NCG070203_DMR_20240403

NCDEQ Division of Energy, Mineral and Land Resources
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Complete,sign,scan and submit the DMR via the ,i.or in.y.to N11Uf 5 permit Data Monitoring-,Rtypit or yldAgo jorol within
30 days of receiving sampling results. Mail the original,signed hard copy of the DMR tp the 1})ittOlt i3te f f_MlR Regional al Office.
Certificate raf Coverage No, NCG1770, Person Collecting Samples: }
Facility Name:,j b1fIjS 0+� C fl, '!f+'Igh'GOt _Laboratory Name: Ppi' , " ' .S'►
Faeilit Count : LaboratoryCert.Na: '
Discharge during this period:Eees i Ei No (if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark excee ances?D Yes o
If so,which Tier(I,ii,or III)?
A copy of this[AMR has been uploaded electronically via Flap /k clot >_hitt ro gov/I ty r n.2/SWr I,)MRR es 0 No
Date Uploaded: «..
Analytical Monitoring Requirements for Vehicle&Equipment Areas-Benchmarks in (Red)
Parameter _ Parameter Outfall 60► Outfall /A?. Outfall oo3 Outf.it Outfall
Code
NJA Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY 03 o l/ D. 03/ij ogy 03/0/4709
46529 24-Hour Rainfall in inchesV __. . ._ '_/� :_:_:N____.,/�_..m_ .._. _.-j __
C0530 TSS in mg/L(1OO or SU") 28 6° �.V" o1 l�
00552 Non-Polar Oil&Grease in mg/t.('t5) NO 44',3 N
NCOIL Estimated New Motor/Hydraulic Oil
L Usage in gal/month _ 5a ,5 5O _ 56"*0 _
Outfails to Outstanding Resource Waters(ORW),High Quality Waters(HQW),Trout Waters(Tr)and Primary Nurse y Areas(PNA)
have a benchmark TSS limit of Strrnai. All other water classifications have a benchmark of.MO mg/I
ri\l—ates(optional)
"I certify by my signature below,under penalty of law,that this document and all attachments were prepared under m direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information su mitted.Based on my
inquiry of the person or persons who manage the system,or those persons directly responsible for gathering the infor ation,the information
submitted is,to the best of my knowledge and belief,true,accurate,and complete.)am aware that there are significa t penalties for submitting
false information,including the possibility/of fines and imprisonment for knowing violations."
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Signature r Del gated Aut oriz dividual Date r�
Email Address Wu&v.f A on,ii 0 Oldie t 1 CO$4 Phone Number ( 40- 2.S 9- 710
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