NCG140215_DMR_20210301

STORM.WATER,,`DISCHA'R.GEOUTFALL (SDO)---Semi-Annual•MONITORING,FORM
GENERAL PERMIT NO. WG140000
CERTIFICATE OF COVERAGE NO. NCG14_t,2� L S
FACILITY NAME: AIXRAg
PERSON COLLECTING SAMPLES Z>914}/ % 5;?A� Luy
CERTIFIED LABORATORY i�ez A,a+ t4t L',eal Lab # 4,33
Lab #
OPTIONAL INFO: ..
Part A: Stormwater Monitorine Renuirementc
SAMPLE COLLECTION YEAR: C]pa
SAMPLING PERIO.D1- Juy-December _ ❑January -June
COUNTY (rjV
PHONE NO. (33b) rj�?S`` riS 7s
ADD TO LISTSERVEZLJYES []NO EMAIL:
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other
Outfall No.
. Date Sample
Collected
- (mo/dd/yr OR
NO FLOW)'
_
PH
(Standard -.
Units)
TSS
(mg/L )
Event
Duration
-
(minutes)
::Total°'
- Rainfall!
(in(
InTer2 ,
Monthly
?.
Monitoring? -
g•
(y/n):-_..
- -
# of Months in Tier
- .z
25ampling
A
CF
/
W�1 ter, Fr
If "NO FLOW" or "NO DISCHARGE. Enter "Nn FI nW" er ^un
nmrueoar•• f... ..__.
- - - -- -- - -- -•--• •^••� vuau neie. Hudhe.maKe.sure to mark the sample period above.
z If a value is in excess of the benchmark, or outside the benchmark. range (for pH), you must implement the Tier.I or Tier 2 responses in the General Permit. ter 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range. _ 3 TSS benchmark values are 100 mg/l, except when discharging to ORW, HQW,.Trout, and PNA waters where they are 50 mg/l.
' For each sampled measurable- :storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date:7/1/2011-60/30/2015
Last Revised 7/13/11
Page 1 of 2

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HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY -ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES Ej NOW
rr
HAVE YOU CONTACTED THE REGION? YES- F] NO F1
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copy of this DIVIR (including all "No Flow" & "No Discharge" reports) within 30 days of *receipt of sample (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
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
N certify, under penalty of law.- that this document and all attachments were prepared under my-directio* n-orsupervision 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 managei'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 significap"enalties for submitting false information, including the possibility -of fines-and imprisonment for knowing -violations."
(Signature of Permittee) (Date)
Permit Date: 7/1/2011-60/90/2015 Last Revised 7/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE �N�O�. NCG14 O -2 ,1 �
FACILITY NAME: IK/1a
PERSON COLLECTING SAMPLES: _LTI-r NA4 V pkv-/lrFjpv/ c
CERTIFIED LABORATORY:: P"Ce- .(y.ar,a (t A.I Lab # 633
LIMIT VIOLATIONS? YES I] NO [5d Lab #
Part A: Wastewater Monitoring Rpauirpmentc
SAMPLE COLLECTION YEAR:— 6-R wz-Ci I
SAMPLE QUARTER: yjI�1-D-I'Jul-Sept VjOct-Dec QJan-March QApril-June
COUNTY: Gjo CVAle4
PHONE NO. (3 I., t/8S -�Ys rjs�
ADD TO LISTSERVE? AYES [:]NO EMAIL:
DISCHARGING TO CLASS: QSA ❑HQW QPNA QTrout QOther
OPTIONALINFO•
Outfall No.
t
Date Sample
Collected
(mm/dd/yr)
Type of Wastewater
(VE, RM, MD) z
PH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
m L
( y)
TPH using
method1664A
Ste. HEms
(mg/L)
Discharge
Duration
(minutes)
Total Flow
(gallons/day)
30a's
5;
S • I
a'• l
1tL b
�p
:,
t` R SUCT!
N
If wastewaters
stems hav dt
h d i
y e no sc arge n this quarter- report No Flow or No Discharge" here. Please make sure to mark the sample quarter above.
r Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Leaning (VE), Raw Material Stockpiles (RIv4f, 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: 7/1/2010-06/30/2015 "Last Revised 07/13/11
Page 1 of 2

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