NCG020048_MONITORING INFO_20190311

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCGW
DOC TYPE
Q'
Ufli Reoot4,
DOC DATE
❑ 3019051
YYYYMMDD

ANNUAL SUMMARY D.MR - STORMWNTER.
SEND TO CI�N�'RAIJ OFFICE
'r STORMWATFR DISCHARGE OUTI+ALLS (SDO)
GENERAL, PERMIT No. NC(7020000
llcport fll,h 5'7nR1{91Vi1TF,R I�Iunilnrinf l)ala on this form !including Nis l low and f�c) 1)isel)argc and I't rmit Limit Viol;tlioits) by IWARCH 1 ref c'uch vcrrr. --_-
C:1:R'1'llr'ICE1`1'F, U1 COVI+:RA[.<l+' NU. NCG(12� ( � SAMPLE CULL ,CTION YEAR.
FACILITY NAME: �_.�L�/✓1 � COUNTY _
PERSON COLLECTING SANwIP . ''S ,' -I'HONF; NO.
CERTIFIED LABORATOR ' ` 1 .>l�c � L:lh ADD TO LISTSI RVI?'? YES ❑ NO ❑ E)t•IAIL:
Part A.. Stornnvater k1ollitorin g IteL Ilircntents
c)Itlr;lll
No,
Date Sample
('olll�ctcd
(111oldd/p.012 t
NO FLOW)
Ill Tier Z
Monthly
N•lollhoring?
(y/n)
If uE' mouths in
Tier ?
SanipEin);-
Total I��'lo���
(N•IG)
Total Suspended
Solids
(n1l;ll)
a
"1'ul•bidity
(NTU)
Settleable
Solids (all/l)
'fatal
Rainfall
(in)
11:Veni
Duration
(willn(cs)
e
- )VO—
�
-
100
See Footnote`..
O.1 1
G11 P
—
--rLE
-
MA
If' -'NO NI.O1V" or. NO I)15C€InIZCiI;. lu}ter is1U I LOW"-rtr `NC) DISCI €NZCiIi" for each oil tile rite Date >Z,tnVc.
Per NCG02: Tier '2 Nlonthly sampling shall he done until 3 consecutive samples src l)ehnv the bunchnru'k or within dic henchmark range
If a vallzc is ill excess OftlIc'benchmark, or outside the he;tchinarl, range (for IM). you mist rrltptement the Tier I or Ticr 2 rrspunsca in the General Permit.
''E:SS henchru;trk values are 100 ill
u01 except in ORW. 1-]WO. Irotil, anc€ PNA waters where they are 50 nw/l.
511'110 discharge shall nut cause an inslarllarleous swat 11remcm of the turbidity of the recciving water to exccc(L• IO NT(I For freshwater slt'eatrts, lakes, and r'escrvoirs tle.vionatcd
as trout waters;25 NTII f0l' ;111 lakes turd WSel'VOIrs, turd all salt waters: 50 NTU for all other stt•cants and snrfaec 'I'urbidily play be 11101litoreLI at the Si)O.
Altemativciy, the perinittce may choose h) ]rlonilur turbidity in the reccivin" water, din:ctly upstrc:nn alld downstream) of the SI)U.
1'L;rmil Dale' Ill/2010-12/31/2014 Lnst ko,isecl 01-21--1 1
I';lge I ()f2

