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Home My WebLink AboutNCG140439_COMPLETE FILE - HISTORICAL_20170406STORMWATER DIVISION CODING - SHEET -RESCISSIONS. PERMIT NO. DOC TYPE 0 COMPLETE FILE -HISTORICAL DATE OF RESCISSION ❑ �a � O q O Lo YYYYMMDD PROCESS WASTEWATER — Quarterly Discharge Monitoring Report GENERAL PERMIT NO. NCG140000 CERTIFICATE OF COVERAGE NO. NCG14 0 L{ 3 .C1 SAMPLE COLLECTION YEAR: ;k. O t -4- FACILITY NAME: iyRE;ErcS4oRb WG-"vrrart l.t,ep T ,K�.Co,�c. SAMPLE QUARTER: []Jul -Sept []Oct -Dec Nan -March PERSON COLLECTING SAMPLES: PL-A""COUNTY: &U:L-L_ FG 20 CERTIFIED LABORATORY: J Lab # PHONE NO. (336) y06 - 90 6 0 ---- Lab # ADD TO LISTSERVE? ❑YES ❑NO EMAIL: LIMIT VIOLATIONS? YES ❑ NO ❑ DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout OPTIONAL INFO: Part A: Wastewater Monitoring Requirements ❑April -June ❑Other Outfall No. Date Sample 1 Collected (mm/dd/yr) Type of Wastewater Z (VERMMD) , , pH (standard} Total Suspended Solids (mg/L) Settleable Solids (mL/Q TPH usingDischarge method 1664A SG /L) b {mg/L} Duration (minutes) Total Flow 7 (gallons/day} - - - 6-93.4 303.5 53 (15)6 - - O LOW �2% 0 q nu APR �VdR g�lvTlt3P! , ,,,,T I a ORMATION PRULtbo"' 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 abbreviatiomfor 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. 3If 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. 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 TS5 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 Page 1 of 2 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. 7 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 OR 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 (919)807-6379 i ,_ 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 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 that there are siknificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." s1 1 1 : ///Wli . cz�q q/3 (signature of rmittee) Y (Date) Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11 Page 2 of 2 PROCESS WASTEWATER —Quarterly Discharge Monitoring Report GENERAL PERMIT No. NCG140000 CERTIFICATE OF COVERAGE NO. NCG14 O i- 3- q SAMPLE COLLECTION YEAR: a0 16 FACILITY NAME: &RFFNsl3o9n IJFSr-RH Loe,'-T.PcI�N r^P. ��r�TSAMPLE QUARTER: ❑Jul -Sept ®Ott -Dec Dian -March PERSON COLLECTING SAMPLES: A- _ _ , COUNTY: 6- U T_ L i~a2 D CERTIFIED LABORATORY: Lab # PHONE NO. (3�) ko 6 - fo 6a Lab # ADD TO LISTSERVE? ❑YES []NO EMAIL: LIMIT VIOLATIONS? YES ❑ NO ❑ DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout OPTIONAL INFO: Part A: Wastewater Monitoring Requirements ❑April -June []Other Outfall No. Date Sample 1 Collected (mm/dd/yr) Type of Wastewater Z (VE, RM, MD) pH (standard) Total Suspended Solids (mg/L) Settleable Solids (mL/L) TPH usingDischarge method 1664A SGT-HEM' (mg/L) Duration (minutes) Total Flow (gallons/day)' - - 6-93,4 303,5 53 (15f 4• L ac,-� DEC 2 0 2W ^e m.., Y� 'S M 10 IXIIIIII AD► AR, WrA OM NM I" _I lw y 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. 3If 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. 4 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 Page 1 of 2 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 (OR 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 (919)807-6379 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 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 awj�re that t re are significant penalties for'submitting false information, including the possibility of fin es and imprisonment for knowing violations." /// / (Signature of Permitteej Permit Date: 7/1/2010-06/30/2015 Ia li s/r6 (Date) Last Revised 07/13/11 Page 2 of 2 PROCESS WASTEWATER — Quarterly Discharge Monitoring Report RECEIVED GENERAL PERMIT NO. NCG140000 OCT 062016 CENTRAL FILES )WR SECTION CERTIFICATE OF COVERAGE NO. NCG14 O � 3 � �� SAMPLE COLLECTION YEAR: _ aO 16 _ FACILITY NAME: _ C,Psems �ac�¢�_ �( (l tERt`t„ L,D�7P - S,�MPLE QUARTER: �lul-Sept ❑Oct -Dec ❑lan-March ❑April -June PERSON COLLECTING SAMPLES: )i jrGN �4TZtD SEIr MST �SrPi �oLINTY: U = CERTIFIED LABORATORY: • PasSM LAR, Lab # �bQ";)_ PHONE NO. (--leA Lab p ADD TO LISTSERVE? []YES ONO EMAIL: LIMIT VIOLATIONS? YES ❑ NO ❑ DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA [—]Trout ❑Other OPTIONAL INFO: Part A. Wastewater Monitoring Requirements Outfall No. Date Sample Collected {mm/dd/yrJ Type of Wastewater (VE, RM, MD)' pH (standard) Total Suspended Solids (mg/LJ Settleable Solids (mL/L) TPH using method 1664A SGT--HEA � Discharge Duration (minutes} Total Flow (gallons/day) i qI1>1{ I6 I 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. r 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. 