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Fleetwood NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) DISCHARGE MONITORING REPORT (DMR) Form Approved OM B No. 2040-0004 ..(1 I ~~~~~w[E[Q) NAME: ADDRESS: ... PERMITTEE NAME/ADDRESS (Include Facility Namellocation if Different) 12590 WAPPINGER (T) 20 MIDDLEBUSH RD WAPPINGERS FALLS, NY 12590 FLEETWOOD MANOR SD WWTP FLEETWOOD DRIVE WAPPINGERS FALLS, NY 12590 FACILITY: LOCA TION: ATTN: DAWN PARAMETER Temperature, water deg. fahrenheit 00011 1 0 Efflue nt Gross Temperature, water deg. fahrenheit 00011 G 0 Raw Sewage Influent BOD, 5-day, 20 deg. C 00310 1 0 Effluent Gross BOD, 5-day, 20 deg. C 00310 G 0 Raw Sewage Influent pH 00400 1 0 Effluent Gross pH 00400 G 0 Raw Sewage Influent Solids, total suspended 00530 1 0 Effluent Gross NY0021601 PERMIT NUMBER 001-X DISCHARGE NUMBER o c b~ ~a~Mb~IP CODE: ,MINOR TOWN O~stWAl?PINGER TOW K FROM .. MONITORING PERIOD MM/DD/YYYY I I MMIDD/yyYY 09/01/2010 I TO I 09/30/201 0 No DischargeD QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY SAMPLE EX OF ANALYSIS TYPE VALUE VALUE UNITS UNITS VALUE VALUE VALUE SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT '" ~-,,-_. NAMEITITLE PRINCIPAL EXECUTIVE OFFICER I certify underpmalty of law that Ihis document and all attachments \'Vef"t pl"cpa.-ed under my di~ction or Y/!~ f{<P4t4~ TELEPHONE DATE supervision in BCcordmct with a ~stem desiBned 10 assure lblt ~a.lified penOlDlel properly gatbtr and Michael P. Tremper evaluate the infonnntion submitted. Based on my inquiry or!be penon or persons who mllrlage the 10/20/2010 system, Of tbose persons di~ctly responsible for grthcring Ihe infonnatioo, the information suhm itted is, 845-463-7310 Chief Operator ~oC~~l~~::~lm~ti:~1J:e ~1;:~fo~i~ctd~~:;'~:fuif~~lf~ ~~~~~~~~;r;rt~:::~ LI violatiotll. SIGNATURE OF PRINCIPAL EXECmlVE OFFICER OR AREA Code I TYPED OR PRINTED AUTHORIZED AG T NUMBER MMlDDIYYYY COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) Page 1 EPA Form 3320-1 (Rev.01l06) Previous editions may be used. NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) DISCHARGE MONITORING REPORT (DMR) Form Approved OMB.No.2040-0004 PERMITTEE NAME/ADDRESS (Include Facility NameA.ocation if Different) NAME: ADDRESS: WAPPINGER (T) 20 MIDDLEBUSH RD WAPPINGERS FALLS, NY 12590 FLEETWOOD MANOR SD WWTP FLEETWOOD DRIVE WAPPINGERS FALLS, NY 12590 FACILITY: LOCATION: ATTN: DAWN PARAMETER Solids, total suspended SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT ' REQUIREMENT SAMPLE ' MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT 00530 G 0 Raw Sewage Influent Solids, settle a ble 00545 1 0 Effluent Gross Solids, settleable 00545 G 0 Raw Sewage Influent Flow, in conduit or thru treatment plant 50050 G 0 Raw Sewage Influent Chlorine, total residual 50060 1 0 Effluent Gross Coliform, fecal general 74055 1 0 Effluent Gross BOD, 5-day, percent removal 81010 K 0 Percent Removal NY0021601 PERMIT NUMBER 001-X DISCHARGE NUMBER DMR Mailing ZIP CODE: MINOR (SU BR 03) 12590 FROM MONITORING PERIOD MM/DDIYYYY I I MMIDDIVYYY 09/01/2010 I TO I 09/30/2010 No DischargeD External Outfall QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY SAMPLE EX OF ANALYSIS TYPE VALUE VALUE UNITS VALUE VALUE UNITS VALUE '" NAMEIT1TLE PRINCIPAL EXECUTIVE OFFICER Michael P. Tremper Chief 0 erator TYPED OR PRINTED COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) I certify undcrpmalty of law that this document and all attachments were preparnf unclcrroy direction or supervision in acrordooce with 0. system designed to IlSSUfC Iha lfIalified personnel properly gntber and evnlulde the infonnEttion submitted. Bued on my inquiry oClbc person arpcnonl who manage the system, orlhm:c persons direclly responsible for s:alhcri:ng the infonnatian. the infonnBtion submitted is, ~~~:~~~:rf;::~~~~e;J:e ~~~fo~i~ci~dinr:~~~:'~Wi~~lf= :'d:n~~~~~~:r::t~~~ violations. NUMBER MMlDDIYYYY TELEPHONE DATE 845-463-7310 10/20/2010 AREA Code EPA Form 3320-1 (Rev.01/06) Previous editions may be used. Page 2 NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) DISCHARGE MONITORING REPORT (DMR) Form Approved OMB No. 2040-0004 PERMITTEE NAME/ADDRESS (/nclude Facility Nameilocation if Different) FACILITY: LOCATION: WAPPINGER (T) 20 MIDDLEBUSH RD WAPPINGERS FALLS, NY 12590 FLEETWOOD MANOR SO WWTP FLEETWOOD DRIVE WAPPINGERS FALLS, NY 12590 NY0021601 PERMIT NUMBER 001-X DISCHARGE NUMBER DMR Mailing ZIP CODE: MINOR (SU BR 03) 12590 NAME: ADDRESS: A TTN: DAWN MONITORING PERIOD MM/DDNYYY I I M MIDDNYYY 09/01/2010 I TO I 09/30/2010 External Outfall FROM No DischargeD PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. EX FREQUENCY SAMPLE OF ANALYSIS TYPE VALUE VALUE UNITS VALUE VALUE VALUE UNITS Solids, suspended percent removal SAMPLE MEASUREMENT PERMIT REQUIREMENT 81011 KO Percent Removal I certify under-penalty of law that. thill document and all att~hmmts were prepared under my direction or supervision in BCcordlllce with 8 system de>igned to <ri~re Ihm I1Jwifitd pmonnel properly gather and evaluate the infonnalion submitted. Based on my inquiry oflbe penon or penons who manege the system, or those persons directly responsible for g~hering the infonnatiOll. the information submitted is, ~Oc~~~~}:=~'rt(;~1J~ ~~~t~~c~d~:~:np~~bif~~~tf:'e :fu~.i,~~~~f::h~~~ violmiona. TELEPHONE DATE NAMEmTLE PRINCIPAL EXECUTIVE OFFICER 845 463 7310 10/20/2010 AREA Code NUMBER MMlDDIYYYY COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) EPA Form 3320-1 (Rev.01l06) Previous editions may be used. Page 3