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HomeMy WebLinkAboutNCG020313_MONITORING INFO_20190301STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. /V0513 DOC TYPE ❑HISTORICAL FILE MONITORING REPORTS DOC DATE ❑ �OI �U3UI YYYYMMDD February 24, 2019 NC Dept. of Environmental Quality (DEQ) Division of Water Resources Attn: DWR Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 RE: Calendar Year 2018 Stormwater Monitoring Kluttz Mine Dear Sir/Madam: RECEIVED MAR 01 2019 CENTRAL FILES DWR SECTION Enclosed is the calendar year 2018 Stormwater Discharge Outfall (SDO) Monitoring report for: Location Kluttz Mine COC No: NCG020313 If you have questions or require additional information, please contact Mr. Billy Goodman at 704-636- 3194. Sincerely, 6k cam, C, Az4x- Rev. Bruce C. Sheeks Immanuel Lutheran Church — Owner of the Kluttz Mine Enclosures: Original and one copy of the SDO report, original copy of Statesville Laboratories Analytical report. cc: Ronnie Miller Billy Goodman David Miller ANNUAL SUMMARY DISCHARGE MONITORING REPORT (DMR) — STORMWATER SUBMIT TO CENTRAL OFFICE* General Permit No. NCG020000 Calendar Year 7- 0 / 9 *Report ALL STORMWATER monitoring data on this foram (include "No Flow"/"No Discharge" and Benchmark Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year. Certificate of Coverager }No. NCG02 O Facility Name: tk++i N County: Phone Number: (ZA:4 ) ?CzT536 q Total no. of SDOs monitored Z_ Certified Laboratory kesyt le_ A,OJAIv+i clw Lab # 4=�a Lab # Stormwater Discharge Outfall (SDO) No. 0 1_ VMA Outfall? Yes ❑ No pO'** Is this outfall currently in Tier 2 for any parameter? Yes ❑ No a-" 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. 1 Total Rainfall, inches TSS mg1l SS mlll Turbidity, NTU Upstream Turbidity, (U} ty, NTU Downstream D Turbidity, ( ) ty, NTU Nan -polar O&G, mgll (VMA) New Motor Oil Usage gallmo. Stormwater Benchmarks Indhtare No OWirCep +Ff xeoie rcte Bent rrk 100/5 ] 0.1 whma,k 50/25I10 NIA Standard pWater Qualit NIA sl.�r,da.e ter aallty pplias 5 average q fr„s roaG SS manit� a ler Date Sample Collected, molddlyr 01 A N/A 141 A R do,A N Permit Date 10/1/2015 — 9/30/2020 Last Revised 10-2-2015 Certificate of Coverage No. NCG02 ❑❑❑❑ Additional Outfall Attachment (make copies as needed for additional outfaiis) Stormwater Discharge Outfall (SDO) No. 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 ❑ If this outfall was in Tier 2 last year, was monthly monitoring discontinued? Yes, enough consecutive samples below benchmarks to decrease f equency ❑ - 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, mgll SS, mill Turbidity, NTU Upstream (U) Turbidity, NTU Downstream (D) Turbidity, NTU Non -polar O&G, mgll (VMA)(gal/Mo.) New Motor Oil Usage nwater Benchmarks indicate NO �os.v� .a licable Circle Banchtnark 100150 0.1 Benchmark 50/25/1 NIA Water Quality Standard appiiea NIA Water Quality Standard apptma 15 agruires � e eqSfor Tss arsd Non -polar O&G rnonitori Date Sample Collected, mo/ddl r Permit Date 10/1/2015 — 9/30/2020 Last Revised 10-2-2015 Certificate of Coverage No. NCG02 Q®Q! 0 Additional Outfall Attachment (make copies as needed for additional outfalls) Stormwater Discharge Outfall (SDO) No. 0 7� 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 If this outfall was in Tier 2 last year, was monthly monitoring discontinued? Yes, enough consecutive samples below benchM2rks 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, mgll SS, mill