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Part B: Vehicle Maintenance Activ!ty Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
Nan -Polar Total i
In Ter 2
pH Oil & Grease using Suspended TO�I a New Motor Oil Usage
Monthly # of Months in Ter 2
Outfal! Date Sample (Standard method 1664 Rainfall I month} I
Salldls (p /
Monitoring? Sampling2
No. Collected 1 Units) SGT HEM (in}
( }
(Y/n)
(ma/dd/Yr) (mg/0
6-92 152 1002,3
EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)?
YES ❑ NO
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copy of this DMR(including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sam
le or at end of monitoring Period in
case of "No Flow") to:
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center j
Raleigh, North Carolina 27699-1617 i
YOU MUST SIGN THIS CERTIFIC477ON 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 aWignificant pens 'esjor submitting false information, including the possibility of fines and imprison ; enj for knowing violations."
Of
Permit Date: 8/1/2017-6/30/2022
-A-a4
(Date)
Last Revised 07/27/17
Page 2 of 2
C � �
PROCESS WASTEWATER — Semi -Annual Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 0 0 3
FACILITY NAME: 1011.1.
SAMPLE COLLECTOR:
CERTIFIED LABORATORY: Lab #
Lim VIOLATIONS? YES ❑ NO Lab #
Part A: Wastewater
Qutfall No.
Requirements
SAMPLE COLLECTION YEAR:
SAMPLE PERIOD: July -December January June
COUNTY: kq V
PHONE NO.: (7d5F} —
ADD TO LISTSERVE? ❑YES ❑NO . EMAIL
DISCHARGING TO CLASS: ❑SA ❑HQW/ ❑PNA [--]Trout ®Other
OPTIONAL INFO:
Date Sample .
1
collected'. .-
Type. of Wastewater
..:..
P H .
Total Suspended
Settleable
.. ,
Hon -Polar.
Oil &Grease
-
Discharge
(mm/dd/yr)
(VE, RM,
(standard
Solids
Solids.
using method
Duration.
(m1A)
1664 SGT HE&f
( /U
(minutes}
-
_
6-93,4
303-s
53
(15)rl
-
C
Total Flow
(gallons/day)'
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 DEMLR RO staff notifies you to continue monitoring.
a pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
Permit Date: 8/1/2017-06/30/2022
Last Revised 07/27/17
Page 1 of 2
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