NCG140180 DMR WW (3)

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG14..0 1 1 n
FACILITY NAME:
PERSON COLLECTING SAMPLES:. ay1✓�ic 1V1c�
CERTIFIED LABORATORY: Aj14 Lab #
414 Lab # _ 1714
LIMIT VIOLATIONS? YES F] NO []
'ars A: wastewater monitoring Requirements
SAMPLE COLLECTION YEAR: OJS
SAMPLE QUARTER: []Jul -Sept C ct-Dec ❑Jan -March []April -June
COUNTY:
PHONE NO. ( /J9j Qbf7 _
ADD TO LISTSERVE? ❑YES EJ90 EMAIL:
DISCHARGING TO CLASS: []SA ❑HQW RPNA []Trout ❑Other
OPTIONAL INFO:
bate Sari le
p
Outfall No ; Coltectecl
Type of Wastewater pH Total Suspended
z Solids
Settleable
solids
TPH using
Discharge.
method 1664A Total Flow
(mm/ddJyr)
(VE RM, MD) (standard}'
(mL)
(mL/lj
Duration:
SGT HEM6
(minutes} (gallons/day)'
FF.g/
6-93 ° 30g.5
53
OW _
If wastewater systems have not d
C
reed in this ntinrtar— rannrt "Pin rin-11 nr ^ni nI__.._ __i__i
Z - - . • . - . _. . ---b, . I-- Blanc 3uIt: w nidi IF, LIM sarnpie quarter above.
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.
3if 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 wastewater discharges to HOW 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 Last Revised 07/13/11
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e 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 continuously 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. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 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.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO. FLOW" "NO DISCHARGE" WITHIN m DAYS OF RECEIPT OF 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
[phone]
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 inquiry of 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. 1 am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing
violations."
J-4�
(Signature of Permittee)
(Date)
Permit Date: 7/1/2010-06/30/2015
Last Revised 07/13/11
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