NCG130067_2024 DMR_20240419

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG130000
Non-metal Waste and Scrap
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data MOnitQlingReD4ft(MIN UQIQad form within •
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the infaaingSSBaationtsrAt.
Certificate of Coverage No. NCG13 C7 Person Collecting Samples: At. (I
Facility Name: Nix a,/ 1lj4cj Laboratory Name: ,^ 01AII'`)
Facility County: Rock� Laboratory Cert. No::NC., QtJ 1( LAJF G,4i' At- cci ( 1Ci
Discharge during this period:El Yes 6 No (if no, skip to signature and dote)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?ffYes ❑ No
If so, which Tier (I, II, or III)? TCr .
A copy of this DMR has been uploaded electronically via https://edocs-deq.nc.gov/Forms/5W-CMR e Yes 0 No
Date Uploaded:
•
Analytkal Monitoring Requiremr'nts for Vehicle & Equipment Areas -Benchmarks in (Red)
•
Parameter Parameter Outfall l Outfall 2 Outfall 3 Outfall 1 / Outfall
Code ._.-
N/A Receiving Stream Class C C. C C
N/A , Date Sample Collected MM/DD/YYYY rt 031 oG/,t s/ ; '
46529 24-Hour Rainfall in inches J /
COS30 TSS in mg/1 (100 or SO') a•�U .7 1 ?t
00552 Non-Polar Oil &Grease in mg/L(15) CI rJ/A u N
IA
NCOIL Estimated New Motor/Hydraulic Oil Z
Usage in gal/month eS l - I
' 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 mF./L.All other water classifications have a benchmark of 100 mg/t
Notes (optional): 771 icC os.r:4-// 1 t ir�.r it. A4..{Ire ��. 7t:f ) I >�-,'c �cv� 4/0(,,�
'1 certify by my signature below, under penalty of law,that this document and ail attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel property gather and evaluate the information submitted. Based on my
rnquary of the person or persons who manage the system, or those persons directly responsible for gathenng the information, the information
submitted is, to the best of my knowledge and belief, true,accurate,and complete_ I am aware that there are significant penalties for submitting
false information, including the possibility of fines and imprisonment for knowing violations.'
/ - v-. Y- /9- 0,ig
Signature of Permittee or Delegated Authorized Individual Date
Email Address Phone Number
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NCDEQ Divisio of Energy, Mineral nd Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG130000
Non-metal Waste and Scrap
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoricja2`, Qr11QMR) Upload form within
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the approvnate OfMtR Regional Office.
Certificate of Coverage No NCG13 Person Collecting Samples:
Facility Name: Laboratory Name:
Facility County: Laboratory Cert. No.:
Discha•ge during this period:❑ Yes ❑ No (if no, skip to signature and dote)
Has your facility implemented mandatory Tier response actions this sample Aeriod for any benchmark exceedances? Yes ❑ No
If so, which Tier (I, II, or Ill)?
A copy of this DMR has been uploaded electronically via httos://edocsdeo.nc.gov/Forms/SW-DMF ❑ Yes ❑ No
Date Uploaded:
Analytical Monitoring Requirements for Vehicle & Equipment Areas —Benchmarks in (Red)
Parameter Parameter Outfall lY Outfall 7 Outfall -- —0atfa1 ' Dubs,
Code
N/A Receiving Stream Class C C
N/A Date Sample Collected MM/DD/YYYY 07/oC feat
46529 24-Hour Rainfall in inches f J M
C0530 TSS rnmg/L (l00or50•) Yf IC/
00552 Non.Polar Oil & Grease in mg/L(15) AVA
NCOIL Estimated New Motor/Hydraulic 0 I
Usage in gal/month
• 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
I 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 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 gathenng the information, the information
submitted is, to the best of my knowledge and belief, true, accurate,and complete. I am aware that there are significant penalties for submitting
false information, including the possibility of fines and imprisonment for knowing violations,"
Signature of Permittee or Delegated Authorized Individual Date
Email Address Phone Number