NCG140172_DMR_20210412

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NC6140000
CERTIFICATE OF COVERAGE NO. NCG14 U L Z— SAMPLE COLLECTION YEAR: t7 z I
FACILITY NAME: A $ -tr (o SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec []lan-March ❑April -June
PERSON COLLECTING S MPLES: Dr 1,J A lx� kik4%c COUNTY:
CERTIFIED LABORATORY: Xl ,,c /I L-g, J. Lab # 2 i r PHONE NO. (Z` fj
Lab R ADD TO LISTSERVE? ❑YES^ NO EMAIL:
LIMIT VIOLATIONS? YES ❑ NO ®--_ DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other
OPTIONAL INFO:
Part A: Wastewater Monitoring Requirements
Outfall No.
Date Sample
�
Collected
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD)z
pH
(standard)
Total Suspended
Solids
(mg/0
Settleable
Solids
(MLA)
TPH using
method 1664A
SGT-HEW
(mg/L)
Dlsiharge
Duration
(minutes)
Total Flow
(gallons/day)'
303,5
53
(15)r
-
A 'K
% 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.
` 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: 7/1/2030-06/30/2015 % Last Revised 07/13/11
Date of last pH meter calibration: l �a s=�62( 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 SO% of the Summer 7Q10 Flow as per 1SA
NCAC 028.02-24. 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 QNE COPY OF IHIS AbINUAL SUMMARY (INCLUDINGAL "NO FLOW". *#NO DISCHARGE")RECEIPT OF SAMPLE
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
[phone]
YOU 41USTSIGN THIS CERTIFICAnON 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."
of Permtteej
Permit Date: 7/i/2010-06/30/2015
V1-/? -vu
(Date)
Last Revised 07/13/11
Page 2 of 2