NCG030675_DMR_20221219

NCDEQ Division of Energy, Mineral and Land Resources
Discharge Monitoring Report (DMR) Instructions
Completing the DMR Form:
1. The total precipitation shall be recorded using data from an on-site rain gauge.
Unattended sites may be eligible for a waiver of the rain gauge requirement if
approved in writing by the applicable DEMLR Regional Office.
2. Sampling results for each parameter shall be compared to the benchmark values for
the appropriate receiving stream classification (listed in parentheses).
3. Monitoring results shall be in numerical format; below detection limit (BDL), non-
detect (ND) or other non-numerical formats are not acceptable. When results are
below detection limits, they must be reported in the format "<XX mg/L," where "XX" is
the numerical detection limit in mg/L. Where fecal coliform results (if applicable)
exceed the dilution upper limit, the result should be reported as ">XX".
4. For sampling periods with no discharge at any single outfall, the DMR report is still
required to be completed and submitted.
5. If the sampled storm event coincides with a known non-stormwater discharge that is
deemed permitted under 15A NCAC 02H .0106, then this shall be noted on the DMR in
the notes section.
6. If any pollutant is sampled more frequently than required by the general permit and at
a sampling location covered under the general permit,then per permitting
requirements, those sampling results must be submitted on a DMR.
Submitting the DMR Form:
Do not send paper DMRs to the Central Files.
1. 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.
2. Mail the original, signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Winston-Salem Regional Office
NC Department of
Address: Environmental Quality
Received
450
West Hanes Milt Road.Suite3 DEC ' 9 � �
Winston-Salem.NC 27105 ',``j`�'�
Phone.[phone] Winston-Salem
Fax:[phone] Regional Office
Contact Winston-Salem Regional Office Staff -31,

NC Department of
Environmental Quality
NCDEQ Division of Energy, Mineral and Land Resources Received
Stormwater Discharge Monitoring Report (DMR) Form for NCG030000 DEC 1 9 2O'2
Metal Fabrication Winston
Click here for instructions
12..�IUntii C
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. NCG03 0675 Person Collecting Samples: Brandon Patrick
Facility Name:American Emergency Vehicles REV Laboratory Name: Statesville Analytical
Facility County: Ashe Laboratory Cert. No.: 440
Discharge during this period:EYes ❑No (if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?Eves E No
If so, which Tier(I, II, or III)?
A copy of this DMR has been uploaded electronically via https://edocs.deq.nc.gov/Forms/SW-DMR ElYes 'ENo
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in(Red)
Parameter Parameter Outfall P1 Outfall P2 Outfall Outfall Outfall
Code
N/A Receiving Stream Class C+ C+
N/A Date Sample Collected MM/DD/YYYY 11/28/2022 11/28/2022
46529 24-Hour Rainfall in inches 0.24" 0.24"
C0530 TSS in mg/L(100 or 50*) <2.762 <2.703
00400 pH in standard units(6.0-9.0 FW, 7.13 6.79
6.8-8.5 SW)
01119 Copper,total recoverable in mg/L <0.002 <0.002
(0.010 FW,0.0058 SW)
01051 Lead,total recoverable in mg/L <0.0005 <0.0005
(0.075 FW,0.22 SW)
01094 Zinc,total recoverable in mg/L(0.126 <0.01 <0.01
FW,0.095 SW)
00340 Chemical Oxygen Demand(COD)in <20 <20
mg/L(120)
00552 Non-Polar Oil&Grease in mg/L(15) <5.05 <5.0
* 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
FW(Freshwater)SW(Saltwater)
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 sy - designed to assure that qualified personnel properly gather and evaluate the information submitted.Based on my
inquiry of the person or pers..s who manage the system,or those persons directly responsible for gathering the information,the information
submitted is,to the best of my k .wledge and belief,true,accurate,and complete.I am aware that there are significant penalties for submitting
false infor axon,in luding the pos 'bilit o ines and imprisonment for knowing violations."
/2-
S1 gnat t o P rmit ee or •. :gated Authorized Individual Date
Jeff. [e-mail] 4 336-977-9021
Email Address Phone Number