NCG020558_COMPLETE FILE - HISTORICAL_20070831

STORMWATER-DIVISION CODING SHEET -- -.:
RESCISSIONS.
PERMIT NO.
DOC TYPE
e' COMPLETE FILE -HISTORICAL
DATE OF
.RESCISSION
0`7
YYYYMMDD

0� 1N A 7-, Qq Michael F. Easley, Governor
William G. Ross Jr., Secretary
f North Carolina Department of Environment and Natural Resources
Q Coleen H, Sullins, Director
Division of Water Qualify
August 31, 2007 RECEIVE®
Mr. Jintny A. Harris SEP 0 5 2007
HLD Mining, LLC
Box 129 Si DWQ—Nls ARO
Simpson, NC 27879 �1d
Subject: NPDES General Permit 000
Certificate of Coverag
HLD Mining, LLC CG02055$
-
Formerly Blue Sky LLC-Pit # 1
Pitt County
Dear Mr. Harris:
Division personnel have reviewed and approved your request to transfer coverage under the General Permit,
received on July 17, 2007.
Please find enclosed the revised Certificate of Coverage. The terms and conditions, contained in the General
Pertnit 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, please contact the Stormwater Permitting Unit at [phone], extension 502.
Sincerely,
ORiGINAL SIGNED EY
KEPI °ILK! ;;
Coleen H. Sullins
cc: DWQ Central piles
Washington Rebrional Office, Water Quality Section
Stormwater Pcrnnitting Unit
N i�n,�e Carolina
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Phone [phone] Customer Service
Intemet h2o.enr.statemc.us 512 N. Salisbury St. Raleigh, NC 27604 FAX [phone]
An Equal OpportunitylAffirmative Action Employer — 50% Recycled110% 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. NCG2020558
STORMWATER 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,
HLD MINING, LLC
is hereby authorized to discharge stormwater from a facility located at
HLD MINING, LLC
NC HIGHWAY 33 EAST
GRIMESLAND
PITT COUNTY
to receiving waters designated as Chicod Creek, a class C NSW stream,- in the Tar -Pamlico River Basin in
accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts 1, 11, III, IV,
V, and VI of General Permit No. NCG020000 as attached.
This certificate of coverage shall become effective August 31, 2007.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day August 31, 2007. ORIGINAL SiGINED -jY
Y.'EiN PICKLE
-Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

.. �...<, ....,,,.,:..n...,, .,

W A rFj9pG
O�QF
Michael F. Easley, Governor
William G. Ross Jr., Secretary
G3
North Carolina Department of Environment and Natural Resources
0 -r
Alan W. Klimek, P.E. Director
Division of Water Quality
June 12, 2006
Mr. Cecil Boyd, Jr.
Blue Sky LLC Pit #1
8620 Humie Olive Rd.
Apex, NC 27502
Subject: Stormwater General Permit NCG020000
Operations and Maintenance Reminder
Blue Sky LLC Pit #1
COC Number 020558
Pitt County
Dear Permittee:
Our records indicate that you have been issued a Stormwater General Permit and a Certificate of
Coverage for your facility. These permits have specific conditions that must be met in order for you to
be in compliance with your permit. It is your responsibility, as the permit holder, to read and comply
with the conditions contained in the permit.
It is our responsibility, as the issuing authority, to make sure that the operation and maintenance of
your facility complies with the conditions contained in your permit. To assist you in complying with
these conditions, we are attaching a Technical Bulletin specific to your permit requirements. We are
currently in the process of developing our inspection schedule. Therefore, you should have all of
your records up to date as we may be contacting you in the near future to set up an inspection of your
facility.
If you have any questions, please do not hesitate to contact Samir Dumpor, Pat Durrett or myself at
[phone].
Si cerely
L
Al Hodge, Supervisor
Washington Regional Office
Surface Water Protection Unit
Encl.
CC: WaRO files
North Carolina Division of Water Quality Internet h2c.enr.state,nc.us
943 Washington Square Mall Phone: [phone]
Washington, NC 27889 FAX [phone]
NonrthCarolina
;Vatmrally
An Equal opportunity/Affirmative Action Employer — 50% RMcled110% Post Consumer Paper

O�pF W A 7-' gq Michael F. Easley, Governor
William G. Ross Jr., Secretary
rNorth Carolina Department of Frivironment and Nalural Resources
p Alan W. Kbrnck, P.E. Director
Division of walcr Quality
February 7, 2005 RECE VEC)
Cecil Boyd, Jr FEB 2 1 2005
Blue Sky LLC Pit #1
8620 Humie Olive Rd
Apex, NC 27502 DWQ- AR0
Subject: NPDES Stormwater Permit Coverage Renewal
Blue Sky LLC Pit #1
COC Number NCG020558
Pitt 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 Jonathan Diggs of the Central Office Stormwater
Permitting Unit at [phone], ext.537.
Sincerely,
for Alan W. Klimek, P.E.
cc: Central Files
Stormwater & General Permits Unit Files
Washington Regional Office
Nne
orth Carolina
111 AllUYIllf
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-t617 Phone [phone] Customer Service
Internet: h2o.enr.state.nc.uslsulsiormwater.html 512 N. Salisbury St. Raleigh, NC 27604 FAX [phone]
An Equal Opportunity/Affirmative Action Employer-- 50% Recycled110%a 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. NCG020558
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,
Blue Sky LLC Pit #1
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
Blue Sky LLC Pit #1
NC Hwy 33
Grimesland
Pitt County
to receiving waters designated as Chicod Creek, a class QNSW stream in the Tar -Pamlico River Basin in
accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II,
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

{I
ofWAT AT
� y
Mr. Cecil Boyd, Jr.
Blue Sky, LLC
8620 Humie Olive Rd.
Apex, NC 27502
Dear Mr. Boyd:
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
August 10, 2001
Subject: General Permit No. NCG020000
Blue Sky, LLC — Pit No. 1
COC NCG020558
Pitt County
Gregory J. Thorpe, Ph.D.
Acting Director
Division of Water Quality
In accordance with your application for a discharge permit received on January 31, 2001 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 Aisha Lau at telephone number (919)
733-5083 ext. 578.
Gregory J. Thorpe
cc: Washington Regional Office
Central Files
Stormwater and General Permits Unit Files
N. C. Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 [phone]
Customer Service
1 800 623-7748

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG020000
,• CERTIFICATE OF COVERAGE No. NCG020558
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,
Blue Sky, LLC
is hereby authorized to discharge stormwater and mine dewatering water from a facility located at
Blue Sky, LLC — Pit No. 1
NC Hwy. 33
Grimesland
Pitt County
to receiving waters designated as an unnamed tributary to Chicod Creek, class C NSW waters in the Tar -Pamlico
River Basin in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in
Parts 1, I1, III, IV, V, VI and VII of General Permit No. NCGO20000 as attached.
This certificate of coverage shall become effective August 10, 2001,
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day August 10, 2001.
� £ -co� "'
Gregory J. Thorpe, Ph.D.
Acting Director
Division of Water Quality
By Authority of the Environmental Management Commission

