NCG020437_COMPLETE FILE - HISTORICAL_20180215

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V
DOC TYPE
Ld'HISTORICALFILE
❑ MONITORING REPORTS
DOC DATE
❑
YYYYMMDD

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCGNE
DOC TYPE
❑ HISTORICAL FILE
DOC DATE
❑
YYYYM MDD
0

State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STATE'STORMWATER PERMIT NAME/OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION
1. Stormwater Management Permit Number: 1vc o237lC�g-� ��
2. Project Name: Forterra Brick - Sampson Mine 11
3. Current Permit Holder's Company Name/Organization: Forterra Brick, LLC
4. Signing Official's Name: J. David McKeown Title: Regional Environmental Manager
5. Mailing Address: 5100 Brickyard Road
City: Columbia State: SC Zip: 29203
6. Phone: ( 803 ) 691-3121 Fax: 8( 03 ) 786-9703' RECFI,/F
FEB 15 2M8
II. PROPOSED PERMITTEE / OWNER / PROJECT / ADDRESS INFORMATLON4,( „L HLES
This request is for: (please check all that apply) DWR SECTION
0 Name change of the owner (Please complete Items 1, 2 and 3 below)
❑ Name change of project (Please complete Item 5 below)
❑ Change in ownership of the property/company (Please complete Items 1, 2, 3, and 4 below)
❑ Mailing address / phone number change. (Please complete Item 4 below)
Other (please explain):
1. Proposed permittee's company name/organization: Meridian Brick I -LC
?. Proposed. permittee's signing official's name: J. David McKeown
3. Proposed permittee's title: Corporate Environmental Manager
4. Mailing Address: 5100 Brickyard Road
City: Columbia State: SC
Phone: [phone] T Fax: ( 803 )786-9703
Zip: 29203
5. New Project Name to be placed on permit: Meridian Brick Lt-C - Sampson Mine n
Please check the appropriate box. The proposed permittee listed above is:
❑ HOA or POA (Attach documentation showing that the HOA or POA owns, controls, or has a
recorded easement for all areas that contain stormwater system features. Print name of HOA or
POA in #1 above and provide name of HOA/POA's authorized representative in #2 above)
® The property owner
❑ Lessee (Attach a copy of the lease agreement and complete Property Owner Information on
Page 4)
❑ Purchaser (Attach a copy of the pending sales agreement. Final approval of this transfer will bs
granted upon receipt of a copy of the recorded deed)
❑ Developer (Complete Property Owner Information on page 4)
SSW N/O Change Rev24Sept2012 Page 1 of 4

III. REQUIRED ITEMS
A request to transfer a permit will not be approved by the Division of Water Quality (DWQ) unless all
of the applicable required items listed below are included with the submittal. Failure to provide the
listed items may result in processing delays or denial of the transfer.
1. This completed and signed form. This certification must be completed and signed by both the
current permit holder and the new applicant if this is a change: of ownership.
2. Legal documentation of the property transfer to a new owner.
3. A copy of any recorded deed restrictions, covenants, or easements, if required by the permit.
4. The designer's certification (DWQ Engineer and Designer Certification Forms are available from
each DWQ Regional office), if required by the permit and if not already submitted to DWQ.
5. If the proposed permittee is a firm, partnership, association, institution, corporation, limited liability
company, or other corporate entity, provide documentation showing the authority of the named
representative to act on behalf of the proposed permittee.
6. The $40.00 processing fee. If this is an initial transfer from the original permittee the processing
fee is not required. Subsequent ownership transfers will require the $40.00 processing fee.
IV. CURRENT PERMITTEE'S CERTIFICATION
Please check one of the following statements and fill out the certification below that statement:
® Check here if the current permittee is only changing his/her/its name, the project name, or mailing
address, but will retain the permit. I, �� _, the current
permittee, hereby notify the DWQ that I tm changing my name and/or I am changing my mailing
address and/or I am changing the name of the permitted project. I further attest that this application
for a name/ownership change is accurate and complete to the best of my knowledge. I understand
that if all required parts of this application are not completed or if all required supporting information
and attachments listed above are not included, this application package will be returned as
incomplete.
I] Check here if current permittee is transferring the property to a new owner and will not retain
ownership of the permit.
1, , the current permittee, am submitting this application
for a transfer of ownership for permit # . I hereby notify DWQ of the sale or
other legal transfer of the stormwater system associated with this permit. I have provided a copy of
the most recent permit, the designer's certification for each BMP, any recorded deed restrictions,
covenants, or easements, the DWQ approved plans and/or approved as -built plans, the approved
operation and maintenance agreement, past maintenance records, and the most recent DWQ
stormwater inspection report to the proposed permittee named in Sections II and V of this form. I
further attest that this application for a name/ownership change is accurate and complete to the best
of my knowledge_ I understand that if all required parts of this application are not completed or if all
required supporting information and attachments fisted above are not included, this application
package will be returned as incomplete. I assign all rights and obligations as permittee to the
proposed permittee named in Sections II and V of this form. I understand that this transfer of
ownership cannot be approved by the DWQ unless and until the facility is in compliance with the
permit.
Signature:
I
Date:
a Notary Public for the State of
County of , do hereby certify that
personally appeared before me this the
day of , 20 , and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal, (Notary Seal)
Notary Signature
SSW N/O Change Rev24Sept2012 Page 2 of 4

V. PROPOSED PERMITTEE CERTIFICATION: (This section must be completed by the
Proposed Permittee for all transfers of ownership)
I, , hereby notify the DWQ that I have acquired
through sale, lease or legal transfer, the responsibility for operating and maintaining the permitted
stormwater management system, and, if applicable, constructing the permitted system. I
acknowledge and attest that I have received a copy of: (check all that apply to this permit)
ethe most recent permit
the designer's certification for each BMP
❑ any recorded deed restrictions, covenants, or easements
❑ the DWQ approved plans and/or approved as -built plans
❑ the approved operation and maintenance agreement
❑past maintenance records from the previous permittee (where required)
DWQ stormwater inspection report showing compliance within 90 days prior to this transfer
I have reviewed the permit, approved plans and other documents listed above, and I will comply with
the terms and conditions of the permit and approved plans. I acknowledge and agree that I will
operate and maintain the system pursuant to the requirements listed in the permit and in the
operation and maintenance agreement. I further attest that this application for a name/ownership
change is accurate and complete to the best of my knowledge. i understand that if all required parts
of this application are not completed or if all required supporting information and attachments listed
above are not included, this application package will be returned as incomplete.
Signature:
I
Date:
a Notary Public for the State of
County of , do hereby certify that
personally appeared before me this the
day of , 20 , and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal,
Notary Signature
(Notary Seal)
Additional copies of the original permit and the approved Operation and Maintenance agreement can
be obtained from the appropriate Regional Office of the Division of Water Quality.
This completed form, including all supporting documents and processing fee (if required), should be
sent to the appropriate Regional Office of the North Carolina Department of Environment and Natural
Resources, Division of Water Quality, as shown on the attached map.
Please note that if the Proposed Permittee listed above is not the property owner, the property owner
must complete and sign page 4 of this document. Both the lessee / developer and the property
owner will appear on the permit as permittees.
SSW N/O Change Rev24Sept2012 Page 3 of 4

VI. PROPERTY OWNER CONTACT INFORMATION AND CERTIFICATION
If the Proposed Permittee listed in Sections Il and V of this form is not the Property Owner, the
Property Owner must provide his/her Contact Information below and sign this form:
Printed Name:
Organization:
Title within the Organization:
Street Address:
City:
Mailing Address:
City:
Phone:
Email:
State:
(if different from street address)
State:
Fax:
Zip:
Zip:
I certify that I own the property identified in this permit transfer document and have given permission
to the Proposed Permittee listed in Sections II and V to develop and/or, lease the property. A copy
of the lease agreement or other contract, which indicates the party responsible for the construction
and/or operation and maintenance of the stormwater system, has been provided with the submittal.
As the legal property owner I acknowledge, understand, and agree by my signature below, that I will
appear as a permittee along with the lessee/developer and I will therefore share responsibility for
compliance with the DWQ Stormwater permit. As the property owner, it is my responsibility to notify
DWQ by submitting a completed Name/Ownership Change Form within 30 days of procuring a
developer, lessee or purchaser for the property. I understand that failure to operate and maintain the
Stormwater treatment facility in accordance with the permit is a violation of NC General Statute
(NCGS) 143-215.1, and may result in appropriate enforcement action including the assessment of
civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Signature of the property owner Date:
I, , a Notary Public for the State of
County of , do hereby certify that
personally appeared before me this the
day of , 20 , and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal,
Notary Signature
(Notary Seal)
SSW N/O Change Rev24Sept2012 Page 4 of 4

