NC0020427_Pretreatment_20240212

Larry Cobler
Wastewater Plant Operations Director R O C K I N GHAM
A CITY LOOKING FORWARD
RECEIVED
FEB 12 2024
NDDEQ/DWR/NPDES
CITY OF ROCKINGHAM
ANNUAL PRETREATMENT
. PROGRAM REPORT
FOR 2023
200 Byrd Drive, Rockingham, NC 28379 . Phone [phone] . Fax [phone] .larry(o)gorockingham.com

Larry Cobler
Wastewater Plant Operations Director
NC Department of EQ
Division of Water Resources
PERCS Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
t0A KINGA1AM
A CITY LOOKINO FORWARO
ANNUAL PRETREATMENT REPORT FOR JANUARY 1, 2023 TO DECEMBER 31, 2023
SUMMARY
During this reporting period Trinity and TransCarolina were found to be in Significant
Non -Compliance.
Trinity was found to be in Significant Non -Compliance for failing to conduct any annual
metals sampling for 2023 as required by their Industrial User Permit.
TransCarolina was also found to be in Significant Non -Compliance for failing to conduct
any annual metals sampling for 2023 as required by their Industrial User Permit.
There were thirty two Notice of Violations issued to five industries in 2023. Perdue was
the only industry without any Notice of Violations for this reporting period.
The City of Rockingham continues to operate a fair and sound pretreatment program
for our industrial users as required by the State of North Carolina.
200 Byrd Drive. Rockingham, NC 28379 . Phone [phone] . Fax [phone] . [e-mail]

Larry Cobler Wastewater Plant Operations Director `0CKN,1 (( ..1 A YA
A CITY LOOK/NO FORWARD
CITY OF ROCKINGHAM
ANNUAL PRETREATMENT PROGRAM REPORT
REPORT DATE: February 6, 2024
PERIOD COVERED: January 1, 2023 to December 31, 2023
WASTEWATER TREATMENT PLANT NAME: City of Rockingham, WWTP
NPDES NUMBER: NCO020427
CONTACT PERSON FOR THIS REPORT: Larry D. Cobler
CONTACT PERSONS TITLE: Wastewater Plant Operations Director
MAILING ADDRESS: 514 Rockingham Road
Rockingham, NC 28379
TELEPHONE NUMBER: 1-910-895-9434
EMAIL ADDRESS:
I have personally examined the information in this report and based upon my inquiry of
those individuals for obtaining the information reported herein, believe that the
information is true and correct.
Respectfully submitted by,
Liarryboobler
Plant Operations Director
City of Rockingham, WWTP
200 Byrd Drive, Rockingham, NC 28379 , Phone [phone] . Fax [phone] [e-mail]

0�2
Larry Cobler
Wastewater Plant Operations Director R O C_. K! N G H A M
A C1TY LOOK/NO FORWARD
NC Department of EQ
Division of Water Resources
PERCS Unit
1617 Mail Services Center
Raleigh, NC 27699-1617
ANNUAL PRETREATMENT REPORT FOR January 1, 2023 TO December 31, 2023
NARRATIVES
Marcal Cordova LLC. had seven Notice of Violations this reporting period. Four of the
violations were for BOD and three were for TSS.
Cascades Molded Pulp had five Notice of Violations this reporting period. Four of the
violations were for pH and one was for BOD.
Trinity Manufacturing had one Notice of Violation and were in Significant Non -
Compliance. The violation was for pH and Trinity was found to be in Significant Non -
Compliance for failure to sample for metals for 2023.
Trans Carolina Products was found to be in Significant Non -Compliance for failure to
sample for metals for 2023.
Cascades Tissue Group had five Notice of Violations this reporting period. All five
violations were for BOD.
Perdue has met all requirements for this reporting period.
200 Byrd Drive, Rockingham. NC 28379 *Phone [phone] *Fax [phone] [e-mail]

m
Wastewater rPlant Operations Director R O C K I N 'G H A � y /� �
A CITY LOOKING FORWARD
Pretreatment Section
NC Dept. of NRCD/DWQ
1617 Mail Service Center
Raleigh, NC 27699-1617
ANNUAL PRETREATMENT REPORT FOR JANUARY 1, 2023 TO DECEMBER 31, 2023
WASTE REDUCTION ACTIVITIES
City Of Rockingham, WWTP hauls our dewatered sludge to the Anson County landfill
for disposal.
Marcal Cordova LLC. participates in the following waste reduction activities: W13,
W51.
Trinity Manufacturing participates in the following waste reduction activities: W13,
W23, W24, W32, W34, W41.
Trans Carolina participates in the following waste reduction activities: W13, W23,
W241 W32, W34, W41.
Cascades Tissue Group participates in the following waste reduction activities: W13,
W141 W21, W23, W24, W25, W311 W32, W33, W34, W361 W51.
Cascades Molded Pulp participates in the following waste reduction activities: W13,
W14, W21, W23, W24, W31, W33, W36.
Perdue participates in the following waste reduction activities: W21, W22, W23, W24,
W25, W31, W32, W36.
200 Byrd Drive, Rockingham, NC 28379 . Phone [phone] . Fax [phone] [e-mail]

Larry Cobler
Wastewater Plant Operations Director I t o (-. K 1? '+iy �(-, , f 1 A I V
A ClT LOOK/NO FORWARD
NC Department of EQ
Division of Water Resources
PERCS Unit
1617 Mail Services Center
Raleigh, NC 27699-1617
ANNUAL PRETREATMENT REPORT FOR JANUARY 1, 2023 TO December 31, 2023
WASTEWATER RECEIVED FROM OUTSIDE SOURCES
SOURCE: TOWN OF ELLERBE, NC
Jan. 2023
2.301 MGD
Feb. 2023
2.749 MGD
Mar. 2023
2.513 MGD
Apr. 2023
2.801 MGD
May 2023
1.988 MGD
Jun. 2023
1.511 MGD
Jul, 2023
1.707 MGD
Aug. 2023
1.901 MGD
Sep. 2023
1.939 MGD
Oct. 2023
1.748 MGD
Nov. 2023
1.625 MGD
Dec. 2023
2.777 MGD
TOTAL: 25.560 MGD
200 Byrd Drive, Rockingham, NC 28379 . Phone [phone] . Fax [phone] . [e-mail]

