NCG070044_2024 DMR_20240524

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report( D6+,!R) Form for NCGO70000
Stone,Clay,Glass,&Concrete Prbducts
Click here for instructions
Complete,sign, scan and submit the DMR via the Stormwater NPDE.S 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. NCGO7 0044 Person Collecting Samples:Mark Poythress(Microbac)
Facility Name:Wilbert Burial Vault Company Laboratory Name:Microbac Laboratories,Inc.
Facility County:Robeson Laboratory Cert. No.:K4CO229
Discharge during this period:El Yes ❑ No (if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?❑Yes ❑� No
If so,which Tier(I, II,or III)?
A copy of this DMR has been uploaded electronically via httos://edocs.deq.nc.g,ov/Forms/SW-DMR Q Yes ❑ No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in(Red)
Parameter Parameter Outfall 001 Outfall 002 Outfall °°3 Outfall 004 Outfall
Code
N/A Receiving Stream Class C;Sw C;Sw C;Sw
N/A Date Sample Collected MM/DD/YYYY 03/28/2024 03/28/2024 03/28/2024
46529 24-Hour Rainfall in inches 0.48 0.48 0.48
00400 pH in standard units(6.0—9.0 FW,
6.8-8.5 SW) 6.3 6.7 7.4
CO530 TSS in mg/L(100 or 50*) 16.2 33.0 40.2
00552 Non-Polar Oil&Grease in mg/L(15) N/A N/A N/A
NCOIL Estimated New Motor/Hydraulic Oil <rjrj gal <55gal <55 gal
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
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 gathering 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."
05/23/2024
Signature of Permittee or Delegated Authorized Individual Date
[e-mail] [phone]
Email Address Phone Number