NCG020878_COMPLETE FILE - HISTORICAL_20160309

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V uGUp,oBq
DOC TYPE
VHISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ V� U3U
YYYYMMDD

Conway,Jean
From: Policarpo, John N SAW [e-mail]>
Sent: Wednesday, March 09, 2016 3:54 PM
To: Coburn, Chad
Cc: Conway, Jean
Subject: RE: Google Earth Placemark: Coastal Mine 10-92.kmz
Hi Chad,
I know you're out of the office but I may have an old JD for the area but I can't tell. We can discuss when you get back. We can
add it to the list of the other enforcement complaints.
Thanks
John
John N Policarpo
US Army Corps of Engineers
Wilmington District
910-251-4487
-----Original Message -----
From: Coburn, Chad [mailto:[e-mail]]
Sent: Thursday, March 03, 2016 2:51 PM
To: Policarpo, John N SAW <[e-mail]>
Cc: Conway, Jean <[e-mail]>
Subject: [EXTERNAL] FW: Google Earth Placemark: Coastal Mine 10-92.kmz
John,
have a complaint site in Brunswick Countyjust north of Supply that I wanted to refer to you. I visited the site (mine) with Jean
Conway with our Division of Energy, Mineral, & Land Resources and found a couple ditches through wetlands and some other
issues that you might be interested in. I've included a location kmz file with the parcel, owner, and soils info from the County
web site. They have a wetlands layer that I included which looks like a mirror of the soils layer. For the most part the wetlands
overlay looks pretty accurate for the western part of the site that we looked at. I was hoping that you might be able to check
and see if a JD or preliminary JD was issued for the parcel. We saw several wetland delineation flags still left over on the site so I
told Jean that I would check with you. Maybe we can add this site to our list to visit in Brunswick?
Thanks
-----Original Message -----
From: Conway, Jean
Sent: Monday, February 29, 2016 10:57 AM
To: Coburn, Chad <[e-mail]>
Subject: Google Earth Placemark: Coastal Mine 10-92.kmz
Coastal Land and Sand mine boundary

Page 16 of 38
https:llwww.foodshield.orglmemberlworkgroupslfile.cfm?template=fileshow&gid=C5711 C... 3/8/2016

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
GENERAL PERMIT NO. NCG020000
CERTIFICATE OF COVERAGE No. NCG020878
STORMWATER AND MINE DEWATERING DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 1.43-215.1, other.lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
Charles Jackson
is hereby authorized to discharge stormwater and process wastewater and from a facility
located at
Coastal Land &: Sand Company
'610 Middle River Road
Supply
Brunswick
to receiving -waters designated as Beaver Dam Swamp, a class C, SW water in the Lumber 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:13, 2015.
This Certificate,of Coverage shall remain in effect for'theAuration of the General Permit.
.Signed this day May 13, 201.5.
ORIGINAL SIGNED M
KEN PICKLE
for Tracy E.-Davis, P.E., Director
Division of Energy, Mineral, and Land Resources
By the Authority of the Environmental Management Comrission

NCG020878
Map Scale 1:24,000
Coastal Land &.Sand Company, LLC
Coastal Land &=Sand Company Kline
Latitude: 340 03' 40" N
Longitude.: 78° 15'-45:5" W
County: Brunswick
Receiving Stream: Beaver Dam Swamp
Stream Class: C, SW
Index Number: 15-25-1-12-3 (Lumber River Basin)
=a
Facility Location

