NCG070115_DMR_20240403

NC Department of
Environmental Quality
NCDEQ Division of Energy, Mineral and Land Resources ..•• Received
Storrnwater Discharge iNslonitoring Report }fit)form for NCG07000CAPR 3 2024
Stone, Clay, Glass, &Concrete Products `�
Click l'r re instructions 'f Winston-Salem
l_c.r....le for .�..root.. .. Regional Office
Complete,sign,scan and submit the DMR via the Stormwater NPDE S Permit Data Mc ni oiln F'+gkart ti>MR)..DQI.Oaci forr n within
30 days of receiving sampling results. Mail the original,signed hard copy of the DMR to the,faismfriate OF Wit.R fitsional Office.
Certificate of Coverage No. NCG076 i/5. Person Collecting Samples: Hfc1r4„,J Ao t ers
Facility Name: 1-.cfici;is. 0/de 45/I-r Laboratory Name: p4tf,e / 4 k
Facility County: ( c,( I .(ol Laboratory Cert. No.: 61C G O )0//.1
Discharge during this period: Yes ❑No (Trio,skip to signature and date)Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?0 Yes E No
If so,which Tier(I, II,or III)?
A copy of this DMR has been uploaded electronically via htt_s i dnc tiu.t *• ,i> o r;,SW- i €i I I Yes 0 No
Date Uploaded:
Analytical Monitoring Requirements for Vehicle&Equipment Areas-Benchmarks In(Red)
Parameter Parameter Outfall '2- Outfall Outfall Outfall Outfall
Code
N/A Receiving Stream Class ivl1-
N/A Date Sample Collected MM/DD/YYYY 2-6. 2.L)
46529 24-Hour Rainfall in inches
C0530 TSS in mg/L(WO or 501 fS fli
_. _.
00552 Non-Polar Oil&Grease in rng/L(15) N i
NCOIL Estimated New Motor/Hydraulic Oil ,,��rr��
Usage in gal/month L✓
''Outfalis to Outstanding Resource Waters(ORW),High Quality Waters(HQW),Trout Waters(Tr)and Primary Nursery Areas(PNA)
have a benchmark TSS limit of SC)mg/L.All other water classifications have a benchmark of'i00 mti/t.
Notes(optional): y_
"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
ins iry of the person or persons who manage the system,or those persons directly responsible for gathering the information,the information
tted is,to the best of my knowledge and belief,true,accurate,and complete.I am aware that there are significant penalties for submitting
f formation,in ing the possibility of fines and imprisonment for knowing violations."
t a,�l''rp-n VSig bture of Permittee or Delegated Authorized Individual Oa
Email Address Phone Number