NCG210166_DMR Upload Review_20230625

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 5/5/2023 7:56:59 AM(DMR Submittal)
Submit by bethany.georgoulias 6/26/2023 10:14:00 AM(DMR Submittal Review)
0 Upload noted that company is requesting release from monthly monitoring under the Tier Two and
Tier Three response actions.
• The task was assigned to DEMLR SW Admin for DMRs 5/5/2023 7:57:00 AM
• bethany.georgoulias reassigned the task to bethany.georgoulias 6/24/2023 9:17:15 AM

[rftDQ -
DMR Submittal from 5/5/2023
Permit and Facility Information:
..............................................................................................................................................
Permit Number* Enter COC or Individual Permit Number
NCG210166
Must begin with NCS or NCG
Facility Name:* Georgia-Pacific Wood Products LLC
County:* Wayne
Note: Facility name and county are used to help the reviewer verify the permit number entered,and to display the
Regional Office address on the submitter's form(not here). These metadata details will be pulled from current BIMS
information after the DMR(s)are filed. If the submittal is accepted,simply note any errors in the reviewer's comments.
Monitoring Period Information:
Monitoring Period What is the YEAR of the sample date(s)?
Year:* 2023
DMR Upload* Click the upload button or drag and drop files here to attach document.
Signed DMR.pdf 833.39KB
Only PDFs are accepted.
Comments: Please note that all sampling results were below their respective benchmark values
for this monitoring period(March)and the previous two monitoring periods(January
&February).GP is requesting release from monthly monitoring under the Tier Two
and Tier Three response actions.
* By checking the box and signing box below, I certify that:
• I have given true,accurate,and complete information on this form;
• I agree that submission of this Discharge Monitoring Report(DMR)Upload form is a"transaction"subject to Chapter 66,
Article 40 of the NC General Statutes(the"Uniform Electronic Transactions Act");
d I agree to conduct this transaction by electronic means pursuant to Chapter 66,Article 40 of the NC General Statutes
(the"Uniform Electronic Transactions Act");
cl I understand that an electronic signature on this upload form has the same legal effect and can be enforced in the same
way as a written signature;AND
cl I intend to electronically sign and submit this DMR Upload form.
Full Name:* Elizabeth Meyer
Name of person submitting this form
Email Address:* elizabeth.meyer1 @gapac.com
Phone Number:* 9105477080
Signature:
4N_qt 60 jwlt

Date:* 05/05/2023

Review
Review Date: 06/26/2023
Confirm Permit No.* Correct the permit ID number if needed.
NCG210166
Confirm DMR Year* 2023
Multiple DMRs will be automatically filed in a subfolder denoting the sampling year entered above.
Can submittal be Yes
accepted?* No(Explain why below)
Do Central Office No
staff need to be Yes
alerted?*
Do Regional Office No
staff need to be Yes
alerted?
Central Office Staff to alert
Select E-mail*
CO Staff member [e-mail]
Regional Office Staff to alert
Select E-mail*
RO Staff Member [e-mail]
Type of Permit* General
Ensures DMR(s)filed correctly.