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Wprint this form to PDF Rotum PDF of this form to DLR CO by email. cc DLR RO and DWQ SPU
MINING PERMIT APPLICATION REVIEW FORM
for the
DIVISION OF WATER QUALITY
Project Name: HLD Mine DLR Permit #: 74-66 County: Pitt Address:
YES NO Date Commencing
Is this mine a new mine? ED r 2001
Have land disturbing activities
started? Date? Iv r 2001
Latitude:35.5747 Longitude:-77.1981
Please return comments to (at DLR CO): Judy Weh_ne_r l l
Comments due by: 6/17/11
SECTION BELOW TO BE FILLED OUT BY DWQ:
Is the RO concerned that the operation, as proposed, would violate standards of water quality? No
Comments: NPDES permit is active, and since there is no change in size of mine or process, we don't have
any issues with issuance of this permit.
Watershed/Stream Name & Classification: Tar/Pam River basin; Chicod Creek; class C, NSW
DWQ Compliance Status of Mine: Compliant
YES NO
NPDES permit required?=
r
r
NPDES permit existing?
r (Permit #NCG020588 }
0,
If an NPDES permit is not required, is DWQ
still concerned about wetland degradation
Ei
r
by dewatering?
Should permittee contact DWQ RO
immediately? (e.g. to schedule a site visit if
r RO Contact Name:
r
mine has already begun digging or is
Contact Reason:
dewatering without DWQ permit)
401 JWetland Cert. required?
r
401 Wetland Cert. existing?
r Permit #
R.
Does DWQ RO currently have enough
information to determine if a 401 :
r
U
certification is re uired?
Rev September 2010

WPrint this form to PDF
Return PDF of this form to DLR CO by email. cc DLR RO and DWQ 5PU
YES NO
Are wetlands disturbed at this site?
r
Does DWQ RO suspect or know of nearby
r
r
wetlands to the site?
Is a wetland delineation required,prior to
J By: r�JD or Consultant
DWQ issuing the permit?
,r
,r Onsite? Or r 0ffsite?
Stream Determination Needed?
r
r
Stream'Determination Completed?
r
r
Does DWQ RO need a statement that no
wetlands/streams are disturbed
r
for this project from applicant?
Buffer Determination Needed?
L
Buffer Determination Completed?
r
r
Recycle system permit existing?*
EJ Permit #
New Recycle System permit required?*
Enough information to determine?
Non -discharge permit existing?*
'r Permit #
L-.
Will wastewaters discharge to HQW waters
r ,
f- .7Q10
Unknown (permittee determine): r
with a 7Q10=07 "*
Flow:
Has Violation
O&M Requirements
Does DWQ require DLR to;hold the permit
DWQ it further
HQW17Q10 Concerns(e.g.
ME—J.
so can review
orbecause-DWQ
Reason:
requires more information)?Otter.
RO contact:
'r , Hold Until:
Mine must wait to dewater until an O&M
IJ
r
plan is approved?
*The NPDES SW and WW permit NCG020000 covers closed -loon recycle systems, designed to exclude aff stormwater_run-off from
the system and operate at or below two -feet of freeboard. These systems may be permitted by a Non -discharge Recycle System
Permit from the Aquifer Protection Section (APS), OR may instead be permitted underNCG020000 to eliminate an additional permit.
Recvcle systems that do not meet those criteria are considered discharging systems, and are subiect to the NCG020000 discharge
permit.
**To obtain 7Q10 flows, permittees must contact the DWQ Stormwater Permitting Unit. If DWQ does not have a flow estimate fora
specific stream, permittees will be asked to obtain one. Permittees should contact J. Curtis Weaver at the USGS: 919-571-4043, for
more information on obtaining a 7Q10 flow. USGS will not determine a 7Q10 flow for tidally influenced water bodies.
Reviewed b :
DWQ RO Surface Water: WaRO Regional Office: Samir Dumpor Date: June 10, 2011
RO Aquifer Protection Section: Regional Office: Date:
SPU DWQ Central Office Reviewer (if applicable):
Rev September 2010

n14
r 6 /V 4 d ' - QS
April 22od 2011
North Carolina Department Of
Environment and Natural Resources
1612 Mail Service Center
Raleigh, NC 27699
To Whom It May Concern:
HLD MINING, LLC
PO BOX 129
SIMPSON, NC
3054 STANLEY ROAD
GREENVILLE, NC 27858
252-746-9316
252-746-7508 FAX
ECOVE
MAY 3 1 2011
Mr," WARD
This request is in reference to mining Permit # 74-66 for HLD Mining, LLC. We are requesting a renewal
for our permit for a period of 10 years. We are in the process of having the new mine maps processed. Per
enclosed invoice, we are working with H. C. Harris, Jr. Engineering and Surveying, P.A. Inc. in Winterville,
NC to have the maps processed, but they are not yet complete. As soon as the maps are complete we will
have the appropriate copies delivered to Raleigh.
We feel that we are in compliance with all requested paperwork except the maps. Our mine is also in
compliance with required regulations. We at this point are not requesting any modifications to existing
permit. We are only requesting renewal to continue to mine within permitted boundaries.
We appreciated you wo ing with us on this matter.
J my Ha
HLD Mining, LLC
[2^3i—I�r
AJ
LD
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ti
NORTH CAROUNA DEPAUMEW OF TRMSPORTAMON
DIVISION OF limmAYS - GtS UNtf
��- U.S.DEPARTMBa OF TRANSPMAIM
{ - FRDHiAt HIGHWAY ADMINIS MTION
L�1J`
Jf uy AY. ; 2011
OUALII-Y SEC7UN
Winn aLwWMon,, AoHlNG ON RrGIGNAL OF ~I0E

STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND
NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO.'NCG020000
TO DISCHARGE STORMWATER, MINE DEWATERING, AND PROCESS WASTEWATER UNDER THE
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, this permit is
hereby issued to all owners or operators, hereafter_permittees, which are covered by this permit as
evidenced by receipt of a Certificate of Coverage by the Environmental Management Commission to
allow the discharge of stormwater, mine dewatering wastewater, and process wastewater to
the surface waters of North Carolina or to a separate storm sewer system conveying discharges
to surface waters, from active and inactive mining sites, in accordance with the terms and
conditions set forth herein.
Coverage under this General Permit is applicable to:
e Stormwater point source discharges associated with mining and quarrying of non-
metallic minerals (except fuels), mine excavation, processing, and vehicle maintenance;
♦ Mine dewatering wastewater discharges;
♦ Wastewater discharges from sand and/or gravel operations;
♦ Operation of non -discharging closed -loop recycle systems (and infrequent overflows);
• Process wastewater discharges from non -closed -loop recycle systems.
The following activities and associated discharges are. ce, 1�d from coverage tinder this permit:
♦ Borrow Pits covered by the DOT statewide stormwater permit,
♦ Peat Mining,
r Coal Mining.
• Metal Mining,
♦ Oil and Gas Extraction Operations, and
♦ Combined Mining/Asphalt Operations (where asphalt operation is not covered by a separate
permit).
The General Permit shall become effective on January 1, 2010.
The General Permit shall expire at midnight on December 31, 2014.
Signed this day December 29, 2009.
Coleen H. Suffifis, Director
Division of Water Quality
tY
By the Authority of the Environmental Management
2 6 2011
LAND QUALITY SEC] ION
�1ac atr.G i ON REGtONIAL OFFICE