Part It: Vehicle Maititell llice Activity Nionitoring Requirements for facilities usirig > 55 gal of new motor oil/rmmth on averalie
Outfall
wo,
r
Date S.unplt'
Collected
Oil
NO I� LO W)
Ill Tier 2
Monthly
Motiitorin}
{y/ii 1
It of Months
in Tier 2
z
Saunpliii};
New 'Motor
Oil Usage
{ Vuionlhj_
-
Tota] ltlow
{N1C;}
�_ _
TPH using method
1(,1,;lA .Y�,7'-I1lsrb!
tin 1)
Total Suspended
solids
(m g/1)
p1I
{Standarrl
Units)
Total
Rainfall
(in)
Event
Duration(mo/dd/yr
(3ninittes)
_
is 3
I lro'
6-9'
HAS YOUR 1'ACILITY HAD 4 Olt MORE RFNCHMARK EYCEEDENCES
A'I ANY ONE OLATAIA, (INCLUDING VEHICLE MAINTENANCE)? VES ❑ NO ❑
HAVE YOU CONTAt"I ED THE REGION? YES ❑ NO
WHO AT THE REGION HAVE YOU SPOKEN 11111'Il•1
MAIL ORIGINAL AND ONE, CO11Y OFTHIS ANNUAL SUMMARY (INCLUDING AI,L "NO FLOW" "NO DISCHARGE" & I..IMIT
VIOLATIONS).BY N111RCII I Ole EACH YEAR `I'O:
Division of Walcr duality
Attu: DWQ C:c;nind files
1617 Mail Service Cc )lur
Raleigh, North Carolina 27699-1617
(9 It)) 807-6300
YOU MIJ.V' SIGN THIS CERTIFICA'MON FOR ANY INFO1tMATION RLPORITD:
"I certify, under penalty or lave, that this document and all attachments were prepared under lily direction or supervision in accordance nce with a system de'signed
to assure that qualified personnel properly gather and evaluate tile information submitted. Based on my inquiry of the person or persons who manage the
system, ur those persons directly responsible for f;nthering the inturnlilt ion, the information submitted is, to the be%t of lily knowledge and Relief, true, accurate,
and complete. I gun aware that there are significant penalties to]- slibmilting false information, including the possibility of fi3lcs alld imprisonment for knowing
vin3.Jinnc �� n
(Si} natt c of Ycrinittce)
Perniil Date: I/l/2010-12/31/2014
(Date)
Lam Revisull01-21-11

f `4 1 ANNUAL SUMMARY DMR - STORMWATER
11 SEND TO CENTRAL OFFICE * it
STORMWATER DISCHARGE OUTFALLS (SDO)
GENERAL PERMIT NO. NCG020000
*Report ALL STORMWATER Monitoring Data on this form (including No Flow and No Discharge and Permit Limit Violations) by MARCH 1
CERTIFICATE OF COVERAGE NO. NCG02O YU
FACILITY'NAME: fig f�e--5
PERSON COLLECTING SAMPLES gab S
CERTIFIED LABORATOR d Lab #
Lab #
Part A: Stormwater Monitorine Requirements
SAMPLE COJLLECTION YEAR:t�
COUNTYt� l�
PHONE NO. W)
ADD TO LISTSERVE? YES ❑ NO ❑ EMAIL:
NEW
Outl'a1l'
No.
Date Sample '
• Collected
(moldd/yr OR
t
NO FLOW.)
In Tier 2
Monthly
Monitoring?
(y1h),.
# of lbionths in .
Tier 2
z -
Sampling
Total Flow.
(MG)
Total Suspended
Solids -
(mgA)
a
Turbidity..Settleable
JNTU)
Solids (nil/1)
.
Total
Rainfall
(in)
-Event
Duration,
(minutes):
1003,4
See Footnote"'
0.1
G 6
3r r
o
0
,
' If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here and the Date Range.
2 Per NCG02: Tier 2 Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range
3 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier l or Tier 2 responses in the General Permit.
4 TSS benchmark values are 100 mg/1 except in ORW, HWQ, trout, and PNA waters where they are 50 mgll.
3The 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 SDO.
Alternatively, the permittee. may choose to monitor turbidity in the receiving water, directly upstream and downstream of the SDO.
Permit D-tte: 1 ! 1 l2010-12/31 /201 A Last Revised 0 1 -2 1 -11
Page I of 2