Larry Cobler Wastewater Plant Operations Director R o C �n
K I N G H A I V i
.. _MaTUAWWO
W
A CITY LOOKING FORWARD
CITY OF ROCKINGHAM
ANNUAL PRETREATMENT REPORT
NC Department of EQ
Division of Water Resources
PERCS Unit
1617 Mail Services Center
Raleigh, NC 27699-1617
Dental Facilities
The City of Rockingham has six dental facilities on its sewer system and all six
have installed Amalgam Separators. The six dental facilities are in compliance.
200 Byrd Drive. Rockingham, NC 28379 . Phone [phone] . Fax [phone] [e-mail]

Larry Cobler
Wastewater Plant Operations Director
A GiT'Y LOOKING fORWARZ)
January 23, 2024
Mr. Todd Barnes, Plant Mgr.
TransCarolina
PO Box 1519
Hamlet, NC 28345
Subject: VIOLATION OF INDUSTRIAL USER PERMIT #0014
SELF -MONITORING VIOLATION
SIGNIFICANT NON-COMPLIANCE
Dear Mr. Todd Barnes,
This letter is to serve as a NOTICE OF VIOLATION for failure to complete a
portion of your Industrial Self -Monitoring for 2023. TransCarolina failed to conduct
annual metals sampling for 2023 as required by your Industrial User Permit and
therefore is in Significant Non -Compliance.
In the future the City would advise that TransCarolina make the necessary
changes to insure that all parts of your self -monitoring requirements are met. Failure to
comply with Industrial User Permit may result in enforcement actions taken by the City
of Rockingham.
If you have any questions regarding this notice, feel free to contact me at
910-895-9434. Thank you
Z'Jazi'i
Larry DtCobler
Plant Operations Director
City of Rockingham, WWTP
200 Byrd Drive. Rockingham, NC 28379 - Phone [phone] . Fax [phone] . [e-mail]

�_*W4
. iy.VIwI
Larry Cobler [� r�
Wastewater Plant Operations Director R O CK I I d G 1L
� t1
A CITY LOOK/NO FORWARO
January 23, 2024
Mr. Todd Barnes, Plant Mgr.
Trinity Manufacturing
PO Box 1519
Hamlet, NC 28345
Subject: VIOLATION OF INDUSTRIAL USER PERMIT #0009
SELF -MONITORING VIOLATION
SIGNIFICANT NON-COMPLIANCE
Dear Mr. Todd Barnes,
This letter is to serve as a NOTICE OF VIOLATION for failure to complete a
portion of your Industrial Self -Monitoring for 2023. Trinity Manufacturing failed to
conduct annual metals sampling for 2023 as required by your Industrial User Permit and
therefore is in Significant Non -Compliance.
In the future the City would advise that Trinity Manufacturing make the necessary
changes to insure that all parts of your self -monitoring requirements are met. Failure to
comply with Industrial User Permit may result in enforcement actions taken by the City
of Rockingham.
If you have any questions regarding this notice, feel free to contact me at
910-895-9434. Thank you
Since ly,
n" - 10 - ro(�dj
rry . Cobler
Plant Operations Director
City of Rockingham, WWTP
200 Byrd Drive, Rockingham, NC 28379 . Phone [phone] . Fax [phone] . [e-mail]

PUBLIC NOTICE
CITY OF ROCKINGHAM
514 ROCKINGHAM ROAD
ROCKINGHAM, NC 28379
In accordance with State and Federal requirements, the City of Rockingham, NC hereby
gives notice that the following industries were found to be in Significant -
Noncompliance with the City of Rockingham's Industrial Pretreatment Program for the
calendar year of 2023:
TRANSCAROLINA
TransCarolina failed to complete their Industrial Self -Monitoring sampling requirements
for 2023 placing them in Significant -Noncompliance for the year
TRINITY
Trinity Manufa4uring failed to complete their Industrial Self -Monitoring sampling
requirements for 2023 placing them in Significant -Noncompliance for the year.
Monty R. Crump, City
City of Rockingham
January 23, 2023

AFFP
PUBLIC NOTICE CITY OF ROCKINGH
Affidavit of Publication
STATE OF NORTH SS
CAROLINA }
COUNTY OF RICHMOND }
Christine Johnson, being duly sworn, says:
PUBLIC NOTICE
CITY Or ROCKINGHAM
514 ROCKINGHAM ROAD
ROCKINGHAM, NC 28379
In accordance with State and Federal requirements, the City of Rockingham, NC
hereby gives notice that the following industries were found to be in S.grificant-
Noncompliance with the City of Rock.ngham's Industrial Pretreatment Program fcu
the calendar year of 2023.
That she is Legal Advertising Representative of the The
Richmond County Daily Journal, a daily newspaper of TRANSCAROLINA
general circulation, printed and published in Rockingham, TransCarolina failed to complete their Industrial self -Monitoring sampling
Richmond County, North Carolina; that the publication, a requirements for 2023 placing them in significant -Noncompliance for the year
copy of which is attached hereto, was published in the
January 24, 2024
That said newspaper was regularly issued and circulated
on those dates.
SIGNED:
Legal Advertisidg Representative
TRINITY
Trinity Manufacturing failed to complete their Industrial Self -Monitoring sampling
requirements for 2023 planing them in Significant -Noncompliance for the year.
Monty R. Crump, City Manager
City of Rockingl,,am
January 23, 2024
Subscribed to and sworn to me this 24th day of January
2024.
P�� .....• `SO�`''ti
tJOTAAy
Amy Johnson, Notary Public,'Rfchmond County, North i
Carolina
My commission expires: July 29, 2024 " Nn • j0U$L�C' 2U
Go
20034508 01147861 910-997-6617
201-City of Rockingham
514 Rockingham Road
ROCKINGHAM, NC 28379