%,ar fi1T1Gd ce oT uepi si x l uu) xenewal Norice
our Certificate of Deposit has renewed with the terms
tated on the front and reverse of this notice. You
iay select another investment option or redeem your CD
ithout,penalty until the grace and date.
f you have already made changes to your CD, please
lisregard this notice. Thank you.
HLD MINING LLC
3054 STANLEY ROAD
GREENVILLE NC Z7858-8803
Account Number:
025-9483259
Date Renewed:
08-18-2010
Renewal Value:
519,762.85
Renewal Term:
013 Months
Maturity Date:
09-18-2011
Compounding Frequency:
Daily
Grace End Date:
08-28-2010
Interest Rate!
0.75%
Annual Percentage Yield:
0.75%
Account Type:
Fixed Rate
Dote of Notice 08/18/2010
er
RBC Bank (USA)
MAY262011
LAtJI] C�UA�EC 109JAl.lOFFIC�
�•dASHI�GTON

H.C. Harris, Jr. Engineering and 5urveying, P.A. Inc. Invoice
)C)(
2 1 6 Main Street
Winterville, NC 26590
511 To:
HLD Mining, LLC
Annette tlarr15
Po5t Office BOX 129
Simpson, North Carolina 27879
Invoice #: 10003-02
Invoke Date: 3/30/201 1
Due Date: 3/30J201 1
Project No.: f 0003-NC 33 Mining} Permit
De5crlptlon
Hours/Qty
Rate
5erviced
Amount
Design/Drafting - CAD Construction 5taWng
1.5
70.00
3/ 1 G/201 1
105.00
Create stakeout plan for held crew, export survey
file and download to data collector,
Two Man Survey Crew - Boundary Survey
4.5
1 1 5.00
3/ 17/201 1
5 1 7.50
Three Man Survey Crew - Boundary survey
5
135.00
3! 18/201 1
675.00
De5ign/Draftmg - CAD Site Visit
0.25
70.00
3/ 15/201 1
17.50
JIMMY HARRIS -SITE VISIT,IN AREA RETURNING
FROM WIMCO.
$1.315.00
$0.00
$11315,QQ

APPLICATION FOR A MINING PERMIT
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT
AND NATURAL RESOURCES
LAND QUALITY SECTION
APPLICATION FOR A MINING PERMIT
(PLEASE PRINT OR TYPE)
1. Name of Mine L� / L� County
River Basin
Latitude (decimal degrees to four places)
Longitude (decimal degrees to four places) II
2. Name of Applicant*
' 'o lm7ln 7 q G G C-
3. Permanent address for receipt of official mail**
o,i , Nb 2,799
Telephone a' 71�6 _( 31 � f Alternate No. ( ) '?]it- J/ 0 :A
4. Mine Office Address_15
Telephone G3S)' q3/ - -
Mine Manager.
We hereby certify that all details contained in this Permit Application are true and correct to the best of our
knowledge. We fully understand that any willful misrepresentation of facts will be cause for permit
revocation.
***Signature Date
Print Name I 1111MU 54r-KI's
Title 00,
0 •
* This will be the name that the mining permit will be issued to and the name that must be indicated.on the
reclamation bond (security) that corresponds to this site.
The Land Quality Section must be notified of any changes in the permane�ddress or telephone number.
*** Signature-of_commy officer required. �� MAC 2 6 2011 L
G.S. 74-51 provides that the Department shall grant or deny an application for apermit within 60.days of receipt of a
complete application or, if a public hearing is held, within 30 days followin ' the 1�►ea ing;ar►'d;tie�`ftiirigfafEany
supplemental information required by the Department. All questions must bed�ressedrand:all `required maps
provided before this application can be considered complete. Attach additional hseets as needed.
-1-

r

APPLICATION FOR A MINING PERMIT
NOTE: All of the following questions must be thoroughly answered regarding your mining operation for
the intended life of the mine. All responses must be clearly conveyed on a corresponding, detailed mine map.
A. GENERAL CHARACTERISTICS OF THE MINE
1. Answer all of the following that apply:
❑ If this is an application for a NEW permit, indicate the total acreage at the site to be covered by the
permit (this is the acreage that the "new permit" fee will be based upon):
Of this acreage, how much is owned and how much is leased? Acres owned:
Acres leased: Property owner if leased:
[� If this is an application for RENEWAL of a mining permit, indicate the mining permit n ber and
the total (overall) acreage covere y the existing permit: Mining Permit No.: -
Total permitted acreage (this is the acreage that the "renewal" fee will be based upon): I& Pit
❑ If this is an application for a MODIFICATION to a mining permit, indicate the mining permit
number and the total (overall) acreage covered by the existing permit.
Mining Permit No.: Total permitted acreage:
Does the modification involve acreage within the previously approved permitted boundary?
Yes ❑ No ❑, if yes, indicate the acreage to be covered by this modification (this is the acreage
that the "major modification" fee will be based upon):
Does the modification involve acreage outside the previously approved permitted boundary?
Yes ❑ NoFT If yes, indicate the additional acreage to be covered by this
modification: (NOTE: you must complete all of Section F. of this application form
entitled Notification of Adjoining Landowners).
Of this acreage to be added to the permit, will any portion of this acreage be affected (i.e.: disturbed,
ground cover removed) by the raining operation? Yes ❑ No ❑ (if no, a "minor modification"
fee of $ 1 00.00 is required, despite the "undisturbed" acreage to be added). If yes, indicate the
acreage to be affected within the acreage to be added to the permit (the total acreage to be added to
the permit is the acreage that the "major modification" fee will be based upon):
❑ If this is an application for TRANSFER of a mining permit, indicate the mining permit number and
the total (overall) acreage covered by the existing permit.
Mining Permit No.: Total permitted acreage:
SEE THE FEE SCHEDULE AT THE END OF THIS FORM FOR THE PROPER FEE AMOUNT TO BE
PAID FOR THE REQUESTED PERMIT ACTION(S) AND CORRESPONDING ACREAGE NOTED
ABOVE
2. Name of all materials mined:
3. Mining method:
❑ Hydraulic Dredge H
Front-end Loader & Truck ❑ Shovel & Truck
Dragline & Truck Self -loading Scraper
Other (explain): L= (CLtiC t e-Fatck.
4. a. Expected maximum depth of mine (feet) 40
Depth is relative to what benchm k? (e.g., natural ground level, mean sea level, road elevation, etc.)
b. Expected average depth of mine (feet) !*
-2-