Turbidity, NTU Upstream (U) Turbidity, NTU Downstream (D) Turbidity, NTU Non -polar O&G, mgll (VMA) New Motor 011 Usage a€Imo. Stormwater Benchmarks indkere No �'"" a licaLle Benchmark 100150 0.1 Sennccllimark 50/25/10 NIA �ndard appli pjlt�a9 NIA water t appaluality Standard appllas 15 ave gearequ res Tss ar,tl Non -polar OSG mo+dton Date Sample Collected, moldd/ r NM N,a AIIA N A " A NIA MIA r C�t> 3v-i8 7 00 JV14 )V Permit Date 10/112015 — 9130/2020 Last Revised 10-2-2015 Certificate of Coverage No. NCG02 O®M© 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 property 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 §122.221 Sign 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 (919) 807-6300 Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at: (919) 707-9220 Permit Date 10/1/2015 — 9/30/2020 Last Revised 10-2-2015 ` Analytical Results Hammill Construction Co., Inc. 5051 St. Stephens Church Rd Gold Hill, NC 28071 Receive Date: 11/05/2018 Reported: 11 /12/2018 For: Comments: STATESVILLE ANALYTIyAL s Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst 181105-19-01 Settleable Solids Kluttz#1 0.1 mllL SM254OF-2011 11/07/2018 CL 181105-19-01 TSS Kluttz#1 7.875 mg/L SM25401}2011 11/09/2018 WC 181105-19-01 Turbidity Kluttz#1 8.8 NTU EPA 1801 11/06/2018 MD 181105-19-02 Settleable Solids Kluttz#2 <0.1 ml/L SM254CF-2011 11/07/2018 CL 181105-19-02 TSS Kluttz#2 5.125 mg/L SM25400.2011 11/09/2018 WC 181105-19-02 Turbidity Kluttz#2 8.93 NTU EPA 180.1 11/06/2018 MD 181105-19-03 Settleable Solids Zion 0.1 ml/L SM254CF-2011 11/07/2018 CL 181105-19-03 TSS Zion 5.375 mg/L SM2WD-2011 11/09/2018 WC 181105-19-03 Turbidity Zion 8.14 NTU EPA 180.1 11/06/2018 MD Respectfully submitted, Dena Myers NC Cert #440, NCDW Cert #37755, EPA #NCO09U9 PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 1 of 4 ,l '' .3 Condition of Receipt Sample Number 181105-19-01 Temp on Arrival: 3.2 Parameter Schedule: Settleable Solids Received on Ice Parameter Schedule: TSS Received on Ice Parameter Schedule: Turbidity Received on Ice Sample Number 181105-19-02 Temp on Arrival: 3.2 Parameter Schedule: TSS Received on Ice Parameter Schedule: Settleable Solids Received on ice Parameter Schedule: Turbidity Received on Ice Sample Number 181105-19-03 Temp on Arrival: 3.2 Parameter Schedule: Settleable Solids Received on Ice Parameter Schedule: TSS Received on ice Parameter Schedule: Turbidity Received on Ice PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 2 of 4 ,� t ;3 { ,� �� � i + . � � , � _. . _ t ' s __ � ._'� ;- .�} L . . � � ' Client: �` a. ^� ✓� hS (� J �. : O 0, S'1'ATBVILLEANAL-.'PtC:AL 122 Coot Saeel PC), FInz 228 (704) 872.4697 Chain of _ Address: O S + s , k Q /} J U— o ( 1 ! v `�— k,8 p'I _ Contact Person: Phone # 0 `f -oi? 534 ` FAXI 70`( a-? PO # Requisitioned by: (Time Dale) Custody Record Customer Sample IDS LaD•ID s Time Sp mpled I[irab �) — Date SampJed (Grab Orly) tdatrl, w Wn Pruactas n:Vuesrcd fm �ady�i� SQf 4��(�5 Relinquished by:� �. Time (0 em, pm Date I g Sampled by: �1�N Received by: / f Time ! 