HomeMy WebLinkAboutNCG140253_MONITORING INFO_20150323STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT N0.
DOC TYPE
❑HISTORICAL FILE
�'MONITORING REPORTS
DOC DATE
� ab� 5 0 3 a 3
YYYVMMDD
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 D
2
SAMPLE COLLECTION YEAR:
FACILITY NAME: ��GL �G 3
l Ui%
znr,�jnJ SAMPLE QUARTER: ❑Jul -Sept
Oct -Dec ❑Jan -March ❑April -June
PERSON COLLECTING SAMPLES: %/�j /oS�
..!
COUNTY:
PHONE NO. qJ/11 %G
CERTIFIED LABORATORY:
_
Lab #
ADD TO LISTSERVE? []YES❑NO EMAIL: j
Lab #- :.
LIMIT VIOLATIONS? YES ❑ NO L4
DISCHARGING TO CLASS: ❑SA
❑HQW - ❑PNA ❑Trout ❑Other 5 S �/
OPTIONAL INFO:
I
.
Part A: Wastewater Monitoring Requirements
F
D, .. No.
Rate Sampie
1
-Collected
(mm/dd/Yr}
; ;
Type of Wastewater
:.; _ ,
°
pH
total Sus fended = .
t 1?
L Solids
._Settleable
g -
5ands
PH trsrng
- =.
method Ib64A
R = c -
HENIG
ti
Dtsdiarge f
F
17uration
- TotaLFlow
_(gallons/day)„
.q'•�
1V
Map
j
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.
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.
a pH limits are 5-9 S.U. for wastewater discharges to freshwaters, and 6.9-8.5 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 bate; 7/1/2010-06/30/2015; . I 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 :D224. Permittee�3.vho'discharge"wastewater to HQW waters shall•obtain a Summet,7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summmer.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.
i
f
MAIL ORIGINAL AND ONE COPY OFTHIS ANNUAL SUMMARY ONCLU
AT END OFMONITORIN&PERIOD IN CASE OF "NO FLEW"] TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North -Carolina 27699-1617
(919) 807-6379 1
E") WITHIN 30 DA'
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: 1
"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 end 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."
{Signature of Permitteef
Permit Date- 7/1/2010-06/30/2015,
3 i -7
(Date)
Last'Revised 07/13/11
D1ge 2 of 2
i
j
PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
i
CERTIFICATE OF COVERAGE NO. NCG14 69 SAMPLE COLLECTION YEAR:
FACILITY NAME: 3 ^ l 411 SAMPLE QUARTER: []Jul -Sept IROct-Dec Dan -March
PERSON COLLECTING SAMPLES: , 1A dSCOUNTY: /UGr i ,cti�
CERTIFIED LABORATORY: Lab # PHONE NO. q1 7G ... �7/ X,
-. Lab # ; .. ADD TO LISTSERVE? ❑YES ONO EMAIL:
LIMIT VIOLATIONS? YES ❑ NO DISCHARGING TO CLASS: QSA QHQW ❑PNA QTrout Q(ither SG -Vc&/
OPTIONAL INFO:
Part A: Wastewater Monitoring Requirements
]April -June
.
Date Sample
i E
mm
r ,_' -
TYPe,of Wastewater
MDjz
{ pH•'
rd).
Natal Suspended
1
�Smobplif�dOutfall
W'
*Settleable;
TPH
_ ;? T
method 1i564A' ''�
rDtscharge F
�tl
—
Tatal Flow �_
-
ga I;lo ny�)r
F
.'_£_'� _3"':..
� F :-€.�i-r iE'::
_ i�1G .fir �` -
--_3r
_L- � !_� .Ir,
�.�:—'•�.,�
_�- _
f
r
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.
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.
