NCG160223_2023 DMR_20230623

June 23, 2023
DEQ Winston-Salem Regional Office
Attn: DEMLR Stormwater Program
450 West Hanes Mill Road, Suite 300
Winston-Salem, NC 27105
Re: Stormwater Discharge Outfall Monitoring Reports (DMR)
Fibrecrete Preservation Technologies, Inc.
Surry County
General Permit NCG160000
Certificate of Coverage Number NCG160223
Dear Stormwater Program,
We respectfully submit the enclosed original copy of the Stormwater Discharge Outfall
Monitoring Report (DMR) for Fibrecrete Preservation Technologies Inc under General
Permit Number NCG160000, Certificate of Coverage NCG160223. This submission is
for stormwater discharge sampling for the following sampling period (Year 4, P1 , 2023 —
January — June 2023) as outlined in Part II , Section B of our stormwater discharge
permit.
If you have any questions or comments regarding this Stormwater Discharge Outfall
Monitoring Report (DMR), please contact us at your convenience.
Sincerely,
Bartholomew S. Pharr, President
Fibrecrete Preservation Technologies, Inc.
Enclosures: Stormwater Discharge Outfall Monitoring Report (DMR)
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NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG160000
Asphalt Paving Mixtures and Blocks
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. NCG16 0223 Person Collecting Samples: Ryan R. Osborne (INENCO, Inc.)
Facility Name: Fibrecrete Preservation Technologies, Inc. Laboratory Name: Pace Analytical Services, LLC
Facility County: SURRY Laboratory Cert. No.: 40, 37712
Discharge during this period: ✓❑ Yes El No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? ❑ Yes ❑✓ No
If so, which Tier (I, II, or Ill)?
A copy of this DMR has been uploaded electronically via https://edocs.deq.nc.gov/Forms/SW-DMR ✓❑ Yes ❑ No
Date Uploaded: 06/23/2023
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Code Parameter Outfall 1 Outfall Outfall Outfall Outfall
N/A Receiving Stream Class C
N/A Date Sample Collected MM/DD/YYYY 06/11/2023
46529 24-Hour Rainfall in inches 0.27
C0530 TSS in mg/L (100 or 50*) 4.3
Additional parameters for outfalls in drainage areas that use >55 gallons per month of new hydraulic oil on average
00552 Non-Polar Oil & Grease in mg/L (15)
NCOIL Estimated New Motor/Hydraulic Oil
Usage in gal/month
* Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HOW), 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
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, 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 t possibility of fines a .mprisonment for knowing violations."
Civy 06/23/2023
Signature of Permittee or Delegated Authorized Individual Date
Email Address Bart.Pharr©USLAmerica.com Phone Number 336-786-8244

NCDEQ
Division of Energy, Mineral and Land Resources
• Report (DMR) Form for NCG160000
Stormwater Discharge Monitoring p
Asphalt Paving Mixtures and Blocks
Click here for instructions
Data Monitorin Re ort DMR U IoacJ form within
can and submit the DMR via the Stormwater NPDES Permit o riate DEMLR Re Tonal Office.
Complete, sign, s of the DMR to the appr P
30 days
of receiving sampling results. Mail the original, signed hard copy
tin Samples: Ryan R. Osborne (INENCO, Inc.)
f Coverage g P
Certificate o e No. NCG16 0223 Person Collet g
Pace Analytical Services, LL
Laboratory Name:
Facility Name: Fibrecrete Preservation Technologies, Inc. 37712
Facility County: SURRY Laboratory Cert. No.. 40,
Dgduring ischar e this period: 0 Yes Ej No (if no, skip to signature and date)this sam 0 No
le
Has your facility implemented mandatory Tier response actions Neriod for any benchmark exceedances? Yes
If so, which Tier (I, II, or III)? P
A copy of this DMR 0 Yes ❑ No
has been uploaded electronically via https //edocs deq nc Gov/Forms/SW-DMR
Date Uploaded: 06/23/2023
Analytical Monitoring Requirements
Re uirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter Parameter Outfall 1 Outfall Outfall Outfall Outfall
Code
N/A Receiving Stream Class C
N/A Date Sample Collected MM/DD/YYYY 06/11 /2023
46529 24-Hour Rainfall in inches 0.27 _
C0530 TSS in mg/L (100 or 50*) 4.3
Additional parameters for outfalls in drainage areas that use >55 gallons per month of new hydraulic oil on average
o
00552 Non-Polar Oil & Grease in mg/L (15)
Estimated New Motor/Hydraulic Oil
NCOIL I 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 TSS limit of 50 mg/L. All other water classifications have a benchmark of 100 mg/L
Notes (optional):
I certifyby
if signature below, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
my g
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Basedon my
the information
inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, submitting
rY
submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for su g
false information, incl ding the possibility of fines an• �r' - ment for knowing violations."
06/23/2023
Signature of Permittee or Delegated Aut • • rized Individual Date
Email Address Bart.Pharr@ USLAmerica.com Phone Number 336-786-8244
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