Pretreatment Annual Report (PAR)
Significant Non -Compliance Report (SNCR)
PAR covers this calendar year => a o a 3
Control Authority=Program=Town Name
WWTP = Wastewater Treatment Plant, use separate form for each WWTP.
SIU = Significant Industrial User
SNC = Significant Non -Compliance
WWTP Name
NPDES #
_>
_> N� c�vao�a
A SNCR Form must be submitted with every PAR, please write "None " if you had No SIUs in SNC during calendar year
IUP
#
Pipe
#
Industry Name
Parameter
or "Reporting"
SNC' ( Yes / No )
for each 6-m nth period.
Jan. - June
July - Dec.
©©©g
loo r
'72r,`,,,=�
r �`
Yes
,e
0 �(
003
q l �`
z ot*+f;
eS
Yes
Attach a copy or me Division s Nius in SNC: Historical Report" for your POTW's SIUs behind this page .
Is the database correct ? Notify the Division of any errors ! Database indicates SNC history for previous years.
EVERY SNC MUST be explained in the Narrative, How was, is, or will it be resolved?
REPEAT SNCs are serious matters that MUST be explained in the Narrative.
Form name: PAR,SNCR,2001
Date Revised: 1/4/2001

Chapter 9, PAR Guidance
Pretreatment Performance Summary (PPS)
1. Pretreatment Town Name: r-,�'
2. "Primary" NPDES Number NC00 �<f
or Non -Discharge Permit # if applicable =>
3.
PAR Begin Date, please enter 01 /01 /yyyy
3. => (')jZQ41AqA3
4.
PAR End Date, please enter 12/31/yyyy
4. =>) a
5.
Total number of SIUs, includes CIUs
5. =>
6.
Number of CIUs
6. =>
7.
Number of SIUs with no IUP, or with an expired IUP
7. =>�_
8.
Number of SIUs not inspected by POTW .
8. =>
9.
Number of SIUs not sampled by POTW
9. =>
to.
Number of SIUs in SNC due to IUP Limit violations
10. =>
n.
Number of SIUs in SNC due to Reporting violations
11. =>�_
12.
Number of SIUs in SNC due to violation of a Compliance Schedule, CO, AO or similar
12. =>
13.
Number of CIUs in SNC
13. => _ 0
14.
Number of SIUs included in Public Notice
14. => Q�
15
Total number of SIUs on a compliance schedule, CO, AO or similar
15. => 0-
16.
Number ofNOVs, NNCs or similar assesed to SIUs
16. =>
17.
Number of Civil Penalties assessed to SIUs
17. =>_�
18.
Number of Criminal Penalties assessed to SIUs
18. =>0
19.
Total Amount of Civil Penalties Collected 19. =>
$
20.
Number of IUs from which penalties collected
20. =>
Votes:
AO Administrative Order IUP Industrial User Pretreatment Permit POTW
CTU Categorical Lidustrial User NNC Notice of Mon -Compliance SIU
Publicly Owned Treatment Works
Significant Industrial User
CO Consent Order NOV Notice of Violation SNC
Significant Non -Compliance
IU Industrial User PAR Pretreatment Annual Report
revised 1/2018: PAR-PPS-20 18

Pretreatment Program Info Database
printed on: 12/22/2023
for Program Name Rockingham
WWTP Name City of Rockingham
Program Approval Date 07/01/1983
Pretreatment Status Full
Region FRO
County Richmond
NPDES N b
um er NC0020427
NPDES Effective Date 11/01/2020
Last PAR Rec 01/30J2023
PAR Due Date 03/01/2024
mercury
1631
NPDES Expire Date
P� 02/28/2025
Current Fiscal 08/18/2021
required
Year PCI Done
POTW is Primary WWTP TRUE
Last Audit on 06/13/2019
Audit Year NeA23/24
yes
Design Flow mgd 9.0000 % Design mgd is SIU permitted
26.33
Permitted SIU flow (mgd) [Pt_SIU) 37
WWTP SIU's Program SIUs
WWTP CIU's 1 Program CIUs
HWA LTMP
IWS SUO
ERP
date Inactive Date Next Due
Date Received by DWR
03/22/2021 08/29/2011
06/11/2019 09/19/2012
09/19/2012
Date Approved
08/31/2011
08/30/2019 10/08/2012
10/08/2012
Adopt Date Required
Date Adopted
09/11/2012
Info in this Box from Pt Contacts
Date Date Date
PT —Pro, Attended Attended Attended
�••••-• •- y,r11111C rnainc cnt ran nVVA VVKSP IUV VVKSp NAK VVKSp
Mr. Guy Slagle 1 11(843) 669-4491
[e-mail] Engineer 181 E. Evans St. Suite 21 29501
Mr. Larry Cobler I rim'I(910) 895-9434 1 k910) 895-9244 11 1 1
[e-mail] I Wastewater Plant Operations 1514 Rockingham Road 8379
Ms. Nicole Roberts 1 11(843) 669-4491 ( () 3/15/2001 ! 1
181 E. Evans St. Suite 21 9501
DWR Central Office Contact retreatment Staff
DWR Regional Contact tephanie Zorio

