NCG020120_COMPLETE FILE - HISTORICAL_20170217

STORMWATER DIVISION CODING SHEET
RESCISSIONS.
PERMIT NO.
�J
� �� ol a o
DOC TYPE
❑COMPLETE
FILE -HISTORICAL
DATE OF
RESCISSION
❑
01O19OaI9
YYYYMMDD

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year 7o I(o
*Report ALL STORMWATER monitoring data on this form (include "No Flow"/"No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG02
Facility Name: EofZ"tt1zaA 8[zi I , Li, L - A 15w,u Covn-7y /Y%1,VE
County: ^AA) 5ot4
Phone Number: ( /72�1 Z&ZI&O Total no. of SDOs monitored
Certified Laboratory Kr (,f) Le4vPx4orf,:?5 Lab # NC 5V9
Lab #
Stormwater Discharge Outfall (SDO) No. I VMA Outfall? Yes ❑ No
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No 21
Was this outfall ever in Tier 2 during the past year? Yes ❑ No
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑
Other ❑
Outfall No.
Total
Rainfall,
inches
TSS,
mg/I
SS,
mlll
Turbidity,
NTU
Upstream
Turbidity, (U ) y,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mgll
(VMA)
New
Motor Oil
Usage
allmo.
Stormwater
Benchmarks
fndicato NO
FLOW if
a ficaLle
Circle
9enchmark
i 0a15o
V
circle
Benchmark
! L
SU12rJI� U
NIA
Water Quality
standard applies
NIA
Water Duality
Standard applies
f 5
>65 ga
average requires
TSS and Non -polar
O&G monitorin
Date Sample
Collected,
molddl r
MENNIMM
M
r
Gbn
1
5S
07 ► fo
17-t5i
ASS 2ym
Permit Date 101112015 — 9/3012020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ❑O ❑i Z❑Qo
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."
[Required by 40 CPR §122.22]
Signature
Date 02,
1-7
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 10t112015 - 9/30/2020
Last Revised 10-2-2015

�l
Ln
,1' ANNUAL SUMMARY DISCHARGE MONITORING
REPORT DMR — WASTEWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year Zo I (o
Report ALL WASTEWATER monitoring data on this form (include "No FlovVT No Discharge" and Limit Violations) from
the Drevious calendar year to the DEQ by MARCH 1 of each near.
Certificate of Coverage No. NCG02 ❑o
Facility Name: Pp RnZ) f2A f p.?uL,� I — - At) So Gvur,�y Ji'I„76
County: —"Soo
Phone Number: (_I0!-1) Z0- Z1 fib Total no. of outfalls monitored
Certified Laboratory , bonu4vf )e.s Lab # Nif .5
Lab #
Wastewater (WW) Discharge Outfall No. I
Is this an industrial sand mine (See 40 CFR §436 Subpart D)?
Yes ❑
No [0
Does this outfall discharge WW to SA waters?
Yes ❑
No to
Does this outfall discharge WW to SB or PNA waters?
Yes ❑
No
Does this outfall discharge WW to HQW or ORW waters?
Yes ❑
No
If so, what is the 7010 flow rate? or Tidally influenced
waters,
7010 not available ❑
Does this outfall discharge WW to Trout (Tr) designated waters?
Yes ❑
No
Were there any limit violations in the calendar year?
Yes ❑
No
Outfa ll No.
—
Daily Flow
Rate, cfs
pH,
SU
TSS,
mg/l
SS,
mlll
if applicable
Discharge
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Fecal
Coliform,
col/100 ml
SA
Effluent
Limitations
Mo. Ave l Daily Max.
HQW orORW
50% of
f1
7Q10
Indicate NO
FLOW
if
freshwater
6.0-9.0
saltwater
6.8-8.5
Industrial Sand
25145
HQW orORW
20130
HQW or ORW
Wd Tr or PNA
10115
HQW, ORW,
SA, SB, PNA,
oranyTrout
0.1 /0.2
No Limit
Circle Water
Quality Standard
'hat applies:
50/25/10
NIA
WaterQualtty
Standard applies
NIA
Water Quality
Standard applies
NIA
Date Sample
Collected,
molddl r
O Di5c
7PWA-r, RA6L
PI-
S50-5
Perm it Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

