NCG070115_2024 DMR_20240625

NCDEQ Division of Energy,Mineral and Land Resources
Complete,sign,scan and submit the DMR via the ',n;:..',•r I- ' - .r.n '!I: 1 I. il,'I'. 1's!c:t Itci.4ll i,,,i.,,Jf''''"within
30 days of receiving sampling results. Mail the original,signed hard copy of the DMR to the ,i.::iiyietc-Li M'i.r_f.i.} r_d U_fii
Certificate of Coverage No.NCGO7 0 l 15 _Person Collecting Samples: Hit F'rr,..) Po c6 ciS
Facility Name: 4 d4 M 0 id(4 f 1 IZ Laboratory Name: f G(.( / G hi
Facility County: t..i I f jd ' Laboratory Cert.No.: N(U o )0/14
Discharge during this period:ISI Yes ❑No (if no,skip to signature and dote)
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 l it tc,:.//e Jk.,:J' c;,'' ., •.'I.,i.c !'->'.: I'i"k 2 Yes ❑No
Date Uploaded:
Analytical Monitoring Requirements for Vehicle&Equipment Areas—Benchmarks in :ile('i
Parameter Parameter Outfall 'L Outfall Outfall Outfall Outfall
Code /
N/A Receiving Stream Class l Y 6
N/A Date Sample Collected MM/DD/YYYY 2-&L`).)
46529 24-Hour Rainfall in inches s
C0530 TSS in mg/L(100 cr 50') iS 4
00552 Non-Polar Oil&Grease in mg/L(15) Pitt
NCOIL Estimated New Motor/Hydraulic Oil
—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'.1 r,,p/t.All other water classifications have a benchmark of I t,o nre/L
Notes(optional):
1 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
ted is,to the best of my knowledge and belief,true,accurate,and complete.lam aware that there are significant penalties for submitting
for ation,in ing the possibility of fines and imprisonment for knowing violations."
I
Sig •ture of Permittee or Delegated Authorized Individual Date
Email Address Phone Number