NCG100202_2023 DMR_20230626

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report(DMR) Form for NCG100000
Used Motor Vehicles
Click here for instructions
Complete,sign,scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report(DMR) Upload form within
30 days of receiving sampling results. Mail the original,signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NCG10 0202 Person Collecting Samples: Philip Pennington
Facility Name:Foss Recycling, Inc.-Havelock Facility Laboratory Name: Pace Analytical
Facility County:Lenoir Laboratory Cert. No.: 12
Discharge during this period:0Yes No (if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?El Yes No
If so,which Tier(I, II, or III)?
A copy of this DMR has been uploaded electronically via https://edocs.deq.nc.gov/Forms/SW-DMR Yes D No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in(Red)
Parameter Parameter Outfall 001 Outfall Outfall Outfall Outfall
Code
N/A Receiving Stream Class C
N/A Date Sample Collected MM/DD/YYYY 05/19/2023
46529 24-Hour Rainfall in inches 1.25
C0530 TSS in mg/L(100 or 50*) <3.0
00400 pH in standard units(6.0—9.0 FW, 7.50
6.8—8.5 SW)
00340 Chemical Oxygen Demand in mg/L N/A*
(120)
01051 Lead,total recoverable(as Pb)in <0.025
mg/L(0.075 FW,0.22 SW)
Ethylene Glycol in mg/L(any amount
77023 detected Tier One;8,000 mg/L Tier <5.0
Two and Three)
00552 Non-Polar Oil&Grease in mg/L(15) <4.9
NCOIL Estimated New Motor/Hydraulic Oil N/A
Usage in gal/month
* Outfalls to Outstanding Resource Waters(ORW),High Quality Waters(HQW),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 100 mg/L
FW(Freshwater)SW(Saltwater)
Notes(optional): "Lab used old version of chain of custody which did not have COD on it.It will be ensured that they use the new version in the future.
"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 ii knowled•- and belief,true,accurate,and complete.I am aware that there are significant penalties for submitting
false informatio inclu.• g the.;.ssibility of ' es and imprisonment for knowing violations."
, (pi)(0/
Signature of Permi or Dele.. • Authorized Individual Date
[e-mail] 910-990-4891
Email Address Phone Number