IFA
=7jP2
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Charles Jackson
Coastal Land & Sand Company, LLC
311 42nd Street -North
North Myrtle Beach, SC 20582
Dear Mr. Jackson:
Donald R. van der Vaart
Secretary
May 13, 2015
Subject: General Permit No. NCG020000
Coastal Land.& Sand Company Mine
COC NCG020878
Brunswick County
1n accordance with your application for a discharge permit -received on February 13, 20.15, we -are
forwarding herewith the subject certificate of coverage "to discharge under the subject state - NPDES
general permit. This,pertnit-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:Environmentai Protection
Agency dated October 15„ 2007 (or- as subsequently amended).
Please take notice that this certificate of coverage is not,transfei-able except after notice "to the Division of
Energy, Mineral,,and Land Resources. The Division may require � modification or revocation and
•reissuance of the certificate, of coverage.
Please note that the attached General Permit expires on June 1, 2015. Your COC will be automatically
renewed to cover the full 5-year term of the soon to be'reissued°permit. 1n the interim you inust.abide by
the terms of the expiring permit. You can review the proposed general. permit changes once they are
posted at: hM:Hp2rtal.ncdenr:org/web/wg/ws/su/current=notices
Please note that thine dewatering:wastewater includes wet"pit overflows. caused solely by direct rainfall
and groundwater seepage for this type of mining"operation. Any discharge of this water (and any
storrnwater commingled with it) is subject"to'the effluent:iimitations.in this permit.
This permit does not:affect the legal requirements to obtain other permits which may be required by the
Division of Energy, Mining, and Land Resources, orpermits required by the Division of Water
Resources; Coastal Area Management Act, or any other federal or local governmental permit"that may be
required.
Division of Energy, Mineral and Land Resources
Energy Section • Geological.Survey Section • Land Quality Section
1612 Mail Service Center, Raleigh, North Carolina•27699-1612 • Telephbne.919-707-92001 FAX: [phone]
512.North Salisbury Street,_ Raleigh, North Carolina 27604 : intemet: htt Ji rtal.ncdenr.or j/web11r1
An Equal Opportun4y l Affirmative Action Employer - 50% Recycled 110% Post Consumer Paper

Mr. Jackson
May 13, 2015
Page 2 of 2
If you have any questions concerning this permit, please contact Richard Riddle at telephone number
[phone].
Sincerely,
ORIGINAL SIGNED M
KEN PICKLE
for Tracy E. Davis. P.E., CPM
cc: Wilmington Regional Office
Central Files _ _ _
�Stormwater Permitting Program Files,/
Division of Energy, Mineral and Land Resources
1612.Mail Service Center, Raleigh, NC 27699-1612 • Phone: [phone]'•. Fax: [phone]
Location: 512 N. Salisbury Street, Raleigh, NC 27604 • htl :II ortal.ncdenr.or Iweblid
An Equal Opportunity/Affirmative Action Employer

Coastal Land & Sand Company Mine
Dewatering Operating and Monitoring Plan
April 2015
NT #.14066
The operation and monitoring of discharge water from Coastal Land & Sand
Company Mine shall adhere to the following limitations. All water that collects
within the pit area through groundwater seepage and/or direct rainfall shall be
extracted out of the pit area on an as need basis. All water that is extracted will
be routed through the adjacent pond and discharge from the pond outlet
structure.
All pond discharge will route water to onsite wetland areas by where it will collect
and slowly infiltrate ensuring maintenance of the ground water table. The
infiltration process will continually recharge the water table and also protect the
wetland areas from any impacts associated with the mining operations.
The pond outlet and conveyance swale will be required to be inspected on a
monthly basis. An inspection of the swale and outlet point shall be perfon-ned
monthly to ensure that any type of channelization is not occurring at any outlet
location. If needed, the vegetated buffer should be reestablished and
channelization should be removed. Vegetation should remain; at all times; a
minimum six (6) inches in height. All silt fencing shall remain at,the excavation
limits as. specified by site plans. Any accumulated sediment should be removed
from the base when the depth reaches one (1) foot.
Any discharge from dewatering activities shall not exceed 95,000 gpd. All
discharge shall be directed to the identified wetlands for containment and
infiltration as previously mentioned. No discharge shall overwhelm and overflow
from these wetlands therefore preventing any discharge to any off -site waters.
All waters that are discharged should be done so from the existing pond area.
By doing so this should limit the likelihood that contaminated water is being
discharged and routed through'to wetlands.
A sample of the dewatering discharge should be. taken from the pump outlet for
testing in accordance with the regulations set forth in the dewatering permit. A
log of dates indicating when dewatering has taken place shall be kept in the
mining office. Quarterly reports are required to be submitted to NCDENR DWQ.
If no dewatering has taken place. during the quarter, then a statement should be
submitted indicating that no discharge occurred during the quarter.
For questions regarding dewatering regulations and procedures, please contact
NCDENR DWQ — Richard Riddle or the appropriate representative.
JKBlneh
14066 04-02-15-43M plan

