NCG140170_DMR_20220112 (2)

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVf RAGE NO. NCG14_0 I L 6 SAMPLE COLLECTION YEAR: z� /
FACILITY NAME: _ �rn� SAMPLE QUA TER: ❑Jul -Sept Oct -Dec ❑Jan -March ❑April -June
PERSON COLLECTING S MPLES: %7 5A-M pk COUNTY:
CERTIFIED LABORATORY: Lab # PHONE NO., _ T77S
Lab # ADD TO LISTSERVE7 ❑YES []NO EMAIL:
LIMIT VIOLATIONS? YES ❑ NO DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other
OPTIONAL INFO:
Part
IAI-.etea n.n RA­;+nA.g P.
Outfall No.
Date Sample
Collected
(mm/dd/yr)
Type of Wastewater
z
(VE, RM, MD)
pH
(standard)
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using
method 1664A
S (mg/L) 6
mB/U
Discharge
Duration
(minutes)
Total Flow
�
(gallons/day)
6-9 3,4
303.5
53
(15)6
-
scie
ES
ON
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.
' 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 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
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Date of last pH meter calibration:

Part a-- Whicip Maintenance Activitv Monitoring Requirements for facilities usine > SS eat of new motor oil/month — averaged over a calendar veer.
Outfall
No.
Date Sample
Collected
(mo/acted'
pH
(Standard
Units)
TPH using method
1664A SGT HEM
(mg/L)
Total Suspended
Solids
(mg/L)
Event
Duration
(minutes)
Total a
Rainfall
(in)
New Motor Oil
Usage
(gal/month)
!n Tier 2
Monthly
Monitoring?
(y/n)
# of Months
in Tier 2
2
Sampling
6-9
15
1002,3_
-
-
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDE CES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail Original and one copy of this DMR f including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample for 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:
"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 galber and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly resqgnsible for he inAe information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
am aware that there areftAnifl
(Signature of Pe
Permit Date: 7/1/2011-60/30/2015
tting false information, including the possibility of fines and imprisonment for knowing violations."
/2-
(Date)
Last Revised 7/13/11
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