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 Page 1 of 2 e 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 he set to 50% of the Summer 7Q10 Flow as per 15A NCAC 028 .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, "N2 ¢15[HA6gE"1 WrrHlhJ 30 DAYS OF$E&EIPT OF SAMPLE IOR AT END OF MONITORING PERIOD IN CASE OF "NO FLOW"ITO: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919)807-6379 YOU MUSTSIGN THIS CERTLCi4TION FOR ANY WFORMATION REPORTEP "I certify, 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, atcurate, and / complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing (Signature of Permit Date: 7/1/2010-06/30/2015 101 4 hL (Date) Last Revised 07/13/11 Page 2 of 2 PROCESS WASTEWATER -- Quarterly Discharge Monitoring Report GENERAL PERMIT No. NCG140000 CERTIFICATE OF COVERAGE NO. NCG14.O a 3 ri SAMPLE COLLECTION YEAR: ;�-o 16 FACILITY NAME: WESYi5IZN Loc>P - TEMPbQ,42SAMPLE QUARTER: ❑1ul-Sept ❑Oct -Dec ❑Jan -March ®April -June PERSON COLLECTING SAMPLES, TYLIM MyERS Gcwc¢--TE PcoAOUNTY: 6-- .) xLFC7R D CERTIFIED LABORATORY.' Pf� -T 5N1 LAC,, Lab # L-I O -�'— PHONE NO. ( jgji Lab # ADD TO LISTSERVE? ❑YES []NO EMAIL: LIMIT VIOLATIONS? YES ❑ NO ❑ DISCHARGING TO CLASS. ❑SA ❑HQW ❑PNA ❑Trout ❑Other OPTIONAL INFO: Part A. Wastewater Monitoring Requirements Outfall No. Date Sample Collected' (mm/dd/yr) " Type of Wastewater (VE, RM, MD) x pH (standard) Total Suspended Solids (mg/L) Settleable Solids (mL/L) TPH using method 1664A SGT-N Ee Discharge Duration (minutes) Total Flow � (gallons/day) - - 6-9 '4 30 ' 519 3 (15) , - - aS#4 RA 6 ;tL! M0. .O wr 6.'�> 7z,o !/� Jjn // JUL 1 1 016 FILES UVVK \` w A V \� rj 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 Cieanout (MD). Report more than one type if the waste -stream Is commingled. 31f 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. 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 Page 1 of 2 6 Process wastewater discharges shall only be monitored for TPH when commingled with starmwater 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 026 .0224. Perrnittees 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-1 WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR AT END OF MONITORING PERIOD IN CASE OF -NO FLOW" TO: Division of Water Quality y s Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919)807-6379 A YOU MUST M THfS CERTlF1CATlONfO_R ANYINFORMATION REPORTED. "I certify, 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 property 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 ware that there �fe significant penalties for submitting false information, including the possibility of Tines and imprisonment for knowing violations."/ � / / 1---Z/ (Signature of Permit Date:7/1/2010-06/30/2015 -7-/1511L (Date) Last Revised 07/13/11 Page 2 of 2 PROCESS WASTEWATER - Quarterly Discharge Monitoring Report GENERAL PERMIT NO. NCG140000 w CERTIFICATE OF COVERAGE NO. NCG14 0 4 19 Tap+t' FACILITY NAME: &A1 EMS60ft Wg6rG H U -1 LcoP- Ga+ci T PERSON COLLECTING SAMPLES: CERTIFIED LABORATORY: tab # Lab # LIMIT VIOLATIONS? YES ❑ NO ❑ Part A: Wastewater Monitoring Requirements SAMPLE COLLECTION YEAR: a 016 SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec ®Jan -March COUNTY: _ &-VTJ-F00Z0 PHONE NO. ( b3_ } 4O6 - 9060 ADD TO LISTSERVE? ❑YES ❑NO EMAIL: DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other OPTIONAL INFO: ❑April -June Outfall No. Date Sample Collected' (mm/dd/yr) Type of Wastewater { VE, RM, MD)' pH (standard) Total Suspended Solids (mg/L) Settleable Solids (mL/L) TPH usingDischarge method 1664A SGT HENfs (mg/L) Duration (minutes) Total Flow (gallons/day)7 - - - 6-9.4,E 303' 53 (15)6 - O r L+o D N114 c t ro„ W FORMATint t panr+cr+ p 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. z 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. 