NCG140185 DMR WW (2)

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PROCESS WASTEWATER - Quarterly .Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
NCG14'� / �_
SAMPLE COLLECTION YEAR: 2 G' .
CERTIFICATE OF COVERAGE NO.
_
SAMPLE°QUA,� TER: Jul -Sept []Oct -Dec Jan -March
. QApril-June
fACILITY NAME:-
777 rG /��
COUNTY: /��iiJ/c�C
PERSON COLLECTING SAMPLES:
L. Li e n� Lab #. f
PHONE NO.
CERTIFIED LABORATORY:/Vt%i�
La b # �7 7 7
ADD TO LISTSERVE? AYES []NO EMAIL:. I
LIMIT VIOLATIONS? YES ❑ NO FT.
DISCHARGING TO CLASS: []SA [�HQW ❑PN OTrout []Other
OPTIONAL INFO:
Part A:. Wastewater Monitoring Requirements
=
=
__ _ _
Date Sam le
P Type Wastewater pH
T- PH using
Total Suspended able. I Discharge
Settle method 1664A I
Total Flow
of - - _Duration
ohds Solids SGT HEIV16
OutfallNo. Collected z :_. standard S _
) _ -_ (rnmutes)
= 7_;
gallons/day)
i 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:
3 I ane ffluent 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.
4 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 ;ds�charges to HQWwaters, lO mg/L for Trout and PNA:waters, and 30 mg/L for all other water classifications
I Last.Revised 07/13/11,
Permit Date: 7/1/2010-06/30/2015; Pagel of 2
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e Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPN 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 HQW waters shall be set to 50% of the Summer 70,10 Flow as per.15A
NCAC 0213:0224. Permitteeg Who discharge wastewater to HQW waters shall -obtain a SummeNQ10 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.
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MAIL ORIGINAL AND ONE COPY CIF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW" "NO DISCHARGE") WITHIN 30 DAYS! OF RECEIPTOF SAMPLE (OR
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
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YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, underpenalty 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 persons who manage the system, or
those persons directly responsible'forgathering the information; the information submitted is; to the best of my knowledgeand belief, tru ,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.'r
9 xs —'/6 V
(Signature of Permittee (Date)
Permit Date: 7/1/2010-06/30/2015. �. Last Revised 07/13/11
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