NCG140176_DMR_20230103 (2)

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report RECEIVE[
GENERAL PERMIT NO. NCGI40000 JAN 9 5' 2021
gg ;;EN' I hfHi_ i"1L E:5
CERTIFICATE OF COVERAGE NO. NCG14 —L SAMPLE COLLECTION YEAR: O� 2 �' DWR SECTION
FACILITY NAME: 0 v 5 SAMPLE QUARTER: []Jul -Sept Mod -Dec []Jan -March []April -June
PERSON COLLECTING MPLES: COUNTY: U K C 0 k v,
CERTIFIED LABORATORY: 1292 r C Lab # PHONE NO. (2!2_9 400— O ,%-23
Lab # 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
3
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
SGT-HEV
(mg/L)
Discharge
Duration
(minutes)
Total Flow
�
(gallons/day)
-
-
-
6-93A
303,5
53
(15)6
3 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.
Z 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.
° 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: 7/112010-06/30/2015 Last Revised 07/13/11
p I� r> v —Lo L� Page 1 of 2
Date of last H meter calibration: J

1
e Process wastewater discharges shall only be monitored for TPH when commingled with stormuiater discharges from ViVIA.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 HOW waters shall be set to SO% of the Summer 7Q10 Flow as per 15A
NCAC 02B .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 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 acase-by-case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW" "NO DISCHARGE"1 WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CA_ S_ E OF "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOIJ iyfuST SlGAI TM15 CER77F1G4TlON 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, liellef, true, accurate, and
complete. I am awire that there are signlf 6c i penaltiesfor sabrnittin6`false Information, including the possibility of fines and imprisonment for knowing
violations." r
(Signatur f ermittee) (Date)
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/23/11
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