NCG140390_2023 DMR_20230801

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report(DMR) Form for NCG140000
Ready-Mix Concrete
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. NCG14 03CA 0 Person Collecting Samples: j
Facility Name:‘-kN r evA LIL Laboratory Name:
,v i.
Facility County: "1 , Laboratory Cert. No.: a
Discharge during this period:❑Yes R4 o (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 Ees ® No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities-Benchmarks in(Red)
Parameter
Code Parameter Outfall } Outfall outfali Outfall Outfail
N/A Receiving Stream Class f
{ N/A Date Sample Collected MM/DD/YYYY
46529 24-Hour Rainfall in inches
C0530 TSS in mg/L(100 or 50*) ) �`
00400 pH in standard units(6.0-9.0)
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 gat/month l l q
* 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 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 the possibility of fines and imprisonment for knowing violations."
I �„
0 , \� . ,
Signature of Permittee or Delegated Authorized Individual Date
Email Address Phone Number

NCDEQ Division of Energy, Mineral and Land Resources
Wastewater Discharge Monitoring Report(DMR) Form for NCG140000
Ready-Mix Concrete
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. NCG14 Person Collecting Samples: M
Facility Name:V\,\4ir Ah R . krj .x 1 te, Laboratory Name: !\Pi
Facility County:14,-,f,cfm Laboratory Cert. No.:
Discharge during this period:❑Yes 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 [U4es ❑No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Effluent Limits in(Red)
Parameter Parameter Outfall Duffel! Outfall Outfall Outfall
Code
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY \tr.(Y-4\:
('
Daily Flow Rate in cfs(50%of 7Q10
82220 for HQW/ORW)
C0530 TSS in mg/L(30,20,or 10*) (1/4„_, '
,' 1
, ,i
00400 pH in standard units{6.0-9.0 \ .7, \ )
freshwater,6.8-8.5 saltwater) ` ,
Settleable Solids in HQW,ORW,SA, I
00545 SB,Tr&PNA(5 mill) !�
Non-Polar Oil&Grease in mg/L(N/A,
00552 } but samples above 15 require tiered
j responses) <
*Outfalls to Outstanding Resource Waters(ORW),High Quality Waters(HQW)have a TSS limit of 20 mg/L,outfalls to Trout Waters(Tr)and
Primary Nursery Areas(PNA)have a TSS limit of 10 mg/L.All other water classifications have a benchmark of 30 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 infor ation,including the possibility of fines and imprisonment for knowing violations."
1/4-P6 _i
t;)/3.,cl,,„, ¢' r 17 3
Sign re of Permittee or Delegated Authorized Individual Date
Email Address Phone Number
1rOC' it A-V"1+r ,r 1 ►ii 10( @ VNJ , 1.,,°.r` '+ip 0/1 p ug)LOC -90 ' J

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report(DMR) Form for NCG140000
Ready-Mix Concrete
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. NCG14 0 5—` Person Collecting Samples: 7 V tit
Facility Name: ,\C\rig s ®;rt-z;i" LL— Laboratory Name: t4 Pc
Facility County: ' IC*Nxe-Nor-lic4Laboratory Cert. No.:
Discharge during this period:❑Yes o (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 III)?
A copy of this DMR has been uploaded electronically via https://edocs.deq.nc.gov/FormsJSW-DMR [Ies ❑ No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in(Red)
Parameter Parameter Outfall Outfall Outfall Outfall Duda
Code
N/A Receiving Stream Class I y%
N/A Date Sample Collected MM/DD/YYYY 1
46529 24-Hour Rainfall in inches 1 \ C Y\C)._ iNC,..) 3<,..."
C0530 TSS in mg/L(100 or 50*`) ' t�
i 00400 pH in standard units(6.0—9.0)
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 I
Usage in gal/month I i i t l
*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
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 the possibility of fines and imprisonment for knowing violations."
' 1/414-3 Cia,-, $A' 'OkiaLkkL--) Cn 31 Id' 03 3
Signature of Permittee or Delegated Authorized Individual Date
Email Address Phone Number
VI Mi 1r ,r G c . ,)c, v� re ar,,,. '104 (gig Lk--dO

NCDEQ Division of Energy, Mineral and Land Resources
Wastewater Discharge Monitoring Report (DMR) Form for NCG140000
Ready-Mix Concrete
Click here for instructions
Complete,sign,scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report(DMR)Upload form within 1
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. NCG14O 6' Person Collecting Samples: !, t'1
LaboratoryName:
Facility Name: �C, � . �c1►y,�;,X �` /y Pc
Facility County: Laboratory Cert. No.: t f
Discharge during this period:❑Yes [ 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:/ledocs.deq.nc.gov/Forms/SW-DMR a<es ❑ No
Date Uploaded: l
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Effluent Limits in(Red)
Parameter Parameter Outfall Outfall Outfall Outfall Outfall
Code
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY {
82220 Daily Flow Rate in cfs(50%of 7Q10
for HQW/ORW)
C0530 TSS in mg/L(30,20,or 10*) I I c 6MCLr3-.IL) I
00400 pH in standard units(6.0-9.0 i,� \
freshwater,6.8-8.5 saltwater) Ur
00545 Settleable Solids in HQW,ORW,SA,
SB,Tr&PNA(5 ml/L)
Non-Polar Oil&Grease in mg/L(N/A,
00552 but samples above 15 require tiered
responses) r r
*Outfalls to Outstanding Resource Waters(ORW),High Quality Waters(HQW)have a TSS limit of 20 mg/L,outfalls to Trout Waters(Tr)and
Primary Nursery Areas(PNA)have a TSS limit of 10 mg/L.All other water classifications have a benchmark of 30 mg/L.
Notes(optional): I
"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 the possibility of fines and imprisonment for knowing violations."
t.
I Qu ae ' ► �. ;. . it- 31 -c90 3
Signature of Permittee or Delegated Authorized Individual Date
Email Address Phone Number