NCG020155_MONITORING INFO_20190306

STORMWATER DIVISION CODING SHEET
NCG PERMITS i
PERMIT NO.
/V
DOC TYPE
❑HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ �VI / 00 to
YYYYMMDD

ANNUAL SUMMARY DMR - STORMWATERJ
SEND TO CENTRAL OFFICE * 1
STORMWATER DISCHARGE OUTFALLS (SDO) MdR � 6 JREFEIVED
GENERAL PERMIT NO. NCG020000 '
*Report ALL S7ORMWA7'C:R Monitoring; Data on this form (including No Flow and No Discharge and Permit Limit Violations) by RA [f%"it;d'ear.
CERTIFICATE OF COVERAGE NO. NCG02 D 1 S S
FACILITY NAME: Sh21+on QO-1,2Lf — —
PERSON COLLECTING SAMPLES
,WeMur
CERTIFIED LABORATORY5earc-t,4- nLit # AlC#3y
Lab # xr- 37701
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEA11:
ab IS
COUNTY CASwel j
!
PHONE NO. 3( 3Cp )
ADD TO LISTERVE? YES ❑ NO ®
EMAIL:
TOTAL RAINFALL: y�%.-a
_
INCHES
EVENT DURATION: a 1[a
M INUTF.S
Outfall No.
Date Sample
Collected
(moldd/yr OR
NO FLOW)'
In Tier 2
Monthly
Monitoring?
(y/tt)
# of Months in
Tier 2 .
2
Sampling
Total Flow
(MG)
Total Suspended
Solids
(mg/1)
J
Turbidity
NTU
( )
Settleable Solids
}
-
-
-
-
-
too ''r
Sec Footnote '
0.1
oaa
N0 F�LoGJ
1
I
I
I
I
I
I
1
1
I
I
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 he done until 3 consecutive samples are below the henclunark or within the benchmark range
3 lfa value is in excess of the benchmark, Or Outside the benchmark range (liar PH), you must implement the Tier I or Tier 2 responses in�the General Permit.
a "FSS benchmark values are 100 mg/l except in ORW, HWQ, trout, and PNA waters where they arc 50 ntg/l.
s The discharge shall not cause an instantaneous measurement ol'Ihe turbidity of the receiving water to exceed: 10 NTIJ for freshwater streams, lakes, and reservoirs designated
as trout waters; 25 Nl'U Im- all lakes and reservoirs, and all salt waters; 50 NTU for all other streams and suriacc waters. Turbidity may he monitored at the SDO.
Alternatively, the permitlee may choose to monitor turbidity in the receiving water, dir'eclly upstream and downstream of the SDO.
Permit Date: 1/1/2010-12/31/2014 Last Revised 01-19-10
Page I of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements for Facilities using > 55 gal of new motor oil/month on average
Outfall
No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)
In Tier 2
Monthly
Monitoring?
(y/rr)
# of Months
in
pli 2
Z
Sampling
New Motor Oil
Usage
(gal/month)
Total Flow
(MG)
TPH miring
nrellrurl I664A
SCT=HEM
m 11
Total Suspended
Solids,
(mg/1)
pH,
. (Standard
Units)
-
15
too
6-9
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEENDENCES
AT ANY ONE OUTFALL (INCLUDING VEIIICLE MAINTENANCE)? YES ❑ NO El
HAVE YOU CONTACTED THE REGION? YES ❑ NO 0
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) 13Y MARC11 I OF EACH YEAR TO:
Division of.Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN T111S CERTIFICATION FOR ANY INFORMATION REl ORT IsD:
"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. [lased 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 hest of my knowledge and belief, true, accurate,
and complete. [ am aware that there are significant penalties for- submitting false information, including the possibility of fines and imprisonment for knowing
violations."
(Signature orermil(ee)
Permit Date: I / I /2010-12/31 /201 d
oa a7 Iq
(Date) -
Last Revised 01-19-10
Page 2 of 2