RE: [SEND SECURE] James Chapman - Carroll visit update
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!.;
Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oillmonth on average
Outfall ,
No..''
Date Sample
Collected
(mo/dd/yr OR
1
NO FLOW)
In Tier 2
_Monthl Y
Monitoring,
(Y�n)
# of Months
in Tier 2'
Sampling z
New Motor.
Oil Usage
-aUmonth
Total'Flow .
(MG)'
TPH using rnelhod
I664A SGT-HEM
(m
Total Suspended:,
Solids
(m
pH
(Standard
Units
Total .
Rainfall
(in
Event
Duration
(minutes
15
1QQ•
ti-9
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES
AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
WHO AT THE REGION HAVE YOU SPOKEN WITH?
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE" & LIMIT
VIOLATIONS) BY MARCH 1 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 INFORMATION REPORTED:
"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
(Date)
Permit hate: 1/1/2010-12/31/20W
Last Revised 0 1 -21 - i
Page 2 of 2

RE: [SEND SECURE] James Chapman - Carroll visit update
Page 6 of 10
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https://voltage-pp-OOOO.aetna.con-t/reader/br/NonBranded5l2/381 cf245a89a23675b4c76d9... 5/21 /2015

-j;
TIER 2-or BENCHMARK EXCEEDENCE DMR - STORMWATER
SEND TO YOUR LOCAL REGIONAL OFFICE'
STORMWATER DISCHARGE OUTFALLS (SDO)
GENERAL PERMIT NO. NCG020000 (MINING)
* Use this form if you have EXCEEDED BENCHMARKS for any parameter or are in Tier 2 Monitoring. Send sample results to DWQ Regional Office within 30 days of receipt
from lab.
CERTIFICATE OF COVERAGE NO. NCG02 f2 -.
PERSON COLLECTING SAMPLES 1 e b O fi
CERTIFIED LABORATORY Lab #
Lab #
Part A: Stormwater Monitoring; Requirements
SAMPLE COLLECTION PERIOD: 1 B-2--[-]
MONTHLY: MONTH !r hh
FACILITY NAME: _ ja /;. 5�lsx.r_t� �� u Q rr
COUNTY
PHONE NO. P37 t i a )S__0
Outfall
'No.
Date Sample
Collected
(mo/dd/yr OR '
NO FLOW)'.
In Tier 2
Monthly.
Monitoring?
(y/n)
# of,Months
to Tier2
2
Sampling
Total, Flow
(MG)
Total Suspended
Solids
;(mY}::..:
' a
Turbidit y
(NTU) :
Settleable
Solids (mlA)
Total.
Rainfall
(in) .
Event
Duration
(minutes)
-
_
1o0 `
See Footnote '
04
1
1
MAR 2 0
2015
�
I
1 if "NO FLAW" or "NO DISCHARGE, Enter "NO FLOW ' or "NO DISCHARGE" for each outfall here and the Date Range.
2 Per NCG02: Tier 2 Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range
3 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier I or Tier 2 responses in the General Permit.
4TSS benchmark values are 100 mg/l except in ORW, HWQ, trout, and PNA waters where they are 50 mgA.
5 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 receiving water, directly upstream and downstream of the SDO.
Permit Date: 1/1/2010-12/31/2014 Last Revised 0 1 -2 1 -11
Page I of 2