APPLICATION FOR A MINING PERMIT
5. Has any area(s) at this site been mined in the past? Yes []� No ❑
If yes, when and by whom was this activity conducted? ue. -5k4 �C c-1-�a�
J �:.�.�o�- Per=�•, :' L.,.T
6. Number of years for which the permit is requested (10 years maximum): jC w1--s
B. MAPS
1. Clearly mark and label the location of your mining operation on six (6) conies of a 7.5-minute quadrangle
and a county highway map. These maps, in addition to six. (6) copies of all mine maps and reclamation
maps, must be submitted with each permit application.
7.5-minute quadrangles may be obtained from the N.C. Geological Survey:
Mailing Address: Physical Address:
1612 Mail Service Center OR 512 North Salisbury Street, 5`h Floor
Raleigh, North Carolina 27699-1612 Raleigh, North Carolina 27604
[phone]
County highway maps may be obtained from the N.C. Department of Transportation:
North Carolina Department of Transportation — Geographic Information Systems (G1S)
Mailing Address:
NCDQT Q15 Unit
1587 Mail Service Center
Raleigh, North Carolina 27699-1587
Physical Address:
NOOT Q13 Unit
3401 Carl Sandburg Court
Raleigh, North Carolina 27610
[phone]
2. Mine maps must be accurate and appropriately scaled drawings, aerial photographs or enlarged
topographic maps of the entire mine site. All aspects of the mine site must be clearly labeled on the
maps along with their corresponding (approximate) acreage. As a reminder, mining permits can
only be issued for up to 10 years; thus, all mitre and reclamation maps must only denote those
activities that are intended to be conducted during the life of the mining permit. All maps must be
of a scale sufficient (see minimum requirements listed below) to clearly illustrate the following, at a
minimum:
a. Property lines of the tract or tracts of land on which the proposed mining activity is to be located
including easements and rights -of -way.
b. Existing or proposed permit boundaries.
c. Initial and ultimate limits of clearing and grading.
d. Outline and width of all buffer zones (both undisturbed and unexcavated).
e. Outline and acreage of all pits/excavations.
f. Outline and acreage of all stockpile areas.
g. Outline and acreage of all temporary and/or permanent overburden disposal areas.
h. Location and acreage of all processing plants (processing plants may be described as to location and
distance from mine if sufficiently far removed).
i. Locations and names of all streams, rivers and lakes.
j. Outline and acreage of all settling and/or processing wastewater ponds.
k. Location and acreage of all planned and existing access roads and on -site haul roads.
1. Location of planned and existing on -site buildings.
m. Location and dimensions of all proposed sediment and erosion control measures.
n. Location of 100-year floodplain limits and wetland boundaries.
o. Names of owners of record, both public and private, of all tracts of land that are adjoining the mining
permit boundary; if an adjoining tract is owned or leased by the applicant or is owned by the lessor of
the mine tract, names of owners of record of tracts adjoining these tracts, that are within 1,000 feet of
the mining permit boundary, must he provided on the mine map.
-3-

APPLICATION FOR A MINING PERMIT
p. Names of owners of record, both public and private, of all tracts of land that'are adjoining the mining
permit boundary which lie directly across and are contiguous to any highway, creels, stream, river, or
other watercourse, railroad track, or utility or other public right-of-way. If an adjoining tract is owned
or leased by the applicant or is owned by the lessor of the mine tract, names of owners of record of
tracts adjouung these tracts, that are within 1,000 feet of the mining permit boundary, must be
provided on the mine map(s). NOTE: "Highway" means a road that has four lanes of travel or less
and is not designated as an Interstate Highway.
q. Map legend:
1. Name of applicant
2. Name of mine
3. North arrow
4. County
5. Scale
6. Symbols used and corresponding names
7. Date prepared and revised
8. Name and title of person preparing map
Map scales should meet the following guidelines:
PERMITTED ACREAGE
MAP SCALE
0-49 Acres
1 inch = 50 feet
50-199 Acres
1 inch = 100 feet
200+ Acres
1 inch = 200 feet
(NOTE: Smaller scaled maps may be acceptable if they clearly illustrate the above items)
-4-

APPLICATION FOR A MINING PERMIT
A table/chart must be provided on the mine map that clearly lists the approximate acreage of tailings/sediment
ponds, stockpiles, wastepiles, processing area/haul roads, mine excavation and any other major aspect of the
mining operation that is proposed to be affected/disturbed during the life of the mining permit. A table/chart
similar to the following will be acceptable:
CATEGORY
AFFECTED ACREAGE
Tailings/Sediment Ponds
Stockpiles
t 35
Wastepiles
--
Processing Area/Haul Roads
33 5r
Mine Excavation
4f
Other (Explain)
_ o
Total Disturbed Acreage
rl 3
NOTE:
IN ADDITION TO THE ABOVE, THE MAPS MUST ALSO INCLUDE ANY SITE -SPECIFIC
INFORMATION THAT IS PROVIDED IN THE ANSWERS TO THE FOLLOWING QUESTIONS IN
THIS APPLICATION FORM (PLEASE NOTE THE ITALICIZED QUESTIONS/STATEMENTS
THROUGHOUT THE FORM). THIS APPLICATION WILL NOT BE CONSIDERED COMPLETE
WITHOUT ALL RELEVANT ITEMS BEING ADEQUATELY ADDRESSED ON THE MINE MAPS.
-5-

APPLICATION FOR A MINING PERMIT
C. PROTECTION OF NATURAL RESOURCES
1. Describe in detail the sequence of events for the development and operation of the mine and reference the
sequence to the mine map+(s). Attach additional sheets as needed.
(`
'il °ZrYvkxj f � 1�SU t i Oro M Yv1 �vt G t�•1Gltc�o�� Ci�n G�L� G� � P �GIL� � � y\
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� 4�t ,ems La.�c��► o +� arm r.�
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R•GU�(.�1 ✓� r✓1kjh� 5(opc5 uS armg5 aI -lgyp r err c�'LV a 'V �4�✓�"L I ��� �
2. Describe specific erosion control measures to be installed prior to land disturbing activities and during
mining to prevent offsite sedimentation (include specific plans for sediment and erosion control for mine
excavation(s), wastepiles, access/mine roads and process areas), and give a detailed sequence of installation
and schedule for maintenance of the measures. Locate and label all sediment and erosion control measures
on the mine maps) and provide typical cross-sections/construction details of each measure. Engineering
designs and calculations shall be required when needed to justify the adequacy of any proposed measures.
u r 'Xr e a S 40 rr- w\a t n LA -VIA 1'5�Kr6c'<-L C t,5
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0.-+r-V- 5rokk (4:puC r ecs b,c�v� eAA. Lis e
3. a. Will the operation involve washing the material mined, recycling process water, or other waste water
handling? Yes No �C . If yes, briefly describe all such processes including any chemicals to be
used.
b. Will the operation involve discharging fresh or waste water from the mine or plant as a point discharge
to the waters of the State? Yes)r No . Ifyes, briefly describe the nature of the discharge and
locate all proposed discharge Dints (along with their method of stabilization) on your mine tnap(s).
uI a e-+ t o -6 ,e S Gas � t i S e- b r t L t- `t y f)"�j -
O4 cc�ier''-4?� ,<
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�� �� "JC wM, -6- U

APPLICATION FOR A MINING PERMIT
Will any pqrt of the proposed mine excavation(s) extend below the water table?
Yes No . If yes, do you intend to dewater the excavation(s)? Yes
No . If yes, what impact, if any, will mine dewatering have on neighboring wells?
Estimated withdrawal rate in gallons per day: . Locate all existing wells on the mine
map(y) that Ire within .500 feet of the proposed excavation area. Provide data to support any
conclusions or statements made, including any monitoring well data, well construction data and
current water withdrawal rates_ Indicate whether the proposed mine locale is served by a public
water system or private wells.
d. If you answered yes to any of the above questions, provide evidence that you have applied for or
obtained the appropriate water quality permit(s) (i.e., non -discharge, NPDES, Stormwater, etc.)
from the Division of Water Quality, Water Quality Section. In addition, the applicant is required
to register water use with the Division of Water Resources if the operation withdraws more than
100,000 gallons per day and needs a capacity use permit from the Division of Water Resources if
the operation lies in a capacity use area and withdraws more than 100,000 gallons per day.
cA �
4. a. Will the operation involve crushing or any other air contaminant emissions?
Yes No If yes, indicate evidence that you have applied for or obtained an air
quality permit issu d by the Division of Air Quality or local governing body.
b. How will dust from stockpiles, haul roads, etc., be controlled?
by . F ruL .l r cu,� cis
war'--Cvk�
-7-