^a
Energy, Mineral
and Land Resources
ENV€ ONMENTAL QUALITY
Mr. J. David McKeown
Forterra Brick, LLC
5100 Brickyard Road
Columbia, SC 29203
Dear Mr. McKeown:
PAT MCCRORY
Governor
DONALD R. VAN DER VAART
Secrerury
TRACY DAVIS
Director
May 5, 2016
REC115EAVE®
MAY 11 2016
CENTRAL FILES
DV'JR SECTION
Subject: NPDES Stonnwater Permit NCG020437
Forterra Brick, LLC
Formerly Hanson Brick East, LLC
Sampson County
Division personnel received your request to revise your stormwater permit Certificate of
Coverage to accurately reflect your new company and/or facility name.
Please find enclosed the revised Certificate of Coverage. The terms and conditions contained
in the General Permit remain unchanged and in full effect. This revised Certificate of
Coverage is issued under the requirements of North Carolina General Statutes 143-215.1 and
the Memorandum of Agreement between North Carolina and the U.S. Environmental
Protection Agency.
If you have any questions or need further inf-ormation, please contact the Stormwater
Permitting Program at [phone].
Sincerely,
for Tracy E. Davis, P.E., CPM, Director
Division of -Energy, Mineral and Land
Resources
cc: Fayetteville Regional Office
Stormwater Permitting Program Files
Central Files
State of North Carolina I Emfronmental Quality I Energy, Mineral and Land Resources
1612 Mail Service Center 1 512 North Salisbury Street I Raleigh, North Carolina 27699-1612
919 707 9220 T

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
GENERAL PERMIT NO. NCG020000
CERTIFICATE OF COVERAGE No. NCG020437
S`I'ORMWATER AND PROCESS WASTEWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
Forterra Brick, LLC
is hereby authorized to discharge stormwater and to operate treatment systems and discharges
associated with mine dewatering wastewater and process wastewater from a facility located at.
Forterra Brick, LLC — Sampson Mine 11
Old Brick Mill Road SR 1403
Roseboro
Sampson County
to receiving waters designated as UT Little Coharie Creek, a class C. SW stream in the Cape Fear
River Basin in accordance with the effluent limitations, monitoring requirements, and other
conditions set forth in Parts I, II, III, and IV of General Permit No. NCG020000 as attached.
This certificate of coverage shall become effective May 5, 2016.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day May 5, 2016,
P-'cz
for Tracy E. Davis, P.E., Director
Division of hnergy, Mineral, and Land Resources
By the Authority of the Environmental Management Commission

State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STATE STORMWATER PERMIT NAME/OWNERSHIP CHANGE FORM
CURRENT PERMIT INFORMATION 7Z-tf (2)' -
w
Stormwater Management Permit Number: NC20237 ##- G 3
G
2. Project Name: Hanson Brick - Sampson Mine II
3. Current Permit Holder's Company Name/Organization:
4. Signing Official's Name: J• David McKeown
5. Mailing Address: 5100 Brickyard Road
City: Columbia
6. Phone: ( 803 ) 691-3121
Hanson Brick East, LLC
Title: Regional Environmental Manager
State: SC
Zip: 29203
Fax: [phone]
II. PROPOSED PERMITTEE / OWNER / PROJECT / ADDRESS INFORMATION
This request is for: (please check all that apply)
[x] Name change of the owner (Please complete Items 1, 2 and 3 below)
❑ Name change of project (Please complete Item 5 below)
❑ Change in ownership of the property/company (Please complete Items 1, 2, 3, and 4 below)
❑ Mailing address / phone number change. (Please complete Item 4 below)
❑ Other (please explain):
1. Proposed permittee's company name/organization: Forterra Brick, LLC
2
3
Proposed permittee's signing official's name: J- David McKeown
Proposed permittee's title
Regional Environmental Manager
4. Mailing Address: 5100 Brickyard Road
City: Columbia
Phone: 8{ 03�) 691-3121
5. New Project Name to be placed on permit
State: SC
Fax: ( 803 ) 786-9703
Zip: 29203
Forterra Brick, LLC - Sampson Mine II
Please check the appropriate box. The proposed permittee listed above is:
❑ HOA or POA (Attach documentation showing that the HOA or POA owns, controls, or has a
recorded easement for all areas that contain stormwater system features. Print name of HOA or
POA in #1 above and provide name of HOA/POA's authorized representative in #2 above)
❑x The property owner
❑ Lessee (Attach a copy of the lease agreement and complete Property Owner Information on
page 4)
❑ Purchaser (Attach a copy of the pending sales agreement. Final approval of this transfer will be
granted upon receipt of a copy of the recorded deed)
❑ Developer (Complete Property Owner Information on page 4)
/fnr.p O: t�rar 7mrr�
SSW N/O Change Rev24Sept2012 Page 1 of 4
rad L e a . =T� ,G �Lroc/�ss ��h/is

III. REQUIRED ITEMS
A request to transfer a permit will not be approved by the Division of Water Quality (DWQ) unless all
of the applicable required items listed below are included with the submittal. Failure to provide the
listed items may result in processing delays or denial of the transfer.
1. This completed and signed form. This certification must be completed and signed by both the
current permit holder and the new applicant if this is a change of ownership.
2. Legal documentation of the property transfer to a new owner.
3. A copy of any recorded deed restrictions, covenants, or easements, if required by the permit.
4. The designer's certification (DWQ Engineer and Designer Certification Forms are,available from
each DWQ Regional office), if required by the permit and if not already submitted to DWQ.
5. If the proposed permittee is a firm, partnership, association, institution, corporation, limited liability
company, or other corporate entity, provide documentation showing the authority of the named
representative to act on behalf of the proposed permittee.
6. The $40.00 processing fee. If this is an initial transfer from the original permittee the processing
fee is not required. Subsequent ownership transfers will require the $40.00 processing fee.
IV. CURRENT PERMITTEE'S CERTIFICATION
Please check one of the following statements and fill out the certification below that statement:
® Check here if the current permittee is ly changing his/her/its name, the project name, or mailing
address, but will retain the permit. I, the current
permittee, hereby notify the DWQ that I m changing my name and/or I am changing my mailing
address and/or I am changing the name of the permitted project. I further attest that this application
for a name/ownership change is accurate and complete to the best of my knowledge. I understand
that if all required parts of this application are not completed or if all required supporting information
and attachments listed above are not included, this application package will be returned as
incomplete.
❑ Check here if current permittee is transferring the property to a new owner and will not retain
ownership of the permit.
I, , the current permittee, am submitting this application
for a transfer of ownership for permit # . I hereby notify DWQ of the sale or
other legal transfer of the stormwater system associated with this permit. I have provided a copy of
the most recent permit, the designer's certification for each BMP, any recorded deed restrictions,
covenants, or easements, the DWQ approved plans and/or approved as -built plans, the approved
operation and maintenance agreement, past maintenance records, and the most recent DWQ
stormwater inspection report to the proposed permittee named in Sections II and V of this form. I
further attest that this application for a name/ownership change is accurate and complete to the best
of my knowledge. I understand that if all required parts of this application are not completed or if all
required supporting information and attachments listed above are not included, this application
package will be returned as incomplete. I assign all rights and obligations as permittee to the
proposed permittee named in Sections II and V of this form. I understand that this transfer of
ownership cannot be approved by the DWQ unless and until the facility is in compliance with the
permit.
Signature:
Date:
a Notary Public for the State of
County of , do hereby certify that
personally appeared before me this the
day of , 20 , and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal, (Notary Seal)
Notary Signature
SSW N/0 Change Rev24Sept2012 Page 2 of 4

V. PROPOSED PERMITTEE CERTIFICATION: (This section must be completed by the
Proposed Permittee for all transfers of ownership)
I, , hereby notify the DWQ that I have acquired
through sale, lease or legal transfer, the responsibility for operating and maintaining the permitted
stormwater management system, and, if applicable, constructing the permitted system.
acknowledge and attest that I have received a copy of: (check all that apply to this permit)
H
the most recent permit
the designer's certification for each BMP
❑ any recorded deed restrictions, covenants, or easements
❑ the DWQ approved plans and/or approved as -built plans
❑ the approved operation and maintenance agreement
epast maintenance records from the previous permittee (where required)
DWQ stormwater inspection report showing compliance within 90 days prior to this transfer
I have reviewed the permit, approved plans and other documents listed above, and I will comply with
the terms and conditions of the permit and approved plans. I acknowledge and agree that I will
operate and maintain the system pursuant to the requirements listed in the permit and in the
operation and maintenance agreement. 1 further attest that this application for a name/ownership
change is accurate and complete to the best of my knowledge. I understand that if all required parts
of this application are not completed or if all required supporting information and attachments listed
above are not included, this application package will be returned as incomplete.
Signature:
Date:
I, , a Notary Public for the State of
County of , do hereby certify that
personally appeared before me this the
day of , 20 , and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal,
(Notary Seal)
otary Signature
Additional copies of the original permit and the approved Operation and Maintenance agreement can
be obtained from the appropriate Regional Office of the Division of Water Quality.
This completed form, including all supporting documents and processing fee (if required), should be
sent to the appropriate Regional Office of the North Carolina Department of Environment and Natural
Resources, Division of Water Quality, as shown on the attached map.
Please note that if the Proposed Permittee listed above is not the property owner, the property owner
must complete and sign page 4 of this document. Both the lessee /developer and the property
owner will appear on the permit as permittees.
SSW N/O Change Rev24Sept2012 Page 3 of 4