0 S / am, pm Date- Transported by: � / ✓ Relinquished by: Time am, pm Date �!! Molding times met: Received by: ------•------- Time am, pm Date �^1_Compliance work: Comgigaite sampling 41: Time begin am, pm Date —II Non-compliance work: Time end am, pm Date Lab Comments: Samples Transported on tw; Gorda to Samotinq L Time begin am, pm Date • Time end__ am, pm Date Inldals: 00 N N X 0 on O P I February 11, 2018 NC Dept. of Environmental Quality (DEQ) Division of Water Resources Attn: DWR Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 CC RECEiV GD RE: Calendar Year 2017 Stormwater Monitoring FEB 15 NIB Kluttz Mine CENTRAL FILES DWR SECTION Dear Sir/Madam: Enclosed is the calendar year 2017 Stormwater Discharge Outfall (SDO) Monitoring report for: Location Kluttz Mine COC No: NCG020313 If you have questions or require additional information, please contact Mr. Billy Goodman at 704-636- 3194. Sincerely, '�R. C. %W" Rev. Bruce C. Sheeks Immanuel Lutheran Church — Owner of the Kluttz Mine Enclosures: Original and one copy of the SDO report, original copy of Statesville Laboratories Analytical report. cc: Ronnie Miller Billy Goodman David Miller S fA ANNUAL SUMMARY DISCHARGE MONITORING REPORT (DMR) — STORMWATER SUBMIT TO CENTRAL OFFICE* General Permit No. NCG020000 Calendar Year 2017 "Report ALL STORMWATER monitoring data on this form (include "No Flow PNo Discharge" and Benchmark ` Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year. Certificate of Coverage No. NCG02 O❑®�© Facility Name. K I k44-2- PA I rj e- County: r.Z a- r• r 1A.5 Phone Number: 7( D,q ) 21 q " $ 3 Total no. of SDOs monitored Z Certified Laboratory ���s v i I' l e- A,Ma�y�i'cdl Lab # Lab # Stormwater Discharge Outfall (SDO) No. 4 1 VMA Outfall? Yes ❑ No 10, Is this outfall currently in Tier 2 for any parameter? Yes ❑ No 2" 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/l SS, mlll Turbidity, NTU Upstream (U) Turbidity, NTU Downstream (D) Turbidity, NTU Non -polar O&G, mgll (VMA) New Motor Oil Usage allmo. Stormwater Benchmarks MNO FLOWif lkaAW Qhcla Berict rk ndka[e 100150 D•1 aide Ek-mhrrrark 50/25/10 NIA ad& tr�ad NIA Staaity r4rpes gi 15 ass galft o. av raga mQWrVs T�°r O&Going Date Sample Collected, mo/ddl r dsos i7 /.25 3S.J5- <a. 1 55 AJ as Ail A nN A IZ Zo / 6•40 13.Z v• 3Z. N Permit Date 10/1/2015 — 9/30/2020 Last Revised 10-2-2015 Certificate of Coverage No. NCG02 ❑❑❑❑ Additional Outfall Attachment (make copies as needed for additional outfalls) Stormwater Discharge Outfall (SDO) No. 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 ❑ 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/l SS, mill Turbidity, - NTU Upstream y (U)•Turbidity, NTU Downstream (D).Turbidity, NTU Non -polar O&G, mgll (VMA) New Motor Oil Usage allmo. Stormwater Benchmarks indteata No FLOW applicable Clrole Benchmark 1o{i150 fl.t Circle Benchmark 5l]12511 NIA Wafar Quality Standard applies NIA Water Qunfity standard applies 7 �55 yaumo. average raqukes TSS and Non -polar OdG rnonljorino Date Sample Collected, mo/dd/ r Pennit Date 101112015 — 9/30/2020 Last Revised 10-2-2015 Certificate of Coverage No. NCG02 0JUI D Additional Outfall Attachment (make copies as needed for additional outfalls) Stormwater Discharge Outfall (SDO) No. Q Z 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 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_ O Z Total Rainfall, inches TSS, mg/I. i SS, mill Turbidity, .'NTU Upstream (U) Turbidity, NTU Downstream (D) Turbidity, NTU Non -polar O&G, mg/I (VMA) New Motor Oil Usage al/To. Stormwater Benchmarks Wdicste No FLowtr rrcavre 9enc math 100/50 0.1 BGnchm:,k 50/26/10 NIA Sn�ata P'wl" NIA sce,dard " � Pw 15 s g. requires TO&G monitoring Date Sample Collected, moldd/ r QS OS' 17 1. Z5 it. 1 CO• 1 j n+ A N A /V 7 A MIA 1 Z 7-4) ZI-7 a IJ A N1A k1A N Permit (late 1011/2015 — 9/30/2020 Last Revised 10-2-2015 Certificate of Coverage No_ NCG02 300© 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 §122221 Sign; Date Mail Annual Summary Stormwater DMR to the NCDEQ Central Office: Note the address is correct — Central Files is housed in DVVR (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 (919) 807-6300 Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at: (919) 707-9220 Permit Date 10/1/2015 — 9/30/2020 Last Revised 10-2-2015 .. ... 