„/ Certificate of Coverage No. NCG02 [EEU]❑o-
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."
[Required by 40 CFR §122.22]
Signature • P-'w;----
Date DZ ,7 Zoi-7
T
Mail Annual Summary Wastewater 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 1011/2015 — 9/30/2020
Last Revised 10-2-2015

RECEIVED
ANNUAL SUMMARY DMR - WASTEWATER MAN 0 2 2016
. SEND TO CENTRAL OFFICE *ENR SECTION
PROCESS MINEMEWATERING WASTEWATER
GENERAL PERMIT NO. NCG020000
" Report All Wastewater discharge monitoring data on this form (including No Flo+t, and No Discharge and Pennit Limit Violations) by MARCH 1 of each year. If
on have limit violations, you must also have turned in a Limit Violation DMR to your local Regional Office wilhin 30 dt vs of receiving sam le results from a lab.
CERTIFICATE OF COVERAGE NO. NCG02 0 1 2 0
FACILITY NAME: Manson Brick - Anson County Mine
PERSON COLLECTING SAMPLES:
CERTIFIED LABORATORY: K&W Laboratories Lab # N 559
Lab #
LIMIT VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitorine Requirements
SAMPLE COLLECTION YEAR: 2015
COUNTY- Anson
PHONE NO. (7nA ) 961-2160
ADD TO LISTSERVE? YES ❑ NO❑ EMAIL:
INDUSTRIAL SAND'? ❑ DISCHARGING TO SA WATERS;? ❑
Outfall No.
Date Sample
Collected
Total Total Flow
Total Suspended
Solids'
Turbidity'
Settleable Solids
pH
Fecal Coliforms
-
mmldd/yr
MG
mg/1 1,2
NTU"
ml/1
Standard
col/ml"'
001
No Discharge 01/01
2015 to 03/31/2
15
001
No Discharge 04/01
2015 to 06/30 2015
001
No Discharge 07/01
2015 to 09/30 2
15
No Discharges
from Process 1 Mine
Dewaterin
Occur at This E
ite
All mines must monitor WW discharges for TSS. Only industrial sand mine discharges are subject to TSS limits.
2 If an effluent limit is exceeded, the permittee is required to institute monthly monitoring for that parameter for the remaining permit term.
3 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 discharge.
4 Only facilities discharging to SA waters are required to monitor for Fecal Coliforms.
Permit Date: I / 1 /2010-12/31 /2014 Last Revised 0 1 -2 1 -11
Page I of 2

Part A Continued: Wastewater Monitoring Requirement
Outfall No.
Date Sample
Collected
Total Flow•
Total Suspended
Solids
Turbidity
Settleable Solids
pH
Fecal Coliforms
-
mm/dd/yr
MG
mg/1 1,2
NTU
ml/l
Standard
col/ml '
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 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 violations."
(Signature of Permittee)
Permit Date: 1/1/2010-12/3112014
Z 5' zwLo
(Date)
Last Revised 0 1 -2 1 -11
Page 2 of 2

