NCG140253 DMR WW (2)

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PROCESS WASTEWATER - Quarterly .Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14 6 2- --5- 3 SAMPLE COLLECTION YEAR. 20 �5
FACILITY. -NAME: a / << 63. SAMPLE -QUARTER: OJuI-Sept []Oct -Dec . OJan-March; [J�April-June
PERSON COLLECTING SAMPLES:��� os 5 COUNTY: J(/G
PHONE NO. GI( IO % . 2— / 2.5:
CERTIFIED LABORATORY: Lab # ADD TO, LISTSERVE? YES QNO EMAIL: f
Lab.# ; ❑:
LIMIT VIOLATIONS? 'YES F NO 0. DISCHARGING TO CLASS: FSA ❑HQW ❑PNA []Trout []Other
' OPTIONAL INFO: �
Part A: Wastewater Monitoring Requirements
1 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.
2 Reportthe 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 I'imits are 6-9 S.U. forwastewater discharges to freshwaters, and 6.8-8.5 S. U. fo.r discharges to saltwaters..
s TSS limits are 20 mg/L for wastewater di 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 f Last Revised 07/13/11,
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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 u
be measured continously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A
NCAC 02B .0224: Permitteet who discharge wastewater to HQW waters shall obtain a Summer' TQ10 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
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report on a. case-by-case basis.
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. eased on my inquiryof 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. I am aware that there
are significant penalties for submitting false information, including the possibility of.fines and imprisonment for knowing
violations." �.
(Signature of Permittee)
Permit Date: 7/1/2010-06/30/201%.
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(Date)
Last Revised 07/13/11
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