Part B:,vehicle Maintenance Activitv Monitoring Requirements for facilities using > 55 gal of new motor oil/month on average
ff
Outfall
No.
Date Sample
Collected
(mo/dd/yr OR
t
NO FLOW)
In Tier 2
Monthly
�
Monitoring.
(y/n)
# of
Months in
Tier 2
Sampling z
New Motor Oil
Usage
(al/month)
Total Flow
(MG)
TPH using
method I664A
SGT--HEM m
Total Suspended
Solids
m )
pH
(standard
Units )
Total
Rainfall
(in)
Event
Duration
(minutes)
-
IS m
100 m
6-9
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEENDENCES AT YES ❑ NO
ANY ONE OUTFALL (ALL SDOs INCLUDING VEHICLE MAINTENANCE)?
HAVE YOU CONTACTED THE REGION? YES C✓1 NO ❑
WHO AT THE REGION HAVE YOU SPOKEN WITH?
USE THIS FORM IF YOU HAVE EXCEEDED BENCHMARKS FOR ANY PARAMETERS.
SEND THIS DMR TO YOUR LOCAL DWQ REGIONAL OFFICE WITHIN 30 DAYS OF RECEIPT OF SAMPLE RESULTS FROM THE LAB:
Asheville Regional Office (ARO)
Roger Edwards, Surface Water Protection
Supervisor
2090 US Highway 70
Swannanoa, NC 28778
COURIER 12-59-01
Phone: [phone]
Fax:[phone]
Fayetteville Regional Office (FRO)
Belinda Henson, Surface Water Protection
Supervisor
225 Green Street
Systel Building Suite 714
Fayetteville, NC 28301-5043
COURIER 14-56-25
Phone: [phone]
Fax: [phone]
Mooresville Regional Office (MRO)
Rob Krebs, Surface Water Protection
Supervisor
610 East Center Avenue, Suite 301
Mooresville, NC 28115
COURIER 09-08-06
Phone: [phone]
Fax: [phone]
Raleigh Regional Office (RRO)
Danny Smith, Surface Water Protection
Supervisor
3800 Barrett Drive
Raleigh, NC 27609
COURIER 52-01-00
Phone: [phone]
Fax: [phone]
Washington Regional Office (WaRO)
Al Hodge, Surface Water Protection
Supervisor
943 Washington Square Mall
Washington, NC 27889
COURIER 16-04-01
Phone: [phone]
Fax: [phone] or [phone]
Wilmington Regional Office (WRO)
Rick Shiver, Surface Water Protection
Supervisor
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
COURIER 04-16-33
Phone: [phone]
Fax: [phone]
Winston-Salem Regional Office (WSRO)
Steve Tedder, Surface Water Protection
Supervisor
585 Waughtown Street
Winston-Salem, NC 27107
COURIER 13-15-01
Phone: [phone]
Fax: [phone]
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"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 awar that there are s' m icant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
7- �3_ /�.
Signature of Permittee (Date)
Permit Date: 1/1/2010-12/31/2014 Last Revised 0 1 -2 1 -11
Page 2 of 2

PROCESS/MINE DEWATERING WASTEWATER DISCHARGE MONITORING REPORT (DMR)
Please Mail Original And One Copy To Mailing Address Below
GENERAL PERMIT NO. NCG020000
Part A: Facility Information
Samples Collected In Quar .10 30 4 (all samples shall be reported within 30 days following inoultoring period) 20/f5
Certificate Of Coverage No. NCGt}2 a2C� tY County of Facility i? -
Facility Narne Name of Laboratory
Facility Contact a r Lob Certification #
Facility Contact Phone No. hd"1 ) 3f mil, lAi}
Part d: Process Wastewater and Mine Dewatering Wastewater Monitoring Requirements
ofitrill
Niiln bcr
Receiving Siremn N4 nie
..Date.
snm;i[e�coliected
;:.50050.:
: 040O..
00530...
0007E
Daily Fla}vt
pH..
< .
Total Suspendea,Solids
�`urbldity,E
rS�#tl�si �e�ollds
-. 1
i { j3 �/. ✓�`
1 ttS s 1 �'
-„ ��
ttnit
_ / l-t�{ 1 ' �yL
rr ylyi -FsJii l
$-z�
7;1"y rz
rri`.,7`lrnl/lf, •'!
I Measured continuously using a ilo%v measuring device or estimated using manufacturer's pump curves and pump logs.
Part C: Certification
1!=
MW
"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 flues and imprisonment for knowing violations."
(Signature o Per tee) (Date -
Part D: Mailing Address
Attu: Central Files, DENR, N.C. Division of Water Quality, 1617 Mail Service Center, Raleigh, NC 27699-1617