4 pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-B.5 S.U. for discharges to saltwaters..
s TSS lim' its are 20 mg/L for wastewater discharges to HQW waters, 10 mg/Cfor Trout and PNA waters, and 30 mg/Lfor all other v,iater classifications. '
Permit bate: 7/1J2010-05/30/2015, Last Revised 07/13/11 `
Page 1 of 2
i
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 contin6ously or calculated. Flow limits for wastewater discharges to HQW waters shalt be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 028.0224. Permittee3 who discharge wast6 ate to HQW waters shall obtain a Summed aQ10 flow and report this information to DWQ. Ifthe 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. '
i
MAIL ORIGINAL AND ONE COPY:OF.THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW', "NO DISCHp
AT END OF MONITORING IPERICiD 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'qualihed 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 f.or 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.fnes and -imprisonment for knowing
violations. ;
i
(Signature of Permittee) (Date)
Permit Date: 7/1/2010-06/30/2015. Last:Revised 07/13/11
.D�ge 2 of 2
PROCESS WASTEWATER — Quarterly Discharge Monitoring:Report
GENERAL PERMIT NO. NCG140000
I
CERTIFICATE OF COVERAGE NO. NCG14 0 3 -5- 3
FACILITY NAME:
PERSON COLLECTING SAMPLES:
CERTIFIED LABORATORY: _ _ Lab # -
Lab #
LIMIT VIOLATIONS? YES ❑ NO []
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR:G J y
SAMPLE QUARTER: NJul-Sept ❑Oct=Dec ❑Jan -March ❑April -June
COUNTY:
PHONE NO. /u 7e, Z Ci 1j
ADD TO LISTSERVE? ❑YES ❑NO EMAIL: I
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PN A ❑Trout ❑Other_ Sc
OPTIONAL INFO:
autfall No.
p
1
Collected°
(mm/ddJyr)
-..�<<TP
Type of Wastewater
-- z_ E F
(VE, RM MD}
_
;£ ,plit
G
(standard}
7ata15uspended
°� ° Solids
{mg/L) :
Settleable
a
;Solids
a;y
(mL/Lf_
H sing .:.i
,method 1664A
.=.---
SGTNFlVf.x
= ;:,
Discharge F
,_
Duration a
s {_(gallons/day)
[mmutesy 1
,
Total -Flow
_
I
1
•
1
I
I
l
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 i uarter 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'effiuent 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/Lfor all other water classifications.
Permit Date: 7/1/2010-06/30/2015, Last Revised 07/13/11
Page 1 of 2
i
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.
r Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall beset to 50% of the Summer 70110 Flow as per 15A
NCAC 02B .0224. Permitteeg who discharge�wastd% at& to HQW waters shall•obtain a Summe?WQ10 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.
-
AT END OF MONITORING PERIOD lh
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
.Raleigh, North -Carolina 27699-1617
(919) 807-6379
m
{NCLU
m
OR
YOU MUST SIGN THIS CERTIFIG4TION 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'qualifecl 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 gatheringthe 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. . i;.=.
(Signature of Permittee) (Date)
i
. i
Permit Date: 7/1/2010-06/30/2015 Last:Revised 07/13/11
p-age 2 of 2
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PROCESS WASTEWATER — Quarterly Discharge- Monitoring Repbrt
GENERAL PERMIT.NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 0 3
FACILITY NAME: �� CC' _ ,�G ���f GCJ r ;
PERSON COLLECTING SAMPLES:
CERTIFIED LABORATORY: Lab #
' Lab �#
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR:
SAMPLE QUARTER: [Jul -Sept []Oct -Dec ❑j Jan -March ❑April -June
COUNTY:
PHONE NO. I u ^ %G 22 J j
ADD TO LISTSERVE? [_]YES ❑NO EMAIL: -' !
DISCHARGING TO CLASS: []SA ❑HQW'' ❑PN A ❑Trout ❑Other SC SuJ
OPTIONAL INFO:
Outfall No.
:.
Date Sam le
P
Cone ctedl `
:, ..'s��.:;_.....
(mm/cld/yr}
- a
7 "e.of Wastewater.-
Yp
z -
: -
{VE, RM, MD} L.
_ZT o
�`
_�. Hmethod
T yPri��-:
[standard] -
S.r
F__,
k =,. r
Total"suspended
wSoEids
- Y f {.
[mg/Lj
3.t3 �f - x
£Settleable
`Solidsr:-=' }.
- :-
(mL/Lj
_-`�TPli
_ <�9 !
1664A
_ - - -
.:'
SG7' HFN1�
t /-
"� r _
_Discharge
' Uaration I
(minutes)
Total_Flow,
c - i-
allons da
/ y)
-'�-
{
I
7F#
i
I
I
I
3
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.
