HomeMy WebLinkAboutNCG020766 DMR SWn. e4ck,, i— 4- Z.
PROCESS/MpVE DEWATERING WASTEWATER DISCHARGE MONITORING REPORT (DMR)
u Please Mail Original And One Copy To Mailing Address Below
RECEIVED
GENERAL PERMIT NO. NCG020000
Part R: FacilityinformationNOV 0 6 2015
Samples Collected In Quarter: 10 W 30 40 (all samples shall be reported within 30 days following monitoring period)
`a`CENTRAL FRES
`'°'" �p -�� SWR SECTION
Certificate Of Coverage No. NCCO20�p
Facility Nome County of Facility
Name of Laboratory
Facility Contact l Lab Certification g
Facility Contact Phone No. LCL W -1/r,
Part B: Process Wastewater and MMne Dewatering Wastewater Monitoring Requirements
i 1 bate 50056..'.
001174". '
76 - '0054$ -
+�undbcr Recciviug Stream Nome Sample Collected Dally Flow t ` ' pH. ' "rotn�' `Usoce toe Sollos ' Turbidity 1, Settleable Solids
�mo/ddtvr Alm) unit m NTUs mYl
t Measured continuously using a (low rneasuring device or estimated using manufacturerh pomp craves and pump la
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Part C: Certification
1 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 tie information, the information submitted is, to the best
of my knowledge and belief, true, accurate, and complete. I am aware that there are significant p nasties r sub ' g false information,
Including the possibility of fines and imprisonment for knowing vio ,
(S a of Permittee) (Date)
Part D.• Mailing Address
Attn: Central Files, DENR, N.C. Division of Water Quality,1617 Mafi Service Center, Raleigh, NC 27699-1617
4-T" `4`a-� �� Cab.,�`;�,p.# SWU-244-012005
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