Allocation Table
Headwaks last approved: 0611416
Allocation Table updated: "'r.-3
Permits last modified: 01/09/21
r101%^;s>
Rockingham
ur,mri—
NCO020427
Industry
I
IUP
WDUSTRYNA\LES
Permit
Pipe
Count
r :,:v.,r:.,:>
number
number
1
Cascade Tissue Croup - NC.. Inc.
0004
(101
2
Cascades Mouldcd Pulp
0012
Wf
3
Perdue Foods LLC
0003
001
4
Trans Carolina Products LLC
0014
0063
5
Trinth klanuf4evring. Inc:,
()U09r1)01
CMii
Trinii) Manulectanng. Inc. (Cat )
0009,1)02
002
6
Marca) Cordova LLC
Of)1;
001
Column Total;
Basta
NAIIL frtm MVA (lbsldayl ->
Uncontrollable Loading (lbs day) =>
Total Allowable foe lndustry (MAIL) (Ibs:day) ->
Total Pcrniltrd to Industry (lbs da)) ->
Percent Allow. Ind (MAIL) still available (°t,) ->
ALLOCATION TABLE
Printed: 10/26/2023, 3:48 PlA
Page 1 of 3
5preadsiaet lletructions:
)) Applicabls Nahies should be antered in the Heavy Bamerr:d cc&s. Rest of ;vorksheet i< prolected, oassavord ,s "2".
:) Formulas are discussed in the Comprehensk a Guidance. Chapter 6, Section G
D HWA and AT worksheets it his workbook are finked. Pollutant Flames. MAHLs, Basis. and UnconlroNaVe bad :n this AT vmrksheet we
, G,naticalry entated trom'ne HblA spreadsheet. This includes pollutant names !n columr: AT through SK.
Z'arametert;1^t ghughted in t'eftw ika,e s ha",*s t rlf =11s !i 'ar�Ai '+lt dif<G3f or'
T5T,e
Renewal
Modification Mid
of
Ffiective
Fffeeticc Permit
Industn
Date
Date Expires
Tissue - not cat. have ecrtific-d
07'01 `.7.1
06'30 26
Paper
07 '0 1 '21
06 3026
Poultn
(17 01:''_ 1
06"30 26
Sodilan If)pochlorite (no process xmM)
07'01 21
OW30,26
455-'ecticide. plus &A. Hcpochloritc,
07.'01%21
0613026
455-'esticidc. plus Sect Ihpocitlonte
0701/21
1W30:26
Paper Mill
001'21
:1, : � 06 3026
XPDES 'crmihed
FLOW
BOD
Permit Limits
Permit Limits
Conc. Load
NIGD
aL jM_
mg,l Ib3 da
0.4500
450.000
2100.00 7881.30
0.0120
12.000
2 t 00.00 210.17
1 34Ck)
1.300.000
32500 3523.65
0.0900
90.(")'
OA15U
15.000
_
4(K)00 50.64
U.0114
11.9m
r' ,t
503:000
_ c 11469,18
1 23134
.2.38191 2.381.900
vines Design
Workbook Name : Rockingham HWA nrAT 10-26-23.xis, Worksheet tame: Tab

Allocation Table
Headwcrks last approved: W14/16
Allocation Table updated: "-J SA-2a
Permit last mcdifecl: 01/08/21
Po-w-
Rockingham
m--oflsc-
NCO020427
Industry
TUP
I DUSTAY N,XMFS Permit
Pipe
Cot:nt
, ,.Ira„s.-'&' ntunber
numb:'
I Cascade Tissue Group - NC, Inc. 0(934
001
2 Cascades Mciuldcd Pulp CWl12
001
3 Perdue Foods LLC 0003
(K)1
4 Trans Carolina Products LLC 0014
0003
5 Tnnity Manut'deturing, Inc titlWOM
(101
Tnnit) btanutactunug, Inc. (C'at.1 0009,002
002
6 Marcal Cordova LLC 0015
001
Column Totals =>
Baas >
AIAIIL from HWA fibs-da) I "'-
Uncontrollable Loading fibs,dati)==
Tota; Allox%able for Industry (MAIL) (tbc`dayl >
Total Pemtitted to Industn (lbsrday) �>
Percent :Uhnv. Ind. t ALAIL1 still avaitoble 1 ,;)
5 Percent N FIL (lhs dav) , >
ALLOCATION TABLE
Printed: 10126/2023, 3.48 F
Page 2 a
TSS
Ammonia
Arsenic
Cadmium
Chromium
Copper
Cyanide
Permit Limits
Pcmiit Lim.ts
Pcrinit Limit:
Permit Limits
I Permit Limits
I Pettnit Limits
Permit Luniw
C'onc, Load
Cone. Load
Cone Load
Cone. T_owi
Colic, L )ad
Conic. Load
Cone. Loci
mg 1 ibs-dq
mil ibs'day_
ni .I Ibs'day
mg 1 Ib 'day
m_ I Ib-'day
mgl Ibs%day
me'1 lhs dig
400.00 1501.20
400.00 40.03
200.00 2168.40
400.00 50J14
1594.11
53j:t
Design
225I8
'0.8 %
1126
L_J
Design
938.25
128.71
809.54
0.00
100.0 %
46.9 i
U.000U
AS/Nn/TF
inhibiton
0.6000 0.0751
0.31M 0.0375
-^-
O 2200 0.V31K
0.0751
0.0375
1 0.0218
0 OOtMI
AS,W-IF
AS/N.VTF
ASJNtTF
Streaam Std
inN*Jon
Ir'u: ition
;nhbton
5.1949
1 12 9367
-.5.76041
t/1.0059
r0.1404
0.3487
F31
5i.1891
1"'963
5.4117
9
100.0 1,1 1 54.4
1 99; ^0I
Workbook Name: Rockingham HWA w AT 10-26-23.xis, Worksheet Name: Tab

