NCG030727_2023 DMR_20230705

NCDEQ Division of Energy,Mineral and Land Resources
Stormwater Discharge Monitoring Report(DMR) Form for NCG030000
Metal Fabrication
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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. NCGO3 r )a� Person Collecting Samp es:jt. ,C
Facility Name: Laboratory Name: om'
Facility County �J `` t6-
Laboratory Cert. No.: Z
Discharge during this period: eC J No (if no,skip to signature and date) 1111
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? es ©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/5W-DMR
Date Uploaded: es ©No
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in ir,Ta.il
Parameter
Code Parameter 0u�tl OutfallO D.3 Outfall Outfall
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY � 2423 Dc/ 2; - 'z z
46
529 24-Hour Rainfall in inches j, /a CID /,cO
C0530 TSS in mg/L;<,4w t 4- 8 S-w 1 p•. 3
pH in standard units y i� /
f/� /[y(� /(/� �yJ
01119 Copper,total recoverable in mg/L .co 3 Ati� 9 -
01051 Lead,total recoverable in mg/L
01094 Zinc,total recoverable in mg/L°l
d> 33cD 0,2 cr, 0,3c)0
00340 Chemical Oxygen Demand(COD)in A) /�
mg/L _.' J
00552 Non-Polar Oil&Grease in mg/L W 5 /Jf, A)- ,J
Outfalls to Outstanding Resource Waters(ORW),High Quality Waters(HOW),Trout Waters(Tr)and Primary Nursery Areas(PNA)
have a benchmark TSS limit of , All other water classifications have a benchmark of .,
-,f,(Freshwater)S' (Saltwater)
1JO- rt - P - '
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
fa n o ation,including the possibility of fines and imprisonment for knowing violations."
Ley/Ly 713033
l
ign ure of Permittee or Delegat Au orized Individual Date
14C 1.1Ieye Kern/pipe,corn --14V 5c �I-330'
ErnaAddress Phone Number