NCG210510_2024 DMR_20241104

NCDEQ Division of Energy,Mineral and Land Resources
Stormwater Discharge Monitoring Report(DMR) Form for NCG210000
Timber 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. Mail the original,signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NCG21O51 O Person Collecting Samples:rY (,4 'gykA /c
Facility Name:tsp ro:R vps\?v oilAc.ts- RV(� Laboratory Name: pa( A1/1 ,fit c 4
Facility County: 1-tAj f /' Laboratory Cert. No.: 3��-Fi7
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)?
A copy of this DMR has been uploaded electronically via https://edocs.deq.nc.gov/Forms/SW-DMR Erces El No
Date Uploaded: ,( it-1
Analytical Monitoring Requirements for Outfalls with Industrial Activities—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*)
00340 Chemical Oxygen Demand (120)
Additional parameters for outfalls in drainage areas that use>55 gallons per month of new hydraulic oil on average
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):'ke of-teC� G�ll�Q -\z MCA►t1 n[InY1lunC Gy 1 Vl (1cLL,ci`(eryse . (+'CX i C)
-For o vd-'ec A f. 004 t c cS- beN- 2O 21 NI trx l vl ' ;(mil
"I certify b} y signature below,under penalty of law,that this document and all attachments were prepared unsder my direction or supervision in
ac ordanc ith a system designed to assure that qualified personnel properly gather and evaluate the information submitted.Based on my
inq iry of qA - person or persons who manage the system,or those persons directly responsible for gathering the information,the information
ub itted ., .the best of my knowledge and belief,true,accurate,and complete.I am aware that there are significant penalties for submitting
f•Is- 'nform: ,including the possibility of fines and imprisonment for knowing violations."
l Ed 0L'1 /Z07.14
Sig At ure of\Ot nittee or Delegated Authorized Individual Date
Email Address Phone Number
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