ANNUAL SUMMARY DMR - WASTEWATERI �
li SEND TO CENTRAL OFFICE* I
PROCESS MINEIDEWATERING WASTEWATER
GENERAL PERMIT NO. NCG020000
* Report All Wastewater discharge monitoring data on this form (including No Flow and No Discharge and Permit Limit Violations) by MARCH I of each year. If
you have limit violations, you must also have turned in a Limit Violation DMR to your local Regional Office within 30 clays of receiving sample results from a lab.
CERTIFICATE OF COVERAGE NO. NCCO2 t5 1 S S
FACILITY NAME: Slit? iron, ----
PERSON COLLECTING SAMPLES:
CERTIFIED LABORATORY:'Re.5ey(-h +A,,okyfics Lab # QC-4 3y
Lab 4 lt3-j'iot
LIMITS VIOLATIONS? YES ❑ NO
Part A: Wastewater Monitoring Re uirements
SAMPLE COLLECTION YEAR:
COUNTY: _G-Swel( --
N.
PHONE NO. (336 3 $9- SCA t-3
ADD TO LISTERVE? YES ❑ NOQ EMAIL:
INDUSTRIAL SANDr? ❑ DISCHARGING TO SA WATERS`? ❑
Outfail No.
Date Sainple
Collected
C
50050
Total Flow
00530
Total Suspended
Solids'
00400
Turbidity}
00545
Settleable Solids
00400'
pH
31616
Fecal Colifo2 ms
-
mm/dd/yr
MG
Mg/I1'2
NTU2'
in1/l
Standai•d2
col/ml ''
y -oo t
03 .zS //S
d3,1 -7
<5`
/a,y
<o. 1
sb
IDLI oOt
00 11 IS
.J3a 2
<
<o.
3jo
l0y co
8 18
a3-)
SS
S.S
<'o.
6-7' 7
loq Oo 1
laC) 1)
-7, o1-7
j
1
i
1
i
a 1
All mines must monitor W W discharges for TSS. Only industrial sand mine discharges are subject to TSS limits. f
` If an effluent limit is exceeded, the permittee is required to institute monthly monitoring for that parameter for the remaining pen pit term.
s 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 al the
Stormwater Discharge Outfall. Alternatively, the permittee may choose to monitor turbidity in the receiving water. directly upstream and downstream of the discharge.
a Only facilities discharging to SA waters are required to monitor For Fecal coliforms.
Permit Date: 1/1/2010-12/31/2014 Last Revised 01-05-10
Page 1 of 2

Part A CoWhrrred: Wastewater Monitoring Reouirements
Outfall No.
Date Sample
Collected
50050
Total Flow
00530
Total Suspended
Solids
00400
Turbiditys
00545
Settleable Solids
00400
pH
31616
Fecal Coliforms
-
mm/dd/yr
MG
mg/11'1
NTU '
ml/I IStandard'
col/ml '
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE" & LIMIT
VIOLATIONS? 13Y MARCII I OF EACH YEAR TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION RI:POR rry:
"I certify, under penalty of law, that this document and all attachments svere 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.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
o-) /27 2
(Date)
Permit Date: 1/1/2010-12/31/2014 Last Revised 01-05-10
r� Page 2 of 2

I ANNUAL SUMMARY DMR - WASTEWATER 1 I
11 FEND 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 Permit Limit Violations) by MARCH I of each year. If
you have Iimit violations, you must also have turned in a Limit Violation DMR to your local Regional Office withi►r 30 datzs of receiving sample results from a lab.
CERTIFICATE OF COVERACE NO. NCG02 0 l S S
FACILITY NAME: 1+vn
PERSON COLLECTING SAMPLES: Sari r ,r h ^�
CERTIFIED LABORATORY:Se:srcL,dt noty c!s ab4 NL3tl
Lab 0 37`701
LIMITS VIOLATIONS? YES ❑ NO ❑
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: 6?a1 I
COUNTY: _ Ga15w C- lj 1
Pl1ONE NO. (,�3b ) 389-E&i-3
ADD TO L1STERVE'' YES ❑ NO® EMAIL: _Scab 4'pSS C�Sa�cwt.5 necort�,cd�-1
INDUSTRIAL SAND? ❑ DISCHARGINC TO SA WATERS 4.. ❑
Outfall No.
Date Sample
Collected
50050
Total Flow
00530 .
Total Suspended
Solids
00400
Turbidity'
00545
Settleable Solids
00400
pH
31616
Fecal Coliforms
-
mm/dd/yr
MC
mgrlr'"
NTU2'
ml/l
Standard
colrml ''
-ool
63 ao 1-7
.a3a-7
11-a
a6-0
<0. 1
—7 64
0 -DOI
0& 30 1-1
.33R-7
ot-1-C6t
a -7
.a3a
r•O
ay.
-7, of
yS
r
r
p-;
LES
j
JUN
1
1
' All mines must monitor W W discharges fbr TSS. Only industrial sand mine discharges are subject to `1'SS limits. 1
If an effluent limit is exceeded, the permittee is required to institute monthly monitoring for that parameter for the remaining permit term,
s The discharge shall not cause an instantaneous measurement of the turbidity ol' the receiving water to exceed: 10 NTU for freshwater streams, lakes, and reservoirs
designated as trout waters, 25 NTU for all takes and reservoirs, and all salt waters; 50 NTIJ 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 ofthe discharge.
d Only facilities discharging to SA waters are required to monitor for Decal coliiorms.
Permit Date: 1/1/2010-12/31/2014 Last Revised 01-05-10
Page 1 of 2