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — WASTEWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year 2015
`Report ALL WASTEWATER monitoring data on this form (include "No Flow"/"No Discharge" and Limit Violations) from
the previous calendar year to the DEQ by MARCH 1-of each year.
Certificate of Coverage No. NCG02
LD]
Facility Name: Hanson Brick - Anson County Mine MAiR
County: Anson CENTRA I
Phone Number: 7( 04 )261-2160 Total[DWpfW i itored 1
Certified Laboratory K&W Laboratories tab # NC 559
Lab #
Wastewater (WW) Discharge Outfall No. 001
Is this an industrial sand mine (See 40 CFR §436 Subpart D)?
Yes ❑
No ER
Does this outfall discharge WW to SA waters?
Yes ❑
No
Does this outfall discharge WW to SB or PNA waters?
Yes ❑
No
Does this outfall discharge WW to HQW or ORW waters?
Yes ❑
No
If so, what is the 7010 flow rate? or Tidally influenced waters,
7010 not available ❑
Does this outfall discharge WW to Trout jr) designated waters?
Yes ❑
No
Were there any limit violations in the calendar year?
Yes ❑
No
Outfall No.
001
Daily Flow
Rate, efs
pH,
SU
TSS,
mgll
SS,
milt
"ap'"`able
Discharge
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Fecal
Coliform,
colH00 ml
SA
Effluent
Limitations
Mo. Ave l Daly Maa.
HQW or QRW
60%of
7010
lndketeNO FLOW
trappacahle
rreshv�eler
6.0-9.0
GaftMtef
6.8-8.5
Induautal Sand
16145
HQWorORW
20130
HQWorORW
NaTr or PHA
10115
HOW, ORW
$A, Se,Rw,
oranyTrout
0.110.2
No Limit
circtsWater
qta� applies:Standard
50125/10
NIA
Water Quality
Staadardapplies
NIA
WaterQuouty
Standard applies
NIA
Date Sample
Collected,
molddl r
1011/15 to 12/31/15
NO DISCHARG
ES FROM RROCES&W
E DEWATE
ING OCCUR A
THIS SITE
Permit Date 10/112015 — 913012020
Last Revised 10-2-2015

Certificate of Coverage No. N0002 Q E)KI
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."
[Required by 40 CFR §122.22]
Signature l •/t -
Date 7-lz5-/Zc,1U
Mail Annual Summary Wastewater 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 101112015 - 9/30/2020
Last Revised 10-2-2015

Y
I ANNUAL SUMMARY DMR - STORMWATER I
SEND TO CENTRAL OFFICE * 1! RECEIVED
STORMWATER DISCHARGE OUTFALLS (SDO) MAR 0 2 2016
GENERAL PERMIT NO. NCG020000
CENTRAL FILES
IK
*Report ALL STORMWATER Monitoring Data on this form (including No Flow and No Discharge and Permit Limit Violations) by MARCH I of ac year.
CERTIFICATE OF COVERAGE NO. NCG02 0 1 2 0
FACILITY NAME: Hanson Brick - Anson County Mine
PERSON COLLECTING SAMPLES Jason Smith
CERTIFIED LABORATORY K&W LaborajQrjes Lab # NC 559
Lab #
Part A: Stormwaler Monitoring Requirements
SAMPLE COLLECTION YEAR: 2015
COUNTY Anson
PHONE NO. 7( 04 ) 261-2160
ADD TO LISTSERVE? YES ❑ NO ❑ EMAIL:
Outfall
No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)I
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in
Tier 2 2
Sampling"
Total Flow
(MG)
Total Suspended
Solids
(mom)
;
Turbidity
(NTU)
Settleable
Solids (ml/l)
Total
Rainfall
(in)
Event
Duration
(minutes)
-
-
-
-
100 '
See Footnote '
0.1
S-001
No Discharge
01/01/2015 to
06/30/2015
S-001
No Discharge
07/01/2015 to
09/30/2015
' if "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW"' or "NO DISCHARGE" for each outfall here and the Date Range.
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.
J TSS benchmark values are 100 mg/l except in ORW, HWQ, trout, and PNA waters where they are 50 mg/l.
5The 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 permiaee 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 1 of 2
CD
t c
Mac

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month on average
Outfall
No.
Hate Sample
Collected
(mo/dd/yr OR
NO FLOW)
In Tier 2
Monthly
Monitoring.
(y/n)
# of Months
in Tier 2
Sampling2
New Motor
Oil Usage
(al/month
Total Flow
(MG)
TPH using method
1664A SGT.HEAf
� (m )
Total Suspended
Solids
(m )
pH
(Standard
Units)
Total
Rainfall
(in)
Event
Duration
(minutes)
-
15
100
6-9-
5-001
01/01/2015 to
06/30/2015
No Dischar
<55
S-001
07/01/2015 to
09/30/2015
No Discharge
<55
HAS YOUR FACILITY HAI) 4 OR MORE BENCHMARK EXCEEDENCES
AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES [:]NOR]
WHO AT THE REGION HAVE YOU SPOKEN WITH?
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALI, "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 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
(Sigtfature of Permittee)
Permit Date: 1/1/2010-12/31/2014
Z, Za/&r9
(hat
Last Revised 0 1 -21-11
Page 2 of 2