VI. PROPERTY OWNER CONTACT INFORMATION AND CERTIFICATION
If the Proposed Permittee listed in Sections II and V of this form is not the Property Owner, the
Property Owner must provide his/her Contact Information below and sign this form:
Printed Name:
Organization:
Title within the Organization:
Street Address:
City:
Mailing Address:
City:
Phone:
Email:
State:
(if different from street address)
State:
Fax:
Zip:
Zip:
I certify that I own the property identified in this permit transfer document and have given permission
to the Proposed Permittee listed in Sections II and V to develop and/or, lease the property. A copy
of the lease agreement or other contract, which indicates the party responsible for the construction
and/or operation and maintenance of the stormwater system, has been provided with the submittal.
As the legal property owner I acknowledge, understand, and agree by my signature below, that I will
appear as a permittee along with the lessee/developer and I will therefore share responsibility for
compliance with the DWQ Stormwater permit. As the property owner, it is my responsibility to notify
DWQ by submitting a completed Name/Ownership Change Form within 30 days of procuring a
developer, lessee or purchaser for the property. I understand that failure to operate and maintain the
stormwater treatment facility in accordance with the permit is a violation of NC General Statute
(NCGS) 143-215.1, and may result in appropriate enforcement action including the assessment of
civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Signature of the property owner
day of
Date:
a Notary Public for the State of
County of , do hereby certify that
personally appeared before me this the
, 20 , and acknowledge the due execution of the
forgoing instrument. Witness my nand and official seal,
Notary Signature
(Notary Seal)
SSW N/O Change Rev24Sept2012 Page 4 of 4

x
Energy, Mineral
and Land Resources
ENVIRONMENTAL QUALITY
May 5, 2016
Mr. J. David McKeown
Forterra Brick, LLC
5100 Brickyard Road
Columbia, SC 29203
PAT MCCRORY
Governor
DONALD R. VAN DER VAART
N5 rvtary
TRACY DAVIS
Uireclar
Subject: NPDES Stormwater Permit NCG020437
Forterra Brick, LLC
1,'ormerly Hanson Brick East, LLC
Sampson County
Dear Mr. McKeown:
Division personnel received your request to revise your stormwater permit Certificate of
Coverage to accurately reflect your new company and/or facility name.
Please find enclosed the revised Certificate of Coverage. The terms and conditions contained
in the General Permit remain unchanged and in frill effect. ''his revised Certificate of
Coverage is issued under the requirements of North Carolina General Statutes 143-215.1 and
the Memorandum of Agreement between North Carolina and the U.S. Environmental
Protection Agency.
If you have any questions or need further information. please contact the Stormwater
Permitting Program at [phone].
cc Fayetteville Regional Office
Stormwater Permitting Program Files
Central Files
Sincerely,
ORIGINAL SIGNED W
KEN PICKL�
for Tracy E. Davis, P. ., CPM, Director
Division of Energy, Mineral and Land
Resources
f; M AY 12 2016
L_I -
' 't
Stale of'Notch Carolina I Hnvironmental Quality I Energy, Mineral and band Resources
1612 Mail Service Center 1 512 North Salisbury street I Raleigh, North Carolina 27699-1612
919 707 9220 T

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
GENERAL PERMIT NO. NCG020000
CERTIFICATE OF COVERAGE No. NCG020437
STORM WATER AND PROCESS WASTEWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the federal Water Pollution Control Act, as amended,
Forterra Brick, LLC
is hereby authorized to discharge stormwater and to operate treatment systems and discharges
associated with mine dewatering wastewater and process wastewater from a facility located at:
For -terra Brick, LLC — Sampson Mine 11
Old Brick Mill Road SR 1403
Roseboro
Sampson County
to receiving waters designated as UT Little Coharie Creek, a class C SW stream in the Cape Fear
River Basin in accordance with the effluent limitations, monitoring requirements, and other
conditions set forth in Parts I, I1, III, and IV of General Permit No. NCG020000 as attached.
This certificate of coverage shall become effective May 5, 2016.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day May 5, 2016.
ORIGINAL SIGNED W
KEN PICKLE
for Tracy E, Davis, P.E., Director
Division of Energy, Mineral, and Land Resources
By the Authority of the Environmental Management Commission

_-' State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STATE STORMWATER PERMIT NAME/OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION ��74e U' -
1. Stormwa#er Management Permit Number: NCC 237 w G Q a.,Q 3
2. Project Name: Hanson Brick - Sampson Mine Il
3. Current Permit Holder's Company Name/Organization: Hanson Brick East, LLC
4. Signing Official's Name: J. David McKeown Title: Regional Environmental Manager
5. Mailing Address: 5100 Brickyard Road
City: Columbia
6. Phone: 8( 03 ) 691-3121
State: SC Zip: 29203
Fax: $f a3 ) 786-9703
Il. PROPOSED PERMITTEE / OWNER / PROJECT I ADDRESS INFORMATION
This request is for: (please check all that apply)
x❑ Name change of the owner (Please complete Items 1, 2 and 3 below)
❑ Name change of project (Please complete Item 5 below)
❑ Change in ownership of the property/company (Please complete Items 1, 2, 3, and 4 below)
❑ Mailing address / phone number change. (Please complete Item 4 below)
❑ Other (please explain):
1. Proposed permittee's company name/organization: Forterra Brick, LLC
. Proposed permittee's signing official's name:
J. David McKeown
3- Proposed permittee's title: Regional Environmental Manager
4. Mailing Address: 5100 Brickyard Road
City: Columbia
Phone: [phone]
State: SC
Fax: ( 803 ) 786-9703
Zip: 29203
5. New Project Name to be placed on permit: Forterra Brick, LLC - Sampson Mine II
Please check the appropriate box. The proposed permittee listed above is:
❑ HOA or POA (Attach documentation showing that the HOA or POA owns, controls, or has a
recorded easement for all areas that .contain stormwater system features. Print name of HOA or
POA in #1 above and provide name of HOA/POA's authorized representative in #2 above)
© The property owner
❑ Lessee (Attach a copy of the lease agreement and complete Property Owner Information on
page 4)
❑ Purchaser (Attach a copy of the pending sales agreement. Final approval of this transfer will be
granted upon receipt of a copy of the recorded deed)
❑ Developer (Complete Property Owner Information on page 4)
/41r fJ (2 l�rarti 7 � -
SSW N/O Change Rev24Sept2012 Page 1 of 4 �D c�.�s r�� wra� ���
12
LI­e
lJ J A1�416

III. REQUIRED ITEMS
A request to transfer a permit will not be approved by the Division of Water Quality (DWQ) unless all
of the applicable required items listed below are included with the submittal. Failure to provide the
listed items may result in processing delays or denial of the transfer.
1. This completed and signed form. This certification must be completed and signed by both the
current permit holder and the new applicant if this is a change of ownership.
2. Legal documentation of the property transfer to a new owner.
3. A copy of any recorded deed restrictions, covenants, or easements, if required by the permit.
4. The designer's certification (DWQ Engineer and Designer Certification Forms are,available from
each DWQ Regional office), if required by the permit and if not already submitted to DWQ.
5. If the proposed permittee is a firm, partnership, association, institution, corporation, limited liability
company, or other corporate entity, provide documentation showing the authority of the named
representative to act on behalf of the proposed permittee.
6. The $40.00 processing fee. If this is an initial transfer from the original permittee the processing
fee is not required. Subsequent ownership transfers will require the $40.00 processing fee.
IV. CURRENT PERMITTEE'S CERTIFICATION
Please check one of the following statements and fill out the certification below that statement:
® Check here if the current permittee is ly changin his/her/its name, the project name, or mailing
address, but will retain the permit. I, /�, , the current
permittee, hereby notify the DWQ that I m changing my name and/or I am changing my mailing
address and/or I am changing the name of the permitted project. I further attest that this application
for a name/ownership change is accurate and complete to the best of my knowledge. I understand
that if all required parts of this application are not completed or if all required supporting information
and attachments listed above are not included, this application package will be returned as
incomplete.
❑ Check here if current permittee is transferring the property to a new owner and will not retain
ownership of the permit.
1, , the current permittee, am submitting this application
for a transfer of ownership for permit # . I hereby notify DWQ of the sale or
other legal transfer of the stormwater system associated with this permit. I have provided a copy of
the most recent permit, the designer's certification for each BMP, any recorded deed restrictions,
covenants, or easements, the DWQ approved plans and/or approved as -built plans, the approved
operation and maintenance agreement, past maintenance records, and the most recent DWQ
stormwater inspection report to the proposed permittee named in Sections 11 and V of this form. I
further attest that this application for a name/ownership change is accurate and complete to the best
of my knowledge. I understand that if all required parts of this application are not completed or if all
required supporting information and attachments listed above are not included, this application
package will be returned as incomplete. I assign all rights and obligations as permittee to the
proposed permittee named in Sections II and V of this form. I understand that this transfer of
ownership cannot be approved by the DWQ unless and until the facility is in compliance with the
permit.
Signature:
County of
Date:
a Notary Public for the State of
do hereby certify that
personally appeared before me this the
day of , 20 , and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal, (Notary Seal)
Notary Signature
SSW N/O Change Rev24Sept2012 Page 2 of 4

