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PROCESS WASTEWATER — Semi Annual Discharge Monitoring Report
ort
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 0 0 3 a
FACILITY NAME: hotm&O, Otom.l.. AA . a—J
SAMPLE COLLECTOR: K v (t lnlu - -
CERTIFIED LABORATORY: _ Lab #
UMRVIOLATIONS? YES ❑ NO Lab #
Part A: Wastewater Monitoring Requirements
Date Sample Non -Polar
1 Type of Wastewater H Total Suspended. Settleable Oil &Grease Discharge
Outfali No. Collected P
(mm/dd/yr) N� RM, MD)2 (standard) Solids Solids using method Duration Tots! Plow 7
( /L) (mLA) 16RSGT HEV (minutes) (gallons/day)
6_93,4 30" 53 (mg/L)
41 Ai
O r0
If wastewater systems have not discharged in this quarter — r �►
SAMPLE COLLECTION YEAR:
SAMPLE PERIOD: uly-DecemberWanuary-June
COUNTY:
PHONE NO.: (7} — G
ADD TO LISTSERVE? ❑YES ❑NO EMAIL•
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ®Other_ C.
OPTIONAL INFO:
1
2 epart 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 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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