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PROCESS WASTEWATER — Quarterly Discharge Monitoring Report 0 Copy-State
GENERAL PERMIT NO. NCG140000 o Copy-Plant
0 Copy-File
1 QTR
CERTIFICATE OF COVERAGE NO. NCG14 0 4 1 9 SAMPLE COLLECTION YEAR: 2020
FACILITY NAME: Chandler Concrete Piedmont-WINSTON #118 SAMPLE QUARTER: VJan-March I !April-June Jul-Sept ! IOct-Dec
PERSON COLLECTING SAMPLES: SCALES4!o COUNTY: FORSYTH
CERTIFIED LABORATORY:Pace Analytical Lab#633 SAY 2020 PHONE NO. ( 336) 226-1181
CcN TRAL FILE;> ADD TO LISTSERVE? I DYES L<NO EMAIL:
LIMIT VIOLATIONS? YES ® NO I I DVJR s c C)C; DISCHARGING TO CLASS: ❑SA HQW ❑PNA ['Trout Other: WS-V NSW
OPTIONAL INFO:
Part A:Wastewater Monitoring Requirements
Non-Polar
Date Sample Total Suspended Settleable Oil&Grease Discharge
1 Type of Wastewater pH Total Flow
Outfall No. Collected Solids Solids using method Duration
(mm/dd/yr) (VE, RM, MD)- (standard) (gallons/day)'
(mg/L) (mL/L) 1664 SGT-HEM6 (minutes)
(mg/L)
•
6-93.4 303,5 53 (15)6 -
1 NO FLOW VE RM MD - - N/A NIA - N/A
No Discharge this Period -
'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 DEMLR 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.
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 DEMLR.If the permittee cannot obtain a Summer 7Q10 flow for the receiving waters at the
discharge location,the permittee shall notify DEMLR,and the DEMLR Regional Office may require an annual flow report on a case-by-case basis.
Permit Date:8/1/2017-06/30/2022 Last Revised 07/27/17
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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 Resources
Attn: DWR 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 subm ng false information,including the possibility of fines and imprisonment for knowing violations."
0?- 2.17/2-a
(Signature of Permittee) (Datk)
Permit Date:8/1/2017-06/30/2022 Last Revised 07/27/17
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