ALLOCATION TABLE
Printed: 1012612023, 3:48 °M
Page 3 of 3
Allocation Table
Headvvcrks last approved: 06/ 14116
Allocation Table updated: '):2ii'2.1
Permits last modified: 01108/21
Fo
Rockingham
i.voEs>:=�
sr-
NC0020427
Lead
Mercury
!Molybdenum
Nickel
Selenium
Silver
Zinc
indtistn
Permit Limits
Permit Limits
Permit Limits
Permit Limits
Permit Limits
Pennit Limits
Permit Limits
IUP
IN VA�ILS Peniiit
Pipe
Cone Load
Conc. Luad
Colic. I otid
Cone. Load
Cone. Load
Cone. Load
Cone. Loac
Count
P r -.„ ;:rua. number
nunil�:r
ing l lbs day
MF1 Its ila
mg/l lbsda
mg'l )b
me I ib
mg I Ihs da
mgil lb
I
Cascade Ti,sue Group - NC. fnc, 0004
001
0.4500 I AS89
1.0000 3.7531
_
Cascades Moulded Pulp 0012
001
3
Perdue Foods LLC 0003
(lilt
4
Trans Carolina Products LLC (1014
0003
0.1500 0 1126
3.t)0ru): 1251'
5
Trinity kiLinufactunng. Inc. 000,4001
001
0.5000 0.0626
6 M910 0.7504
Trinity Manufacturing, Inc. Wat.) 0009 002
002
0.3200 0.031x
t:
Marcal Cordova LLC 0015
001
0.0318
r 0.000000
0.0
1.8640
4).0000
0.0000
6 755.
Column Totals ---
ASINitrTF
AS,'Nit'TF
AS'NItiTF
Basis ':
inhibition
Stream Ski
rihibiten
Stream Std
Stream Sid
inhibition
MAUL frmi II1kA (tbs da)) f-
16,4171
0.025715
8.2085
8.5716
0 2U57
32 834!
Gncontrollabie Loading i lbs dwo -
0.5733
0.003510
0.5195
0.1135
0.011
0.050
1.596(
Total Allowable for Industry i NIAIL) (Ibsday) -'
15.843S
0.022205
8,0950
8.5599
0.1472
31..238'
Total Permitted to indimry (Ibs'dayl =>
0.0318
7)00000
0.000o
18540
0.0(0)
0.00)()
Percent Alkiw.Ind .(MAIL ) still available t°n)--
99,81.
10000�
1VALLF!
-7.0°1
100.0''.4
100.060
79.4
5 Peta tt M.A.HL i lbs. day) - =
0.82tl9
0.0(J 1286
0.4 J 04
0.4286
U.OI )3
l .f l l'
Workbook Name: Rockingham MNA v AT 10-26-23.xis, Worksheet Name. Tab

Pretreatment Annual Report (PAR)
Industrial Data Summary Faun (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
Maximum (mg/1) =>
or Maximum (lb/d) =>
or Average (mg/1) =>
or Average Loading (lb/d) =>
% violations,(chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 0/9) =>
% violations,(chronic SNC is >= 66%) =>
% TRC violations., (SNC is >= 33 %) =>
Total # of samples =>
Maximum (mg/1) =>
or Maximum (lb/d) =>
' or Average (mg/1) ->
or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66a/o) =>
% TRC violations, (SNC is >= 33 %) =>
% violations,(chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
Maximum (mg/1) =>
or Maximum (]b/d) =>
or Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >— 33 %) =>
% violations,(chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Control Authority,
Town Name —> .. ;
WWTP Name => gr
NPDES # => e e' D
lst 6 months, dates => f) l- ell - jn3 to OL-1#-?"3
2nd 6 months, dates => j j 7-0/-1923 to 11.31.2627
Industry
Name CuscadCK 111zme- G�� o
lUP #� c
Pipe #
POTW must enter at least one of these IUP — Industrial User Permit lb/d => Pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non Compliance mgd => million gallons per day
An period oottld be month, Qtr, or 6-month & if BDL , 112BDL, or zero values used. TRC => Technical Review Criteria W WTP — wastewater tivatment plant

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (1DSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) _>
or Maximum Qb/d) =>
* or Average (mg/1) =>
or Average Loading (lb/d) =>
% violations, (chronic SNC is >— 66%) _>
% TRC violations, (SNC is >= 33 %) =>
% violations, (chronic SNC is >= 669/6) =>
% TRC violations, (SNC is >= 33 %) =>
1pdustry Name CCLScc e5 7 5s
1UP # OOLIq
Pipe # 001
months n men st talon men st "mon men st mo n mon
Total # of samples =>
Maximum =>
• or Minimum =>
% violations, (chronic SNC is >= 66%) => ,,
% TRC violations, (SNC is >= 33 %) => N/A
% violations, (chronic SNC is >= 660/9) => N/A
% TRC violations, (SNC is >= 33 %) => N/A
Total # of samples =>
Maximum (mg/1) _>
+ or Maximum (lb/d) =>
or Average (mg/l) =>
or Average 14ading Nil) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is x 33 %) =>
% violations,.(chronic SNC is >= 660/0 =>
% TRC violations, (SNC is >= 33 O/o) =>
* POTW must enter at least one of these lup —> Industrial User Permit lb/d pounds per day
four rows, Please indicate how avcrages were calculated SNC — Significant Non-ConWlimce mgd y million gallons per day
Avg period could be mar , or 6-month & if BDL , MDL, or zeao values used. TRC �7 Technical Review Criteria W WFP => wastewater treatment PlAnt
.-L._...._. n A 0 V41u .......• n .worn 17 1 4 t a Ala if rr1RV 14— r,x . "d ins in wwir PAR Nurntw rwh w-4 ttn mull Tt 1P nine - Paw of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
or Average loading (lWd) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
Maximum (mg1l) _>
* or Maximum (lb/d) _>
* or Average (ate) _>
* or Average Loading (Ib/d) _>
violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
% violations,(chronic SNC is >= 660%) _>
% TRC violations, (SNC is >= 33 °/a) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (]b/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Control Authority,
Town Name => , ¢"�a
WWTP Name =>
NPDES # _> &a O
1st 6 months, dates => D 1- O I •,-p.%3 to 04- 30--w!1
2nd 6 months, dates => d'7_OI.1D23 tO 1� •31.20QJ
Industry
Name a r+
lUP #
* POTW must enter at least one of these IUP —> Industrial deer Permit lb/d =>
pounds per day
four toys, Please indieate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6-month & if BDL , 1/2BDL, or zem values used. TRC => Technical Review Criteria W WTP -> wastewater treatment plant

