20210824_DWR

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: 78-52 Project Acti!7t
Modification Transfer Release
Applicant Name: Williams Dirt and Sand LLC
Applicant's Email: County:
Project Name: Williams Dirt and Sand YES NO Date Commencing
Have land disturbing activities started?? X 171 01/01/2004
Latitude: 34.8664 Longitude: -79.0440
Please return comments to (at DEMLR CO): Adam Parr [e-mail]
Comments due by: 09/08/2021
SECTION • TO BE FILLED OUT BY DWR
YES NO
Is this mine an active permit in BIMS? ✓
Is the RO concerned that the operation, as proposed, would violate standards of water quality? F 1 ✓
Comments: Per info provided by applicant. JID provid-led- showing no waters.
Does this mine (or previous owner) have DWR back fees to pay? Ll ./
(If Yes, amount):
Watershed/Stream Name & Classification: UT to Little Marsh Swamp C;Sw
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? �✓ �✓
Is a Pumping Operation & Monitoring (OM) Plan needed?
Are wetlands disturbed at this site? I ❑ I Z
Does DWR RO suspect or know of nearby wetlands to the site? I ❑ 1 �✓
Is a wetland delineation required prior to DWR issuing the permit? I El 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?
Rev.April 2021

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 ❑ z
because DWR requires more information)?
Has Violation
O&M Requirements
HQW/7Q10 Concerns
Pay back fees or renew DWR permit LI
Other
Please describe the
reason to hold the
permit:
RO contact: Hold Until:
Mine must wait to dewater until an O&M plan is approved?
Reviewed by
Central Office Date Regional Office Date
DWR RO Surface Water Chad Turlington 08/23/2021
RO Aquifer Protection Section
Rev.April 2021