:'`W(Freshwater)SW{Saltwater)
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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,orthose persons directly responsible forgathering 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_"
Signature of Permittee or Delegated Authorized individual Date
I If.6��vrr2�u� .Cvm te �- C��259/
Email AddressPhone Number