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 6.8-85 S.U. for discharges to saltwaters..
s TSS Jimits are 20 mg/L for wastewater discharges to H W waters, 10 mg/t for Trout and PNA waters, and 30 mg/L for all other water classifi I ations.
Permit Date: 7/1/2010-06/30/2015, I Last Revised 07/13/11
Page 1 of 2
i
I
a 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. Permittee�-who'dischargewastewate.r to HQW waters shall obtain a 5umme?,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 inay require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPYOF.THIS ANNUAL SUMMARY INCLUDING ALL "NO FLOW" "NO DISCHARGE" VI
AT END OF- MONITORING, PER1011 IN CASE OF "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North -Carolina 27699-1617
(919) 907-6379
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under Penalty of taw, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure thatqualified personnel properly gather and evaluate the information submitted. Based on my in of the person or persons whIu manage the system, or
those persons directly responsible;�for gathering the information, the information submitted is, to the best of my knowiledge and belief, true, accurate, and
complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonm# nt for knowing
violations." i
(Signature of Permittee)
(Date)
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
l �'ge 2 of 2
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P.RQCESS WASTEWATER— Quarterly Discharge Monitoring'Reptirt
GENERAL PERMIT NO. NCG140000
3
CERTIFICATE OF COVERAGE NO. NCG14 0_2
FACILITY NAME: ,49%h GL 116 3 Gcl1 m; nJ
PERSON COLLECTING SAMPLES:
CERTIFIED LABORATORY: Lab #
Lab #
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitorine Requirements
SAMPLE COLLECTION YEAR: U
SAMPLE QUARTER: ❑Jul -Sept ❑Oct=Dec ❑I Jan -March April -tune
COUNTY: LiiGr,://�fi✓av�-Y
PHONE NO.
ADD TO LISTSERVE? ❑YES ❑NO EMAIL: I
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PN A ❑Trout ❑Other SG Si.-
OPTIONAL INFO:
..
Outfall No.
._ =
Date Sample
Collected
[min/dd%yr)�(minutes)
p-
-
of Wastewater
= v z
RM;
_k
�� pH
_ t - �_.,
Total Suspended
__ -
Solids
Settleable t
_
Solids
TPH
,
rtiefhod�166�IA:
,-'
Discharge
Duratron
= To#all low:
_ ,_
ok
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.
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.
31f an effluent limit is exceeded twice in a row, the perrnittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
a p1� 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 fo 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 contimiously 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. Permitteeg who 'discharge wastewater to HQW waters shall obtain a Summe? WQ10 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.
j
I
MAIL ORIGINAL AND ONE COPY.OF.THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE" WITHIN 30 DAYS! OF
AT END OF MONITORING,PERIOD 1N CASE OF "NO FLOW" TO: I
Division afWater Quality
Attn: DWQ Central Files li
1617 Mail Service Center
.Raleigh, North -Carolina 27699-1617
(919) 807-6379 -
is
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 thatiqualihed 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 responsiblefor gathering the information, the information submitted is' to the best of my knowledge and belief, true, accurate, and
complete. 1 am aware that there are significant penalties for submitting false information, including the possibility of.fines and.imprisonment for knowing
violations.'`
(Signature of Pe mittee) :' � (Date)
Permit. Date: 7/1/2010-06/30/2015,
y
OR
Last;Revlsed 07/13/11
p,lge2of2
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PROCESS WASTEWATER — Quarterly Discharge Monitoring:Repbrt
GENERA. PERMIT No. NCG140000
^ - i
CERTIFICATE OF COVERAGE NO• NCG14 O-,l
FACILITY NAME: l-21h e& 116 3
PERSON COLLECTING SAMPLES:
CERTIFIED LABORATORY: Lab #
— =Lab #
LIMIT VIOLATIONS? YES ❑ NO ..
Part A: Wastewater Monitoring Reauirements
SAMPLE COLLECTION YEAR: G `�
SAMPLE QUARTER: []Jul' -Sept ❑Oct -Dec ❑Jan -March: April -June
COUNTY: /lic-rt/ t/l��✓�-v�,� f
PHONE NO. 5io
ADD TO LISTSERVE? OYES ❑NO EMAIL -
DISCHARGING TO CLASS: ❑SA []HOW ❑PN A ❑Trout ❑Other SG Sc.�
OPTIONAL INFO-
=
Qutfall.I+lo.