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
Maximum (mg/1) _>
* or Maximum (lb/d) =>
* or Average (mg/1) =>
° or Average Lauding (lb/d) =>
% violations, (chronic SNC is >— 66°/*) =>
% TRC violations, (SNC is >= 33 */o) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 */*) =>
Total # of samples =>
* Maximum =>
* or Minimum =>
* q✓S .
*
% violations, (chronic SNC is >= 66*/*) =>
% TRC violations, (SNC is >= 33 */e) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 */*) =>
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (ib/d) =>
* or Average (mg/l) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 */o) =>
% violations.,.(chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 */o) =>
Ipdustry Name Pe,,Ad L( c
lup # () n, (") 3
Pipe #
PO'T'W must enter at least one of dme TUP — TundusVW User Permit 1b/d => pounds pet day
fax rows, Pkase wdwft bow averagies were calcutabed SNC — Significant Non -Compliance mgd => million gdkms per day
Avg period could be month, Qlr, or 6-nwntll & if BDL MD1.,, cr zero vnhxs used. TRC => Technical Review Criteria W WTP => wastewater treetmem ptart
r`b.s....r pea fl".i.tw.v— Pith nMs .* Papnuum 17 VA 14 Rl%nk WAV P,rm CAwnv snd inn. in vnur PAR Number ench set Rs ewh It IP nine - Page of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
Maximum (mg/1) =>
* or Maximum Ob/d) =>
* or _ Average (mg/1) =>
or Average Loading (lb/d) => _
% violations,(chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
% violations,(chronic SNC is >= 66%) => -,
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
or Maximum (lb/d) =>
* or Average (mg/1) =>
* or Average Loading (lb/d) =>,
% violations, (chronic SNC is >= 66%) => ,
% TRC violations, (SNC is >= 33 %) =>
, o violations,(chronic SNC is >= 66%) => -
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
Maximum (mg/1) =>
or Maximum (lb/d) =>
or Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) => ,
% TRC violations, (SNC is >= 33 %) =>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) =>
Control Authority,
Town Name =>
WWTP Name => C o R9�1i; ncs%14r"1
NPDES # =>
Ist 6 months, dates => p 1, p j _ �OX3 to O(- 30-2,023
2nd 6 months, dates => Q7_ 0 j.aj:Z3 to j�.31 -202T
Industry
Name C0.SCQ/j& /}i6b Pu1,62
IUP# 00/�
Pipe # Q C7 I
.j
W.R[. M
191MEM
NOW=
IOi%M
(�.iTG .�' � 1iiiM�.
• .
-
mu
-Ly��-[K�I��-
IR3I.�T�Z.TIfl
.. .
.
i►.T.t.[
.
f►.jT[.�
.
f►/TC� ..��
���/►.1��
�Jl�
W� WA
t,�
•INIM
0 WARM
w=jw&=WAW-4=wiwfimm
WMAM
W%WMA
���J!`��
���
"
rir-=■
,WM
_ i _; :
rfr:=��
BDL => Below Detection Limit mg/l => milligrams per liter
POTW must enter at least one of these IUP => Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6-month & if BDL , 1 /2BDL, or zero values used. TRC => Technical Review Criteria W WTP => wastewater treatment plant

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) => ^
% TRC violations, (SNC is >= 33 %) => a
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum =>
* or Minimum =>
% violations, (chronic SNC is >= 66%) => ,
% TRC violations, (SNC is >= 33 %) => o
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Industry Name ci S• coJes Ma Id , pc.. W
IUP# t70%91
Pipe # , 3 01
��, ��,:1�rr.rrr��i���r,
iTi'','i�i1:�IG�T,.G
,'fR.5�Ii1�
rr,rr.•s�rrra���.rT.rf��i�•rrt�r,1»
WON. /!■
����
���'
I�
i'
WAWA
/
.
%�[ iTi?iii�fR�..TTTiTi�(►�[.Ti'iT.T�Tii�l�%
n.�.�f��[..�iTiTit7i�il�.T7T.T'.�i1�ftRG
n.,�
1>� u„ .� V.1T[. �. , � � , , D.rrcTrrTl� DST[. 1TIT.T51�f � f►�T[ .r�tm
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or Average (mg/1) =>
* or Average Loading (lb/d) => _
% violations, (chronic SNC is >= 661/16) =>
% TRC violations, (SNC is >= 33 %) => A
% violations�..(chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
BDL => Below Detection Limit mg/I => milligrams per liter
a POTW must enter at least one of these IUP => Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6-month & if BDL , 1/2BDL, or zero values used. TRC => Technical Review Criteria WWTP => wastewater treatment plant
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Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
Maximum (mg/1) =>
* or Maximum (lb/d) =>
or Average (mg/1) =>
or Average Loading (lb/d) =>
% violations,(chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
% violations,(chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
Maximum (mg/1) =>
or Maximum (ib/d) =>
# or Average (mg/1) =>
or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
% violations,(chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
a
T
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or Average (mg/1) =>
or Average Loading (lb/d) => _
% violations, (chronic SNC is >= 66%) => ,
% TRC violations, (SNC is >= 33 %) =>
% violations,(chronic SNC is >= 66%) _> s
% TRC violations, (SNC is >= 33 %) =>
Control Authority,
Town Name => o
W WTP Name =>
NPDES # => C D ` D
1 st 6 months, dates => D I- O 1- j0A3 to 0 4, 30.202 3
2nd 6 months, dates => ()?-0/-1D23 to N-31 �2OQ?
Industry
Name M grC4 / 66,400,Gg
IUP# Q01s
Pipe # Sri 1
'�� ..,
7�[�_rTT•Tf��I111T[.
•TST:iifRi�
.
.l.� �
1�% r� i��V�[��1R3[.
��:.:�.��
• .....
Lz=
um
h.JT[�
. .
PiT]<�tTit• i�LOUMM
1Z-LMTE.
.
mrri*fth to
r'
MOM
L .i
/
W��
I i
�I►/1����
�7:
�n
Q
�►.►i����■r
BDL => Below Detection Limit me => milligrams per liter
' POTW must enter at least one of these IUP => Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6-month & if BDL , I/213DL, or zero values used TRC => Technical Review Criteria WWTP => wastewater treatmew plant