ANNUAL SUMMARY DISCHARGE MONITORING '
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year 2015
"Report ALL STORMWATER monitoring data on this form (include "No Flow"/"No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG02
Facility Name: Hanson Brick - Anson County Mine
County: Anson
Phone Number: 7{ 04 ) 261-2160 Total no. of SDOs monitored 1
Certified Laboratory K&W Laboratories lab # NC 559
Lab #
Stormwater Discharge Outfall (SDO) No. 001 VMA Outfall? Yes ❑ No
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No
Was this outfall ever in Tier 2 during the past year? Yes ❑ No [D RECEIVES
If this outfall was in Tier 2 last year, was monthly monitoring discontinued? l�
Yes, enough consecutive samples below benchmarks to decrease frequency ❑ MAR 0 2 2016
Yes, received approval from DEMLR to reduce monitoring frequency ❑ CENTRAL FILE:
No, turbidity benchmark exceedanoes did not require monthly monitoring ❑ DWR SECTION
Other Cl
Outfall No.
, Total
Rainfall,
Inches
TSS,
mg1l
SS,
mill
Turbidity,
NTU
Upstream
(U)Turbidity,
NTU
Downstream
(D) Turbidi,
ty,
NTU
Non -polar
O&G, mg1(gallmo)
(VMA)
New
Motor Oil
Usage
Stormwater
Benchmarks
lndrcareMO
aFLl0ica6la
C rete
9encnmerk
100150
0.1
circle
benchmark
50/25110
NIA
standdard ppOea
NIA
Standard Pv
15
>65 ga4rno.
averageregtkef
TG&G monitod"r
Date Sample
Collected,
molddl r
i
1011I15 to 12/31/15
NO DISCHA
RGE
< 55 gallmo
Permit Date 10/112015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ©©❑"L
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."
[Required by 40 CFR §122.22]
Signature
Date V
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 1011/2016 — 9/3012020
Last Revised 10-2-2015

4 = ANNUAL SUMMARY DMR - WASTEWATER
11 SEND TO CENTRAL OFFICE* 11
PROCESS MINEIDEWATERING WASTEWATER
GENERAL PERMIT NO. NCG020000
* Report All Wastewater discharge monitoring data on this form (including No Flow and No Discharge and Permil Limil Violations) by MARCH I of each year. If
you have limit violations, you must also have turned in a Limit Violation D111R to your local Regional Office within 30 days of receivin sample results front a lab.
CERTIFICATE OF COVERAGE No. NCG02 0 1 2 0 SAMPLE COLLECTION YEAR: 2014
FACILITY NANIE: Hanson Brick -Anson CoZt]i Mine _ COUNTY: Anson
PERSON COLLECTING SAMPLES: Jason Smith PIIONE NO. (Ind ) ?R1-5)1A0 _
CERTIFIED LABORATORY: K&W Laboratories Lab # NC 559 ADD TO LISTSERVE? YES ❑ NOD EMAIL:
Lab #
LIMIT VIOLATIONS? YES ❑ NO X❑
Part A: Wastewater Monitoring Requirements
INDUSTRIAL SAND? ❑ DISCHARGING TO SA WATERS'? ❑
Outfall No.
Date Sample
Collected
Total Flow
Total Suspended
Solids
Turbidily3
Settleable Solids
pH
Fecal Colifonns
rnm/dd/yr
MG
mg1I
NTU"
m1R-
Standard
collml '
001
No Dischar e 01/01
2014 to 03l31/114
14
001
No Discharge 04/01
014 to 06/30
001
No Discharge 07/01
2014 to 09/30 21014
r!
a 'r-fs
001
No Discharge 10/01
2014 to 12131 /2
14
U_ I V r L)
F
✓ J
No Discharges
from Process IM
ne Dewatering
RAL Fit Fc:
Occur at This
ite
' All mines must monitor WW discharges for TSS. Only industrial sand mine discharges are subject to TSS limits.
2 If an effluent limit is exceeded, the permittee is required to institute monthly monitoring for that parameter for the remaining permit term.
3 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 discharge.
° Only facilities discharging to SA waters are required to monitor for Fecal coliforms.
�a
—W.0
Permit Date: 1/112010-12/31/2014 Last Revised 01-21-11
Page 1 of 2