:9
Coastal Land & Sand Company Mine
Dewatering Operating and Monitoring Plan
April 2015
NT # 14066
The operation and monitoring of discharge water from Coastal Land & Sand
Company Mine shall adhere to the following limitations. All water that collects
within the pit area through groundwater seepage and/or direct rainfall shall be
extracted out of the pit area on an as need basis. All water that is extracted will
be routed through the adjacent pond and discharge from the pond outlet
structure.
All pond discharge will route water to onsite wetland areas by where it will collect
and slowly infiltrate ensuring maintenance of the ground water table. The
infiltration process will continually recharge the water table and also protect the
wetland areas from any impacts associated with the mining operations.
The pond outlet and conveyance Swale will be required to be inspected on a
monthly basis. An inspection of the swale and outlet point shall be performed
monthly to ensure that any type of channelization is not occurring at any outlet
location. If needed, the vegetated buffer should be reestablished and
channelization should be removed. Vegetation should remain; at all times; a
minimum six (6) inches in height. All silt fencing shall remain at the excavation
limits as specified by site plans. Any accumulated sediment should be removed
from the base when the depth reaches one (1) foot.
Any discharge from dewatering activities shall not exceed 95,000 gpd. All
discharge shall be directed to the identified wetlands for containment and
infiltration as previously mentioned. No discharge shall overwhelm and overflow
from these wetlands therefore preventing any discharge to any off -site waters.
All waters that are discharged should be done so from the existing pond area.
By doing so this should limit the likelihood that .contaminated water is being
discharged and routed through to wetlands.
A sample of the dewatering discharge should be taken from the pump outlet for
testing in accordance with the regulations set forth in the dewatering permit. A
log of dates indicating when dewatering has taken place shall be kept in the
mining office. Quarterly reports are required to be submitted to NCDENR DWQ.
If no dewatering has taken place during the quarter, then a statement should be
submitted indicating that no discharge occurred during the quarter.
For questions regarding dewatering regulations and procedures, please contact
NCDENR DWQ — Richard Riddle or the appropriate representative.
JKBlnah
14006 04-02-15-O&M plan

Ag
Division of Water Quality 1 Surface Water Protection
�es� mar
NCDER National Pollutant Discharge Elimination S}'stern
No . Gxo. 13 n , .cKr oe
�•�•+c*+�c.rt Iwo 4�' Res .0
NCG020000
NOTICE OF INTENT
FFott AGVN(7.)' USE ONLY
Dale Received
Year I Moni4 I Day
CcrtiGcate of Co+.. c
7
c - N. -I ;, Amofint
Pc it Assigned to
r�
4
National Pollutant Discharge'Elimination System application for coverage under General Permit
NCG020000:
STORMWATER DISCHARGES associated with activities classified as:
SIC (Standard Industrial Classification) Code - 14XX Mineral Mining Industry (except as specified below)
The following activities are also included:
• Active or inactive mining operations (including borrow pits —except for NCDOT borrow pits) that discharge
stormwater contaminated with or that has come in contact with, any overburden, raw material, intermediate
products, finished products, byproducts or waste products located on the site of.such operations;
• Stormwater from vehicle maintenance activities at mining operations;
• Overflow from facilities that recycle process wastewater; and/or
• Mine dewatering (wastewater)
The following activities are specifically excluded from coverage under this General Permit:
• Stormwater discharges associated with peat mining, coal mining, and metal mining;
• Stormwater discharges from mining operations which are intermixed on site with stormwater from asphalt
operations and/or concrete operations; [� f
• Stormwater discharges associated with oil and gas extraction operations; and ' `EC,EiVE-01
• Stormwater discharges associated with tourist gem mines C
• NCDOT borrow pits are covered under NCS000150 uC2014
The following discharges are covered by NPDES general permit NCG5200DO instead, Gt320f 00' fA,',1�•
VtUAVVATER PERMJ7TING
• Point source discharges of stormwater and wastewater from in -stream sand mining operations (i.e., san
dredging or dipping operations).
Please contact the NPDES Wastewater Point -Source Group for more information on coverage under this
permit.
Please print or tvoe al! entries in this aDDHCation form.
1) Mailing address of ownerloperator lofficial address to which all permit correspondence will be mailed):
Legal Owner Name Coastal Land& Sand Company. LLC
(Attach the most recent Annual Report to the NC Secretary of State showing the current legal name,of the corporation or entity.
Alternatively this permit can be given to an individual or government authority. This name must be the samename as -appears on the
Division of I -and Resources' Mining Permit)
Signee's Name (as signed for in permit signature at bottom) Charles Jackson. MemberyManager
Coastal Land & Sand Company. LLC
Street Address 311 42"d Street North
City North Myrtle Beach State SC ZIP Code 29582
Telephone No. 910-740-9129 Email. mjackson19(cDnc.rr.com
Alternate Contact Name Email (if different)
Alternate Contact Telephone (if different)
Page 1 of 8
SWU=NCG02-NOI Last revised 9/5/2012