APPLICATION FOR A MINING PERMIT
E. DETERMINATION OF AFFECTED ACREAGE AND BOND
Ae following bond calculation worksheet is to be used to establish an appropriate bond (based upon a range
of $500 to $5, 000 per affected acre) for each permitted mine site based upon the acreage approved by the
Department to be affected during the life ofthe mining permit. Please insert the approximate acreage, for each
aspect o the mining operatiothat you intend to affect duriniz the life o�is miniagpermit Lin addition. please
insert tn, he appropriate reclamation cost/acre for each category„from the Schedule o Reclamation Casts
provided with this a IicatiOn orm OR ou can de Or to the De artment to calculate your bond for you based
upenyoour maps and standard reclamation costs:
AFFECTED RECLAMATION RECLAMATION
CATEGORY ACREAGE COST/ACRE* COST
Tailings/Sediment Ponds:
3. 5 Ac.
X
$ 5 D b _ /Ac. =
$ �'
Stockpiles:
Ac.
X
$ _ _ J X Q C ./Ac. =
$^ f� 30 G
Wastepiies:
Ac.
X
$ _ ' G O C IAc. -
$ - y
Processing Area/Haul Roads:
•_ Ac.
X
$ `L� 0 0 /Ac.
Mine Excavation:
•1 '% Ac.
X
$D /Ac. -
$
Other:
, " ` Ac.
X
$ - - /Ac. _
$
TOTAL AFFECTED AC.:
Y :& Ac.
(TOTAL PERMITTED AC.:
1 d V Ac.)
Tem 2ggy & Permanent Sedimentation & Erosion Control Measures
Divide the TOTAL AFFECTED AC. above into the -following two categories. a) affected acres that drain into
Eroposed/existing excavation and/or b) affected acres that will be graded for positive drainage where measures will
e needed to prevent offshe sedimentation and sedimentation to onsite watercourses and wetlands.
a) internal Drainage %("-c�/I Ac.
b) Positive Drainage
Inflation Factor:
7�50,
Ac. X $1,500-00 = $
SUBTOTAL COST: S "
a�
0.02X SUBTOTAL COST: $� X Permit Life (1 to 10 years):
INFLATION COST: $
TOTAL COST — SUBTOTAL COST + INFLATION COST
Total Reelamntion Bond Cost: $ �` f
(round down to the nearest $100.00)
-14-

APPLICATION FOR A MINING PERMIT
5. a. A buffer will be required between any mining activity, and any mining permit boundary or right-of-
way. It may be an unexcavated buffer (no excavation, but roadways, berms and erosion &
sedimentation control measures may be installed xvithin it), an undisturbed buffer (no disturbance
within the buffer whatsoever), or a combination of the two, depending upon the site conditions. Note
that all buffers must be located within the mining permit boundaries.
How wide a buffer will be maintained between any mining activity and any mining permit boundary,
or right-of-way at this site? A minimum buffer of 25 feet is recommended, although a wider buffer
may be needed depending on site conditions. Show all buffer locations and ii idths on Me nine
nap(s). n
' (O I'f /j A IEf4y"G-a' 5
b. A minimum 50 foot wide undisturbed buffer will be required between any land disturbing activities
within the mining permit boundaries and any natural watercourses and wetlands unless smaller
undisturbed buffers can be justified. Depending on site conditions, a buffer wider than 50 feet may
be needed.
How wide an undisturbed buffer will be maintained between any land disturbing activities within
the mining permit boundaries and any natural watercourses and wetlands at this site? Shoi,, all buffer
locations and widths on the mine map(s).
50
Tam V\
Gt p;-- t y `fit iS PJ 4!5 1:r',r try
0
6. a. Describe methods to prevent landslide or slope instability adjacent to adjoining permit boundaries
during mining. Minimum 2 horizontal to 1 vertical slopes or flatter for clayey material and
minimum 3 horizontal to 1 vertical slopes or flatter for sandy material are generally required, unless
technical justification can be provided to allow steeper slopes.
hJ� f d:J wa �V-

APPLICATION FOR A MINING PERMIT
b. Provide a cross-section on the mine inap(s)for all fill slopes (beans, wastepiles, overburden disposal
areas, etc.), clearly, indicating the intended side slope gradient installation of any benches oncb`or•
slope drains (with supporting design information) if needed., and the method of final stabiliz-ation.
C. Ln excavation(s) of unconsolidated (non -rock) materials, specifv the angle of all cut slopes including
specifications for benching and sloping. Cross -sections for oll cut slopes must be provided on the
mine map(s).
rL �-t 55 J� X c_ cc.v C 0 w t� �1 3 I � S O p S
`✓.i U 1 t. � C `E (� �'"• � �. C +� � ,cj l� Gl. i.1 J L f r rJ ` �. �— / • _ C�'� � r'i(iL.t_; t•1
d. In hardrock excavations. specify proposed bench Nvidths and heights in feet. Provide cross -sections
of the ]nine excavation clearly noting the angles of the cut slopes. tiridths of all safety benches and
mine benches. and the expected maximum clepth ofthe excavation.
7. Describe other methods to be taken during mining to prevent physical hazard to any neighboring dwelling
house, public road, public; commercial or industrial building from any mine excavation. Locate all such
structures on the mine snap if they are ivithin 300 feet of any proposed excavation. f(
t ru.c*cA r r- S ;�; `3-' •� i ter. D ~�� � ' w� t 11 t-
8. Describe what kind of barricade will be used to prevent inadvertent public access along any high wall area
and when it will be implemented. Vegetated earthen berms. appropriate fencing and adequate boulder
barriers may be acceptable high wall barricades.. I construction detail/cross-section and location of each
type of barricade to be used trust be indicated on the urine naup(sj.
--- V, C'�Z r s l ��
1 t G � S C.c. s o , - Gr,�-c 5 G � ePOSE ��'e
P c-P r'O pE ✓`, /
APPLICATION FOR A MINING PERMIT
9-

9. Are acid producing minerals or soils present? Yes No � How will acid water
pollution from the excavation, stockpiles and Nvaste areas be controlldd? k
10. a. Describe specific plans (including a schedule of implementation) for screening the operation from
public view such as maintaining or planting trees, bushes or other vegetation, building berms or other
measures. Show the location of all visual screening on the mine maps) and provide cross -sections
through all proposed berms or proposed spacing si_es and species for tree plantings.
5-e r,6 S 4-0 Ok iOruy 4-h
Crv�ps
-�'`Ir 33 Ct{561 irte� P 4,0
b. Could the operation have a significantly adverse effect on the purposes of a publicly owned park,
forest or recreation area? If so, how will such effects (i.e., noise, visibility, etc.) be mitigated?
11. Will explosives be used? Yes No f If yes, specify the types of explosive(s) and
describe what precaution(s) will be used to prevent physical hazard to persons or neighboring property
from flying rocks or excessive air blasts or ground vibrations. Depending on the mine's location to nearby
structures, more detailed technical information may be required on the blasting program (such as a third -
party blasting study). Locate the nearest offsite occupied structure(v) to the proposed excavation(s) on
the mine map and indicate its approximate distance to the proposed excavation.
12. Will fuel tanks, solvents, or other chemical reagents be stored on -site? Yes No
ffyes, describe these materials, how they will he stored rind method of containment in cas of spill. Indicate
tho localion(s) of all storage facilities on the mine Jnap(4),
-10-