Part A C'nnliuued: Wastewater Monilorine Re(tuiremenls
Outfall No.
Date Sample
Collected
50050
Total Mow
00530
Total Suspended
Solids'
00400
Turbidity3
00545
Settleable Solids
00400
pH
31016
Fecal Coliforms
-
mm/dd/yr
MG
mg/I1'
NTU 2,3
m1/12
Standardz
col/ml'
MAIL ORIGINAL ANI) ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE" & LIMIT
VIOLATIONS) BY MARCII 1 OF EACH YEAR TO:
Division of Water Quality
Attn: DWQ Central miles
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
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.
l am aware that there are significant penalties for submitting false information, including the possibility of tints and imprisonment for knowing violations."'
(Signature of Permittee)
Or j sot IF
(Date)
Permit Date: 1 / 1 /2010-12/31 /2014
Last Revised 01-05-10
Page 2 of 2

I ANNUAL SUMMARY DN .R - Sr BORN WAT +J,RI I
II SEND TO CENTRAL OFFICE * 11
STORMWA TER DISCHARGE OUTFALLS (SDO)
GENERAL PERMIT NO. NCG020000
E *Report ALL STORMWA7TR Monitoring Data on this form (including No Flow and No Discharge and Permit Limit Violations) by AJAR,CH 1 r f each year. i
CERTIFICATE OF COVERAGE NO. NCG02 o l S S
FACILITY NAME: Ske-i+or\ QVorr�
PERSON COLLECTING SAMPLES t,
CERTIFIED LABORATORY&5e rc-hgfioo,l4f�cS La # N&O'3y
Lah# �t-3'17of
Part A: Stormwater MonitorinL, Reauirements
SAMPLE COLLECTION YEAR: 3dl-7
COUNTY Co,S.ie- 4 f
PHONE NO. (336L) .�f8 SCo13 1^ r
ADD TO LISTERVE7 YES ❑ NO,M EMAIL: Coit,/o55 SQ1QM5rUnECcrS7,[�^
TOTAL RAINFALL: a.S-`i INCHES
EVENT DURATION: 305:.s MINUTES
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)I
In Tier 2
Monthly
Monitoringa
'!
(y/u)
# of Mouths in
Tier 2
Sampling z
Total Flow
(MG)
Total Suspended
(mg I)
TurbiditySettleable
(NTU)
Solids
(MI/1)
-
-
-
-
-
100 '4
See FootnlatC '-'
0.11
++I
I
j�
1
FER 0 9 MIR
R
1
L ILES
yI-
IJI
I
If "NO FLOW" or "NO 1)1SC1-1ARGL, Lnter "NO FLOW" or "NO 1)1SCHA1WH- for each out falI here and the Date Range.
Per NCG02: "Pier 2 Monthly sampling shall be done Until 3 consecutive samples are below the bcnclin ark or within the benchmark ran c
a lfa value is in excess of the benchmark, or outside the benchmark range (I0r PI -I), you must intpictncnt Ihe'I'icr I Or'I'icr 2 responses ill, tile General Permit.
4'I'SS benchmark values are 100 mg/l except in ORW, I-IWQ, trout, and ['NA waters where they arc 50 ntg/I.
s"l'he discharge shall not cause an instantaneous measurement of the turbidity of the receiving water to exceed: 10 N'RJ leer freshwater surants, lakes, and reservoirs designated
as trout waters; 25 NIU f'or all lakes and reservoirs, and all salt waters; 50 N'I'IJ for all other streams• and surface waters. Turbidity may he monitored at tltc SDO.
Alternatively, the permittee may choose to monitor turbidity in the receiving water, dircelly upstream and downstreant of the SDO.
Permit Date: 1 / 1 /2010-12/31 /2014 Last Revised 01-19-10
Page I of 2

