NCG520052_Owner (Name Change)_20160601

PAT MCCRORY
Water Resources
ENVIRONMENTAL QUALITY
(,ur,•run,
DONALD R. VAN DER VAART
S. JAY ZIMMERMAN
nirei lot
June 1, 2016
Mr. Keith Adams
Tarheel Sand and Stone, Inc.
1108 Tuckda Way
Hamptonville, NC 27107
Subject: Renewal of coverage / General Permit NCG520000
Tarheel Sand Mine #53
Certificate of Coverage NCG520052
Davie County
Dear Permittee:
The Division hereby renews Certificate of Coverage (CoC) NCG520052 to discharge under General
Permit NCG520000. This CoC is issued pursuant to the requirements of North Carolina General Statue
143-215.1 and the Memorandum of Agreement between North Carolina and the US Environmental
Protection agency dated October 15, 2007 [or as subsequently amended].
If any parts, measurement frequencies or sampling requirements contained in this General 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, the 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. The Division may require modification or revocation and reissuance of the certificate of coverage.
Contact the Winston-Salem Regional Office prior to any sale or transfer of the permitted facility.
Regional Office staff will assist you in documenting the transfer of this CoC.
This permit does not affect the legal requirements to obtain any other Federal, State, or Local
governmental permit that may be required.
If you have any questions concerning the requirements of the General Permit, please contact John
Hennessy [919 807-6307 or [e-mail]].
for S. Jay Zimmerman, P.
Director, Division of Water Resources
cc: Winston-Salem Regional Office
NPDES file
State of North Carolina I Environmental Quality I Water Resources
1617 Mail Service Center I Raleigh, NC 27699-1617
919 807 6300 919-807-6389 FAX
https://deq. na goy/about/divisions/water-resources/water-resources-permits/wastewater-brancb/npdes-wastewater-permits

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
GENERAL PERMIT NCG520000
CERTIFICATE OF COVERAGE NCG520052
DISCHARGE OF IN -STREAM SAND MINING WASTEWATER, ASSOCIATED STORMWATER
AND SIMILAR DISCHARGES 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,
Tarheel Sand and Stone, Inc.
is hereby authorized to discharge instream mining wastewater from the following facility:
Tarheel Sand Mine #53
U.S. Hwy 64 E
Lexington
Davie County
to receiving waters designated as the Yadkin River, a class WS-IV CA stream in subbasin 03-07-02
of the Yadkin -Pee Dee River Basin. All discharges shall be in accordance with the effluent
limitations, monitoring requirements, and other conditions set forth in Parts I, II, III and IV
hereof.
This certificate of coverage shall become effective June 1, 2016.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day June 1, 2016
for if ay Zimmerman, P.G.
Director, Division of Water esources
By Authority of the Environmental Management Commission

Water Resources
ENVIRONMENTAL QUALITY
Tarheel Sand and Stone, Inc.
Attn: Jerry K. Adams, Owner
1108 Tuckda Way
Hamptonville, NC 27020
SUBJECT:
March 24, 2016
PAT MCCRORY
Governor
DONALD R. VAN DER VAART
,Secretary
S. JAY ZIMMERMAN
Director
RECEIVED
APR 0 5 2016
CENTRAL FILES
DWR SECTION
Compliance Evaluation Inspection
Tarheel Sand Mine #68 - NCG520013 & Tarheel Sand Mine #53 — NCG520052
Yadkin County
Dear Mr. Adams:
Ron Boone, of the NC Division of Water Resources (DWR or the Division), Winston-Salem Regional
Office (WSRO), conducted compliance evaluation inspections (CEI) of the subject facilities on March 23,
2016. Your assistance and cooperation during the inspections was greatly appreciated. Inspection checklists
are attached for your records and results of the inspections are summarized below.
The #68 mine has recently been in operation and you stated during the inspection that it operates
approximately 45 — 50 days per year. However, no effluent monitoring or documentation of operations has
been done and none was available during the inspection. Also, there are no warning signs on the river
upstream of the dredge to warn people of the mining activity ahead. Please read the NCG520000 permit in
detail, especially Part I, to ensure you fully comply with all operational requirements of the permit. Part II is
also important to understand and fully comply with. Mr. Boone can help to answer any questions you may
have.
The #53 mine has not been in operation or had a discharge for approximately 20 years. You're
reminded that if and when the company decides to put this sand mine back into operation and a wastewater
discharge is produced at the site, the company must be in immediate compliance with all conditions of the
NCG520000 permit.
Please note that violations of the NCG520000 permit at either of these sites, are subject to civil
penalties of not more than $25,000 per day per violation. Please correct the violations at the #68 mine as
soon as possible and if you have compliance related questions, feel free to contact us at any time.
State of North Carolina I Environmental Quality I Water Resources
450 West Hanes Mill Road, Suite 300 I Winston-Salem, North Carolina 27105
336 776 9800

If you have any questions or concerns regarding the inspections or this letter, please don't hesitate to contact
Mr. Boone or me at 336-776-9800.
Sincerely,
Sherri V. Knight, P.E.
Regional Supervisor
Water Quality Regional Operations
Division of Water Resources
Attachments:
1. BIMS Inspection Report x2
CC: DWR NPDES Unit
Central Files
WSRO