V. PROPOSED PERMITTEE CERTIFICATION: (This section must be completed by the
Proposed Permittee for all transfers of ownership)
I, , hereby notify the DWQ that I have acquired
through sale, lease or legal transfer, the responsibility for operating and maintaining the permitted
stormwater management system, and, if applicable, constructing the permitted system. I
acknowledge and attest that I have received a copy of: (check all that apply to this permit)
Hthe most recent permit
the designer's certification for each BMP
❑ any recorded deed restrictions, covenants, or easements
❑ the DWQ approved plans and/or approved as -built plans
❑ the approved operation and maintenance agreement
❑past maintenance records from the previous permittee (where required)
DWQ stormwater inspection report showing compliance within 90 days prior to this transfer
have reviewed the permit, approved plans and other documents listed above, and I will comply with
the terms and conditions of the permit and approved plans. I acknowledge and agree that I will
operate and maintain the system pursuant to the requirements listed in the permit and in the
operation and maintenance agreement. I further attest that this application for a name/ownership
change is accurate and complete to the best of my knowledge. I understand that if all required parts
of this application are not completed or if all required supporting information and attachments listed
above are not included, this application package will be returned as incomplete.
Signature: Date:
a Notary Public for the State of
County of , do hereby certify that
personally appeared before me this the
day of , 20 , and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal,
(Notary Seal)
Notary Signature
Additional copies of the original permit and the approved Operation and Maintenance agreement can
be obtained from the appropriate Regional Office of the Division of Water Quality.
This completed form, including all supporting documents and processing fee (if required), should be
sent to the appropriate Regional Office of the North Carolina Department of Environment and Natural
Resources, Division of Water Quality, as shown on the attached map.
Please note that if the Proposed Permittee listed above is not the property owner, the property owner
must complete and sign page 4 of this document. Both the lessee / developer and the property
owner will appear on the permit as permittees.
SSW N/O Change Rev24Sept2012 Page 3 of 4

VI. PROPERTY OWNER CONTACT INFORMATION AND CERTIFICATION
If the Proposed Permittee listed in Sections 11 and V of this form is not the Property Owner, the
Property Owner must provide his/her Contact Information below and sign this form:
Printed Name:
Organization:
Title within the Organization:
Street Address:
City:
Mailing Address:
City
Phone:
Email:
State:
(if different from street address)
State:
Fax:
Zip:
Zip:
certify that I own the property identified in this permit transfer document and have given permission
to the Proposed Permittee listed in Sections li and V to develop and/or, lease the property. A copy
of the lease agreement or other contract, which indicates the party responsible for the construction
and/or operation and maintenance of the stormwater system, has been provided with the submittal.
As the legal property owner I acknowledge, understand, and agree by my signature below, that I will
appear as a permittee along with the lessee/developer and i will therefore share responsibility for
compliance with the DWQ Stormwater permit. As the property owner, it is my responsibility to notify
DWQ by submitting a completed Name/Ownership Change Form within 30 days of procuring a
developer, lessee or purchaser for the property. I understand that failure to operate and maintain the
stormwater treatment facility in accordance with the permit is a violation of NC General Statute
(NCGS) 143-215.1, and may result in appropriate enforcement action including the assessment of
civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Signature of the property owner Date:
a Notary Public for the State of
County of , do hereby certify that
personally appeared before me this the
day of , 20 , and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal,
(Notary Seal)
otary Signature
SSW N/O Change Rev24Sept2012 Page 4 of 4

tic
Energy, Mineral
and Land Resources
ENVIRONMENTAL OVALITY
May 5, 2016
Mr. J. David McKeown
Forterra Brick, LLC
5 100 Brickyard Road
Columbia, SC 29203
PAT MCCRORY
Govemor
DONALD R. VAN DER VAART
Secreran,
TRACY DAVIS
Director
Subject: NPDI-S Stormwater Permit NCG020437
Forterra Brick, LLC
I ornrerly Hanson Brick East, LLC
Sampson County
Dear Mr. McKeown:
Division personnel received your request to revise your stormwater permit Certificate of
Coverage to accurately reflect your new company and/or facility name.
Please find enclosed the revised Certificate of Coverage. The terms and conditions contained
in the General Permit remain unchanged and in full effect. This revised Certificate of
Coverage is issued tinder the requirements of North Carolina General Statutes 143-21 5.1 and
the Memorandum of Agreement between North Carolina and the U.S. Environmental
Protection Agency.
If you have any questions or need further information, please contact the Stormwater
Permitting Program at [phone].
Sincerely,
MGM SIGNED B`
KEN PICKLE
for Tracy E. Davis, P.E., CPM, Director
Division of Energy, Mineral and Land
Resources
cc: Fayetteville Regional Office
Stormwater Permitting.l'rogram.L'iles
Central Files
State of Norlh Carolina I Environmental Quality I Energy, Mineral and Land Resources
1612 Mail Service Center 1 512 North Salisbury Street I Raleigh, North Carolina 27699-1612
9l9 707 9220 T

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION Of ENERGY, MINERAL, AND LAND RESOURCES
GENERAL PERMIT NO. NCG020000
CERTIFICATE OF COVERAGE No. NCG020437
STORMWATER AND PROCESS WASTEWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
Forterra Brick, LLC
is hereby authorized to'discharge storinwater and to operate treatment systems and discharges
associated with mine dewatering wastewater and process Wastewater from a facility located at:
Forterra Brick, LLC — Sampson Mine II
Old Brick Mill Road SR 1403
Roseboro
Sampson County
to receiving waters designated as UT Little Coharie Creek, a class C SW stream in the Cape Fear
River Basin in accordance with the effluent limitations, monitoring requirements, and other
conditions set forth in Parts 1, II. III, and IV of General Permit No. NCG020000 as attached.
This certificate of coverage shall become effective May 5, 2016.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day May 5, 2016.
ORIGINAL SIGNED B`
KEN PICKLE
for Tracy E. Davis, P.E., Director
Division of Energy, Mineral, and Land Resources
By the Authority of the Environmental Management Commission

Georgoulias, Bethany �. .
From:
[e-mail]
Sent:
Friday, October 23, 2015 2:41 PM
To:
SVC DENR.stormwater
Subject:
Confirmation for Renewal of DEMLR Stormwater NPDES General Permit
** Do not reply to this e-mail as it is from an unmonitored mailbox. **
Thanks for renewing your permit using our online option. No further action is necessary. The new General
Permit is available for printing from our website at http://portal.ncdenr.org/web/Ir/stormwater. If you have
questions, please contact Bethany Georgoulias at [e-mail] phone [phone] or
Bradley Bennett at [e-mail] phone [phone]. If you forgot to print your Certificate of
Coverage (COC), you can resubmit the data and print another copy.
This COC is issued pursuant to the requirements of North Carolina General Statute 143-215.1 and the
memorandum of Agreement between the state of North Carolina and the U.S. Environmental Protection
Agency, dated October 15, 2007 (or as subsequently amended.)
The General Permit authorizes discharges of stormwaterlwastewater and specifies your obligations for
discharge controls, management, monitoring, reporting, and record keeping. Please review the new permit to
familiarize yourself with all of the changes. Parts V and VI contain the Standard Conditions, including
Compliance and Liability; Reporting, Monitoring and Records requirements; Operation and Maintenance
obligations; and Definitions.
Your facility has six months from receipt of the COC to update its Stormwater Pollution Prevention Plan
(SPPP) to comply with changes in SPPP requirements. Other changes are effective immediately. Please note
that Tier 3 Actions (if applicable) are triggered by four benchmark exceedances beginning on the effective
date of -the renewal permit and do not count prior-exceedances: Please visit our website above to review the new General Permit carefully.
Your coverage under the General Permit is transferable only through the specific action of DEMLR. This
permit does not affect the legal requirements to obtain other permits which may be required by DEQ, nor does it
relieve the permittee from responsibility for compliance with any other applicable federal, state, or local law,
rule, standard, ordinance, order, judgment, or decree.
CONFIRMATION DETAILS
Permit Number: NCG020437
Effective Date: 10-01-2015
Expiration Date: w 09-30-2020_ _ __—___—
Organization Name: Hanson Brick East LLC
.Facility Name: Hanson Brick - Sampson Mine 11
Admin Region: Fayetteville
County_Name:_ - - Sampson_-_
Regulated Activity: _ Mining Activities Stormwater Discharge COC
Receiving Stream Name: M --Little Coharie Creek (Sinclair Lake)
Receiving Stream Class: C;Sw
25

Basin
;Cape Fear
Facility Address:_ -
,_ Old Brick Mill Rd Sr 1403
-Facility City
�Roseboro - -- --
��
Facility State:
-�
NC
Facility Zip:
�283_82
Affiliation Type:
Owner
Fax Number:--e_-_
_ [phone]
Work Phone Number:
[phone]
_—..,.,�---��
First Name.
�w....�_._.
Mike
Middle Name:
Last Name: _--�---�
—Shipley _ .. .� _�
....�..,.
Email:
[e-mail]
26

WDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
July 14, 2015
Hanson Brick East, LLC
Attn: Martin Brown, Plant Manager
PO Box 518
Roseboro, NC 28382
Subject- COMPLIANCE EVALUATION INSPECTION
Hanson Brick East, LLC
Sampson Mine II, Certificate of Coverage- N C G 020437
NPDES General Permit-NCG020000
Sampson County
Dear Mr. Brown:
Donald R. van der Vaart
Secretary
On July 9, 2015, a site inspection was conducted for the Sampson Mine II facility located on Old Brick Mill
Road, Roseboro, Sampson County, North Carolina. A copy of the Compliance Inspection Report is enclosed
for your review. The time and assistance provided by you and Mr. Buck Jackson, Maintenance Supervisor,
during the inspection is greatly appreciated. The site visit and file review revealed that the subject facility is
covered by NPDES General Permit-NCG020000, Certificate of Coverage- N C G 020437. Permit coverage
authorizes the discharge of stormwater and/or wastewater from the facility to receiving waters designated as
a UT to Little Coharie,Creek, a Class C;Sw waterbody in the Cape Fear River Basin.
As a result of the inspection, the facility was found to be in compliance with the conditions of the NCG020000
permit. Please refer to the enclosed Compliance Inspection Report for additional comments and
observations made during the inspection.
Please be advised that violations of the NPDES General Permit are subject to a civil penalty
assessment of up to $25,000 per day for each violation. If you or your staff has any questions,
comments, or needs assistance with understanding any aspect of your permit, please contact me at (910)
433-3394 or by e-mail at [e-mail].
Sincerely,
Michael Lawyer, CPSWQ
Environmental Program Consultant
Enclosure
cc: FRO - Land Quality Section, Stormwater Files-NCG020437
Division of Energy, Mineral, and Land Resources
Land Quality Section
Fayetteville Regional Office, 225 Green Street - Suite 714, Fayetteville, North Carolina 28301
Phone: [phone] FAX: [phone] / Internet: hftp://Nftal.ncdenr.org/web/I
An Equal Opportunity 1 Affirmative Action Employer- 50% Recycled 110% Post Consumer Paper

Compliance Inspection ReAort
Permit: NCG020437 Effective: 01/01/10 Expiration: 12/31/14 owner: Hanson Brick East LLC
SOC: Effective: Expiration: Facility: Hanson Brick - Sampson Mine II
County: Sampson Old Brick Mill Rd Sr 1403
Region: Fayetteville
Roseboro NC 28382
Contact Person: J David McKeown Title: Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
On -site representative Martin Brown 910-525-4128
On -site representative Buck Jackson 910-525-4128
Related Permits:
Inspection Date: 07/09/2015 Entry Time: 10:00AM
Primary Inspector: Mike Lawyer lot,
Secondary Inspector(s):
Exit Time: 12:35PM
Phone: [phone] Ext.729
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Mining Act^:ities Stormwater Discharge COC
Facility Status: ® Compliant Not Compliant
Question Areas:
® Storm water
(See attachment summary)
Page: 1

Permit: NCG020437 Owner- Facility: Hanson Brick East LLC
Inspection Date: 07109/2015 Inspection Type :Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
Made observations of mine site with Buck Jackson, Maintenance Supervisor. There is currently only one stormwater outfall
consisting of a "brick bat" weir in the outer perimeter berm. Stormwater runoff from the stockpile areas and slopes runs into
the excavation pits where it would then have to rise several feet before reaching the perimeter berm and weir. It was evident
at the time of inspection that stormwater does not routinely discharge from the mine site. There is also no mine dewatering
or wastewater processing activittes at the site. Annual Summary DMRs were available for review at the brick plant and
indicated no discharges for each semi-annual monitoring period during 2013 and 2014. A Stormwater Pollution Prevention
Plan (SPPP) has been developed to cover both the mine site and brick plant. The SPPP appeared to contain all permit
required components. Weekly BMP inspections are also being conducted and documented.
Permit coverage is currently in the renewal process.
Page: 2

permit; NCG020437 Owner - Facility: Hanson Brick East LLC
Inspection Date: 07/09/2015 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Stormwater Pollution Prevention Plan
Yes No NA NE
Does the site have a Stormwater Pollution Prevention Plan?
® ❑ ❑ ❑
# Does the Plan include a General Location (USGS) map?
® ❑ ❑ ❑
# Does the Plan include a "Narrative Description of Practices"?
® ❑ ❑ ❑
# Does the Plan include a detailed site map including outfall locations and drainage areas?
® ❑ ❑ ❑
# Does the Plan include a list of significant spills occurring during the past 3 years?
® ❑ ❑ ❑
# Has the facility evaluated feasible alternatives to current practices?
❑ ❑ ® ❑
# Does the facility provide all necessary secondary containment?
❑ ❑ ® ❑
# Does the Plan include a BMP summary?
® ❑ ❑ ❑
# Does the Plan include a Spiil Prevention and Response Plan (SPRP)?
Is ❑ ❑ ❑
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
® ❑ ❑ ❑
# Does the facility provide and document Employee Training?
® ❑ ❑ ❑
# Does the Plan include a list of Responsible Party(s)?
® ❑ ❑ ❑
# Is the Plan reviewed and updated annually?
® ❑ ❑ ❑
# Does the Plan include a Stormwater Facility Inspection Program?
® ❑ ❑ ❑
Has the Stormwater Pollution Prevention Plan been implemented?
® ❑ ❑ ❑
Comment
Qualitative Monitoring Yes No NA NE
Has the facility conducted its Qualitative Monitoring semi-annually? ® ❑ ❑ ❑
Comment: Monitoring records indicate no stormwater discharges.
Analytical Monitoring Yes No NA NE
Has the facility conducted its Analytical monitoring? ®❑ ❑ ❑
# Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas? ❑ ❑ U ❑
Comment: Annual summary monitoring records from 2013 and 2014 indicate no stormwater discharges
and that there is no mine dewatering or process wastewater activities/discharges occurring at
this site.
Permit and Outfalls Yes No NA NE
# is a copy of the Permit and the Certificate of Coverage available at the site? ® ❑ ❑ ❑
# Were all outfalls observed during the inspection? ® ❑ ❑ ❑
# if the facility has representative outfall status, is it properly documented by the Division? ❑ ❑ ® ❑
# Has the facility evaluated all illicit (non stormwater) discharges? ® ❑ ❑ ❑
Comment:
Page: 3

NC®LNR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P.E.
Governor Director
June 19, 2012
Hanson Brick East, LLC
Attn: Martin Brown, Plant Manager
PO Box 518
Roseboro, NC 28382
Subject: COMPLIANCE EVALUATION INSPECTION
Hanson Brick East, LLC
Sampson Mine II, Certificate of Coverage NCG020437
NPDES General Permit-NCG020000
Sampson County
Dear Mr. Brown:
Dee Freeman
Secretary
On May 24, 2012, a site inspection was conducted for the Sampson Mine II facility located on Old Brick Mill Road
in Roseboro, Sampson County, North Carolina. A copy of the Compliance Inspection Report is enclosed fog your
review. The time and assistance provided by you and Mr. Chris Egge during the inspection is greatly appreciated.
Permit coverage authorizes the discharge of stormwater and/or wastewater from the facility to receiving waters
designated as a UT (unnamed tributary) to Little Coharie Creek, a Class C;Sw waterbody in the Cape Fear River
Basin. The site visit and file review revealed that the subject facility is covered by NPDES General Permit-
NCG020000, Certificate of Coverage-NCG020437.
As a result of the inspection along with a follow-up visit on June 15, 2012, the facility was found to be in
compliance with the conditions of the NCG020000 permit. Please refer to the enclosed Compliance Inspection
Report for additional comments and observations made during the inspection.
Please be advised that violations of the NPDES General Permit are subject to a civil penalty assessment
of up to $25,000 per day for each violation. If you or your staff has any questions, comments, or needs
assistance with understanding any aspect of your permit, please contact me at [phone] or by e-mail at
[e-mail].
Sincerely,
Michael Lawyer, CPSWQ
Environmental Specialist
Enclosure
cc: -FRO-Surface Water Protection.
FRO -Land Quality
Niki Maher-WBS Compliance & Permits Unit
DWQ Central Files
Locasion; 225 Green Street, Suite 714, Fayetteville, North Carolina 28301
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748
Internet: http:tiportal.ncdenr.orglweblwq
An Equal Opportunity ;.Aiiimnatve Action Employer
One
NonhCarolina
Natuxall f

Compliance Inspection Report
Permit: NCG020437 Effective: 01/01/10 Expiration: 12/31/14 Owner: Hanson Brick East LLC
SOC: Effective: Expiration: Facility: Hanson Brick -Sampson Mine II
County: Sampson Old Brick Mill Rd Sr 1403
Region: Fayetteville
Roseboro NC 28382
Contact Person: Martin Brown Title: Plant Manager Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
On -site representative Martin Brown Phone: [phone]
On -site representative Chris Egge Phone: [phone]
Related Permits:
Inspection date: 0512412012 Entry TTiim-e�10:00 Exit Time: 12:10 PM
Primary Inspector: Mike Lawye'. e�� Phone: [phone]
Ex�2
Secondary Inspector(s) � 33z°I
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Mining Activities Stormwater Discharge COC
Facility Status: ■ Compliant n Not Compliant
Question Areas:
■ Storm Water
(See attachment summary)
Page: 1