1'�7� Ly.�Ryz T 1�..:'1,..t - si.• �51;� y , e r Analytical Results Hammill Construction Co., Inc. 5051 St. Stephens Church Rd Gold Mill, NC 28071 Receive Date: 05/05/2017 Reported: 05/15/2017 For: Storrnwater Comments: Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst 170505-05-01 Settleable Solids Kluttz#1 <0.1 mI1L SM254OF-1997 05/05/2017 WC 170505-05-01 TSS Kluttz#1 35.5 mg/L SM2540D-1997 05/05/2017 CR 170505-05-01 Turbidity Kluttz#1 55 NTU EPA 180.1 05/05/2017 MD 170505-05-02 Settleable Solids Kluttz #2 <0.1 mI1L SM254OF-1997 05/05/2017 WC 170505-05-02 TSS Kluttz #2 11.125 mg/L SM254OD-1997 05/05/2017 CR 170505-05-02 Turbidity Kluttz #2 17 NTU EPA 180.1 05/05/2017 MD 170505-05-03 Settleable Solids Zion <0.1 ml/L SM254CF-1997 05/05/2017 WC 170505-05-03 TSS Zion 24.222 mg/L SM2540D-1897 05/05/2017 CR 170505-05-03 Turbidity Zion 38 NTU EPA 180.1 05/05/2017 MD Respectfully submitted, Dena Myers NC Cert #440, NCDW Cert #37755, EPA #NC00909 PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 1 of 4 Condition of Receipt Sample Number 170505-05-01 Temp on Arrival: 3 .� Parameter Schedule: Settleable Solids Received on Ice Parameter Schedule: TSS Received on Ice Parameter Schedule: Turbidity Received on Ice Sample Number 170505-05-02 Temp on Arrival: 3 Parameter Schedule: TSS Received on Ice Parameter Schedule: Settleable Solids Received on Ice Parameter Schedule: Turbidity Received on Ice Sample Number 170505-05-03 Temp on Arrival: 3 Parameter Schedule: Settleable Solids Received on Ice Parameter Schedule: TSS Received on Ice Parameter Schedule: Turbidity Received on Ice PO Box 228 ■ Statesville, NC 28687 • 704/872/4697 Page 2 of 4 Client: N --, ^" `, L �/ Go n f C 1 C_t Q n C� ,.� o..n �/ C ti7'A7'ESVILL�: ANALY"CIC AL Address: go h 5\1 4 o cA- 0( _ 122 Court Street • P.O. Box 228 Statesville, NC 28687 (704) 872-4697 �{ i Iv Contact Person:. d Phone # FAX# � 0-(. A19 - 5 �09 7 0�(- � 7 9 - / �4/y Chain of Custody Record PO # Requisitioned by: (Time Date) Customer Sample ID# P ' . ' Lab ID # Time Sampled Grab Only) ( Y1 Date Sampled (Grab Only) Q a Matrix Parameters requested for analysis sn,d9a w wvr k r ( QQ c; 1-4 6-1 b\ d; Relinquished by: �� Time ��• Zla`m! pm Date �!� Sampled by: Received by: Time f I - z S an m Date S / S/ f p Transported by: f Relinquished by: Time am, pm Date _!�/ Holding times met: Received by: - Time am, pm Date ,I_I_ Compliance work: Composite Sampling #1: Time begin am, pm Date _I_I_ Non-compliance work: Time end am, pm Date _/ / Lab Comments: Composite Sampling #2: Time begin am, pm Date Time end am, pm Date _I —I_ � i P �� F' � �' � ! ...y it 0 Analytical Results Hammill Construction Co., Inc. 5051 St. Stephens Church Rd Gold Hill, NC 28071 Receive Date: 12/20/2017 Reported: 12/27/2017 For: Stormwater Comments: Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst 171220-16-01 Settleable Solids Kluttz#1 0.1 ml/L SM254OF-1997 12/21/2017 CL 171220-16-01 TSS Kluttz#1 13.167 mg/L SM2540D-1997 12/22/2017 WC 171220-16-01 Turbidity Kluttz#1 32 NTU EPA 1801 12/22/2017 MD 171220-16-02 