NCG140031 DMR WW (5)

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO - �G ,
FACILITY NAME: 7 0,0 �o I X
PERSON COLLECTING SAMPLES:
CERTIFIED LABORATORY: Lab #
r Lab-#--
LIMIT VIOLATIONS? YES NO
-----------------------
---- - -- -
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: a© /b
SAMPLE QUTr6ollo
E[] u -Sept ❑Oct -Dec Jan -March QApril June
COUNTY:
PHONE NO. (j;(a) !o✓a -D �'/
ADD TO LISTSERVE? AYES [:]NO EMAIL:
DISCHARGING TO CLASS: []SA []HQW E]PNA OTrout ❑Other
OPTIONAL INFO: -1- 421'fs C'/Pd!Xn/ Oki V- 1 aw G)
Date Sample
1
Outfall No. Collected
(mm/dd/yr)
Type of Wastewater
z
(VE, RM, MD)
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1664A
SGT -HEMS
(mg/L)
Discharge
Total Flow
Duration
(minutes) (gallons/day)7
- SC
E -
6-93A
303's
53
(15)6
- -
i ,L F1L'
Nh SEL
1 If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
2 Report the abbreviation for the type of Authorized 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.
3 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 RO staff
notifies you to continue monitoring.
° pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 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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J, fi � rti` •_ F:t ., - .. ".. _•i "_ � -. }, �: L}h."ir:-^r`'i;.�i.^.`{, - r- ..
f e Pi6cess wastewater disc a�rges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater
7but instead is suNect�tg3benchmarks and provisions of Part IV, Section A, including the Tiered Response Action. t
Flow rate can be measured co�xinuously_ or
ca ed. Flow limits for we'stewater discharges to HQW waters shall be set 50% of the Summer 7810 Flow a"§ per 15A
NCA, C 02B:0224 Permittees who discharge wastewater to HQW waters shall obt'a'in'a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
ob i i Ssummer 7Q10 flow -for the receiving waters at the discharge location, the permittee shall notify DWq, and th
e 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
AT -END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO: OF SA MLLE •R
Division of Water Quality -
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh; North Carolina 27699-1617
[phone] - -. -
• 4
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED. -
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a stem designed
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons whom nhe system, or
manage t to
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true accurate
complete. I am aware that theme are sig
violatio^l* "A nificant fen"alties for submitting false information, including the possibility of fines and imprisonment for knowing
Signature of Permittee) �/ � •
(Date)
Permit Date: 7/1/2010-06/30/2015
Last Revised 07/13/11
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