NCG140037 DMR WW (3)

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COE N9. NCG ,eQ 3 2
FACILITY NAME:
PERSON COLLECTING SA PLES: r —s/
CERTIFIED LABORATORY: /V/`f Lab #
L Lab #
LIMIT VIOLATIONS? YES [] NO[^
part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR:®f�
SAMPLE QUARTER: []Jul -Sept (Oct -Dec []Jan -March []April -June
COUNTY:�Z�
PHONE NO.
ADD TO LISTSERVE? ❑YES ❑NO EMAIL:
DISCHARGING TO CLASS:A Trout Other
OPTIONAL INFO:
Date Sample Total Suspended '
Outfall No. Collectedl Type of Wastewater pH
Solids
TPH using;_
Settleable :.
method 1664A
Solids
discharge.
Total Flow
r
(VE, RM, MD) (standard} :
(mm/dd/yr) (mg/L)
SGT HEM6`:
(mL/L)
Duration :.
(minutes):
(9a on
JAR
CENTRAI
FILES
If wastewater systems have not discharged.in this quarter - report "No. Flow" or"No Discharee" here_ Please make sure to mark the camnia m iartar a►,r,,,a
nePort Tne.anoreviauon Tor the type oT Autno.rizea.wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
_..... ..If an effluent limit is exceeded twice.in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RD staff
notifies you to continue monitoring.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
s TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
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6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case-by-case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY INCLUDING ALL -NO FLOW-. "NO DISCHARGE" WITHIN 30 DAYS OF RECEIPT OF SAMPLE IOR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN TN/S CERTIFICATION FOR ANY INFORMATION REPORTED
"I certify, under penalty of law, that thisdocument and all attachment s_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
comp) . I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing
viola o ,", I //) r
of Permittee)
Permit Date: 7/l/2010-06/30/2015
(Date)
Last Revised 07/13/11
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