Settleable Solids Kluttz#2 0.1 ml/L SM254OF-1997 12/21/2017 CL 171220-16-02 TSS Kluttz#2 19 mglL SM25400-1997 12/22/2017 WC 171220-16-02 Turbidity Kluttz#2 25 NTU EPA 180.1 12/22/2017 MD 171220-16-03 Settleable Solids Zion 0"1 ml/L SM2540E-i997 12/21/2017 CL 171220-16-03 TSS Zion 18A mg/L SM254OD-1997 12/22/2017 WC 171220-16-03 Turbidity Zion 33 NTU EPA 180.1 12/22/2017 MD Respectfully submitted, Dena Myers NC Cert #440, NCDW Cert #37755, EPA #NC00909 PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 1 of 4 Condition of Receipt Sample Number 171220-16-01 Temp on Arrival: 3 Parameter Schedule: Settleable Solids Received on Ice Parameter Schedule: TSS Received on Ice Parameter Schedule: Turbidity Received on Ice Sample Number 171220-16-02 Temp on Arrival: 3 Parameter Schedule: TSS Received on Ice Parameter Schedule: Settleable Solids Received on Ice Parameter Schedule: Turbidity Received on Ice Sample Number 171220-16-03 Temp on Arrival: 3 Parameter Schedule: Settleable Solids Received on Ice Parameter Schedule: TSS Received on Ice Parameter Schedule: Turbidity Received on Ice PO Box 228 a Statesville, NC 28687 e 704/872/4697 Page 2 of 4 Client: e,,-, i l l \ ��j n� S O o /X- C , - -/'(704) STMI SVILLEANALYTICAL 122 Court Street • P.O. Box 228 Statesville, NC 28687 872-4697 Address: ! J� k AC Chain of Custody Record Contact Person: 1 Phone # FAX# e C` _ -7 CM � �7� S3 7 a q f, 7 PO # Requisitioned by: (Time Date) Customer Sample IN Lab -ID # - Time Sampled (Grab Only) Dale Sampled (Grab Only) c5 a Matrix Parameters requested for analysis s�d9e w ww Relinquished by: /Z 20 /1 Time �� Za am, pm Date _I_l� Sampled by: Received by: ( Time 1 �ZU DateI2 Z0//'� I am, pm Transported by: bate Relinquished by: Time am, pm _I_l� Holding times met: Received by: . Time am, pm Date —I-1_ ✓ Compliance work: Composite Sampling #1: Time begin am, pm Date _I_I ; Nan -compliance work: Time end am, pm Date _I�/� Lab Comments: Composite Sampling #2: Time begin am, pm Date Time end am, pm Date _I_I ANNUAL SUMMARY DISCHARGE MONITORING REPORT (DMR) - STORMWATER SUBMIT TO CENTRAL OFFICE* General Permit No. NCG020000 Calendar Year 'Z O I la __-000eo -Report ALL STORMWATER monitoring data on this form (include "No Flow')"No Disc ge¢ d Benchmark Exceedances) from the previous calendar year to the DEQ by % RCri1 o- r. Certificate of Coverage No. NCG02 U)JL3jLL]I.f 8 IS 2a17 Facility Name: I LL +?- ;w s_ 6N�RAL 10� County_ _ C.a. � Y Y �5 _ -- --- �`' ,nrC� SEC Phone Number: (76'4 )�i1`1- 5369 _ Total no- of SDCs monitored AW A^ Certified Laboratory m jl le- ...Al �i c. t Lab # q Lab # Stormwater Discharge Outfall (SDO) No. C> l VMA Outfall? Yes ❑ No [R" 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 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. O 1__ Total Rainfall, Inches TSS mg/I SS, mill Turbidity, NTU Upstream (U) Turbidity, NTU Downstream (D) Turbidity, NTLI Non -polar O&G, mg/1 (VMA) New Motor Oil Usage gal/mo. Storrrlwater Benchmarks IndlcataNO ; `b)a Berm rk 100/5D 0.1 9enc-twMa,h 50/25/10 NIA Standard ' , NIA st„da 'w : 15 a„ g>55 e a Eras To c mom nci Date Sample Collected, moldd! r l $ iLD 0. 