Permit: NCG020437 Owner -Facility: Hanson Brick East LLC
Inspection Date: 0512412012 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
Inspection conducted to ensure compliance with the conditions of the NCG020000 General Permit. Met with Mr. Chris
Pgge, Production Supervisor, and Mr. Martin Brown, Plant Supervisor. Made observations of the mine site, which
appeared to be well managed with only one outfall for stormwater discharges and potential overflows from excavation
pits. Reviewed weekly inspection records for BMPs and available monitoring records, which indicated that there had been
no discharges. Facility's Stormwater Pollution Prevention Plan (SPPP) had been misplaced and could not be located at
the time of inspection. A follow-up visit was conducted on 6/15/12 in order to review the facility's SPPP. The SPPP
appeared to contain all permit -required components.
Page: 2

Permit: NCG020437 Owner - Facility: Hanson Brick East LLC
Inspection Date: 05/2412012 Inspection Type: Compliance Evaluation
Stormwater Pollution Prevention Plan
Does the site have a Stormwater Pollution Prevention Plan?
# Does the Plan include a General Location (USGS) map?
# Does the Plan include a "Narrative Description of Practices"?
is Does the Plan include a detailed site map including outfal€ locations and drainage areas?
# Does the Plan include a list of significant spills occurring during the past 3 years?
# Has the facility evaluated feasible alternatives to current practices?
# Does the facility provide all necessary secondary containment?
# Does the Plan include a BMP summary?
# Does the Plan include a Spill Prevention and Response Plan (SPRP)?
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
# Does the facility provide and document Employee Training?
# Does the Plan include a list of Responsible Party(s)?
# Is the Plan reviewed and updated annually?
# Does the Plan include a Stormwater Facility Inspection Program?
Has the Stormwater Pollution Prevention Plan been implemented?
Comment:
Qualitative Monitoring
Has the facility conducted its Qualitative Monitoring semi-annually?
Comment: Available records indicate no discharges.
Analytical Monitoring
Has the facility conducted its Analytical monitoring?
# Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas?
Comment: Available monitoring records indicate no discharges.
Permit and Outfalls
# Is a copy of the Permit and the Certificate of Coverage available at the site?
# Were all outfalls observed during the inspection?
# If the facility has representative outfall status, is it properly documented by the Division?
# Has the facility evaluated all illicit (non stormwater) discharges?
Comment:
Reason for Visit: Routine
Yes No NA NE
■nnn
nn■❑
Yes No NA NE
Page: 3

r. "
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue
Governor
Thomas Greene
Hanson Brick East LLC
15720 John J Delaney Dr
Charlotte, NC 28277
Dear Permittee:
Coleen H. Sullins
Director
February 11, 2010
Dee Freeman
Secretary
Subject: NPDES Stormwater Permit Coverage Renewal
Hanson Brick - Sampson Mine II
COC Number NCG020437
Sampson County
In response to your renewal application for continued coverage under stormwater General Permit NCG020000
the Division of Water Quality (DWQ) is forwarding herewith the reissued stormwater General Permit. This permit
is reissued pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of
Agreement between the state of North Carolina and the U.S. Environmental Protection Agency, dated October 15,
2007 (or as subsequently amended).
The following information is included with your permit package:
• A new Certificate of Coverage
• A copy of stormwater General Permit NCG020000
• A copy of a Technical Bulletin for the General Permit
• Two copies of the Tier 2 / Exceedence Discharge Monitoring Report (DMR) Form for Stormwater
• One copy each of the Annual Summary DMR Forms for Stormwater and Wastewater
• Two copies of the Limit Violation DMR Form for Wastewater
• Two copies of the Qualitative Monitoring Report Form
The General Permit authorizes discharges of stormwater and wastewater, and it specifies your obligations with
respect to discharge controls, management, monitoring, and record keeping. Please review the new permit to
familiarize yourself with all the changes in the reissued permit. If your Certificate of Coverage (COC) restricts
authorization to discharge stormwater only (or other limited terms) based on your original application, or
subsequent modifications to your COC, you must continue to meet these requirements or contact the Stormwater
Permitting Unit to request a modification of this renewal COC.
The more significant changes in the General Permit since your last Certificate of Coverage include the following:
Part II:
• Section B — Language referencing PAMS has been changed. Flocculants may now be used if evaluated
by the Division and administered in accordance with maximum application doses and other requirements.
Part III:
• Section A — The permit now requires a Stormwater Pollution and Prevention Plan (SPPP) tailored to the
mining industry, in lieu of a Stormwater BMP Plan.
• Section A - Inactive mines may be inspected on a reduced schedule: at least once per month and after
0.5" (or more) of rain. To qualily, inactive mines must possess an "Inactive Renewal" from DLR or certify
to DWQ the site has been stabilized. The permittee must notify the DWQ Regional Office of inactive
status. Discharges from inactive mines must still be monitored on the same schedule as active mines.
Wetlands and Stormwater Branch
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Rale'lgh, North Carolina 27604 One
Phone: [phone] l FAX: [phone] Customer Service: 1-877-623-6748 Nofth Carolina
Internet: www.ncwatefquality.org Na fu yrall'y
An Equal Opportunity 1 Affrmanve Action Employer i L

t
Permit Reissuance — Permit Number NCG020437
February 11, 2010
Page 2
• Section B — Revised provisions require that stormwater discharges be sampled twice per year (instead of
annually), and that the sampling results be compared to new benchmark values. (The previous cut-off
concentrations have been removed.)
• Section B — Revised provisions require the permittee to execute Tier One, Tier Two & Tier Three
response actions, based on the first benchmark exceedence (Tier One) and the second consecutive
benchmark exceedence (Tier Two). Tier Two requires that the permittee institute monthly monitoring
(reported to the appropriate Regional Offices) instead of twice -per -year monitoring. Monthly monitoring
shall be done until three consecutive monitoring events show no benchmark exceedences.
• Section B — This part contains a new provision that four exceedences of any benchmark will trigger
increased DWQ involvement in the permittee's stormwater management and control actions. DWQ may
direct the permittee to apply for an individual permit, institute specific monitoring, or may direct the
implementation or installation of specific stormwater control measures.
• Section B — The definition of "Representative Storm Event' (RSE) now allows 48 hours (instead of 72
hours) of little or no precipitation to precede an RSE.
• Section B — Stormwater discharges from a basin designed to contain the 10-year storm must now be
monitored.
• Sections B & C — Failure to monitor according to permit terms triggers monthly monitoring for the
remainder of the permit.
• Section C — Analytical monitoring for Total Petroleum Hydrocarbons (TPH) has replaced the Oil & Grease
parameter in the previous permit.
• Section D — Qualitative monitoring must now be conducted during the same representative storm event
as the analytical monitoring.
• Section D — The permittee is required to keep a written record of his response to problems identified by
his qualitative monitoring observations.
• Section D — If the permittee fails to respond effectively to problems identified by qualitative monitoring, the
permittee may be required by DWQ to perform corrective action.
Section D — Qualitative ROS: Representative Outfall Status may be granted for qualitative monitoring for
some Stormwater Discharge Outfalls (SDOs).
• Section D — If mines do not respond to problems seen in visual monitoring, DWQ may now require that
mines change the monitoring frequency, apply for an individual permit, implement in -.stream monitoring,
install or modify structural stormwater controls, or implement other controls.
• Sections B, C, & D — Inability to sample due to adverse weather must be reported in the SPPP and
recorded in the Annual Summary DMR.
• Section E — A lower TSS Wastewater limit for PNA waters is included in the permit.
• Section E — All mining operations are now required to monitor TSS in wastewater effluent discharges (not
only industrial sand mines). However, TSS limits only apply to industrial sand mining operations.
• Section E — Turbidity limits on effluent discharges have been removed; however, turbidity standards still
apply in the receiving waters.
• Section E — Approval of a Pumping O&M Plan may be required prior to coverage (for sites with
dewatering activities that have the potential to drain wetlands or other surface waters).
• Section E — ATC Requirements have been changed for clarity. These requirements are now outlined for
Mine Dewatering Wastewater, Process Wastewater, Overflow From Non -Closed -Loop Process Recycle
Wastewater Systems, and Overflow From A Closed -Loop Process Recycle (CLPR).
• Section E — Monitoring for Fecal coliforms in discharges to SA waters has been clarified. Fecal coliform
monitoring is now required for all process and mine dewatering wastewater discharges to SA waters.
Part IV:
• Section E — Items 1. and 2. require submittal of a new reporting form: the Annual Summary DMR. This
annual summary of the analytical monitoring results should be submitted to the DWO Central Office by
March 1 of each year.
• Section E — Exceedences and violations must be sent to the appropriate DWQ Regional Office within 30
days of receipt from the lab.
• Section E — Results of "No Flow" or "No Discharge" must be recorded within 30 days from the sampling
period in the SPPP. "No flow" or "No Discharge" must also be reported on the Annual Summary DMR
form.

