NCG140140_2023 DMR_20240112 (4)

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG140000
Ready-Mixed 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.
Mailed in DMRs must contain an original wet signature. Electronic signatures will not be accepted for mailed in DMRs.This is a
requirement until the permittee has registered for eDMR for reporting.
Certificate of Coverage No. NCG14 0140 Person Collecting Samples:Richard Harmon-Harmon En,,ronme,tel,PA
Facility Name: William Ready Mix Products,Inc. Laboratory Name: Waypoi,t AnaIytocaI Services,LLC
Facility County: Union Laboratory Cert. No.: 409
Discharge during this period: ❑Yes ❑■ No (if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions for any benchmark exceedances?Q Yes ❑ No
If so,which Tier(I, II,or III)? Tic,:,
A copy of this DMR has been uploaded electronically via https://edocs.deq.nc.gov/Forms/SW-DMR El Yes ❑ No
Date Uploaded:
Part A:Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in(Red)
Parameter Parameter Outfall Cc Outfall G Outfall Outfall Outfall
Code
N/A Receiving Stream Class WS-III WS-III
N/A Date Sample Collected MM/DD/YYYY 9-23 9-23
46529 24-Hour Rainfall in inches No Flow No Flow
C0530 TSS in mg/L(100 or 50*)
00400 pH in standard units(6.0-9.0 FW,6.8-
8.5 SW)
Non-Polar Oil&Grease in
00552 mg/L(15)for drainage areas that use>55
gal/mo of new hydraulic oil on average
NCOIL Estimated New Motor/Hydraulic Oil
Usage in gal/month
* Outfalls to Outstanding Resource Waters(ORW),High Quality Waters(HOW),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): Outfall 01 removed from the facility.
"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' is,to the b of my knowledge and belief,true, accurate, and complete. I am
aware that there are significantp les for SO ing f information, including the possibility of fines and imprisonment for
knowing violations." -y r'
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Signature of Pf rmittee or Delegated .horized Individual Date