2-S 7- U E D NSA 1v1 A NrA N� IZf 1 43.2 co•i 1.3 N-Tp-t NIA N 1� Permit Date 10/1/2015 - 9/30/2020 Last Revised 10-2-2015 A Certificate of Coverage No. NCG02 Additional Outfall Attachment (make copies as needed for additional outfalls) Stormwater Discharge Outfall (SDO) No. D 2- - VMA Outfall? Yes ❑ No [F, 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 Q� If this outfall was irf 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. U - Total Rainfall, inches TSS, mgll SS, mlll Turbidity, NTU - Upstream (U) Turbidity, NTU Downstream (D) Turbidity, NTU, Non -polar OSG, mg/1 (VMA) New Motor Oil ' Usage allmo.) Stormwater Benchmarks iadksteNO FLOWN , rrcat,� Benchmark 100150 0.1 aencltrtnmada 50/25/10 NIA Water Quality standard applies NIA Water Quality Standard applies .� average�;n, TSS and Non -polar OSG monitorinq Date Sample Collected, moldd/ r v�;"iBl o,z.S 3 U,! 9N N A N jZ1 9( ij ta I 8.4 N A Al .4 /V Permit Date 101112015 - 9/30/2020 Last Revised 10-2-2015 W M Certificate of Coverage No_ NCG02 2[ 0© 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 § 122.221 Signature X C• Date x /4t 117 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 (919) 807-6300 Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at: (919) 707-9220 Permit Date 10/112015 — 9/30/2020 Last Revised 10-2-2015 L•' ANNUAL SUMMARY DISCHARGE MONITORING REPORT (DMR) — STORMWATER SUBMIT TO CENTRAL OFFICE* General Permit No. NCG020000 Calendar Year 2_0 1'� "Report ALL STORMWATER monitoring data on this form (include "No Fiow"rNo Discharge' and Benchmark Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year. Certificate of Coverage No. NCG02 Q ,❑3�/©© Facility Name: LA-++Z County: . T b p* Pk u, 5 _ Phone Number. { 7e -L-1 -i - 5 3y`i Total no. of SDOs monitored Certified Laboratory Aw N 1 Ps c' -p- l Lab # Lab # Stormwater Discharge Outfall (SDO) No. O 1 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 If this outfall was in Tier 2 last year, was monthly monitoring discontinued? / Yes, enough consecutive samples below benchmarks to decrease frequency ❑ RECEIVE Yes, received approval from DEMLR to reduce monitoring frequency ❑ FEB .0 $ 2016 No, turbidity benchmark exceedances did not require monthly monitoring ❑ other _ ❑ CENTRAL FILES Outfall No. Total Rainfall, inches TSS, mg/I SS, mlll Turbidity, NTU Upstream (U) Turbidity, NTU Downstream (D) Turbidity, NTU Non -polar O&G, mg/I (VMA) New Motor Oil Usage a!lmo. Stormwater Benchmarks lndkete NO FLOwii a �canre Circle Benchmark 100/50 0.1 Circle serahmark 50/25/10 NIA Water quality Standard applies NIA water Quality standard applies `� >55 gaiaoo. average requires TSS and Non-potar O&G mere term Date Sample Collected, mo/ddI r 15- 0 . Z1D IV IA A N Z /5" a 12.(0 drl A- /V w- Perm it Date 1011 /2015 - 9/30/2020 Last Revised 10-2-2015 "1 Certificate of Coverage No Additional Outfall Attachment (make copies as needed for additional outfails) Stormwater Discharge Outfall (SDO) No. U Z VMA Outfall? Yes ❑ Is this outfall currently in Tier 2 for any parameter? Yes ❑ Was this outfall ever in Tier 2 during -the past year? Yes ❑ 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 U NCG02 F .v No IJ' No ©� No Outfall No. Total Rainfall, inches TSS mg/1 SS, mIII Turbidity, NTU Upstream (U) Turbidity, NTU Downstream (D) Turbidity, NTU Nan -polar O&G, mg/I (VMA) New Motor Oil Usage al/mo. Stormwater Benchmarks Indkate NO FLOWN a lkabfe Benchrraark 100150 0.1 9enchmark 50/25/10 NIA Standarrd apppliies NIA Stancty Quality , 9 5 aver6age 4 fres 0&0 meTSS and ndte�rlelar Date Sample Collected, mo/ddl r & t3 S� U. 36 0- -L N A Z 7A L / / 0• 3Z _ 0-1- 6 Jl/ Permit Date 101112015 — 9/30/2020 Last Revised 10-2-2015 V Certificate of Coverage No. NCG02 003 QI 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 Y 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 (919) 807-6300 Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at: (919) 707-9220 Permit Date 10/1/2015 — 9/30/2020 Last Revised 10-2-2015 ANNUAL Y I) - STO. L3 SEN TO:' E.Nr AL OFFICE STO"WATER DISCHARGE'OUTFALLS (SDO) GENERAL PERMIT NO, NCG020000 I "12eport ALL ST'OAA4.40,1R Monitoring Data -on this form (including No Flow and No Discharge and Penriit Limit Violations) by MARCH I of each year.'