APPLICATION FOR A MINING PERMIT
D. RECLAMATION PLAN
1. Describe your intended plan for the final reclamation and subsequent use of all affected lands and indicate
the sequence and general methods to be used in reclaiming this land. This must include the method of
reclamation of settling ponds and/or sediment control basins and the method of restoration or establishment
of any permanent drainage channels to a condition minimizing erosion, siltation and other pollution. This
information must be illustrated on a reclamation mop and must correspond directly ivith the information
provided on the mine map(s). In addition, design information, including typical cross -sections, of any
permanent channels to be constructed as part of the reclamation plan and the location(s) of all permanent
channels must be indicated on the reclamation snap.
ck s�A,;� L"j.we s-kzLb -f���
t-o a �6 Gc � t � L � r-a�.5, , _t roc a' S ) bV 1 r
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p r e55 `I-�, � Gi (�' S t+ �-e- v- - n trt
2. is an excavated or impounded bode of water to be left as a part of the reclamation? Yes _/I No
Ifyes, illustrate the location of the body(s) of it Ater 017 the reclamation nrap and provide a scaled
cross -sections) through the proposed body(s) of imter. The minimurn water depth must beat least 4 feet.
measured from the nonnal low water table elevatim on. unless information is provided to indicate that a more
shallow water bgdyl will be productive and beneficial at this site. Will the body(s) of water be stocked with
fish? Yes No if yes_ specify° species.
�. Describe provisions for safety to persons and to adjoining property in all completed excavations in rock
including what kind of permanent barricade will be left. Acceptable permanent barricades are appropriate
fencing; large boulders placed end -to -end, etc. Construction details and locations of all permanent
barricades must be shorn on the reclamation map.
�C,_S-?C_�V S ass C­1 �C 't
--apso� 5—oG�i't° t Qf
4-el-li�1) 4� C-1-1
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-II-

APPLICATION FOR A MINING PERMIT
4. Indicate the method(s) of reclamation of overburden. refuse. spoil banks or other such on -site mine waste
areas, including specifications for benching and sloping- l dual cross -sections and locations for such areas
must be provided on the reclamation map.
dC CVA 617% -� 5 G� i r �n c�sa��� l`hu r�rJG.
#�,� (eve( � V%
5. a. Describe reclamation of processing facilities, stockpile areas, and on -site roadways.
1 � r
Cez,, ne 4-
f LL cx c-c- c5s
'nrduv\�r-
b. Will any on -site roadways be left as part of the reclamation? Yes X No Ifves,
identify such roadways on the reclamation? reap and provide details on permanent ditch line stabilization.
-0 O /� kxt. V be ! � � f �'� r' -i G� � >,ti. C.l GG zf 5 5 ,
c t
�{r�cinw� Wit° c�ivI1/f--��_�s ��,� ��<1�-�� s 5�cI
`J iLL V r
t D i 5 tr G[ S ho v _: h �l ri LCt ✓t
6. Describe the method of control of contaminants and disposal of scrap metal; junk machinen,, cables, or other
such waste products of mining. (Note definition of refuse in The Mining Act of 1971). No off -site
generated waste shall be disposed of on the mine site without prior written approval from the NC
Department of Environment and Natural Resources, Land Quality Section and either the Division of
Waste Management (DWM) or local governing body. if a disposal permit has been issued by DWM
for the site, a copy of said permit must be attached to this application. All tempormy and permanent
refuse disposal areas must be clearly delineated on the mine maps) and reclamation map, along with a list
of 'items to be disposed in said areas.
< <� tij1-a.c
/
t
-1%-

APPLICATION FOR A MINING PERMIT
7. Describe your plan for revegetation or other surface treatment of the affected areas. This plan must
include recommendations for vear-round seeding. including the time of seeding and the amount and type
of seed; fertilizer, lime and mulch per acre. The recommendations must include general seeding
instructions for permanent revegetation and, if necessary, temporary revegetation. Revegetation utilizing
only tree plantings is not acceptable. Recommendations can be sought from:
a. Authorized representatives of the local Soil and � ater Consem-ation District;
b. Authorized representatives of the Division of Forest Resources. Department of Environment and
Natural Resources:_
c. Authorized county representatives of the North Carolina Cooperative Extension Service, specialists
and research faculty -with the Colleges of Agriculture and Life Sciences and Forest Resources at
North Carolina State University -
d. North Carolina licensed landscape architects;
e. Private consulting foresters referred by the Division of Forest Resources. Department of
Environment and Natural Resources:
f. N.C. Erosion and Sedimentation Control Planning and Design Manual;
g. N.C. Surface Mining Manual: A Guide for Permittin{g. Operation and Reclamation;
h. Others as may be approved by the Department.
LIME - RATE OF APPLICATION (tons/acre): 02 4-0YA6 'PI f i�r-Ce'
FERTILIZER - ANALYSIS AND RATE OF APPLICATION (pounds/acre): 10 —10-10
ao0 P>0 "s Pe"-
SEED - TYPE (S) AND RATE (S) OF APPLICATION INCLUDING YEAR-ROUND SEEDING
SCHEDULE (pounds/acre): rNOTE: Include Legumes]
Seed Types:
Seeding Dates:
Seeder Ratcs:
MULCH - TYPE AND RATE OF APPLICATION (pounds/acre) AND METHOD OF ANC1 iORING:
�2 4v",5 pew � lam sk4(( be PY-r.
OTHER VEGETATIVE COVERS — TYPL (S) AND RATE (S) OF APPLICATION INCLUDING
SEEDING SCHEDULE (pounds/acre, trees/acre. spacing of trees/shrubs. etc):
Revegetation and/or reforestation plan approved by:
Signature
Print Name
Title
Agency
-13-
Date

APPLICATION FOR A MINING PERMIT
F: NOTIFICATION OF ADJOINING LANDOWNERS
The "Notice" form, or a facsimile thereof, attached to this application must be sent certified or registered mail;
return receipt requested, to:
(1) the chief administrative officer of each county and municipality in which any part of the permitted
area is located as indicated on the mine map(s);
(2) all owners of record, both public and private, of all tracts of land that are adjoining the mining
permit boundary; if an adjoining tract is owned or leased by the applicant or is owned by the lessor
of the mine tract, all owners of record of tracts adjoining these tracts must be notified (that are
within 1,000 feet of the mining permit boundary) as indicated on the mine map(s); and
(3) all owners of record, both public and private, of all tracts of land that are adjoining the mining
permit boundary which lie directly across and are contiguous to any highway, creek, stream, river,
or other watercourse, railroad track, or utility or other public right-of-way. if an adjoining tract is
owned or leased by the applicant or is owned by the lessor of the mine tract, all owners of record of
tracts adjoining these tracts must be notified (that are within 1,000 feet of the mining permit
boundary) as indicated on the mine map(s). "Highway" means a road that has four lanes of travel
or less and is not designated as an Interstate Highway.
The only exception to the above method of giving notice is if another means of notice is approved in advance by
the Director, Division of Land Resources.
A copy of a tax map (or other alternative acceptable to the Department) must be mailed with the completed
"Notice" form (the proposed overall permit boundaries and the names and locations of all owners of
record of lands adjoining said boundaries must be clearly denoted on the tax map).
The "Affidavit of Notification" attached to this application must be completed, notarized and submitted to the
Department, with the remainder of the completed application form, before the application will be considered
complete.
THIS SECTION MUST BE COMPLETED FOR ALL APPLICATIONS FOR NEW MINING PERMITS
AND ALL MODIFICATIONS OF A MINING PERMIT TO ADD LAND TO THE PERMITTED AREA, AS
REQUIRED BY NCGS 74-50(bl).
SEE THE NEXT TWO PAGES FOR THE "NOTICE"' FORM AND THE "AFFIDAVIT OF
NOTIFICATION"
- 15 -

