NCG210355_2023 DMR_20230915 (2)

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG210000
Timber Products
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.NCG21 0355 Person Collecting Samples: James Boles
Facility Name: Louisiana-Pacific Corporation Laboratory Name: Meritech, Inc.
Facility County:Wilkes Laboratory Cert. No.: 165
Discharge during this period:❑J 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 III)? II
A copy of this DMR has been uploaded electronically via https:/Jedocs.deq.nc.gov/Farms/SW-DMR ❑✓ Yes ❑ No
Date Uploaded:09/15/2023
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in(Red)
Parameter Parameter Outfall 001 Outfall 002 Outfall 003 Outfall Outfall
Code
N/A Receiving Stream Class C C C
N/A Date Sample Collected MM/DD/YYYY 8/3/2023 8/3/2023 8/3/2023
46529 24-Hour Rainfall in inches 1.79 1.79 1.79
C0530 TSS in mg/I.(100 or 50*) 83 305 46
00340 Chemical oxygen Demand `'10) 27 41 <15
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)
N COIL Estimated New Motor/Hydraulic Oil
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 . f.All other water classifications have a benchmark of .1
Notes(optional):
"I certify by my signature beiow,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 forgathering 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/4W I) 09/15/2023
Signature of Permittee or l�ele ated Authorized Individual Date
6 elegated
Address <i/%ni, /74,41-1.6 k v/ t' for/O, (arY+ Phone Number
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