NCG020695 DMR WW (2)

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ANNUAL SUMMARY DMR - WASTEWATER
PROCESS MINE/DMAZTERING WASTEWATER
GENERAL PERMIT NO. NCG020000
'°"` "� trol"'t bn°� "`FMRCH_,1= of each year Tg: •.
}2gport AFll'TYcrsrewatei d�scfiarge riioiutoringtdata onht[�issfor (inclT9 o V,lativ and 1Vo Drschrrrge and permit Limr V cr r s) by
` aY ,.�` s; P;S - - - .':_ 4�"i�,y
/ou`hays limif violations _'you_must alsnhave;tumec( in-a,LimitUiolation_aMR to,y©ur face( ReglanalC�ffice witfiirr,30tday_sot,receiving sample,results,fcarn,a lab: _ _ _
CERTIFICATE OF COVERAGE NO. `� � � -10' 5 SAMPLE COLLECTION YEAR: 2015
FACILITY NAME: Black Ankle Quarry COUNTY: Montgomery
PERSON COLLECTING SAMPLES: N/A PHONE NO.
CERTIFIED LABORATORY: PACE ANALYTICAL Lab #40 ADD TO LISTERVE? YES NO EMAIL:
LIMITS VIOLATIONS? YES e INDUSTRIAL SAND I? DISCHARGE TO SA WATERS 4?
Part A! Wastewater Mnnitnrinu Rennirements
Outfall No.
Date Sample Total Flow
Collected'
Total Suspended Turbidity? Settleable Solids pH Fecal Coliforms
Solids'
-
mm/dd/ MG/CFS
mg/l''2 NTL Z" ml/12 Standard col/m12,4
1Q Pit Dischar e
No Discharge
2Q Pit Discharge
No Discharge
r—k-116 EL..
3Q it Dischar e
No Discharge
4Q Pit Discharge
No Discharge
enV \
'All mines must monitor WW discharges for TSS. Only industrial sand mine discharges are subject to TSS hints.
2If an effluent limit is exceeded, the permittee is required to institute monthly monitoring for that parameter for the remaining permit term.
?The discharge shall not cause an instantaneous measurement of the turbidity of the receiving water to exceed- 10 NTU for freshwater streams, lakes, and reservoirs
designated as trout waters; 25 NTU for all lakes and reservoirs, and all salt waters, 50 NTU for all other streams and surface waters. Turbidity may be monitored at the
Stormwater Discharge Outfall Alternatively, the permittee may choose to monitor turbidity in the receiveing water, directly upstream and downstream of the discharge.
40nly facilities discharging to SA waters are required to monitor for Fecal coliforms.
Permit Date 1/1/2010-12/31/2014 Last Revised 01-21-11
Page 1 of 2

Part A: Continued: Wastewater Monitoring Requirements
Outfall No. Date Sample Total Flow
Collected'
- mm/dd/ r MG
Total Suspended
Solids'
m 1''2
Turbidity' Settleable Solids pH Fecal Coliforms
NTU2'' ml/12 Standard col/ml2,1
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW" "NO DISCHARGE" & LIMIT
VIOLATIONS) BY MARCH I OF EACH YEAR TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMA TION REPOR TED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information sumbitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am aware thhat there are significant penalties for submitting false information, including the possibility of fines and imprisionment for knowing violations."
Permittee)
Permit Date- 1/l/2010-12/31/2014
Last Revised 01-21-11
Page 2 of 2

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT IDMRe _ WA -Q rPWA-rl=P
General Permit No. NCG020000
Calendar Year 2015
Certificate of Coverage No. NCGO20695
Facility Name: Black Ankle Quarry
County: Montgomery
Phone Number: 336-672-1501 Total No. of Outfalls Monitored 1
Certified Laboratory Pace Analytical Lab # 40
Lab #
Wastewater (WW) Discharge Outfall No. 1
Is this an industrial sand mine (See 40 CFR §436 Subpart D)? Yes No X
Does this outfall discharge WW to SA waters? Yes No X
Does this outfall discharge WW to SB or PNA waters? Yes No X
Does this outfall discharge WW to HQW or ORW waters? Yes No X
If so, what is the 7Q10 flow rate? NA or Tidally influenced waters, 7Q10 not available
Does this outfall discharge WW to Trout (Tr) designated waters? Yes B No
Were there any limit violations in the calendar year? Yes No X
Daily Flow
Outfall No. 1 Rate, cfs PH, SU TSS, mgll
SS, mUl
Discharge
Turbidity, NTU
Upstream (U)
Turbidity,
Downstream (D)
Turbidity, NTU
Fecal Coliform,
col/10o ml
(SA)
w --, _ � - k.lndustrea4Sand-2$/4S'
'IQ =(Uo + "�w=ys�r
EfffraerEt .w resluwaEer-b: iiQOK+ov;I�RW L#11"i(1
50./ EMf
lidPtBt`i +las P 9':0 $alhvaker LLQW-or ULt`'4V ands Yr
7h nate UCL"OW if,
A 4 AAaFly fsnr 6.8 .5 ar.PN ttlfl5
aPpsemnh
e3
7iQW ORW,,'
w'
SA, SB
� onp'rrn t
tlal0.2
.- -,.
NoJLimite eo �e
4sitry sra�a ainae.nuna.
5til26ltIQ
N1A w,em cwea
siaml„a wwm
NI. ;ware. Q;u�b w�aab
ePwk, �
-
i
a
-.
NtA "a
r-,,
Date Sample
Collected, mo/dd/yr
-
No Discharge
N/A
N/A
N/A
rerm li Uaie lull/Lu-1, — y/3u/LULU
Last Revised 10-2-2015

Certificate of Coverage No NCG020695
CERTIFICATION
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified personnel properly gather and evaluate the information submitted Based on my inquiry of the person or persons who manage the system, or those
persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am
aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Requ
Signs
Date
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015