DWR 27-55 - 02_BALLANCE TRACT MINE

Return PDF of this form to DEMLR CO by email. cc DEMLR RO, DWR SPU. Send a copy to the permittee.
DIVISION OF WATER RESOURCES
MINING PERMIT APPLICATION REVIEW FORM
THIS SECTION TO BE OUT BY DEIVILR
DEMLR PERMIT: 27-55 Project Acti!7t
Modification Transfer Release
Applicant Name: Allied Properties, LLC
Applicant's Email: [e-mail] County: Currituck
Project Name: Ballance Tract Mine YES NO Date Commencing
Have land disturbing activities started?? X
Latitude: 36.4596 Longitude: -76.1198
Please return comments to (at DEMLR CO): Adam Parr [e-mail]
Comments due by: 12/18/2021
SECTION • TO BE FILLED OUT BY DWR
YES NO
Is this mine an active permit in BIMS? P
Is the RO concerned that the operation, as proposed, would violate standards of water quality? F I I ✓
Comments:
Does this mine (or previous owner) have DWR back fees to pay?
(If Yes, amount):
Watershed/Stream Name & Classification: UT to NEW BRIDGE CREEK
DWR Compliance Status of Mine:
401 Wetland Cert. required? ✓
401 Wetland Cert. existing? ✓
(If Yes, Permit#):
Does DWR RO have enough information to determine if a 401 certification is required? Z I ❑
Is an O & M Plan needed? ✓
Are wetlands disturbed at this site? z
Does DWR RO suspect or know of nearby wetlands to the site? I �✓ ❑
Is a wetland delineation required prior to DWR issuing the permit? I ✓
JD
Consultant
Onsite ❑
Offsite ❑ ❑
Stream Determination Needed? I ❑ I Z
Stream Determination Completed? 1 ❑ z
Does DWR RO need a statement that no wetlands/streams are disturbed for this project ❑ ❑✓
from applicant?
Buffer Determination Needed? ✓
Buffer Determination Completed? �✓
Recycle system permit existing? Ll 1 ❑
(If Yes, Permit#):
New Recycle System permit required? ❑ ✓
Enough information to determine? 1�✓ El I
Rev. December 2020-2020rl

Return PDF of this form to DEMLR CO by email. cc DEMLR RO, DWR SPU. Send a copy to the permittee.
Non-discharge permit existing? ✓
(If Yes, Permit#):
Will wastewaters discharge to HQW waters with a 7Q10=0? ✓
7Q10 Flow:
Unknown Permittee must determine
Does DWR require DEMLR to hold the permit (e.g. so DWR can review it further or ❑✓ ❑
because DWR requires more information)?
Has Violation
O&M Requirements ❑
HQW/7Q10 Concerns 1 El
Pay back fees or renew DWR permit ❑ ❑
Other
Please describe the reason to hold the permit:
RO contact: I Hold Until:
Mine must wait to dewater until an O&M plan is approved? L Z_
Reviewed by
77777 Central Office Date Regional Office Date
DWR RO Surface Water I ROBERT TANKARD 01/08/2021
RO Aquifer Protection Section
Rev. December 2020-2020r1