Permit Reissuance -- Permit Number NCG020437
February 11, 2010
Page 3
Your coverage under the General Permit is transferable only through'the specific action of DWQ.
This permit does not affect the legal requirements to obtain other permits which may be required by DENR, nor
does it relieve the permittee from responsibility for compliance with any other applicable federal, state, or local
law, rule, standard, ordinance, order, judgment, or decree.
If you have any questions regarding this permit package please contact these members of the Stormwater
Permitting Unit: Jennifer Jones at [phone] or Bethany Georgoulias at [phone].
cc: DWQ Central Files
Stormwater Permitting Unit Files
Fayetteville Regional Office
Sincerely,
for Coleen N. Sullins
sr
�yo3
upaakd/

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG020000
CERTIFICATE OF COVERAGE No. NCG020437
STORMWATER, MINE DEWATERING WATER AND/OR PROCESS WASTEWATER
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards
and regulations promulgated and adopted by the North Carolina Environmental Management
Commission, and the Federal Water Pollution Control Act, as amended,
Hanson Brick East LLC
is hereby authorized to operate approved wastewater treatment system(s) and discharge stormwater
and/or wastewater, as approved in the original permit/application or subsequent permit modification,
from a facility located at:
Hanson Brick - Sampson Mine II
1 Mi N Of Hwy 24 On SO
Roseboro
Sampson County
to receiving waters designated as UT Little Coharie Creek, a class C SW waterbody in the Cape Fear
River Basin in accordance with the effluent limitations, monitoring requirements, and other conditions
set forth in Parts 1, II, III, IV, V, and VI of General Permit No. NCG020000 as attached.
This certificate of coverage shall become effective February 11, 2010.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this 111h day of February, 2010.
for Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

Dylan Walters
Hanson Brick East LLC
15720 John J Delaney Dr
Charlotte, NC 28277
Dear Permittee:
4
Michael F. Easley. Covernor
William G. Ross Jr.. Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek. P.E. Director
Division of Water Quality
February 7, 2005
F LJ Z I ZU05
Lim V V
Subject: NPDES Stormwater Permit Coverage Renewal
Hanson Brick - Sampson Mine II
COC Number NCG020437
Sampson County
In response to your renewal application for continued coverage under general permit NCG020000 the Division of Water
Quality (DWQ) is forwarding herewith the reissued stormwater general permit. Please review the new permit to familiarize
yourself with the changes in the reissued permit. The general permit authorizes discharges of stormwater and some types of
wastewater. You must meet the provisions of the permit for the types of discharges present at your facility. This permit is
reissued pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement
between the state of North Carolina and the U.S. Environmental Protection Agency, dated December 6, 1983.
The following information is included with your permit package:
• A new Certificate of Coverage
• A copy of General Stormwater Permit NCG020000
• A copy of a Technical Bulletin for the general permit
• Five copies of Discharge Monitoring Report (DMR) Forms - wastewater and stormwater
• Five copies of Qualitative Monitoring Report Form
Your coverage under this general permit is not transferable except after notice to DWQ. The Division may require modification
or revocation and reissuance of the Certificate of Coverage. This permit does not affect the legal requirements to obtain other
permits which may be required by DENR or relieve the permittee from responsibility for compliance with any other applicable
federal, state, or local law, rule, standard, ordinance, order, judgment, or decree.
If you have any questions regarding this permit package please contact Ken Pickle of the Central Office Stormwater Permitting
Unit at [phone], ext.584.
Sincerely,
for Alan W. Klimek, P.E.
cc: Central Files
Stormwater & General Permits Unit Files
Fayetteville Regional Office
No e hCarolina
lValumlly
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Phone [phone] Customer Service
Internet: h2o.enr.state.nc.uslsulstorrnwater.html 512 N. Salisbury St. Raleigh, NC 27604 FAX [phone]
An Equal OpportunitylAf rmative Action Employer — 50% Recyded110% Post Consumer Paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG020000
CERTIFICATE OF COVERAGE No. NCG020437
STORMWATER AND PROCESS WASTEWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and
the Federal Water Pollution Control Act, as amended,
Hanson Brick East LLC
is hereby authorized to discharge stormwater and to operate treatment systems and discharges associated
with mine dewatering wastewater and process wastewater from a facility located at
Hanson Brick - Sampson Mine 11
1 Mi N Of Hwy 24 On Sr1
Roseboro
Sampson County
to receiving waters designated as UT Little Coharie Creek, a class C SW stream in the Cape Fear River
Basin in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in
Parts 1, II, 111, IV, V, and VI of General Permit No. NCG020000 as attached.
This certificate of coverage shall become effective February 7, 2005.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day February 7, 2005
z et,�
for Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

o�0� w
b-
wa),
—I
February 7, 2005
Dylan Walters
Hanson Brick East LLC
15720 John J Delaney Dr
Charlotte, NC 28277
Michael F. Easley, Governor
William G. Ross Jr., Secretary,
North Carolina Department of Environment and Natural Resources
Alan W. Klimek_ P.E. Director
Division of Water Quality
Subject: NPDES Stormwater Permit Coverage Renewal
Hanson Brick - Sampson Mine II
COC Number NCG020437
Sampson County
Dear Permittee:
In response to your renewal application for continued coverage under general permit NCG020000 the Division of Water
Quality (DWQ) is forwarding herewith the reissued stormwater general permit. Please review the new permit to familiarize
yourself with the changes in the reissued permit. The general permit authorizes discharges of stormwater and some types of
wastewater. You must meet the provisions of the permit for the types of discharges present at your facility. This permit is
reissued pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement
between the state of North Carolina and the U.S. Environmental Protection Agency, dated December 6, 1983.
The following information is included with your permit package:
• A new Certificate of Coverage
• A copy of General Stormwater Permit NCG020000
•. A copy of a Technical Bulletin for the general permit
• Five copies of Discharge Monitoring Report (DMR) Forms - wastewater and stormwater
• Five copies of Qualitative Monitoring Report Form
Your coverage under this general permit is not transferable except after notice to DWQ. The Division may require modification
or revocation and reissuance of the Certificate of Coverage. This permit does not affect the legal requirements to obtain other
permits which may be required by DENR or relieve the permittee from responsibility for compliance with any other applicable
federal, state, or local law, rule, standard, ordinance, order, judgment, or decree.
If you have any questions regarding this permit package please contact Ken Pickle of the Central Office Stormwater Permitting
Unit at [phone], ext.584.
Sincerelv,
'tell Y�
for Alan W. Klimek, P.E.
cc: Central Files
Stormwater & General Permits Unit Files
Fayetteville Regional Office
Noo'rthCarolina
Nittura!!y
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Phone [phone] Customer Service
Intemet: h2o.enr.state.nc.uslsulstormwater.html 512 N. Salisbury St. Raleigh, NC 27604 FAX [phone]
An Equal OpportunitylAifirmative Action Employer— 50% Recycledll0% Post Consumer Paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG020000
CERTIFICATE OF COVERAGE No. NCG020437
STORMWATER AND PROCESS WASTEWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and
the Federal Water Pollution Control Act, as amended,
Hanson Brick East LLC
is hereby authorized to discharge stormwater and to operate treatment systems and discharges associated
with mine dewatering wastewater and process wastewater from a facility located at
Hanson Brick - Sampson Mine II
1 Mi N Of Hwy 24 On SO
Roseboro
Sampson County
to receiving waters designated as UT Little Coharie Creek, a class C SW stream in the Cape Fear River
Basin in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in
Parts I, ll, III, IV, V, and VI of General Permit No. NCG020000 as attached.
This certificate of coverage shall become effective February 7, 2005.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day February 7, 2005
for Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG020000
CERTIFICATE OF COVERAGE No. NCG020437
STORMWATER, MINE DEWATERING, AND/OR OVERFLOW FROM
PROCESS WATER RECYCLE SYSTEMS DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
Hanson Brick East LLC
is hereby authorized to discharge stormwater and to operate or continue operation of treatment systems and
discharges associated with mine dewatering and process wastewater recycling overflow from a facility located at
Hanson Brick — Sampson Mine II.
Mile north of highway 24 on SR 1403
Roseboro
Sampson County
to receiving waters designated as a unnamed tributary to Little Coharie Creek, class C SW waters, in the Cape
Fear River Basin in accordance with the effluent limitations, monitoring requirements, and other conditions set
forth in Parts I, II, III, IV, V, VI and VII of General Permit No. NCGO20000 as attached.
This certificate of coverage shall become effective January 5, 2004.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day January 5, 2004.
W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