United States Environmental Protection Agency
' E PA - Washington, D.C. 20460•
Water Compliance Inspection Report
Form Approved.
OMB No. 2040-0057
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection
1 El 2[ I 3 I NCG520052 111 12 I 16/03/23 117
Type
18 I C I
Inspector FacType
19 I G I 20 L I
211.111II II1III111IIIIIIIIIIIII11111111111111
r6
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA
671 I 70 LJ 71 Li 72 El
Reserved
73I i I74 79
I I I I I 1180
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
POTW name and NPDES Kermit Number)
Tarheel Sand Mine #53
US Hwy 421 Baltimore Rd
Yadkinville NC 27055
Entry Time/Date
02:OOPM 16/03/23
Permit Effective Date
12/08/01
Exit Time/Date
03:OOPM 16/03/23
Permit Expiration Date
17/07/31
Name(s) of Onsite Representative(s)/Tittes(s)/Phone and Fax Number(s)
/1/
Other Facility Data
Name, Address of Responsible Officiat/Title/Phone and Fax Number
Contacted
Jerry Keith Adams,1108 Tuckda Way Hamptonvitle NC
27020//336-468-4003/3362446840 No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Other
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Ron Boon WSRO WQ//336-776-9690/ -V- 4f //e:
Signature of Management Q A Reviewer -Agency/Office/Phone and Fax Numbers Date
,)t44(41/tA- '' Wkt4ca— 3/2 V./IS
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page# 1

31
NPDES
NCG520052
(11 121
yr/mo/day
16/03/23
17
Inspection Type
urs
1
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Facility has not been in operation or had a discharge for nearly 20 years.
Page# 2

Permit: NCG520052
Owner - Facility: Tarheel Sand Mine #53
Inspection Date: 03/23/2016 Inspection Type: Compliance Evaluation
Other Yes No NA NE
Comment: Facility has not been in operation or had a discharge for nearly 20 years.
Page# 3

Pat McCrory
Governor
ATA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Resources
WATER QUALITY PERMITTING SECTION
Donald R. van der Vaart
Secretary
PERMIT NAME/OWNERSHIP CHANGE REQUEST
This form is for ownership changes or name changes of NPDES wastewater permits.
• -Permittee" references the existing permit holder
• "Applicant" references the entity applying for the ownership/name change.
I. NPDES Permit No. (for which the change is requested):
or
Certificate of Coverage #:
II. Existing Permittee Information:
a. Permit issued to (company name):
b. Person legally responsible for permit:
RECEIVED/DENRIDWR
MAR ?.h?Oh
Water Quality
Permitting Sectior
NCOO
N C G 5 2 0 0 5 2
Aaron Sand & Gravel
Tim
First
G
MI
Beeman
Last
Title
Manager
Permit Holder Mailing Address
Winston Salem NC 27127-
City
[phone]
State
Zip
( )
Phone Fax
c. Facility name: Aaron Sand # 53 Mine
d. Facility's physical address:
e. Facility contact person:
1035 Baltimore Road
Address
Yadkinville NC 27055-
City State Zip
Tim Beeman [phone]
First / MI / Last Phone
III. Applicant Information:
a. Request for change is a result of: ® Change in ownership of the facility
® Name change of the facility or owner
If other please explain:
b. Permit issued to (company name): Tarheel Sand & Stone Inc.
c. Person legally responsible for permit:
Jerry K Adams
First MI Last
President
Title
1108 Tuckda Way
Permit Holder Mailing Address
Hamptonville NC
27020-
City State Zip
[phone] [e-mail]
Phone E-mail Address
Page 1 of 2 Revised 7/01/2014

d. Facility name: Tarheel Sand #53 Mine
e. Facility's physical address: 1035 Baltimore Road
f. Facility contact person:
Address
Yadkinville NC
27055-
City State Zip
Jerry K Adams
First MI Last
President
Title
[phone] [e-mail]
Phone E-mail Address
IV. Will the permitted facility continue to conduct the same commercial/industrial activities conducted prior to
this ownership or name change?
® Yes
❑ No (please explain)
If applicable, the applicant shall submit a major permit modification request to DWR. A major modification shall be
defined as one that increases the volume, increases the pollutant load, results in a significant relocation of the
discharge point, or results in a change in the characteristics of the waste generated.
V. Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS ARE
INCOMPLETE OR MISSING:
1. This completed application is required for both name change and/or ownership change requests.
2. Legal documentation of the transfer of ownership (such as relevant pages of a contract deed, or a bill of sale) is
required for an ownership change request. Articles of incorporation are not sufficient for an ownership change.
Applicable regulations: 40 CFR 122.41, 40 CFR 122.61 and 15A NCAC 02H .0114
The certifications below must be completed and signed by both the permit holder prior to the change (Permittee), and the
new applicant in the case of an ownership change request. For a name change request, the signed Applicant's Certification
is sufficient.
PERMITTEE CERTIFICATION (Permit holder prior to ownership change):
I, , attest that this application for a name/ownership change has been reviewed and is accurate and complete to the
best of my knowledge. u derstand that if all required parts of this application are not completed and that if all required
supporting infor - do • not inc , ded, this application package will be returned as incomplete.
Signature
APPLICANT CERTIFICATION
I, , attest that this application for a name/ownership change has been reviewed and is accurate and complete to the
best of my knowledge. I understand that if all required parts of this application are not completed and that if all required
supporting information is not included, this application package will be returned as incomplete.
3,ttl5
Signature Date
XWWWCWxxxxxxxxrxxxx*******
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Division of Water Resources
Water Quality Permitting Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
NPDES PERMIT NAME/OWNERSHIP CHANGE REQUEST
Page 2 of 2
Revised 7/01/2014