NCG050169_International Paper DMR-20250529

RECEIVED
NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG050000 HUH 5 2025
Apparel, Printing, Rubber, Etc. DENR-DEMLR
Land Quality Section
Click here for instructions Mooresville Regional Office
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. NCGOS 0169 Person Collecting Samples:Josh Sorrells
Facility Name: International Paper-Charlotte Container Plant Laboratory Name:Statesville Analytical
Facility County:Mecklenburg Laboratory Cert. No.:440
Discharge during this period: < es No(if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions for any benchmark exceedances? Yes No
If so,which Tier(I, II,or III)?
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in(Red)
Parameter Parameter Outfa Outfall Outfall Outfall Outfall
Code
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY 5-12-2025
00400 pH in standard units(6.0-9.0 FW, 6.19
6.8.8.5 SW)
46529 24-Hour Rainfall in inches 0.83
00552 Non-Polar Oil&Grease in mg/L(15) See Notes
C0530 TSS in mg/L(100 or SO*) 26.86
00340 Chemical Oxygen Demand(COD)in mg/L 23
(120)
NCOIL New Motor/Hydraulic Oil Usage in
gal/month
Notes(optional):Notes(optional): Outfall 001 was sampled on 5/12/2025.Less than 55 gallons of motor/hydraulic oil used each month
for vehicle orequipment maintenance.
"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 tha there are ignificant penalties for submitting false information, including the possibility of fines and imprisonment for
knowin iolati ns." t, �
Signature of Permittee or Delegated Authorized Individual Date