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSP)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
a Maximum (mg/1) =>
or Maximum (lb/d) =>
or Average (mg/1) =>
or Average Loading (lb/d) =>
% violations, (chronic SNC is >— 66%) _>
% TRC violations, (SNC is >= 33 %) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
lttdustry Name A` C CG
iuP # 0.01
Pipe # (Dot
list6motithsff2ndFm-o-n--E mon st mon mon st monthsTotal # of samples => 4
Maximum => 7.5
or Minimum => `
a
% violations, (chronic SNC is >= 660/9) =>
% TRC violations, (SNC is >= 33 %) => Q N/A
% violations, (chronic SNC is >= 66%) => N/A
% TRC violations, (SNC is >= 33 %) => N/A
Total # of samples =>
Maximum (mg/1) _>
$ or Maximum (ib/d) =>
* or Average (mg(1) =>
* or Average Loading (Ibld) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
violations,..(chronic SNC is >= 660/6) =>
% TRC violations, (SNC is >= 33 %) =>
a POT W must ada at least of of diese lUP — Industrial User Permit lb/d => pot" per day
S ificaot Tion C Lavce mgd million gallons Per day
four rows, Please inditxde bow averaaa were calculated SNC 1gn' omp .
Avg period could be ruondi, % or 64mub & if BDL 128DL, or zero vahms used. TRC Technical Review Criteria WWI, I, — wwewow tra-Vnierit plant
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Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
Maximum (mg/l) _>
* or Maximum (Ib/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/!) _>
* or Average Loading (]b/d) _>
violations, (chronic SNC is x 66%) _>
% TRC violations, (SNC is >= 33 %) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 4io) _>
Total # of samples =>
+ Maximum (mg/1) _>
* or Maximum Ob/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >— 33
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 a/o) _>
Control Authority,
Town Name => s3�
W WTP Name => �� ,9
NPDES # _> C D,dl © ala i
I st 6 months, dates => 3Da,3 to 0 L • 30 .
2nd 6 months, dates => Q 7_ 01-3,123 to l a -; t .20Q.?
Industry
Name f CaL,rp%i nac
lUP # Q J y
Pipe # 003
* POTW must enter at least one of these [UP => Industrial User Permit lWd — pounds per day
four rows, Plum indicate how averages were calculated SNC => Significant Non-Canpliance mgd => million gallons per day
Avg period could be month, Qtr, or 6-month & if BDL , InDDL, or zero values uw& TRC => Technical Review Criteria WW]rP => wastewater treatutent plant

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) =>
* or Average (mg/1) =>
* or Average Loading (16/d) =>
% violations, (chronic SNC is >— 66%) =>
% TRC violations, (SNC is >= 33 %) =>
% violations, (chronic SNC is >= 669/6) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum =>
* or Minimum =>
* A V'1
*
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/i) =>
* or Maximum (lb/d) =>
* or Average (mgjl) =>
* or Average Loading (ib/d) _->
% violations, (chronic SNC is >= 668/6) =>
% TRC violations, (SNC is x 33 %) =>
% violations,(chronic SNC is >= 660%) =>
% TRC violations, (SNC is >= 33 %) =>
hpdustry Name
IUp#
Pipe # 003
POTW must enter at least mie of these 1UP — LKhtstriel User Permit lbld =a N mx4 pa day
four rows, Please indicate how averages were eakvlated SNC m> Signiflcaot Nou-Comph mxi mgd million t;alloas per day
Avg period could be month, Qtr, or (-month & if BDL , 12BDL, or wo vat= used. TRC a> Teduiicd Review Criteria W WTP — wwwwatr b atmerit punt
(`hm.trr PAR Auvlwruen Pile nwawe• J. 400AR '" u 11 17 IA Risntr rrVRP Psr f .rev ,n,.l n.y. in wwrc PAR Numhrr ~a h urt fkw ~b n IP ni,w - P� of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSP)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
Maximum (mg/1) _>
" or Maximum (ib/d) _>
or Average (mg/1) _>
or Average Loading (lWd) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 ON _>
violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/l) _>
or Maximum (lb/d) _>
" or Average (me) _>
or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 660%) _>
% TRC violations, (SNC is >= 33 %) _>
% violations,(chronic SNC is >= 660/9) _>
% TRC violations, (SNC is >= 33 °/a) _>
Total # of samples =>
6 Maximum (mg/1) _>
x or Maximum (lb/d) _>
# or Average (me) _>
► or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >- 33 %) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Control Authority,
Town Name -> '
WWTP Name =>�;,
NPDES#=>l,�pclai�_-
1 st 6 months, dates => i- Q 1- ��3 to
2nd 6 months, dates => d? .Q1-Ad23 to 13-31-2027
Industry
Name -n , 4l_
Pipe # 001
° POTW must enter at least one of these ]UP —> Industrial User Permit lb/d => pounds per day
four rows, Please indicate how averages were c*Wated SNC — Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6-month & if BDL , 1213DL, or zero values used. TRC => Technical Review Criteria WWTP => wastewater treatment plant

