NCG070203_2024 DMR_20240625

NCDEQ Division of Energy, Mineral and Land Resources
Storrnwater Discharge Monitoring Report (DMR) Form for NCG070000
Stone, Clay, Glass, & Concrete Products
Click here for instructions
Complete,sign,scan and submit the DMR via the Storrnwater NPDES Permit Data Monitoring Report_(UM J UpLpad form within
30 days of receiving sampling results. Mail the original,signed hard copy of the DMR to the oirriate 0EMLR Regional Office.
Certificate of Coverage No. NCGO7 0.303 Person Collecting Samples: nogd
Facility Name: 4q!l$I5 oi.z.Cs' ne. '�E Laboratory Name: P$cj
Facility County: / i*ekI'A Au, Laboratory Cert. No.: i f 7715(.0
Discharge during this period:El' es ❑No (if no,skip to signature and date) _
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?❑ Yes [Klo
If so,which Tier(I, II,or Ill)?
A copy of this DMR has been uploaded electronically via https: /edocs deq.nc,j;yvjFormilSW:DMR a f�es ❑ No
Date Uploaded: �.
Analytical Monitoring Requirements for Vehicle&Equipment Areas—Benchmarks in (Red)
Parameter Parameter Outfall 00/ Outfall DDZ Outfall OD3 Outfall Outfall
Code
N/A Receiving Stream Class AP} /J J9
N/A Date Sample Collected MM/DD/YYYY Co.5..2D 21 4.6 ZozV G,S 2.429
46529 24-Hour Rainfall in inches , Z.O , ZO • 20 --
00530 TSS in mg/L(100 or 50') _ ers D 1 b
00552 Non-Polar Oil&Grease in mg/L(15)
NCOIL Estimated New Motor/Hydraulic Oil Da (e 0a (000
Usage in gal/month
Outfalls to Outstanding Resource Waters(ORW),High Quality Waters(HOW),Trout Waters(Tr)and Primary Nursery Areas(PNA)
have a benchmark TSS limit of 50-rni;/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."
69—/8 'A9,--/
Signature of Permittee or Delegated Authorized Individual Date
Email Address Phone Number
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