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STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
❑HISTORICAL FILE
L�t MONITORING REPORTS
DOC DATE
rl a e1 5 / o I a
YYYYMMDD
r� PROCESS WASTEWATER— Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE No..NCG14 U-L I 2
FACILITY NAME: - ;
PERSON COLLECTING SAMPLES: 9CUIV 11606cesca-
CERTIFIED LABORATORY; lab #
Lab #
LIMIT VIOLATIONS? YES ❑ NO ❑
SAMPLE COLLECTION YEAR: - Zb 15
SAMPLE QUARTER: Jul -Sept ❑Oct -Dec ❑Jan -March ❑April -June
COUNTY: C49M OCA!,RAIR
PHONE NO, (Sf�)Y3b - 2 01$
ADD TO LISTSERVE? DYES ONO EMAIL: NA
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA []Trout ❑Other
OPTIONAL INFO:
fart A: Wastewater Monitoring Re uirements
L?ate;Smplz
7ype of;Wastewater
pH
7atai ed '
Settleable
7PH using:
metfrod 1664A
tits charge
.:
total Flow :.:
Outfall hfo
�.
E dllede
:
(VE, (iM, MD}
(skatstlard}
Soli ds
5ol�ds
SG7 HEM
1]uratl6n
7
(gallops/dav3,
(mni/dd/yrj
(n+glll
I�►UL)
im8/l}
(minutes).
ZIA
1rN TRAL i'ILES
vv t:G
ON
' 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 -
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 perrnittee is required to institute monthly monitoring for that parameter for six months, unless QWQ Ro staff
notifies you to continue monitoring.
° p" limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 5.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/1 for ail other water classifications.
Permit Date: 7/1/2010-06/30/2025 Last Revised 07/13/11
Page 1 of 2
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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 1V, 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 026 ,0224. Permittees who discharge wastewater to HQW waters shall obtain a.Surnmer 7Q10 flow and report this information'to DWq. if the permittee cannot
- obtain a S6mrriee 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.
Ai O iG N >` DONE COPY OF t iS N UAL SUM RY INCILUDIIVG ALL "NO FLOW" "NO DISCHARGE" WITHI 30 DAYS OF RECEIPT OF -AMP-E 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
YQUMYT&MLUI CERTIFICATION FOR ANY 1NFORMATI(M R£POBI"ED:
"l 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 systems, 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 possllbility of fines and imprlsonment for knowing
violations."
{Signature of
^Za13
(bate)
Permit Date: 7/1/2010-06/30/2015
East ?c2visesl
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE. NO.-NCG14 O J_ f
FACILITY NAME: G Cs L
PERSON COLLECTING SAMPLES: ke-VIA1 Y0
CERTIFIED LABORATORY: Lab # ,
Lab #
LIMIT VIOLATIONS? YES ❑ NO ❑
art A: wastewater monitoring
RECENED
APR 13 2015
CENTRAL FILES
CV4/R SECTION
SAMPLE COLLECTION YEAR: Z ad �
SAMPLE QUARTER: f ]Jui-Sexrt ❑Oct -Dec KJan-March ❑April -June
COUNTY; _ d4lMf3eRLR& 12___�
PHONE NO- ( Iv �14 —_ 1_i ,f
ADD TO LISTSERVE? []YES []NO EMAIL; JQ
DISCHARGING TO CLASS: ❑SA ❑HQw ❑PNA []Trout EjOther
OPTIONAL INFO:
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 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 I of 2
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s 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 28 , 274, Permittees who discharge wastewater to H W waters shall -o tam a Summer 7Q10 flow and report this informatio-n 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:
€3ivision of Water Quality
Attn: DWQ Central Fifes
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
(919) 807-6373
YCMA4 USTS1GN TH15 CM11F1 AVM FORA_ YMORMAVOA 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
violations."
rs
(Signature of Permittee) (Date)
Permit Date: 7/1/2010.06/30/2015 Last Revised 07/23/11
r
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report,
GENERAL PERMIT NO. NCG140000 �
CERTIFICATE OF COVERAGE NO. NCG14 0 _L S _2,.
FACILITY NAME: M 2jZC ��1f/N4s L-Aisjr
PERSON COLLECTING SAMPLES: Lie -wee vEc1��!I3_—
CERTIFIED LABORATORY: IVA __ Lab #
Lab it
LIMIT VIOLATIONS? YES ❑ NO ❑
Part A. Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR. 240j 5
SAMPLE QUARTER: ❑Jul -Sept LXOct-Dec ❑Jan-Mareh _ E]Apri c Q
COUNTY: C J!J M iO4S LA_W D
PHONE NO. jYZQ] tf3(2 • 21?&
ADD TO LISTSERVE? []YES []NO EMAIL: _
DISCHARGING TO CLASS: [:]SA ❑HQW ❑PNA ❑Trout ❑Other
OPTIONAL INFO:
70utfall No.Outfall No.
Date Sample
1
Collected
(mm/dd/yr)
Type of Wastewater
2
{VE, RM, MD)
pH
(Standard}
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method I664A
SC( �+t;/LI /Lj
Discharge
Duration
(minutes)
Total Flow
7
{gallons/day}
6-93''
303,5
I
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: Vehide 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 RC staff
notifies you to continue monitoring.
` pH iimits 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 07/13,111
Page I of 2
6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwa ter 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, inciu6ng the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall beset to 50% of the Summer 7Q10 Flow as per 15A
rUCAC 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 CQPY OF THIS ANNUAL SUMMARY INCLUDING ALL "NO FLOW". "NO DISCHARGE"] WITHIN 30-DAYS OF RECEIPT OF SAMPLE fOR
AT END OF LADNITORINfa 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 MUSTSlGN THIS CER71FICATION 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
violations."
,t 2 •9- 15
(Signature of Permittee) (bate)
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 6 1 ff Z
FACILITY NAME: 1; M _04 5-MA11- Ld If = g = _
PERSON COLLECTING SAMPLES:
CERTIFIED LABORATORY: Lab N
Lab It
LIMIT VIOLATIONS? YES NO ❑
Part A: wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: —_2015
SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec ❑Jan -March ®April -June
COUNTY: C U LM j,7WUM-1_f2 --
PHONE NO. (g«?
ADD TO LISTSERVE? []YES ❑NO EMAIL. - &A
DISCHARGING TO CLASS: ❑SA ❑HQW [jPNA ❑Trout ❑Other
OPTIONAL INFO: IV J9
Qutfall 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 using
method 1664A
SGi NEVI'
(mg/L)
Discharge
Duration
{minutes)
Total Flow
�
(gallons/dayf
-
-
6-93.4
303'5
w
J O 1
015
sa
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.
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: 71112010-0613CY2015 Last Revised 07/13/11
Page i of 2
Prgc4s 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 beset 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 gQRY QF THI ANNUAL SUMMARY IINCLUDING ALL "NO FLOW" "NO DISCHARGE" WITHIN 30 DAYS OF RECEIPT OF SAMPLE OR
AT END OF MQNITORING 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 TFRS 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
violations."
---- _ h - 36~ AN
(Signature of Permittee) (Date)
Permit Date: 7/l/2010-06/30/2015 Last Revised 07/13/11
Page 2 of 2