NCG140032 DMR WW (6)

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NC94 SAMPLE COLLECTION YEAR: G 1 b
FACILITY NAME: n'5 � Yv�;xed SAMPLE QUARTER: ❑Jul-Sept ❑Oct-Dec Dan-March April-June
PERSON COLLECTING SAMPLES: LJ K ie h/c-5..1-- COUNTY: Sf-Ocv
CERTIFIED LABORATORY: Lab# PHONE NO. (76a) CI£Sd.-(06, 1 5
Lab# ADD TO LISTSERVE? OYES EJNO EMAIL:
LIMIT VIOLATIONS? YES n NO x DISCHARGING TO CLASS: OSA
❑HQW ❑PNA ❑Trout IXOther
OPTIONAL INFO:
Part A:Wastewater Monitoring Requirements
TPH using
Date Sample Total Suspended Settleable Discharge
Outfall No. Collected' Type of Wastewater pH method 1664A Total Flow
z Solids Solids 6 Duration
(mm/dd/yr) (VE,RM,MD) (standard) (mg/L) (mL/L) SGT HEM (gallons/day)'
(mg/L) (minutes)
- - - 6-93'4 303'5 53 (15)6 - -
3 M D n6Rt no-P2P
RECEIVED -
Jui 13 ;i1Ln
CENTRAL FILES
[AR SEeTION
'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.
3 I 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.
4 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

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 HOW 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 30 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. I am aware that there are significa •enalties for submitting false information,including the possibility of fines and imprisonment for knowing
violations."
-,1 7S - l .
(Signature of Pe r'ittee) (Date)
Last Revised 07/13/11
Permit Date:7/1/2010-06/30/2015 Page 2 of 2