rT e
'NCG020000 N.O.I.
2) Location of facility producing discharge:
Facility Name Coastal Land & Sand Company Min
Facility Street Address 610 Middle River Road
Facility City Supply State NC ZIP Code cS �! to 4,11
Facility County Brunswick
Facility Contact Charles Jackson
Telephone No, 910 740-9129 Fax:
Contact E-mail rn'ackson19(Z0c.rr_com
3) Physical Location Information:
Please provide a narrative description of how to get to the facility (useTstreet names, state road numbers, and
distance and direction from a roadway intersection). Travel North from the intersection of NC 211 and
US17 for approximately 2.14 miles to Middle River Road (SR1448Travel East'a,long Middle River Road
for approximately 1.8 miles to the site.
4) Latitude 340 3' 40 u N Longitude 78' 15' "45.5 }) W (degrees, minutes, seconds)
Permits:
5) This NPDES Permit Application applies to which of the following:
X New -or Proposed Facility
❑ Existing
6) Standard Industrial Classification:
Date operation is to begin: ASAP
Date began mining:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: 1 4 4 2
7) Provide a narrative description of the types of minerals mined at this facility: Sand
8) Is this mine an inactive mine site? �C
_No7 AAS ',��I-
CXA� 5 1*7
1
❑ Yes If yes, do you posses an "Inactive Renewal" from DEMLR and notified the DWQ Regional Office or
have you certified to the DWQ that the site has been stabilized'? ❑ No ❑ Yes
9) Does this.facility already have a valid Mining Permit from the Division of Energy,,Mineral and Land Resource:
(DEMLR) [formerly DLR]?
X No If No, please. indicate the status of the Mining Permit application: iA�'lication`iri races
❑ Yes If yes, please provide the Mining Permit number: Please also provide a
copy of your DEMLR Mining Permit with this DWQ application.
Note: DWQ cannot issue:a COC for the NCG020000 General Permit until a Mining Permit is issued or
renewed by the DEMLR.
10) Does this facility have any other NPDES permits?
X No
❑ Yes If yes, list the permit numbers for all current NPDES permits for this facility:
-Page 2 of S
SWU-NdG02-NOI Last revised 91.Y?nI?