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < value)
Total # of samples =>
Maximum (mg/1) _>
• or Maximum (lb/d) =>
' or Average (nWl) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >— 660/6) _>
% TRC violations, (SNC is >= 33 %) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
Maximum =>
or Minimum =>
0
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Tote! # of samples =>
Maximum (mg/1) =>
b or Maximum (lb/d) =>
* or Average (mg/1) =>
' or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 a/6) =>
% violations,.(chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Iltdustry Name 1 r �h, 4 H
IUP # 01000 q
Pipe # 0 (0 /
a POTW must m1a at least one of these IUP -> Industrial user Permit lb/d => pounds per day
four rows, Piensc indicate how avangos were calculated SNC a> Significant Non -Compliance nW million plow per day
Avg period could be month, tN, or 64norAh & if BDL , 112BDL, or zeta values used. TRC => Tedmicai Review Criteria W WTP => wastewa l" Moment phial
4-h-* - PAR n., Warner. File.. mane..' J+,iO1bsi no wem 17 IA 1A 111 lk IMP Form r i,nv Hnd ,ur. in v,wr PAR Niunbe r eat-1 at!t thr tmt31 Tt 1P nine . Paw of

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (ib/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _> _
violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _> a
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/1) _>
* or Maximum (lb/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Total # of samples =>
* Maximum (mg/I) _>
* or Maximum (Ib/d) _>
* or Average (mg/1) _>
* or Average Loading (lb/d) _>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
% violations,(chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
Control Authority,
Town Name =>
WWTP Name => C 4
NPDES # _> Ne
1 st 6 months, dates => Di' .v 1 _ aoZ:r to 06.3a
2nd 6 months, dates => 07-a / -A423 to IX 3/ -.2aZ3
Industry
Name rP,
IUP # Q0,0
Pipe # 00 a
Lb
I r
it � .
-_
-■�
_-_
���■���■���■fir■�
.V
-
LKT.�T a
-
L0J,.��`
f + ,1,t.ST
PIT[ ,T,TTifli
imy � n �
nT.ir „, , --a
� � �
}
f41(.I fI I I iitKE
* POTW must enter at least one of these IUP => Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, fir, or 6-month & if BDL , 1 /2BDL, or zero values used. TRC => Technical Review Criteria W WTP => wastewater treatment plant

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
+ Maximum (rng/1) =>
* or Maximum (lb/d) =>
* or Average (mg/1) =>
* or Average Loading (ib/d) =>
% violations, (chronic SNC is >= 66%) _>
% TRC violations, (SNC is >= 33 %) _>
% violations, (chronic SNC is >= 661/6) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum =>
• or Minimtml =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
% violations, (chronic SNC is >= 660%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
Maximum (mg/1) =>
or Maximum (Ib/d) =>
or Average (mg/1) =>
* or Average Loading (ib/d) =>
% violations, (chronic SNC is >= 661%) _> ,
% TRC violations, (SNC is >= 33 %) => a
% violations,.(chronic SNC is >= 66949) _>
TRC violations, (SNC is >= 33 %) =>
BDL => Below Detcction Limit M811 => mr igrams per lAff
POTW must enter at least one of these 1UP => Industrial User Permit Ib/d — pounds per day
four rows, Please indicate how averages were calculated SNC — Significant Nan -Compliance mgd => million gallons per day
Avg period could be month, Qlr or tStttonth & if BDL 1/2BDL, or zero values used. TRC => Technical Review Criteria W WTP ='> wastewater tree VXW Nmrt
Industry Name
lup # (706
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Pretreatment Annual Report (PAR)
Industrial Data Summary Form (IDSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or Average (mg![) =>
or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
Maximum (mg/1) =>
* or Maximum (lb/d) =>
* or Average (mg/1) =>
* or Average Loading (Ib/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) _>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
Q
Maximum (mg/1) =>
* or Maximum (lb/d) =>
a or Average (mg/1) =>
or Average Loading (lb/d) => _
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) => o
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Industry Name 7 f+ ; „ I -
IUP# noo9
Pipe# DDR
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BDL => Below Detection Limit mg/1 => milligrams per liter
POTW must enter at least one of these JUP — Industrial User Permit Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6-month & if BDL, 1/2BDL, or zero values used. TRC => Technical Review Criteria WWTP => wastewater treatment plant

Pretreatment Annual Report (PAR)
Industrial Data Summary Form (1DSF)
Use separate forms for each industry/pipe
Enter BDL values as < (value)
Total # of samples =>
* Maximum (mg/]) =>
* or Maximum (lb/d) =>
* or Average (mg/1) =>
or Average Loading (lb/d) => _
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) => o
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
Maximum (mg/1) =>
* or Maximum (ib/d) =>
or Average (mg/1) =>
* or Average Loading (lb/d) =>
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) => Q
% violations, (chronic SNC is >= 66%) => s
% TRC violations, (SNC is >= 33 %) =>
Total # of samples =>
* Maximum (mg/1) =>
or Maximum (lb/d) =>
x or Average (mg/1) =>
or Average Loading (lb/d) =>
—
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) => Q
% violations, (chronic SNC is >= 66%) =>
% TRC violations, (SNC is >= 33 %) =>
Industry Name -7—l""11 4r,
IUP # OoD �(
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BDL => BeIow Detection Limit mg/1 => milligrams per liter
* POTW must enter at least one of these IUP => Industrial User Pernut Ib/d => pounds per day
four rows, Please indicate how averages were calculated SNC => Significant Non -Compliance mgd => million gallons per day
Avg period could be month, Qtr, or 6-month & if BDL, 1 /2BDI-, or zero values used. TRC => Technical Review Criteria WWTP => wastewater treatment plant