. I CERTIFICATE.OF COVERAGE.NO. NCGO2 03 L' FACILITY NAME: t.,+- -Z PERSON COLLECTING SAMPLES t3 vi I ` ��/ ' CERTIFIED LADORATORY.Shilt,ivi I H+rl �e.h Lab # r 4! •O, —_ ' Lali # Part A: Stormwater Monitoring Requirements SAMPLE COLLECTION YEAR: COUNTY _ , �' ✓ u _ PHONE NO. (2jd2) L-7 9 - D ADD TO LYSTERVE7 YES Ej NO Li EMAIL: _ TOTAL RAINFALL::. _Q ..� - INCHES EVENT DURATION: MINUTES Outfall No: Date Sainple Collected (moldd/yr O NO FLOW) In Tier Z Mnthltal.Suipended oy Manitor[ng? (y/n) # ofMon'ths In Tien x -' : Sampling2 Total Flow:. - (lVIGj To Solids"(Ntp (mgll) {•. , :�iirblillty.:ettleab - Sa Solids (mill) ` 100 '4 See k'obtnote 01 . 01 917-5 /14 0.00 l (e-7 0 O Z ct ZS 1 1`J �-- . 6o e) 1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here and the Date Range. z Per NCa02: Tier 2 Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range s If a value is in excess of the benchmark, or. outside the benchmark range (for pl), you must implement the Tier 1 or Tier 2 responses in the General Permit. TSS benchmark values are 100 mg/1 except in ORW, HWQ, trout, and PNA waters where they are 50 mg/l, "The discharge shall not.eause an instantaneous measurement of the turbidity of the rdceiving'water to exceed: 19 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, N Permit Date; 1/112010-12/31/2014 Last Revised 0 1 - 19- 1. 0 Page 1 of.2 USE THIS `FORM IF W UHA VEB CEE ED W-MMA s ` i S R TO YOU OCA D ` 1! ' • S D � OF . MM UL S FRO T LAB, DWQ REGIONAL OFFJICES; A,slieville Regional Office (Alto) Mooresville Regional Office (MRU)WashingtorrReglonal'Office (WaRO Winston-Salem Regional Office (WSRO) Roger Edwards, Surface Water Protection Rob Krebs, Surface Water Protection, Al Hodoge, Surface Water Protection Stove Tedder, Surface Water Protection Supervisor Supervisor Supervisor Supervisor - IN090 US Highway 70 610 East Center Avenue, Suite 301 943 Washington Square Mall 585 Waughtown Street l-&Annanoa, NC 28778 Mooresville,:NC 281.15 . Washington, NC 27889 Winatoia Sai6k NC 27107 COUi�iIIR 12-59,01 COURIER 09-08"06 COURIER.16.04.01 : COURIER,lk'15=01- jPhone. (828) 2964500 Phone (704).663,1699' ` Phone: (252).946.6481 Phone: (336) 771.5000 Fax: {$28} 299-7043 Pax: (704) 663-6040 Pax: (252) 946-9215 or (252) 975-3716 Fax: (336) 771;463,1. I;nyottevlllo Regional Office (FRO) Raleigh Regional Office (IRO) WilrningtowRegional;Offlce (WRO)` T Belinda Henson, Surface Water Protection Danny -Smith, Surface Water Protection Rick Shiver, S.ur#hco Water Protection- - Supervisor l Supaivlsor Supervisor 225 croon Street 3800 Barrett Drive 127 Cardinal Drlve.Hxtension 5ystal.Huilding.Suite 714. Raleigh; NC,27609 Wilmington, NC 28405-2845 Fayetteville, NC 28301-5043 COURiER•52;01�00 COUR113R 0446.33 COURIER•14�56-25 '+Phone: (919),791=4200 ' Phone:,(910) 796.7215' Phone: (9.10) 433=3300 Fax: (919).571.4718. Fax:'(910).350.2004 Fax: (910) 486.0707 - YOUMUST SIGN THIS. CERTIFICATION FOR ANY1NFORMAZTONREPORTEDr '"I certify, under penalty of law, that this docginent and'all nttaclrnrents