NCG020000 N.O.I.
11) Are you applying fora mining permit in the same location as a previously permitted mine?
LX Na i
❑ Yes If yes, specify permit number and name if known:
12) Does this facility have any Non -Discharge permits (ex: recycle permits)?
X No
❑ Yes If yes, list the permit numbers for all current Non -Discharge permits for this facility:
13) Does total'area of this mine site include ready -mix and asphalt areas?
X No
❑ Yes . if yes, do they have DWO stormwater permits (if owned by the same company)? ❑ No ❑ Yes
(provide permit number }
If not owned by the same company, who is the owner?
14) Will this mining operation precede development activities at this site?
X No
❑ Yes
15) Is this mine located within one of the 20 Coastal Counties and will it add more than 10,000 ft2 of imperviou:
surface?
X No LOCATED IN COASTAL COUNTY BUT NO IMPERVIOUS PROPOSED
❑ Yes If yes, you may be required to apply for an additional state -stormwa.ter permit. Check with your local
Regional Office. See contact information and checklist below.
16) Is this mine located the Neuse, Tar-Pamlico,:or Catawba River Basins, or the Randleman or Jordan Water
supply Watersheds?
X No
❑ Yes- If yes, what size stream.buffers are included on site? ft. Please show buffers in site plans.
If yes, please include information and plans -showing diffuse flow through buffers as required.
Discharge Points, Receiving Waters & Wetlands:
17) Receiving waters:
What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater
and/or wastewater discharges end up in? ut OF Beaver Darn Swamp_
If the site stormwater discharges to a separate storm sewer system, name the operator of'the separate storm
sewer, system (e.g. City of Raleigh municipal storm sewer). N/A
Receiving water classification (if known): C:Sw
Note: Discharge of industrial wastewater to receiving waters classified as WS-11 to WS-V, or SA, must
be approved by the Div. of Water Resources, or Div. of Marine Fisheries. If DWR or DMF does
not approve, coverage under NCG020000 cannot be granted. No new discharges of wastewater -
are permitted in receiving waters classified as WS-1 or freshwater ORW. Wastewater
discharges to Saltwater ORW will not be approved under the NCG02 General Permit..
18) If your facility has wastewater discharges and they are to HWQ and/or PNA waters (Primary Nursery Areas)
waters, what.is the proposed flow rate? N/A (See
httpJ]www_ncdmf.netlmapslFNA maps/index.html, for map)
Page 3 of 8
SWU-NCG02-NOI Lass revised 9/5/2912

r*
NCG020000 N.O.I.
19) Discharge Points:
Number of discharge points (ditches, pipes, channels, etc. that convey discharges from the property):
Onsite: 5tormwater: jMine dew_atering:" 1`- Process Wastewater Overflow:
Offsite: Stormwater: Mute dewa#eying: -�` Process Wastewater Overflow:
Discharge points should be clearly marked on the submitted site plan.
Please provide short narrative description of discharges:
Discharge will consist of collected stormwater and ground waterseepage that is to be extracted from the pit
area Discharge will be directed fo adjacent reclaimed pit that is now a ki nd)
a) Is yourL line dewatering and discharging? (Answer only if you are dewatering)
❑ No
Yet if yes, where to? Surface Waters and/or Wetlands (on -site or off -site)
r-X —Other'(on--site'or'off-site)-Descfibe-.on-site-pond-)
b) Are you dewatering but not discharging? (Answer only if you are dewatering)
❑ Yes If Yes, please explain how you are dewatering, and where that water will be directed:
20) Will mining operations require dewatering near wetlands or impact any stream, groundwater, or wetlands?
X No
❑ Yes
Note: Wetlands must be CLEARLY DELINEATED on the site plan. Mine dewatering activities that have
the potential to drain wetlands or otherwise impact surface water or groundwater MUST develop and
implement a Pumping Operation and Monitoring (O&M) Plan that has been approved by the
Division.
For sites that may drain wetlands - approval of a Pumping O&M _plan_m_ ay be required prior to
coverage under this general permit. The Pumping O&M Plan should be submitted to the
appropriate Regional Office and must be approved prior to operation.
The plan shall include, but is not limited to: (1) Groundwater monitoring strategies to demonstrate the
effect of pumping and to.establish any pumping regime necessary to reduce impacts, and (2) Detailed
plans to maintain surrounding hydrology and respective monitoring to demonstrate compliance. See
checklist at end of document, Contact your local Regional Office for questions specific to your mine.
21) If you are dewatering, are there wetlands or surface waters within 400' of the mine pit perimeter?
X No [_and Management indicates that no wetlands exist within mine limits.
❑ Yes If yes, what distance are they frorh the mine pit perimeter? feet.
22) Have you been required to obtain a 404/401 Certification permits?
X No
❑ Yes If yes, please briefly describe below (include information such a required mitigation, BMPs, setbacks,
and/or O&M plans for on or off -site wetlands or other pertinent. information). Attach other sheets as necessary:
Page 4 of 8
SWl1-NCGrt2-NOi last revised 915=12