Part B- Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month on average
ONo.
No.
Date Sample
Collected
mo/ddl r OR
( Y
NO FLOW)'
lu Tier 2
Monthlyin
,.>
Monitoring,
(Y/n)
Months
in Tier 2
2
Sampling
New Motor Oil
Usage
g
(gal/month)
Total Flow
MG
( )
TPH using
mellrod Ih64A
SGT-HFYVI
m /I)
Total Suspended
Solids,
(mg/1)
pH,
( Standard
Units)
-
-
15 3100
6-9
HAS YOUR FACILITY HAD 4 Olt MORE BENCHMARK EXCEENDENCIS
AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO E]
HAVE YOU CONTACTED THE REGION? YES ❑ NO
WHO AT THE REGION FIAVE YOU SPOKEN WITH?
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE" & LIMIT
VIOLATIONS) I3Y MARCH I OF EACH YEAR TO:
Division of Water Quality
Attn: DWQ Centea! Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN TIIIS CLW771.701770N 1.7)R ANY INF0RiVj7I0N RE ORTLD:
"I certify, under penally of law, that this document and :►II altachn►eats 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."
(Signt�iture of 11'er;nittee)
Permit Date: I/l/2010-12/31/2014
30 1g
(Date)
Last Revised 01-19-10
Page 2 or2

ANNUAL SUMMARY DMR - STORMWATER
Il SEND TO CENTRAL OFFICE * I
STORMWA TER DISCHARGE OUTFALLS (SDO)
GENERAL PERMIT NO. NCG020000
*Report ALL STORMI4"A TER Monitoring Data on this form (including No Flow and No Discharge and Permit I,imit Violations) by MARCH 1 of'each tYear.
CERTIFICATE OF COVERAGE NO. NCG02 a r S 5
SAMPLE COLLECTION YEAR:
a?O1(0
_
FACILITY NAME: 5kop� Q"re-y -
COUNTY CO -Swell
PERSON COLLECTING SAMPLES
PHONE NO. (3X ) 3" -
13
CERTIFIED LABORATORY •L ab #�[ {�cf
ADD'r0 LISTEItVE? YES
❑ NO
EMAIL: --; {o4,noSS@ .Salt r9VL�
L�►6 Lab # —
rOTAL RAINFALL: 35.9'
INCHES r•
EVENT DURATION: 7(Q2O
MINUTES
Part A: Stormwater Monitoring Reauirements
Outfall No.
Date Sample
Cnlleeted
(mo/dd/yr OR
NO FLOW)'
In Tier 2
Monthly
Monitoring.,
(y/n)
# of Months in
Tier 2
Sampling
Total Flow
(MG)
Total Suspended
Solids
(rng/I)
Turbidity
Turbid
(NTU)
Settleable Solids
(MI/1)
-
-
-
-
-
i003';
See Foot nole3'5
0.13
oo�
�--
, a�a
8
-2y 2
<o. r
� 1
•- r
JAN 17
C E N T-RAJ—
DWR SFC'
n�
VED
2017
•1LES
'!ON
r If "NO I -'LOW" or "NO DISCHARGE, Entcr "NO PLOW" or "NO DISCI-IARGI"' for each oulfall here and the Date Range. lcr�
Z Per NCG02: 'tier 2 Monthly sampling shall he done until 3 consecutive samples arc 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 Ticr I or Tier 2 responses in (lie General Permit.
a TSS henchmark values are 100 rng/l except in ORW, H WQ, trout, and PNA waters where they are 50 nigh.
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 N IJ for all Lakes and reservoirs, and all salt waters; 50 NTU, lur all other strearns and surface W1ttCr'S. Turbidity may be rnonrtOred at the SDO
Alternatively, the permittee may choose to monitor turbidity in the receiving water, directly upstream and downstream ofthc SDO.
Permit Date: 1/1/2010-12/31/2014 Last Revised 01-19-10
Page I of 2

