NCG140373 DMR WW (4)

PROCESS WASTEWATER — Quarterly Discharge Monitoring
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COV RAGE O. N G 4 0
FACILITY NAME: 2T
PERSON COLLECTING SAMPL E, mt_ STEP/� G1cv,
CERTIFIED LABORATORY: t I i Lab # ✓z -
Lab# +o
LIMIT VIOLATIONS?YES C NO
Part A: Wastewater Monitoring Reaulrements
`J
R ell
Q=g,t IVED
APR. 10 20i
CENTRAL FILES
DWR SECTIONI
SAMPLE COLLECTION YEAR:
SAMPLE QUARTER: Jul -Sept []Oct -Dec ©Jan -March
COUNTY:1'Ylccklc�., wqr,
PHONE NO. (7ost)_333- 9)39a
ADD TO LISTSERVE? YES Q NO[B EMAIL:
DISCHARGING TO: [3SA WATERS QHQW ❑PNA [-]l'rout
❑April -lune
Date Sample
Outfall No. Collected' Type of Wastewater
(VE, RM, MD)
(mm/dd/yr) .
PH
'(standard),
Total Suspended
Solids
(mg/L)
Settleable
Solids
(mL/L)
TPH using Discharge
method 1664A Duration ne Total Flow
SG7-HFlbf6 (minutes)
) (gallons/day)
(mg/L
6.93A
30as
53
(15)6
3- - Yr ,t�>y .r,�
�• ?
AIV
SVD
D
v
r
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 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.
31f 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.
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 07/06/11
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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 beset to 501yo of the Summer 7Q10 Flow as per ISA
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 DWO, and the DWQ Regional Office may require an annual flow
report on a case-by-case basis.
MAIL ORIGINALAND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW" -NO DISCHARGE") WiTHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE nF "NO FLOW-) TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center-_ ;
Raleigh, North Carolina 27699-1617
[phone]
YOU MUSTSIGN THIS CERTIFICATION FORANY/NFORMA770M REPORTED•
"I certify, under penalty of low, 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. I am aware that there are significant penalties for submitting false information, Including the possibility of fines and Imprisonment for knowing
(Signature of Permittee)
Permit Date: 7/1/2010-06/30/2015
C/ - -iJ�
(Date)
Last Revised 07/06/11
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