NCG020000 N.O.I.
23) Have you been required to obtain a wetland delineation certified by the US Army Corps of Engineers?
X No ❑ Yes If yes, please attach to application submission.
Stormwater BMPs:
24) Does this facility employ any best management practices for stormwater control?
X No ❑ Yes If yes, please briefly describe:
26) Does this facility have a Stormwater Pollution Prevention Plan?
X No ❑ Yes
If yes, when was it implemented?
26) Will vehicle maintenance activities occur at this.facility?
X No ❑ Yes
Wastewater Treatment Facilities:
27) Will mine dewatering discharges occur?
❑ No
X Yes
28) Will discharges of overflows from process wastewater treatment systems occur?
X No
❑ Yes If yes,
a. Does this facility employ chemical additives to flocculate suspended solids? ❑ No ❑ Yes
If yes, please state the narne, manufacturer and the quantity of!average daily usage of the chemical additive
gote: Please see our website-for.a list,of evaluated polyacrylamide (DAMS) products for use in North Carolina:
http://portal.ncdenr.org/web/wg/wstsu/�npdessw
b. Does this facility overflow only during rainfall events exceeding the 1 0-yr, 24-hr rainfall event?
❑ No ❑ Yes
29) Are wastewater treatment facilities (including recycle systems) planned in the 100-year flood plain?
X No
❑ Yes
30) Is your facility washing mined materials?
X No
❑ Yes If Yes, are you discharging this'water?
Page 5 of 8,
S'M I-NrY;m-Nhl Las! ievised`91512012

y i.
NCG020000 N.O.I.
Other:
31) Hazardous Waste:
aj Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
X No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
X No ❑ Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
X No ❑ Yes
d) If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste:
How is material stored:
Where is material stored:
How many disposal shipments per year:
Name of transport I disposal vendor. _
Vendor address:
32) Is your facility providing appropriate secondary containment for bulk storage of liquid materials? See permit
text for secondary containment requirements.
X No
❑ Yes
33) Does your site have an active landfill within the mining permit boundary?
X No
❑ Yes If yes, specify type: ❑ LCID ❑ Other. -
Final Checklist:
This. application will be returned as incomplete unless all of the following items have been included and
initialed for. Please show that the following required .information has been included by initialing in each
space below.
X Fee of $1'00 made payable to NCDENR.
1 Completed application and all supporting documents.
�r Copy of the valid approved mining permit (MP) for the facility or indication of MP'application status.
Copy of a county map or other general location map that shows the mining site and nearest major roads.
P Copy of USGS topographic map showing the mining site and surrounding areas, or other map that clearly
` 1 shows site location in relation to nearby streams, wetlands, and other waters, etc.
1 2 copies of large-scale (minimum 24" x 36") site plan with topographical lines with all outfalls, applicable
buffers and wetlands clearly delineated, and 100-year.flood plain line if applicable.
A copy of your DEMLR mining permit.
NIA A copy of your US Army Corps -approved wetland delineation if you marked "yes" to question 23 above.
A line drawing of the water flow through the facility. A pictorial description of the nature and amount of any
sources of water and any collection and treatment measures.
X If mine site is,in one of the 20 Coastal Counties:
! Applicant has checked with the appropriate regional office to verify the need for a Coastal State
Stormwater permit. Regional Office Contact: Linda Lewis
Page 6 of 8
csnn L11trr_rn_Mrni Last revised 9YWO12