Part It: Vehicle Maintenance Activity Monitoring Re uirements for facilities using > 55 gal of new motor oil/month on average
ONo.
No.
Date Sample
Collected
(rnoldd/yr OR
NO FLOW) '
In Tier 2
Monthly
Monitoring?in
(Y/n)
# of Months
Tier 2
Sampling z
p g
New Motor Oil
Usage
it/month
(g` )
Total Flow
(MG)
TPH using
melhod 1664A
SGT-HGM
(m /1)
Total Suspended
Solids,
m /l
( g)
pH,
(Standard
Units )
-
-
15 3
100
6-9
o- oral
l 2 (, 1lo
n
o0
3.77
< 5-
S
7 8
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEENDENCES
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 I OF EACH YEAR TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Centel -
Raleigh, North Carolina 27699-1617
YOU MUST SIGN T/IIS CERTIFICATION FOR ANY INFORNIATION RI_'PORTF_D:
"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 submilting false information, including the possibility of fines and imprisonment for knowing
violations."
tire of Perinittee)
Permit Date: I/l/2010-12/31/2014
Of It I
{D• te)
Last Revised 01-19-10
Page 2 of 2

ANNUAL SUMMARY DMR - WASTEWATER I
of e"'AJ
11 SEND TO CENTRAL OFFICE* 11
PROCESS MINE/DEWATERING WASTEWATER
GENERAL PERMIT NO. NCG020000
* Report A11 Wastewater discharge monitoring data on this form (including No Flom and No Discharge and Permit Limit I"iol(tions) by MARCH 1 of each year. If
you have limit violations, you must also have turned in a Limit Violation DMR to your local Regional Office within 30 dons of receiving sample results from a lab.
CERTIFICATE OF COVERAGE NO. NCG02 0:
FACILITY NAME: 51y- -}{� Quro.*-•-y _
PERSON COLLECTING SAMPLES: Sean V f4orphy -�
CERTIFIED LABORATORY: g An 1l#l,ttf' Lab # ►k— 7q
Lr,hs Lab # Ak_ 37761
LIMITS VIOLATIONS? YES ❑ NO ❑
Part A: Wastewater Monitoring Re uirements
SAMPLE COLLECTION YEAR: Bodo
COUNTY: W 1
PHONE NO. { 33[. )_3gg• 5-4/3 f
ADI)TO L[s,rERVE? YES ❑ NO® EMAIL: S(,p iOSSI�a $&j�jrlS��p�Cowti
INDUSTRIAL SAND'? ❑ DISCHARGING TO SA WATERS'? ❑
Outfall No.
Date Sample
Collected
50050
Total Flow
00530
Total Suspended
Solids'
00400
Turbidity
00545
Settleable Solids
00400
pH
31616
Fecal Cofiforms
-
mm/dd/yr
MG
mgll''`
NTU''
ml/l
Standard'
colIntl ''
►Uo
.23.27
74
/7-
G-.q
oZz Ytc,
• 2 2-7
3+1-
C. - t -7
R E Or E I1l
-oo►
0
7
J�. 2-
gy,
<o. !
Co- 70
N
MAR!'
44
'All mines must monitor WW discharges for TSS. Only industrial sand mine discharges are subject to TSS limits.
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 NfU for freshwater streams, lakes, and reservoirs
designated as trout waters; 25 NTU for all lakes and reservoirs, and all salt waters, 50 NfU for all other streams and surface waters. Turbidity may be monitored al the
Storm water Discharge Outfal1. 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 coiiforms.
O
ES
A
Permit Date: 1/l/2010-12/31/2014 Last Revised 01-05-10
Page I oft