NOTICE
Pursuant to provisions G.S. 74-50(bl) of The Mining Act of 1971, Notice is hereby given that
has applied on
(Applicant Name)
(Date)
to the Land Quality Section, Division of Land Resources, North Carolina Department of Environment
and Natural Resources, 1612 Mail Service Center, Raleigh, North Carolina 27699-1612, for (check one):
❑ a new surface mining permit,
❑ a modification of an existing surface mining permit to add land to the permitted area; or
❑ a modification of an existing surface mining permit to add land to the permitted area with no disturbance
in the area proposed. Please note that future modification(s) may be submitted by the applicant to
allow disturbance within this area without re -notification of adjoining landowners.
The applicant proposes to mine on acres located
(Mineral, Ore) (Number)
(Miles)
of off/near road
(Direction) (Nearest Town) (Number/Name)
in County.
*SEE ATTACHED MAP FOR PROPOSED PERMIT BOUNDARIES AND CORRESPONDING
ADJOINING LANDOWNER NAMES AND LOCATIONS*
In accordance with G.S. 74-50(bl), the mine operator is required to make a reasonable effort, satisfactory to the
Department, to noti fy all owners of record, both public and private, of all tracts of land that are adjoining the mining
permit boundary; if an adjoining tract is owned or leased by the applicant or is owned by the lessor of the mine tract,
all owners of record of tracts adjoining these tracts must be notified (that are within 1,000 feet of the mining permit
boundary). In addition, the mine operator must also notify the chief administrative officer of the county or
municipality in which any part of the permitted area is located. Any person may file written comment(s) to the
Department at the above address within thirty (30) days of the issuance of this Notice or the filing of the application
for a permit, whichever is later. Should the Department determine that a significant public interest exists relative to
G.S. 74-51, a public hearing will be held within 60 days of the end of the 30-day comment period specified above.
A copy of the permit application materials is on file and available for public review during normal business
hours at the above listed address as well as at the appropriate regional office. For information regarding the
specifics of the proposed mining activity, please contact the applicant at the followine telephone number:
. For information on the mining permit application review process, please contact
the Mining Program staff at [phone]. Please note that the Department will consider any relevant written
comments/documentation within the provisions of the Minin Act of 1971 throughout the apl2lication review
(Addressee/Owner of Record's
Name and Address)
(Date of Issuance of this Notice/
Mailed to Addressee/Owner of Record)
(Name of Applicant: Include Contact Person
& Company Name, if Applicable)
(Address of Applicant)
- 16-

APPLICATION FOR A MINING PERMIT
AFFIDAVIT OF NOTIFICATION
I, , an applicant, or an agent, or employee of an applicant, for a
new Mining Permit, or a modification of an existing Mining Permit to add land to the permitted area, from the N.C.
Department of Environment and Natural Resources, being first duly sworn, do hereby attest that the following are all
known owners of record, both public and private, of all tracts of land that are adjoining the mining permit boundary
(including, where an adjoining tract is owned or leased by the applicant or is owned by the lessor of the mine tract,
all owners of record of tracts adjoining these tracts, that are within 1,000 feet of the mining permit boundary) and
that notice of the pending application has been caused to be mailed, by certified or registered mail, return receipt
requested, to said owners of record at their addresses shown below, such notice being given on a form provided by
the Department:
(Adjoining Landowner Name) (Address)
(Attach additional list if necessary)
1 do also attest that the following individual is the chief administrative officer of the county or municipality in which
any part of the permitted area is located and that notice of the pending application has been caused to be mailed, by
certified or registered mail, return receipt requested, to said office at the following address:
(Chief Administrative Officer Name) (Address)
[i.e.: City Manager, County Manager, Mayor, etc.]
The above attestation was made by me while under oath to provide proof satisfactory to the Department that a
reasonable effort has been made to notify all known owners of record, both public and private, of all tracts of land
that are adjoining the mining permit boundary (including, where an adjoining tract is owned or leased by the
applicant or is owned by the lessor of the mine tract, all owners of record of tracts adjoining these tracts, that are
within 1,000 feet of the mining permit boundary) and the chief administrative officer of the county or municipality in
which any part of the permitted area is located in compliance with N.C.G.S. 74-50(bl) and 15A NCAC 513.0004(d).
I understand that it is the responsibility of the applicant to retain the receipts of mailing showing that the above
notices were caused to be mailed and to provide them to the Department upon request.
Signature of Applicant or Agent
Date
If person executing Affidavit is an agent or employee of an applicant, provide the following information:
Name of applicant:
Title of person executing Affidavit
I
a Notary Public of the County of
State of North Carolina, do hereby certify that
appeared before me this day and under oath acknowledged that the above Affidavit was made by him/her.
Witness my hand and notarial seal, this day of 20
N otary:
my Commission expires:
-17-

APPLICATION FOR A MINING PERMIT
G. LAND ENTRY AGREEMENT
We hereby grant to the Department or its appointed representatives the right of entry and travel upon our lands
or operation during regular business hours for the purpose of making necessary field inspections or investigations as
may be reasonably required in the administration of the Mining Act of 1971 pursuant to G.S. 74-56.
We further grant to the Department or its appointed representatives the right to make whatever entries on the
land as may be reasonably necessary and to take whatever actions as may be reasonably necessary in order to carry
out reclamation which the operator has failed to complete in the event a bond forfeiture is ordered pursuant to G.S.
74-59.
LANDOWNER:
Signature:
Print Name:
(Title, if applicable)
Company
(If applicable)
Address:
Telephone: (
Date Signed:
APPLICANT:
Signature:*
Print Name:
Title:
Company:
Mine Name:
Telephone: (
Date Signed: _
*Signature must be the same as the individual who signed Page I of this application.
cation. six (b) conies of all location
and reclamation maps, and the appropriate processing fee (see next page for fee schedule) in the form a check
or money order payable to the North Carolina Department of Environment and Natural Resources must be
sent to the Land Quality Section Central Office at the address listed on the front cover of this application
form.
Inquiries regarding the status of the review of this application should be directed to the Mining Program staff at
[phone].
- l8-

APPLICATION FOR A MINING PERMIT
MINING IEEE SCHEDULE
Anon refundable permit application processing fee when filing for anew mining permit, a major permit modification or a renewal permit is
required as follows:
New Permit Applications
Permit Modifications
Permit Renewals
Transfers/Minor Modifications*
0-25 acres
$3,750.00
$750.00
$750.00
$ 100.00
26+acres
$5,000.00
$1,000.00
$1,000.00
$100.00
* A nonrefundable 5100.00 permit application processing fee is required for minor permit modifications. Minor hermit modifications include ownership transfers, name
changes, bond substitutions and permit renewals where the mine is inactive and fully stabilized. A minor permit modification also includes lands added to a permitted area,
outside of the minimum permit buffer zone requirements, where no plans for mining related disturbance of the added lands have been approved. All other changes are
considered major permit modifications.
Acres for new permits and renewal permits means the total acreage at the site. Acres for major modification of permits means that area of land affected by the modification
within the permitted mine area, or any additional land that is to be disturbed and added to an existing permitted area, or both.