NCG020000 N.O.I.
• Applicant has included a detailed list of impervious surface areas and percentages, sub -drainage
areas and total drainage area.
If the mine is dewatering and near wetlands, or may otherwise impact surface waters or groundwater,
include the following and contact your local regional office about a Pumping O&M Plan (see below
for contact information). You may be required to provide an approved Pumping O&M plan prior to
NCG02 issuance.
2 copies of detailed Full Size Plans (at least 24" x 36") delineating areas on the plans and listing
acrea a (including: wetlands, ditches, well -placements, pits, borrow areas, overburden storage,
stormwater controlsBMPs, vehicle maintenance areas, settling basins, product process (such as
screening, stockpiles, waste piles), tots€ drainage area, impervious surface percentages (if state sw
programs apply); applicable buffers, and access and/or haul roads).
Pump dewatering size and information on its specifications.
Well information (design, depths, maintenance),
Physical monitoring for the wetlands areas.
Settling pond sizing information, if applicable.
Level spreader design, if applicable.
Details about dewatering method.
Cone of influence calculations.
Description of measures to prevent erosion and flooding.
Description & information about 401i404 permits that have been obtained.
Copy of US Army Corps of Engineers wetland delineations or approved wetland delineation (if
applicable).
I have contacted my local regional office about a Pumping O&M Plan.
Regional Office Contact: Date contacted:
-OR-
X I will not.any impact nearby wetlands, surface waters or groundwater by dewatering.
Certification: North Carolina General Statute 143-215.6 b (i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record; report, plan, or other
document filed or required to be maintained under this Article or a rule, implementing this Article; or who knowingly makes a false
statement of a material fact in a rulemaking proceeding or contested case under this Article; or who falsifies, tampers with, or knowingly
renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
[Environmental Management] Commission implementing this Article shall be guilty of a Glass 2 misdemeanor which may include a fine not to
exceed ten thousand dollars ($10,000).
33) Signatory Requirements (per 40 CFR 122.22)
All applications, reports, or information submitted to the Director shall be signed and certified.
a. All notices of intent to becovered under this General Permit shall be signed as follows:
(1) Fora corporation: by a responsible corporate officer. For the purpose of this permit, a responsible corporate officer means: (a) a president,
secretary, treasurer or vice president of the corporation in charge of a principal business function, or any other person who performs similar
policy or decision making functions for the corporation, or (b) the manager of one or more manufacturing production or operating facilities
employing more than 250 persons or having gross annual sales of expenditures exceeding 25 million (in second quarter 1980 dollars}, if
authority to sign documents has been assigned or delegated to the manager in accordance with corporate procedures.
(2) For a partnership or sole proprietorship: by a general partner or the proprietor, respectively; or
(3) For.a municipality, state, federal, or other public agency: by either a principal executive officer -or ranking elected official.
I hereby request coverage under the referenced General Permit. I understand that coverage under this permit will
constitute the permit requirements for the discharge(s)•and is enforceable in .the same manner as an individual
permit.
I agree to abide by the following as a part of coverage under this General Permit:
1. I agree to abide by the approved Mining Permit for this mining activity. (A copy of the valid mining
permit must be attached to this request.
Page 7 of 8
c+nn r_urnno_nrni Last revised 915=12

'r
NCG020000 N.0.1.
2. 1 agree to not discharge any sanitary wastewater from this mining activity except under the
provisions of another NPDES permit specifically issued therefore.
3. 1 agree that bulk storage of petroleum products and other chemicals shall have adequate protection
so as to contain -all spills on the site.
4. 1 agree that solid wastes will be disposed of in accordance with N.C. statutes and rules governing
solid waste disposal.
5. I agree that maintenance activities for vehicles and heavy equipment will be performed so as to not
result in contamination of the surface or ground -waters,
I agree to abide by the provisions, as listed above and recognize that the provisions are to be considered as
enforceable requirements of the General Permit.
I certify that I am familiar with the information contained in this application and that to the best of my knowledge
and belief such information is true, complete, and accurate.
Printed Name of Person Signing: Charles Jackson
Title, Me er / Mana er
(Signature of Applic t) ate igned)
Notice of Intent must: be a parried by a.check or money order for $100T00 made payable to NCDENR.
Mail the entire package to:
Stormwater and General Permits Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Note
The submission of this document does not guarantee the issuance of an NPDES permit.
For questions, please contact the DWQ Regional Office for your area.
DWQ Regional .Office Contact Information:
Asheville Office ...... [phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ......:..
[phone]
Washington Office ...(252)'946-6481
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........
[phone]
Page 8 of 8
"'^1 Last revised 915/2012