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PRRECEIVED
OCESS WASTEWATER Quarterly/ ®oscharp MonitOrong Report
GENERAL PERMIT N®. Nr-G14®®®0 JUL 2 5 2022
GEt i"F�,�L.FILS
y Z2 MAIR SECTibN
CERTIFICATE OF COVERAGE NO. NCG14 d 1 ' 0: SAMPLE COLLECTION YEAR:
FACILITY NAME:' r a d`'tr SAM AR -Sept QOct c QJan-M 21April-June
PLE: QU TER [Jul Oe arch
- - COUNTY: � �
PERSON COLLECTING AiVIPLES: '► — - -
CERTIFIED LABORATORY: Lab #
PRONE NO. (134i_) '4'5' 95�'S'
Lab # ADD TO LISTSERVE? YES [�NO EMAIL:
LIMITVIOLATIONS? YES _❑ INO -- �! DISCHARGING TO CLASS: E]SA ❑ .QW OPNA prr®ut .DO �,er
OPTIONAL INFO:
'art A. wastewater wiomtonng ne.quirements
' Date Sample
Type af.Wastewater
p. H
To
Total: Suspended
..:
Settleable
TPH usi'»�
method1664A
Discharge
- -
Total Flow
Outfall No.
Collected
x
(VE,:RM, MD)-
(standard)
Solids
Solids
SOT.--HENJ6
Duration
(mm/dd/yr):
(mg/L)
(mL/L)
{mg/L) .
(minutes)
.(gallons%day)
If wastewater systems have not discharged in this quarter-: report"No Flow" or "Nq 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 (RNi),.Mixing Drum
Cleanout (MD). Report moire than one type if the Waste -stream is commingled.'
31f an effluent.limit is exceeded twice in a rpw, the permit fee 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 6.5-8.5 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 Re_ wised 07/13/11
Page 1 of 2
Date of last pH meter. calibration:.
s Process wastewater discharges shall only be monitored for TPH when commingled with stormwater'discharges from VMA areas. TRH 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 beset to 50% of the Summer 7Q10 Flow as per 15A
NCAC 00.0224. 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 Sumrrier 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- -
P.... y-case asis...
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW- "NO DISCHARGE") 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
(919) 807-6379
YQU MUST SIGN THIS CERTIFICATION FOR ANY INEORMATION REPORTED
I certify, under penalty ofaaw; 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 inform ation.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. a am aware hat there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing
violations. -
Ova, of Permittee)
(Date)
Permit Date: 7/1/2010-06/30/2015 Last Revised:0i/13[11
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