Date Sam le
P1 �4
Collected _
= _
mm/dd% r
_.-�
TYpe,af Wastewater
'? ` x
(UE, RM,.MD]
b
y,.s
- { pH
:-� =
=(standard] ,=
Tatal Suspended
b' SolrtlsF,s
{� - ti
(mg/Ll
5ettleab[e
f
6 TP
SGT_-HFNl�
Drsch"arge
k
- u
(rn�nutes]
LLTatal Flaw '
:1(ga]Ions�tla ]s`
- y
_ 1
c
— _
a� 4 %�_
_
4e_tl��b I.
_.
Y #
_
�z C
I
I
.4441
i
I
.
'
I
I
€
' If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sarriple 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.
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.
a pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 5.8-8.5 S.U. for discharges to saltwaters.
s TSS lirinits are 20 mg/L for wastewater ds�rharges to HQW waters,10 mg/Cfor Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2415 !` Last Revised 07/13/11
�! Page 1 of 2
i
i
I -
e Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a IRnit for wastewater,
but instead is subject to berichmarks and provisions of Part IV, Section A, including the Tiered Response Action.
' Flow rate can be measured continuously or calculated. Plow limits for uvasfewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 0213.0224. Perm itte8 who* discharge -wastewater to HQW waters shali•obtain a Summer' �Q10 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 [nay require an annual flow
report on a case -by -case basis.
s
f
MAIL ORIGINAL AND ONE COPY�OF.THIS ANNUALSUMn
AT END OF MONITORING '.PERIOD IN CASE OF "NO FLO"
Division of. -Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
.Raleigh, North -Carolina 27699-1617
(919) 807-6379
L
I PT: O
I
YOU MUST SIGN TH15 cERTmc4T16N FOR ANYINFORMATION REPORTED: I
"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!qualifed personnel properly gather and evaluat 'the information submitted. Based on my inquiry of the person or persons who manage the system, or
those' persons directly responsible far gathering the information, the information submitted is, to the best of my knowledge end belief, true, accurate, and
comp iete. I am aware that there are significant penalties for submitting false information, including the possibility of.fines and imprisonment for knowing
violations." : r.:
(Signature of Permittee)
(Date)
Permit. Date: 7/1/2010-06/30/2015. LasfRevised 07/13/11
I ange 2 of 2
i
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PROCESS WASTEWATER — Quarterly Discharge Monitoring -Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 D 2 S 3
FACILITY NAME: if/77e G. ' Zre 3 L/ / ;%._.s 7�J %✓
PERSON COLLECTING SAMPLES: `L c
CERTIFIED LABORATORY: Lab #
Lab #
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: 20_/ y
SAMPLE QUARTER: ❑!ul-Sept ❑Oct -Dec RJan-March ❑April -tune
COUNTY: /(l'W y
PHONE NO. 97 0 71
ADD TO LISTSERVE? ]YES ❑NO EMAIL: 'e'" , cv
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout []Other S�_v✓
OPTIONAL INFO:
I
•,
OiitfaII No.
-.:
1
Collected
_ -
[rnm/dd/yr}
_
Type of Wastewater
-=� ' z-
,[VE �
; r
v Y
pN _�
{standard]
iTotal Sus ended
� _ p
y ySolitls-:
(mg/L) ; _
5' ;
ettleable
•- i :
_Solid
-
(mL/L}_
r TPH using .
f `_
method 1664A'
Discharge
[mmutesj
,
Tatal Flow
_
F_
i
i
I
I
I
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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 6-4 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, I 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 l tered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for Wastewater discharges to HOW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B -.0224. Permittees who`discharge^waste water to HQW waters shall -obtain a Summer' 7Q10 flow and report this information to DWQ. If the permittee dannot
obtain a Summer7Q10 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 acase-by-case basis.
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
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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 thatiqualiFied 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 jor 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.
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(Signature of Permittee) (Date)
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Permit, Date: 7/112010-06/30/2015. Last'Revised 07/13/11
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