Part A Continued: Wastewater Nlonitorinv Requirements
Outfall No.
Date Sample
Collected
Total Flow
Total Suspended
Solids
Turbidity'
Settleable Solids
pH
Fecal Coliforms
-
mmlddlyr
NIG
mg/1 '
NTII '
1111/1 2
Standard
col/ml '
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 INFORMATION REPORTED:
"I certify, under penally 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."
(Signature of Permittee)
Permit Date: 1/112010-12/31/2014
Z
(Date)
Last Revised 01-21-1 1
Page 2 of 2

I ANNUAL SUMMARY DMR - STORMWATER I
II SEND TO CENTRAL OFFICE x II
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 of each year.
CERTIFICATE OF COVERAGE NO. NCG02 0 1 2 0
FACILITY NAW: Hanson Brick - Anson County Mine
PERSON COLLECTING SAMPLES Jason Smith
CERTIFIED LABORATORYK!SVV Laboratories Lab # NC 559
Lab #
Part A. Stormwater Monitorin Requirements
SAMPLE COLLECTION YEAR: _
COUNTY Anson
PHONE NO. (704 ) 261-2160
ADD TO LISTSERVE? YES ❑ NO ❑
2014
EMAIL:
Outfall
No.
Pate Sample
Collected
{mo/dd/yr OR
t
NO FLOW)
In Tier 2
Monthly
Monitoring?
g
(y/n)
# of Months in
Tier 2
r
Sam Z
p
Total Flowlin
(MG)
Total Suspended
Solids
(mgA)
a
Turbidity
(NTU)
Settleable
Solids {ml/t)
Total
Rainfall
(in)
Event
Duration
(minutes)
-
-
-
-
-
1001,
See Footnote-,'
0.1'
S-001
No Discharge 01
01/2014 to 061301
014
S-001
No Discharge 07
0112014 to 121311
014
1
fell
v LZZL
r
1l n
D�- - •
V'JFt
+ v-t L. h i
v [ f V t
t If 'NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here and the Date Range.
z 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.
4 TSS benchmark values are 100 nigh except in ORW. HWQ, trout, and PNA waters where they are 50 mg/l.
5The 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 pennittee may choose to monitor turbidity in the receiving water, directly upstream and downstream of the SDO.
Permit Date: I/l/2010-12131/2014 Last Revised 0 1 -2 1 -11
Page 1 of 2
.�0

y, Part ai: Vehicle Maintenance Activity Monitorin . Re uirements for facilities usin > 55 gat of new motor oil/month on average
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'
New Motor
Oil Usage
�
(al/month)
Total Flow
(MG)
(
TPH using method
I664A SGT-HEM
(m )
Total Suspended
(m )
pH
(Standard Standard
Units)
Total
Rainfall
(in)
Event
Duration
(minutes)
1531[l0
6 9'
S-001
01/01/2014 to 0
130/2014 - No
Discharge
<55
S-001
07/01/2014 to 1213112014
- No
Discharge
<55
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEF,DF,NCES
AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO ❑X
HAVE YOU CONTACTED THE REGION? YES ❑ NO M
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 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 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
violations."
(Signatuic of Permittee)
Permit Date: 1/1/2010-12131/2014
z 9 a 1.i
(Date)
Last Revised 0 1 -2 1 -11
Page 2of2