NCG070180_2024 DMR_20240625

NCDEQ Division of Energy,Mineral and Land Resources
Stormwater Discharge Monitoring Report(DMR)Form for NCG070000
Stone,Clay,Glass,&Concrete Products
aick here for instructions
Complete,sign,scan and submit the DMR via the Stormwater NPDES 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 DE MLR Regional Office.
Certificate of Coverage No.NCG070204 Person Collecting Samples:
Facility Name:Oldcastle Adams Products,Castle Hayne Laboratory Name:Pace Labs
Facility County:New Hanover Laboratory Cert.No.:12710
Discharge during this period:❑Yes Ej No (if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?Q Yes 0 No
If so,which Tier(I,II,or III)?
A copy of this DMR has been uploaded electronically via https://edocs.deq.nc.gov/Forms/SW-DMR [Z Yes 0 No
Date Uploaded:
Analytical Monitoring Requirements for Vehicle&Equipment Areas—Benchmarks in(Red)
Parameter
Code Parameter Outfall Outfall Outfall Outfall Outfall
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY
46529 24-Hour Rainfall in inches
C0530 TSS in mg/L(100 or 50')
00552 Non-Polar Oil&Grease in mg/L(1S)
NCOIL Estimated New Motor/Hydraulic Oil
Usage In gal/month
Outfalls to Outstanding Resource Waters(ORW),High Quality Waters(HQW),Trout Waters fTr)and Primary Nursery Areas(PNA)
have a benchmarkT55 limit of 50 mg/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 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
fal formatio ,including the possibility of fines and Imprisonment for knowing violations."
06/11/2024
Signature of Permittee or Del e Authorized Individual Date
Email Address Chris.Harce stie.com Phone Number 910-685-3086
li
I I

NCDEQ Division of Energy,Mineral and Land Resources
Complete,sign,scan and submit the DMR via the.. , ,, 'r ',, , l;J(A,i'A iii;i L .t i.J fry•„i within
30 days of receiving sampling results. Mail the original,signed hard copy of the DMR to the ,'i 1uu I-' if l 1 F'E:;i 1_Jl O f(''•
Certificate of Coverage No.NCGO7 Person Collecting Samples: Hit bet.,I RO 4 e,s _
Facility Name: 6.Ai M 0 ide 4_f,�/Z Laboratory Name: pow f 4,k/
Facility County: lid` sri( foie) laboratory Cert.No.: Itl((a p 7 0//J
Discharge during this period:(W Yes ❑No (if no,skip to signature and dote)
Has your facility Implemented mandatory Tier response actions this sample period for any benchmark exceedances?0 Yes ©No
If so,which Tier(I,II,or III)?
A copy of this DMR has been uploaded electronically via htlu.,.//rdLr..Je:1 w p:,1.',_/S4 Cn,Th 2 Yes 0 No
Date Uploaded:
Analytical Monitoring Requirements for Vehicle&Equipment Areas—Benchmarks in{l;i-d)
Parameter Parameter Outfall2 Outfall Outfall Outfall Outfall
Code
N/A Receiving Stream Class in-
N/A Date Sample Collected MM/DD/YYYY 2
46529 24-Hour Rainfall in inches /ts, _
C0530 TSS in mg/L(100 or 50') /.S,L
00552 Non-Polar Oil&Grease in mg/L(15) Pitt
NCOIL Estimated New Motor/Hydraulic Oil
) _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'.1 ;e,r'.All other water classifications have a benchmark of 100 twin.
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
In. iry of the person or persons who manage the system,or those persons directly responsible for gathering the information,the information
ed is,to the best of my knowledge and bekef,true,accurate,and complete.I am aware that there are significant penalties for submitting
f. ation,iniO494t
ing the possibility of fines and imprisonment for knowing violations."
14i.-! V2( 2'-{
Sig .ture of Permittee or Delegated Authorized Individual Data
Email Address Phone Number

NCDEQ Division of Energy,Mineral and Land Resources
Stormwater 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 Stormwater NPDES Permit Data Monitoring Report(DMR)Upload form within
30 days of receiving sampling results. Mall the original,signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Certificate of Coverage No.NCGO7 g , � Person Collecting Samples:
Facility Name: /4 fl4- ( 0(0.gcl--S CD, Laboratory Name:
Facility County: M QLy)el Laboratory Cert.No.:
Discharge during this period:❑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)7
A copy of this DMR has been uploaded electronically via https://edocs.dea.nc.gov/Forms/SW-DMR ❑Yes ❑No
Date Uploaded:
Analytical Monitoring Requirements for Vehicle&Equipment Areas—Benchmarks in(Red)
Parameter Parameter Outfall Outfall Outfall Outfall Outfall
Code
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY
46529 24-Hour Rainfall in inches
C0530 TSS In mg/L(100 or 501
00552 Non-Polar Oil&Grease in mg/L(15)
NCOIL Estimated New Motor/Hydraulic Oil
Usage in gal/month
Outfalis to Outstanding Resource Waters(O W),High Quality Waters(HOW),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 knowledge and belief,true,accurate,and complete.I am aware that there are significant penalties for submitting
false information,Includi : N•ssibility of fines and Imprisonment for knowing violations."
• ///3/X
Signature of Permittee or r•;• •uthorized Individual Date
Email Address Phone Number
. ?Doi aid, Ja pa 6 O/dcaOle, corn gag-371--o/75

NCDEQ Division of Energy,Mineral and Land Resources
Stormwater 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 Stormwater NPDES Permit Data Mpnitoring 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 0180 Person Collecting Samples:
Facility Name:Adams-Dunn,NC Laboratory Name:
Facility County:Harriett Laboratory Cert.No.:
Discharge during this period:❑Yes ElNo (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 https://edocs.deq.nc.gov/Forms/SW-DMR Q Yes ❑No
Date Uploaded:
Analytical Monitoring Requirements for Vehicle&Equipment Areas—Benchmarks in(Red)
Parameter Parameter Outfall Outfall Outfall Outfall Outfall
Code
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY
46529 24-Hour Rainfall in inches
C0530 TSS in mg/L(100 or 50')
00552 Non-Polar Oil&Grease in mg/L(15)
NCOIL Estimated New Motor/Hydraulic Oil
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."
/ U
June 11,2024
Signature of Permittee or Delegated Authorized Individual Date
Email Address [e-mail] Phone Number 910-892-3267