Part A Cr nditued: Wastewater Monitoring Requirements
Outfall No.
Date Sample
Collected
50050
Total Flow
00530
Total Suspended
Solids
00400
Turbidity3
00545
Settleable Solids
00400
pH
31616
Fecal Coliforms
-
mm/dd/yr
MG
mg/1'-
NTUz'
ml/I
Standard
col/ml"';
7
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 276.99-1617
,Y S
YOU MUST SIGN 71115 CER7 PUCATION F"OR ANY INF'ORr1IATION 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 "valuate 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.
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
(Date)
Permit Date: 1/1/2010-12/31/2014
lsast Revised 01-05-10
Page 2 of 2

ANNUAL SUMMARY ])MR - WASTEWATER
SEND TO CENTRAL OFFICE*
PROCESS MINE/DEWATERING WASTEWATER
GENERAL PERMIT NO. NCG020000
" Report All Waste wer discharge monitoring data on this form (including No blow and No Discharge and Permit Limit Violations) by MARCH I of each year. If
YOU have limit violations, you must also have turned in a Limit Violation DMR to your local Regional Office within 30 dams of receiving sample results from a Iab.
CERTIFICATE OF COVERAGE NO. NCG020155 SAMPLE COLLECTION YEAR: 2015
FACILITY NAME: _Shelton Quarry COUNTY: Caswell
PERSON COLLECTING SAMPLES: _Sammy Murphy PHONE, NO. (_336_)_388-5613
CERTIFIED LABORATORY:Research & Analytical Labs_ Lab i 1�i„� #l' '�'QD TO LISTERVE? YI?S [:]NON EMAIL:
Lab #
LIMITS VIOLATIONS? YES ❑ NO ® FEB 0 2 2MINDUSTRIAL SAND" ❑ DISCHARGING TO SA WATERS'? ❑
Part A: Wastewater Monitoring Requirements
CENTRAL FILES
rMAIM c%r-f -r$^K�
Outfall No.
Date Sample
Collected t
50050
Total Flow
00-3 " .._
Total Suspended
Solids'
00400
Turbidity3
00545
Settleable Solids
00400
pH
31616
Fecal Coliforms
-
mm/dd/yr
MG
mg/i''Z
NTU"
ml/IZ
Standard
col/m1"'
104-001
03/23/15
0.2327
17.8
31.53
<0.1
6.95
104-001
06/23/15
0.2327
16.0
41.7
<0.1
6.97
-
104-001
09/29/15
0.2327
64.7
16.5
<0.1
6.79
-
104-001.
10/26/15
0.2327
8.2
24.1
<0.1
6.47
-
' All mines must monitor W W discharges for TSS. Only industrial sand mine discharges are subject to TSS limits.
Z 11'an effluent limit is exceeded, the permittee is required to institute monthly monitoring for that parameter for the remaining permit term,
3 The discharge shal l 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. "I'urbidity 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 Decal coliforms.
Permit Date: 1/1/2010-12/31/2014 Last Revised 0 1 -05-10
Page I ol'2

Part A Cn►rtrrurech. Wastewater Monitoring Requirements
Outfall No.
Date Sample
Collected)
50050
Total Flow
00530
Total Suspended
Solids'
00400
Turbidity
00545
Settleable Solids
00400
pH
31616
Fecal Coliforms
-
mrn/dd/yr
MG
mg/l''
NTU`'
ml/12
Standard?
col/mI2'4
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE" & LIMIT
VIOLATIONSI BY MARCH I OF EACH YEAR TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
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 anti belief, true, accurate, and complete.
l am aware that there are sif_jnificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
oqi
(Signature o ermi tee) (Date)
Permit Date: 1/1/2010-12/31/2014 Last Revised 01-05-10
Page 2 of 2

