NCG140182 DMR WW (4)

PROCESS WASTEWATER — Quarterly Discharge Monitoring deport
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO_NCG14 a1 ..� Z
FACILITY NAME: i`Z _qPl�� & 4 l4
PERSON COLLECTING SAMPLES: -1111,11.0d, >1114!
CERTIFIED LABORATORY;_ /LJ,q ._ Lab #
Lab #,
LIMIT VIOLATIONS? YES [ ] NO []
SAMPLE COLLECTION YEAR: �1%4.
SAMPLE QUARTER: [,lul-SeptOct-Det
COUNTY; (J []Jan -March [:]April -lune
PHONE NO. (Sza) ��.
ADD TO LISTSERVE?PYES-4d-NOEMAIL: Al 14
DISCHARGING TO CLASS: [SA [HQW []PNA QTrout ❑Other
OPTIONAL INFn• A! n
-1 •• ,� a...,C�d.���� fu, the type or 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.
d PH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges 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
Last Revised 07/13/11
Page 1 of 2

e Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does
but instead is subject to benchmarks and .provisions of Part IV, Section A, including the Tiered Response Action. not have a limit for wastewater,
' Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to H W
waters shall be NCAC 026 .0224. Permittees who discharge wastewater to HqW waters shall_obtain a.Summer Zq: D flow and report thistinformatift e Summer DWq l( Q10F low as per 15A
�- obtain a Summer 7410 flow for the receiving waters at the discharge location, the permittee shall 0 fl DW
report on acase-by-case bans. Y q, and the DWq Regional Oee cannot
ffice may require antannual flow
AT END OF MONI0 1 (i p11"112IO1? iN CASA QF "NO FLOW") 7Q,
Division of Water Quality
Attn: DWq Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
)'OU MUST SIGN TN1: CER1/F1CAT1ON FOR ANY INFOAMA,Tf6TN REPORT FpG
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision In accordance with a
assure that qualified personnel properly gather and evaluate the Information submitted.. Based on my inquiry of the _person or persons who manage
designed to
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowled a an
complete. I am aware that there are significant penalties for submitting false information, including the pos�ibiiity of fines and imprisonment for B the system, or
violations."
g, d belief, true, accurate, and
A1. knowing
(Signature of Permlttee)
Permit Date: 7/1/2010-06/30/2015
--3l-2or�f
(Date)
Last Revised 07/1 Q/1 i