NCG050433_2023 DMR_20231011

NCDEQ Division of Energy,Mineral and Land Resources
Stormwater DIl�targe Monitoring Report(DMR)Form for NO6050000
Apparel,Printing,Rubber,Etc.
Chick fere for instructor&
Complete,sign,scan and submit the DMR via the :riniviotrer IMES Permit IteariitorIiv ganuirtt(II>t O)tigatt14 within
30 days of receiving sampling results. Mail the original,signed hard copy of the DMR to the a, roc,riate DEMLR Re mall Office.
Certificate of Coverage No.NCGO5 0433 Person Collecting Samples:Paul Spangenberg
Facility Name: Technimark, LLC-Plant 2 Laboratory Name: Enthalpy Analytical
Facility County:Randolph Laboratory Cert. No.:495
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 Ei No
If so,which Tier(I,II,or III)? Tier I
A copy of this DMR has been uploaded electronically via ----:_ decnicootriFtrerainsTER Q Yes ❑No
Date Uploaded: 10/11/23
Analytical Monitoring Requirements for Vehicle&Equipment Areas—Benchmarks in(Red)
Parameter Parameter Outfall 1 Outfall Outfall Outfall Outfan
Code
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY
46529 24-Hour Rainfall in inches
C0530 TSS in mg/L tarr
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(HQW),Trout Waters(Tr)and Primary Nursery Areas(PNA)
have a benchmark TSS limit of .All other water classifications have a benchmark of
[_otes(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 kno ledge and belief,true,accurate,and complete.I am.aware that there are significant penalties for submitting
false infor tion,including the p sibility of fines and imprisonment for knowing violations."
10/11/23
Signature of ermitte elegatt4Author Individual Date
Email Address [e-mail] Phone Number 919-624-0630