State of North Carolina
Department of Environment-- - ---
and Natural Resources
Division of Water Quality ;
Michael F. Easley, Governor fN 2004
William G. Ross Jr., Secretary f
Alan W. Klimek, P.E., Director
January 5, 2004
Mr. Whit Wilson
Hanson Brick East LLC
PO Box 518
Roseboro, North Carolina 28382
/ • m
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
Subject: NPDES Permit Modification — Name/Ownership Change
Permit NCG020437
Hanson Brick — Sampson Mine II
(Formerly Boren Clay Products)
Sampson County
Dear Mr. Wilson:
In accordance with your request received November 24, 2003, the Division is forwarding the subject
permit modification. This modification documents the change in name at the subject facility. All other terms and
conditions in the original permit remain unchanged and in full effect. This permit modification is issued under the
requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement between North
Carolina and the U. S. Environmental Protection Agency dated December 6, 1983.
If any parts, measurement frequencies or sampling requirements contained in this permit modification are
unacceptable to you, you have the right to an adjudicatory hearing upon written request within thirty (30) days
following receipt of this letter. This request must be a written petition conforming to Chapter 150E of the North
Carolina General Statutes, filed with the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh,
North Carolina 27699-6714. Unless such demand is made, this decision shall be final and binding.
This permit does not affect the legal requirement to obtain other permits which may be required by the
Division of Water Quality, the Division of Land Resources, Coastal Area Management Act, or any other Federal or
Local government permit that may be required. If you have any questions concerning this permit, please contact
Valery Stephens at the telephone number or address listed below.
Sincerely,
Iva
Klimek, P.E.
cc: Central Files
Fayetteville Regional Office, Water Quality Section
NPDES Unit
1617 Mail Service Center, Raleigh, North Carolina 27699.1617
919 733-5093, extension 520 (fax) 919 733-0719
VISIT US ON THE INTE14NET @ httpJ/h2o.enr.slate.nc.us/ [e-mail]

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross Jr., Secretary
Alan W. Klimek, P.E., Director
January 5, 2004
Mr. Whit Wilson
Hanson Brick East LLC
PO Box 518
Roseboro, North Carolina 28382
1 IN Jw
LTo
NCDENR
NORTH CAROUNA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
Subject: NPDES Permit Modification — Name/Ownership Change
Permit NCG020437
Hanson Brick — Sampson Mine II
(Formerly Boren Clay Products)
Sampson County
Dear Mr. Wilson:
In accordance with your request received November 24, 2003, the Division is forwarding the subject
permit modification. This modification documents the change in name at the subject facility. All other terms and
conditions in the original permit remain unchanged and in full effect. This permit modification is issued under the
requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement between North
Carolina and the U. S. Environmental Protection Agency dated December 6, 1983.
If any parts, measurement frequencies or sampling requirements contained in this permit modification are
unacceptable to you, you have the right to an adjudicatory hearing upon written request within thirty (30) days
following receipt of this letter. This request must be a written petition conforming to Chapter 150B of the North
Carolina General Statutes, filed with the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh,
North Carolina 27699-6714. Unless such demand is made, this decision shall be final and Minding.
This permit does not affect the legal requirement to obtain other permits which may be required by the
Division of Water Quality, the Division of Land Resources, Coastal Area Management Act, or any other Federal or
Local government permit that may be required. If you have any questions concerning this permit, please contact
Valery Stephens at the telephone number or address listed below.
cc: Central Files
Fayetteville Regional Office, Water Quality Section
NPDES Unit
1617 Mail service Center, Raleigh, North Carolina 27699-1617
Sincerely,
fan W. Klimek, P.E.
919 733-5083, extension 520 (fax) 919 733-0719
VISIT us ON THE INTERNET @ h11p:lm2o.enr.state.nc.us/ [e-mail]

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG020000
CERTIFICATE OF COVERAGE No. NCG020437
STORMWATER, MINE DEWATERING, AND/OR OVERFLOW FROM
PROCESS WATER RECYCLE SYSTEMS DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
Hanson Brick East LLC
is hereby authorized to discharge stormwater and to operate or continue operation of treatment systems and
discharges associated with mine dewatering and process wastewater recycling overflow from a facility located at
Hanson Brick — Sampson Mine II
1 Mile north of highway 24 on SR 1403
Roseboro
Sampson County
to receiving waters designated as a unnamed tributary to Little Coharie Creek, class C SW waters, in the Cape
Fear River Basin in accordance with the effluent limitations, monitoring requirements, and other conditions set
forth in Parts I, II, III, IV, V, VI and VII of General Permit No. NCG020000 as attached.
This certificate of coverage shall become effective January 5, 2004.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day January S, 2004.
\AWO. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
A 40
IT
LT4
NCDENR
l� a�D4, 2000
Mr. Whit Wilson �ECH O
Sampson Mine II
Post Office Box 25 i A it
Roseboro, North Carolina 2$382
FAYETT EVILLE.
REG, QF�-_Sugcct. General Permit No. NCG020000
Sampson Mine II
COC NCG020437
Sampson County
Dear Mr. Wilson:
In accordance with your application for discharge permit received on October 16, 1997, we are
forwarding herewith the subject certificate of coverage to discharge under the subject state - NPDES general
permit. This permit is issued pursuant to the requirements of North Carolina General Statute 143-215 .1 and the
Memorandum of Agreement between North Carolina and the US Environmental Protection agency dated
December 6, 1983.
If any parts, measurement frequencies or sampling requirements contained in this permit are
unacceptable to you, you have the right to request an individual permit by submitting an individual permit
application. Unless such demand is made, this certificate of coverage shall be final and binding.
Please take notice that this certificate of coverage is not transferable except after notice to the Division of
Water Quality. The Division of Water Quality may require modification or revocation and reissuance of the
certificate of coverage.
This permit does not affect the legal requirements to obtain other permits which may be required by the
Division of Water Quality or permits required by the Division of Land Resources, Coastal Area Management Act
or any other Federal or Local governmental permit that may be required.
If you have any questions concerning this permit, please contact Tony Evans at telephone number
919/733-5083 ext. 584.
Sincerely,
ORIGINAL SIGNED MILLS
WILLIAM C.
Kerr T. Stevens
cc: Fayetteville Regional Office
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG020000
CERTIFICATE OF COVERAGE No. NCG020437
STORMWATER, MINE DEWATERING, AND/OR OVERFLOW FROM
PROCESS WATER RECYCLE SYSTEMS DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
Boren Clay Products
is hereby authorized to discharge mine dewatering and stormwater from a facility located at
Sampson Mine 1I
I Mile North of Hwy. 24 on SR1403
Roseboro, NC
Sampson County
to receiving waters designated as an unnamed tributary to little Coharie Creek, class C-Sw waters, in the Cape Fear
River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, 11, 111-
IV, V, VI and VIl of General Permit No. NCG020000 as attached.
This certificate of coverage shall become effective January 14, 2000.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day January 14, 2000.
ORIGINAL SIGNED BY
WILLIAM C. MILLS
Kerr T. Stevens, Director
Division of Water Quality
By Authority of the Environmental Management Commission

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I I I 1 1078° 33'10.00" W' I I 1 678° 32'I0,00- W I I I D78° 31'10.00" W' 1
Name: ROSEBORO
Date: 1 /6/100
Scale: 1 inch equals 2000 feet
Location: 034' W aj -' N 0780 32' 08 " W
Caption: Stream: UT Little Coharie Creek
Class: C-Sw
Basin #: 03-06-19 Map #: H24NE
nc_

`Y
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
Mr. Whit Wilson
Sampson Mine II
Post Office Box 25
Roseboro, North Carolina 28382
Dear Mr. Wilson:
NCDENR
January 14, 2000
Subject: General Permit No. NCG020000
Sampson Mine lI
COC NCG020437
Sampson County
In accordance with your application for discharge permit received on October 16, 1997, we are
forwarding herewith the subject certificate of coverage to discharge under the subject state - NPDES general
permit. This permit is issued pursuant to the requirements of North Carolina General Statute 143-215 .1 and the
Memorandum of Agreement between North Carolina and the US Environmental Protection agency dated
December 6, 1983.
If any parts, measurement frequencies or sampling requirements contained in this permit are
unacceptable to you, you have the right to request an individual permit by submitting an individual permit
application. Unless such demand is made, this certificate of coverage shall be final and binding.
Please take notice that this certificate of coverage is not transferable except after notice to the Division of
Water Quality, The Division of Water Quality may require modification or revocation and reissuance of the
certificate of coverage.
This permit does not affect the legal requirements to obtain other permits which may be required by the
Division of Water Quality or permits required by the Division of Land Resources, Coastal Area Management Act
or any other Federal or Local governmental permit that may be required.
If you have any questions concerning this permit, please contact Tony Evans at telephone number
919/733-5083 ext. 584.
Sincerely,
Kerr T. Stevens
cc: Fayetteville Regional Office
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG020000
CERTIFICATE OF COVERAGE No. NCG020437
STORMWATER, MINE DEWATERING, AND/OR OVERFLOW FROM
PROCESS WATER RECYCLE SYSTEMS DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
Boren Clay Products
is hereby authorized to discharge mine dewatering and stormwater from a facility located at
Sampson Mine II
I M ile North of Hwy. 24 on SR 1403
Roseboro. NC
Sampson County
to receiving waters designated as an unnamed tributary to Little Coharie Creek, class C-Sw waters, in the Cape rear
River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts 1, 1I,11I,
IV, V, VI and VII of General Permit No. NCG020000 as attached.
This certificate of coverage shall become effective January 14. 2000.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day January 14, 2000.
Kerr T. Stevens, Director
Division of Water Quality
By Authority of the Environmental Management Commission

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I i I I b78° 33'10.00" WI I I I
Name: ROSEBORO
Date: 1 /6/100
Scale: 1 inch equals 2000 feet
078° 32'10.00" W I 1 I b78° 31'10.00" Wi
Location: 0340 N 0780 32' 98." W
Caption: Stream: UT Little Coharie Creek
Class: C-Sw
Basin #: 03-06-19 Map #: H24NE
1997,