NCG140253 DMR WW

PROCESS WASTEWATER -Quarterly .Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000 .
CERTIFICATE OF COVERAGE NO: NCG14(J �- 3 fi&SAMPLE COLLECTION YEAR:. �U /3
S
jy,CG— 3. ��� ,jy,,, MPLE-QUARTER: []Jul -Sept []Oct -Dec j 'Jan -March: El -June
FACILITY -NAME: Ar4li S �
PERSON COLLECTING SAMPLES: �/ �i
oS S COUNTY: 'IV
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CERTIFIED LABORATORY: Lab #
PHONE NO. (j/UZ
Lab # ADD TO LISTSERVE? QYES:;QNOEMAIL: I
LIMIT VIOLATIONS? YES ❑ NO ❑ DISCHARGING TO -CLASS: QSA ❑HQW QPNA OTrout Other Y<f Sw
OPTIONAL INFO:
Part A: Wastewater Monitoring Requirements
Z.
_TPH using i D h_
11f 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:
3 if 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 wastewat6� d. charges 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 Revised Last .R sed 07/13/11.
Page 1 of 2
Date Sample
= - -
Type of Wastewater pHmethod
Tota1:q uspen ed _ Sett ea a
1664A
isc arge
Total Flow
Outfall No, Collected
Z n
RM, MD) ;_ (standard)
Solids Solids _ _
= SGT HElh16
_ Duration E 7-
- (gallons/day)
mm Wye)immutes)
(Mg/L) i
_
_ a
3035
11f 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:
3 if 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 wastewat6� d. charges 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 Revised Last .R sed 07/13/11.
Page 1 of 2

6 Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA 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 continuouslor calculated. Flow limits for wastewater discharges to HQW waters -shall be set to 50% of the Summ
y.er 7Q10 Flow as per 15A
NCAC 0213:0224. Permittees a 'ho discharge wastewater to HQW waters shall obtain a Summer' -'Q10 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 a case-by-case basis.
I
i
MAIL ORIGINAL AND ONE COPY:OF THIS ANNUAL SUMMARY (INCLUDING,
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
30
;
YOU MUST SIGN THIS CERTIFICATION 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 inquiryof the person or personswtjo manage the system, or
those persons directly responsible for gathering the information, the information submitted is; to the best of myknowledge and belief, true, accurate; and
complete. I am aware that there are significant penalties for submitting false information, including the. possibility of.fines and imprisonment for knowing
violations.
4L�
%
(Signature of Permittee) (Date)
Permit Date: 7/1/2010-06/30/2015.
Last: Revised 07/13/11
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