APPLICATION FOR A MINING PERMIT
SCHEDULE OF RECLAMATION COSTS
(Based upon range of $500 - $5,000 per affected acre)
COMMODITY CODES: SG = Sand and/or Gravel, GS = Gemstone, Borrow = Borrow/fill dirt, CS = Crushed Stone;
DS = Dimension Stone, FS = Feldspar, MI = Mica, LI = Lithium, PF = Pyrophyllite, OL = Olivine,
KY = Kyanite/Sillimanite/Andalusite, PH = Phosphate, CL = Clay/Shale, PE = Peat, AU = Gold, TI = Titanium, and OT
= Other
Type
T/S Ponds
S.Diles _
W.piles
P.area/H.R.
Mine Excay.
SG. GS.
$500/ac.(L)
$1800/ac.
$2000/ac.
$1800/ac.
$500/ac.(L)
Borrow
1500(FI)
$2000(PD)
CS, DS,
500(L)
1800
2000
2000
500(L)
FS, M1,
1500(Fl)
2500(PD)
LI, PF, OL, KY
PH
I000(L)
2500
5000
5000
2000(I1)
2500(FI)
5000(PD)
CL
I000(L)
2500
5000
5000
2000(L)
2500(171)
3700(PD)
PE, AU,
1000(L)
2500
3000
3500
2000(L)
Tl, OT
2500(Fl)
5000(PD)
(L) = reclamation to a lake and revegetating sideslopes
(F1) = reclamation by filling in and revegetating
(PD) = reclamation by grading for positive drainage & revegetating
AS PER NCAC 15A 5B.0003, IF YOU DISAGREE WITH THE BOND AMOUNT DETERMINED BY THE
BOND CALCULATION WORKSHEET, YOU MAY SUBMIT AN ESTIMATE OF RECLAMATION COSTS
FROM A THIRD PARTY CONTRACTOR. SAID ESTIMATE MUST BE PROVIDED WITHIN 30 DAYS TO
THE FOLLOWING ADDRESS: Mining Program, Land Quality Section, 1612 Mail Service Center, Raleigh,
North Carolina 27699-1612
ALL ESTIMATES MUST INCLUDE THE FOLLOWING, AS A MINIMUM:
• FINAL GRADING COSTS PER ACRE
• LIME AND FERTILIZER COSTS PER ACRE
• YEAR-ROUND SEEDING MIXTURE COSTS PER ACRE (FROM APPROVED REVEGETATION
PLAN IN APPLICATION/PERMIT DOCUMENT)
• MULCH AND ANCHORING COSTS PER ACRE
• ANY OTHER RECLAMATION COSTS NECESSARY TO COMPLY WITH THE APPROVED
RECLAMATION PLAN FOR THE SITE IN QUESTION
YOU WILL BE NOTIFIED AS SOON AS POSSIBLE OF THE DIRECTOR'S FINAL BOND DETERMINATION.
_22_

Print to* form to PDF
+ .
Return PDF of this form to DLR CO by email, cc DLR RO and DWQ SPU
MINING PERMIT APPLICATION REVIEW FORM
for the
DIVISION OF WATER QUALITY
THIS SECTION TO BE FILLED OUT BY DLR:
Project Name: HLD Ming LLC Mine DLR Permit #: 74-66 County: Pitt Address: hcharrisCa)hcharris.net
YES NO Date Commencing
Is this mine a new mine? r IOC 2001
Have land disturbing activities
started? Date? r r' 2001
Latitude:35.5747 Longitude:-77.1981
Please return comments to (at DLR CO): Judy Wehner QV�
Comments due by., 11/30/11 "U
SECTION BELOW TO BE FILLED OUT BY DWQ:
Is the RO concerned that the operation, as proposed, would violate standards of water quality? See bellow
Comments: Wetlands delineation on site reauired and statement about presence of wetlands within 400' from
excavation cone of influence zone). Provide calculations to proof the adeguacy of sediment basins for final
maximum excavation. Possible 404/401 reauired. O&M Plan reauired. The Consultant will be informed about
this request.
Watershed/Stream Name & Classification: Tar/Pam River Basin; Chicod Creek: class_C, NSW
DWQ Compliance Status of Mine: Compliant
YES NO
'NPDES p+e'rmit.requireif? J.y '
t
NPDES permit existing?
r (Permit #NCG020558 )
4-an NPDES'permifis'not required; is-DWQ-'
still concerned:about'wetlarid degradation
by ewatering?
Should permittee contact DWQ RO
immediately? (e.g. to schedule a site visit if
r , RO Contact Name:
r
mine has already begun digging or is
Contact Reason:
dewatering without DWQ permit)
401 Wetland Cert: required? `
l i e ;
oq'S8 b
:
r ,'
401 Wetland Cert. existing?
r Permit #
r
Rev September 2010

Print this form to PDF
Retum PDF of this for? to DLR CO by email. cc DLR RO and D WQ;-�u
DoesDWQ;RO currently„have,enough
g
information46determine if a'401
IJJJI
certification is required?
4
Rev September 2010

Print tiys form to PDF
Return PDF of this form to DLR CO by email. cc DLR RO and DWQ SPU
YES NO
Are 'wetl'i ds distuebed'at this "site?.
"+ �" '�
r'.,
:,:,
fi:,•
Does DWQ RO suspect or know of nearby
r
r
wetlands to the site?
a! �G,
required- tcIs awetlanddelmeation
'tants 5
-ffstte?DWQ'.is
, r ,
s
r`s,te?f r
Stream Determination Needed?
r
r
Stream Determination, ompleted?,'' ��'
r F �'� �y " g
r l
Does DWQ RO need a statement that no
wet land slstreams are disturbed
r
for this project from applicant?
Buffer Determination Needed? ,. KF$:". d' ''4
r "'=° ,� s ' ` f
f
Buffer Determination Completed?
r
r {
RecycleYsy"stem permit existing?* L'�i`.,,, - .f
Permit #.'New
: ,;
Recycle System permit required?*
r
Enough information to determine?
Non -discharge permit existing?* "
Permit #
r
Will wastewaters discharge to HQW waters
r
r 7Q10
Unknown (permittee determine): r ,
with a 7Q10=0? **
Plow:
;T
r Has Violation;
-'
r r i
Does DWQ require-DLR to hold the,permit-
r, O&M Requirements ;
s
it further
ricerr
HQW17Q10 Cns
r ,
(e.g. so,DWQ.can re�iew or
r Other. Reason:
because: DWO, require's more information)?, ,
.
'
k , _
RO contact:.
Hold Uhtil
Mine must wait to dewater until an O&M
r
r `
plan is approved?
"The NPDES SW and WW permit NCG020000 covers closed -loop recycle systems, designed to exclude all stormwater run-off from
the system and operate at or below two -feet of freeboard. These systems may permitted by a Non -discharge Recycle System
Permit from the Aquifer Protection Section (APS), OR may instead be peen tted under NCG020000 to eliminate an additional permit.
Recvclo systems that do not meet those criteria are considered discharging systems, and are subiect to the NCG020000 discharge
permit.
*`To obtain 7Q10 flows, permittees must contact the DWQ Stormwater Permitting Unit. If DWQ does not have a flow estimate fora
specific stream, permittees will be asked to obtain one, Permittees should contact J. Curtis Weaver at the USGS: 919-571-4043, for
more information on obtaining a 7Q10 flow. USGS will not determine a 7Q10 flow for tidally influenced water bodies.
Reviewed by:
DWQ RO Surface Water: WaRO Regional Office: Samir Dumpor Date: 11/28/2011
RO Aquifer Protection Section: Regional Office: Date:
SPU DWQ Central Office Reviewer (if applicable):
Rev September 2010

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PLAN, SEDIMENTATION AND
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DWG. NAME: HCH_10003 20-1
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