NCG070203_2024 DMR_20240328

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCGO70000
Stone, Clay, Glass, & Concrete Products
Click here for instructions
Complete,sign,scan and submit the DMR via the Storniwater NPDES Permit Data Mon toring REport(DMR) Upload form within
30 days of receiving sampling results. Mail the original,signed hard copy of the DMR to the 22LroiiriateDEMLR Regional Office.
Certificate of Coverage No. NCGO7 Qao3 Person Collecting Samples: Z,EpA/ , #.iv
Facility Name:ti p/9/fls QLACI9sTLo C/rnALOTrE Laboratory Name: PACE -/9,49$
Facility County: J2/EC/c L..tl Qu,6 Laboratory Cert. No.: 3 7 7D/^
Discharge during this period:afes ❑No (if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?❑Yes �lo
If so,which Tier(I,II,or III)?
A copy of this DMR has been uploaded electronically via ps1f edocs_deg;nc,;cayilgr ns[SWpMR r — ❑Yes ❑ No
Date Uploaded: -�
Analytical Monitoring Requirements for Vehicle&Equipment Areas-Benchmarks in !Red)
Parameter Parameter Outfall O0 Outfall 000Z, Outfall 003 Outfall Outfall
Code
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY D3/o1 2D V Q3/D//.?O.1/ 03/0997025/
46529 24-Hour Rainfall in inches , / „fit_ .
C0530 TSS in mg/L(100 or 50') _28.S a 5 .. 2 7A
00552 Non-Polar Oil&Grease in mg/L(15) N,D (,is-,3 AID
NCOIL Estimated New Motor/Hydraulic Oil
L Usage in gal/month 5.5.0 5-5.0 ,SSO --_
* Outfalls to Outstanding Resource Waters(ORW),High Quality Waters(HQW),Trout Waters(Tr)and Primary Nursery Areas(PNA)
have a benchmark TSS limit of 5(Ymg/L.All other water classifications have a benchmark of
Notes(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.I am aware that there are significa t penalties for submitting
false information,including the possibility of fines and imprisonment for knowing violations."
Signature %''// t ?lr Del gated Aut oriz . dividual Date , Q
Email Address 6t" toc/iv.ue% A d/o/C#45//t. cow Phone Number p 6)0- 2 /- 7i��