NCG030019_2023 DMR_20230908

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 00/9 Person Collecting Samples: 7:,,,,rr r fv'c,L jlu,,,t
Facility Name: Mesfe.k �.A`. Laboratory Name: LALarP v;Af 4n./yiic_a/
Facility County: p;{-4- Laboratory Cert. No.: ,,4(//4
Discharge during this period: Yes n No (if no,skip to signature and dote)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?DYes rNo
If so, which Tier(I, II, or Ill)?
A copy of this DMR has been uploaded electronically via https://edocs.deq.nc.gov/Forms/5W-DMR Yes ri No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in ?erf`
Pa ameter Parameter Outfall # ( Outfall Cod42. Outfall Outfall Outfall
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY 4/1y/2.02.3 o-71ty/Z,2.3
46529 24-Hour Rainfall in inches O.G 9 O.0
C0530 TSS in mg/L(100 or 50"j 23 All It g.:2, lvtyl(.
00400 pH in standard units(6.0-9.0 FW,
6.8-8.5SW) -� 7
Copper,total recoverable in mg/L
01119 < D10 k. mi/[.
(0.010 FW,0.0058 SW) O.010141k.
D•OW
01051 Lead,total recoverable in mg/L i1,�/
(0.075 RV;0.22 0. i)OS / <o. oo.S /�
01094 Zinc,total recoverable in mg/L(0.126
FW,0.095SW) f7• US'f 9L l7.Org�uL
00340 Chemical Oxygen Demand(COD)in
mg/L(120) f °,f c7ii Na>` 7C57L�
00552 Non-Polar Oil&Grease in mg/L < 5,v rvig fL -. .$'.d ell 9�,�
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 100 mg/L
(Freshwater) (Saltwater)
M(2 /Notes(optional): ."—Fri cc,/ `4 5,44,,f" e(cc-ffon «, Ily ✓,4 e. 'stk.a ,,,s-f s,-#G- 1„,,./1/4-1aG e.el-[l ./1✓ 4-,:..a:I N/ 24l's'
"i certify by my signature below,under penalty of law,that this document and all attachments were prepared under my direction or supervision in "1'
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 informatio .ncluding the possibility of fines and imprisonment for knowing violations."
09 D7 2oz3
Signature of Permittee or Delegated Authorized
g razed Individual Date
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Email Address 1 Phone Number