3If 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 Page 1 of 2 • e Process wastewater discharges shalt only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater, • - 1. but-l'nstead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action. J 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 ISA 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 IINCLUNING ALL "NO FLAW"."fY0 DISCHARGE" WITHIN 30 DAYS OF RECEIPT OF SAMPLE OR AT END OF MONITORING PERIOD IN CASE OF "NO FLOW" TO: Division of Water Quality T Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919)807-6379 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 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 that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing t3 I6 (Date) Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11 Page 2 of 2 PROCESS WASTEWATER — Quarterly Discharge Monitoring Report GENERAL PERMIT No. NCG140000 CERTIFICATE OF COVERAGE NO. NCG14 o q 3 q SAMPLE COLLECTION YEAR: Z a i S— FACILITY NAME: G ree,%fl oya WeJ+evn, U ba L 7e Cokr,,A�SAMPLE QUARTER: ❑Jul -Sept ®Oct -Dec . [_]Jan -Marl PERSON COLLECTING SAMPLES: }COUNTY: • v14. r CERTIFIED LABORATORY: Lab # PHONE NO. 70 Y ) 4 7 Lab # ADD TO LISTSERVE? ❑YES ❑NO EMAIL: LIMIT VIOLATIONS? YES ❑ NO ❑ DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA [—]Trout OPTIONAL INFO: Part A: Wastewater Monitoring Requirements ❑April -June ❑Other, Outfall No. Date Sample r _ Collected.._ (rtim/ild/yr}„ Type of,Wastewater 2 (VE, RM, MD). pH (standard) Total Suspended- Solids. (mg/L] Settleable Solids (ml/L) TPH using method 1664A. SGT HfM6 (mg/L) Discharge Duration (minutes] Total Flow , (gallons/day) - - - 6-93.4 303.s 53 (15)6 - - IC In Ix X n r %L— ev:i e u, • CIr14TRAL- r+L dO 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. z 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 Page 1 of 2 6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VIVIA 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 .022a. 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 IfOR 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 (919) 807-6379 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 system designed to r 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 that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." ayo 612 0 �� (Signature of Permittee) (Date) Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11 Page 2 of 2 PROCESS WASTEWATER -- Quarterly Discharge Monitoring Report GENERAL PERMIT NO. NCG140000 } � d l 5' CERTIFICATE OF COVERAGE NO. NCG14 �1 3 9 SAMPLE COLLECTION YEAR: FACILITY NAME: (7r'2rZ+1 I'�: u e�` 00'� - Te.,n ar"'� 7_10,;rCOUNTY: SAMPLE QUARTER: IJul-Sept ❑Oct -Dec . Dian -March PERSON COLLECTING SAMPLES: Cay,C..tif �+ - i a: j CERTIFIED LABORATORY: Lab I# PHONE NO. j7W �i%1 4'79 - OS • 's"� Lab # ADD TO LISTSERVE? DYES ONO EMAIL: LIMIT VIOLATIONS? YES ❑ NO ❑ DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout OPTIONAL INFO: Part A. Wastewater Monitoring Reouirements ❑April -June ❑Other Outfall No. Date Sample Collected . mm/dd/yr ( ) Type of Wastewater (VERM, MD}. , 2 pH {standard} Total Suspended Solids (mg/L) Settleable Solids (MLA) TPH usingDischarge method 1664A 5GT-NENl6 (mg/L) Duration (minutes) Total Flow 7 (gallons/day) - 6-91, 303,5 53 (15)6 - - J) t^ T 0 CENTRAL =1l i=c vVN SEC TION ' 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. 3If 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 Page 1 of 2 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. 7 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 (OR AT END OF MONITORING PERIOD IN CASE OF "NO FLOW" 1 TO: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919) 807-6379 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 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 that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing viofati (Signature of Pe (Date) Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11 Page 2 of 2