NC0085936_Effluent_20040708

EFFLUENT
NPDES PERMIT NO.Ib//✓C 0085rl 3‘ DISCHARGE NO. _ MONTH ...- 00".3 e. YEAR . --05C)cf
FACILITY NAME ti W;//:4 s Scv...s CLASS COUNTY .)oh,s40,.!
OPERATOR IN RESPONSIBLE CHARGE'(ORC) %C' ORAA., GRADE PHONE I I. `!34f. 5115'.-
CERIIHEDLABORATORIES(1) 5 i,i5 (2)
CHECK BOX IF ORC HAS CHANGED El PERSON(S)COLLECTING SAMPLES 'YC 002:',1 -
Mail ORIGINAL and ONE COPY to:
ATTN:CENTRAL FILES X _ -- _ 6 Jam _
DIVISION OF WATER QUALITY (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE) DATE
1617 MAIL SERVICE CENTER BY THIS SIGNATURE,I CERTIFY THAT THIS REPORT IS
RALEIGH, NC 27699-1617 ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
50050 00010 00400 50060 00310 00610 00530 31616 00300 00600 00665 1-,<_<EyS
c g * FLOW y ENTER PARAMETER CODE ABOVE
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Monthly Limit < 30 30 - S.
DWQForm MR-1(01/00) D•�/D<2

Facility Status:(Please check one of the following)
All monitoring data and sampling frequencies meet permit requirements
• Compliant
All monitoring data and sampling frequencies do NOT meet permit requirements
Noncompliant
If the facility is noncompliant,please comment on corrective actions being taken in respect to equipment, operation,maintenance,etc.,
and a time-table for improvements to be made.
"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 violations."
CYA2,AV
Permittee (Please print or type)
04
Signature of Permittee** Date
(Required)
9
Rikode., /26960 76 13(f• q«s aFeb aco�
Permittee Address Phone Number Permit Exp.Date
S77;{S jC./6 r�tC (7 • ?
• PARAMETER CODES
00010 Temperature 00556 Oil&Grease 00951 Total Fluoride 01067 Nickel 50060 Total
00076 Turbidity 00600 Total Nitrogen 01002 Total Arsenic 01077 Silver. Residual
00080 Color(Pt-Co) 00610 Ammonia Nitrogen 01092 Zinc Chlorine
00082 Color(ADMI) 00625 Total Kjeldhal 01027 Cadmium 01105 Aluminum
Nitrogen
00095 Conductivity 00630 Nitrates/Nitrites 01032 Hexavalent Chromium 01147 Total Selenium 71880 Formaldehyde
00300 Dissolved Oxygen . 01034 Chromium 31616 Fecal Coliform 71900 Mercury
00310 BODS 00665 Total Phosphorous 32730 Total Phenolics 81551 Xylene
00340 COD 00720 Cyanide 01037 Total Cobalt 34235 Benzene
00400 pH 00745 Total Sulfide 01042 Copper 34481 Toluene
00530 Total Suspended 00927 Total Magnesium 01045 Iron 38260 MBAS
Residue 00929 Total Sodium 01051 Lead 39516. PCBs
00545 Settleable Matter 00940 Total Chloride 01062 Molybdenum 50050 Flow
Parameter Code assistance may obtained by calling the Point Source Compliance/Enforcement Unit at(919)733-5083 or by visiting
the Water Quality Section's web site at h2o.enr.state.nc.us/wqs and linking to the Unit's information pages.
Use only units designated in the reporting facility's permit for reporting data. — --
*ORC must visit facility and document visitation of facility as required per 15A NCAC 8G.0204.
t� i,
**If signed by other than the permittee,delegation of signatory authority must be on file with the state per 15A NCAC 2B .0506(b)
(2)(D). _ .