I ANNUAL SUMMARY DN .R - Sr 'O. ZN WAT +J,R I
11 SEND TO CENTRAL OFFICE * li
STORMWATER DISCHARGE OUTFALLS (SDO)
GENERAL PERMIT NO. NCG020000
*Report ALL S`I'ORMWA7ER Monitoring Data on this form (including No blow, and No Discharge and Permit Limit Violations) by MARCH 1 of euch Near. '
CERTIFICATE OF COVERAGE NO. NCG020155
FACILITY NAME: _Shelton Quarry
PERSON COLLECTING SAMPLES
CERTIFIED LA13011ATORY Research & Analytical Labs Lab # _NC #34_
Lab #
Part A: Storrnwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 2015
COUNTY Caswell
PHONE NO. [phone]
AD1) TO LISTEll V17? YI,S ❑ NO
TOTAL RAINFALL: 51.8
EVENT DURATION: 40,620
EMAIL:
INCHES
MINUTES
Oukfall No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in
Tier 2
Z
Sampling
Total Flow
(MG)
Total Suspended
solids
(rng/1)
►
Turbidity
(NTU)
Settleable Solids
(ml/l)
-
-
-
-
-
100 .4
See Footnote3'-
(}.13
002
NOFLOW 01114-
12/14
-
-
-
-
-
-
—
—
—
—
—
—
"I -CD
—
rcHL I=1LCS
r�
' ll'"NO FLOW" or "NO DISCHARGE. l,nter "NO N,OW" or "NO DISCI-1ARG1 " for each outfall here and the Date Range.
2 Per NCG02: Tier 2 Monthly sampling shall be done until 3 consecutive samples arc below the benchmark or within the benchmark range
3 ]f a value is in excess of the benchmark, or outside the benchmark range (tor 1)1-1}, you must intplcntcrtt the'ficr I or Tier 2 responses in the General Permit.
a'fSS benchmark values are 100 mg/1 except in ORW, I -I WQ, trout, and PNA waters where they arc 50 mg/1.
51111c discharge shall not cause an instantaneous measurement of the turbidity of the receiving water to exceed: 10 NTIJ for 1-reshwatcr streams, lakes. and reservoirs designated
as trout waters; 25 N U for all lakes and reservoirs, and all salt waters; 50 NTU lbr 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, dircctly upstream and downstream of the SDO.
Permit Date: 1/1/2010-12/31/2014 Last Revised 01-19-10
Page 1 of 2

Part 11: Vehicle Maintenance Activity Monitoring Requirements for facilities using> 55 t;al of new motor oil/month on average
Outfall
No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)'
`
In Tier 2
Monthl'
y
Monitoring?
(y/n)
# of Months
in Tier 22
Sampling"
New Motor Oil
Usage
g
(gal/month)
Total !Flow
MC
( )
TPH trsrtrg
method 1664A
SGT-HEM
(m g/1
Total Suspended
Solids
(mg/1)
pH,
{Standard
Units)
-
-
15
fool
6-9
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEENDENCES
AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
WI-10 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
YOU MUST SIGN THIS CERTIFICATION FOR ANI' INI'ORril,,t'1'ION 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."
1 1c.
( ate)
Permit Date: 1 / 1 /2010-12/31/2014
Last Revised 01-19-10
Page 2 of 2

ANNUAL SUMMARY DMR - WASTEWATER
11 SEND TO CENTRAL OFFICE*
4% � i
PROCESS MINE/DEWATERING WASTEWATER
GENERAL PERMIT No. NCG020000
* Report All Wasleivaler discharge monitoring data on this form (including No Flow and No Discharge and Permit Limit t1iolaliuns) by MARCH 1 of each year. Ifs "
You have limit violations; You must also have turned in a Limit Violation DMR to Your local Regional Office within 30 dates of receiving; sample results from a lab.
CERTIFICATE OF COVERAGE, No. NCG020155
FACILITY NAME: _Shelton Quarry
PERSON COLLECTING SAMPLES: _Sammy Murphy
CERTIFIED LABORATORY:Research & Analytical Labs_ Lair #
Lab #
LIMITS VIOLATIONS? YES ® NO ❑
Part A: Wastewater Monitorinu Requirements
_NC 034
SAMPLE COLLECTION YEAR: 2015
COUNTY: Caswcll
PHONE NO, (_336J_388-5613
ADD TO LISTERVE? YES ❑ NO® EMAIL:
INDUSTRIAL SAND'? ❑ DISCHARGING TO SA WATERS? ❑
Outfall No.
Date Sample
Collected
50050
Total Flow
00530
Total Suspended
Solids'
00400
Turbidity'
00545
Settleable Solids
00400
ph!
31616
Fecal Coliforms
-
mm/dd/yr
MG
mg/11"
NTU
ml/1
Standard
colIntl '
104-001
09/29/2015
0.2327
64.7
16.5
<0.1
6.79
-
' All mines must monitor W W discharges for TSS. Only industrial sand mine discharges are subject to TSS'limils.
" 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 Out fall. Alternatively, the perm i(tee 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 I ecal coliforms.
Permit Date: 1/1/2010-12/31/2014 Last Revised 01-05-10
Page 1 of 2

Part A Continued: Wastewater Monitoring Requirements
Outfali No:"
Date Sample
Collected
50050
Total Flow.
{
00530
Total Suspended
Solids'
06466
Turbidity
00545
Settleable Solids
00400
pH
31616
. ►
Fecal Coliforms
-
mmlddlyr
MC
mgll '-
NTU"
ml/l
Standard
col/mt ''
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
YOU MUST SIGN 7711S CERTIFICATION FOR ANY INFORriIATION 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.
am a�varSAhl! -ttaexe-;1re significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Permittee)
(Date)
Perm it Date: 1 / 112010-12/31 /2014
Last Revised 01-05-10
Page 2 of 2

S -� I
M%REI
CRUSHEff�
STO N E ■
October 21, 2015
Central Files
Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27699-1617
Re: Permit NCG020155
Dear Sir or Madam,
I am writing to address the issue of an exceedance from outfall number 104-001 located at Shelton Quarry in Caswell
County. The sample was taken on September 29, 2015 and was reported as having a Total Suspended Solids of 64.7
mg/I. This level is well above the maximum limit for a single sample. This level is also an anomaly as compared to
previous samples. Our permit stipulates monthly testing for this outfall. We will be performing monthly testing for
the 0 quarter. We believe the sampling will show that our outfall is discharging within regulations, in which case we
will revert back to quarterly testing.
If you have any comments or concerns about this method, please contact me at 540-674-5556 or by email at
[e-mail].
Sincerely,
A. Scott Ross
Mining Engineer
Enc: Wastewater Sample Report
P.O. BOX i62o DUBLIN, VA 24084 • TELPHONE 54o-674-SSS6 • FAX 54o-674-o2io

RESEARCh & ANA1yTICAL
LAbORATORiESP INC.
Report of Analysis
10/8/2010
For: Southside Materials ,JG�.•••.••••• ...��,,l+�i
P.Q. Box 697 , ' �•��'� fr. CA.�! •�io
Dublin, VA 24084 lop
Is
; Q ofin
NC#34 Z.' 'w
w S NC #37701 f
Attn: J.S. Murphy
gk
so AO
Client Sample ID: 001 Outfall Shelton Quarry Lab Sample ID: 9624-01
Site: Southside Materials LLC Collection Date: 9/29/2015 8:30
Parameter Method Result Units Rep Limit Analyst Analysis Date/Time
pH SM 4500 H}B-2000 6.79 Std. Units 9/29/2015 0830
Settleable Matter SM 2540 F-1997 <0.1 ml/I 0.1 YJ 9/29/2015
Total Suspended Solids (TSS) SM 2540 D-1997 64.7 mg/L 5 JB 9/30/2015
Turbidity EPA 180.1 16.5 NTU 1 SK 9/29/2015
M
M
NA = not analyzed
P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: [phone] Fax: [phone] vvw .randalabs.com Page 1
ral coa basic v1d

RESEARCh & ANA[yTICA[
LABORATORIES, INC.
AnOlytical / Process Consultations
Phone [phone]
CHAIN OF CUSTODY RECORD
WATER ! WASTEWATER I MISC.
COMMA `(il S 4 r� lew, r4/ H
JOB NO
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p o`c C9
ti� ti ryho �" ��' ^" �`� REQUESTED ANALYSIS
STREETADDRESS `
PROJECT
CITY, STATE, ZIP
SAMPLER NAME (PLEAS PRINT)
CONTACT PHONE
SAMPLER PIIGNATURE
SAMPLE NUMBER
(LAB USE ONLY)
DATE
TIME
COMP
GRAB
TEMP
.0
RES
CI
cr�ow+e
REbAUVEfY i
ARE
Is rn
SAMPLE LOCATION l I.D.
RELINQUISHED BY
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REMARKS: �' �
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SAMPLE TEMPERATURE AT RECEIPT ,
LINQUISHED Y
DATE[TIME
RECEI D BY