were prepared under my direction or supervision in accordwiee with a systent designed to assure that quallfied personnel properly gather and evaluato 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'subnritted is, to the best of iny.knowledge and belief, true, accurate, and complete. I nm aware,that there are slgniflcant.penalties for submitting false Information, includhrg the possibility of fines and Imprisonment for knowing violations," t--'" • (Signa(ure of Pernrittee) r Permit Date: 1/l/2010-12131/2014 bast Revised 01-05-10 February 8, 2015 NCDENR Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 RE: Calendar Year 2014 Stormwater Monitoring Kluttz Mine Dear Sir/Madam: RECENED FEB 16 2015 CENTL FILES DWR SECTION Enclosed is the calendar year 2014 Stormwater Discharge Outfall (SDO) Monitoring report for: Location Kluttz Mine COC No.: NCG 02031`3' If you have any questions or require additional information, please contact Mr. Billy Goodman at 704-636-3194 Sincerely, 0-``� Rev. Bruce C. Sheeks Immanuel Lutheran Church — Owner of the Kluttz Mine Enclosures: Original and one copy of SDO report, original copy of Statesville Laboratories Analytical report. CC' Ronnie Miller Billy Goodman David Miller Analytical Results Hammill Construction Co., Inc. 5051 St. Stephens Church Rd Gold Hill, NC 28071 Receive Date: 09/25/2014 Reported: 09/30/2014 For: Comments: Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst 140925-12-01 pH Kluttz#1 2 Std. Units SM4500HB-2000 09/26/2014 MD 140925-12-01 Settleable Solids Klutfz#i 0.3 mIIL SM2540E-1997 09/25/2014 CL 140925-12-01 TSS Kluttz#1 6.78 mg/L SM254OD-1997 09/26/2014 CL 140925-12-01 Turbidity Kluttz#1 2 NTU EPA 180.1 09/26/2014 MD 140925-12-02 pH Kluttz#2 8 Std. Units SM4500HB-2000 09/26/2014 MD 140925-12-02 Settleable Solids Kluttz#2 0.2 ml/L SM254OF-1997 09/25/2014 CL 140925-12-02 TSS Kluttz#2 8.89 mg/L SM254OD-1997 09/26/2014 CL 140925-12-02 Turbidity Kluttz#2 8 NTU EPA 180.1 09/26/2014 MD 140925-12-03 pH Zion 6 Std. Units SM4500HB-2000 09/26/2014 MD 140925-12-03 Settleable Solids Zion 0.2 ml/L SM254OF-1997 09/25/2014 CL 140925-12-03 TSS Zion 6.61 mg/L SM2540D-1997 09/26/2014 CL 140925-12-03 Turbidity Zion 6 NTU EPA 180.1 09/26/2014 MD Respectfully submitted, To, �..-tivDL,1?m Dena Myers NC Cert #440, NCDW Cert #37755, EPA #NC00909 e PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 1 of 2 Client: �1!4- xl �, O .1 C O �+- �+ �l �/ `%` R C_ STATESVILLE ANALYTICAL ] 22 Court Street • P.O. Box 228 Statesville. NC 28687 704) 872-4697 Chain of Custody Record Address: k v t AJ o-? c Contact Person: Phone # FAX# PO # Requisitioned by: (Time Date) Customer Sample IN # Time Sampled (Grab (Grab Only) Date Sampled (Grab Only) a a Matrix Parameters requested for analysis sivdga w ww 111 OP 2 5 : 12 / ' d 0 .... 12 Y / 04 �0���� S J 4� —7~J C •� �. d . 4 KI Relinquished by: Received by: r/ Relinquished by: . Received by: . Composite Sampling #1: Time begin am, pm Date �l�l Time end am, pm, Date Composite Sampling #2: Time begin am, pm Date Time end am, pm Date _I_/_ Time pm Date Time l� as pm Date/2 Time am, pm Date Time am, pm Date'—/-/ Lab Comments: r 1 ' 7 Sampled by: �11 Z"{ Transported b 1 1 ,Holding times met: � Compliance work: Non-compliance work: Client: /► STA7'ESVILLE ANALYTICAL' t22 Couri sucu °- :P.O. Box�228 Address: - f k :j u 1 e tr S'Wit svilie: NC -28697 (7114) 872.4697, A �— (\FAX# Contact Person: Phone # z° JChain'of PO # Requisitioned by y_ F"""� (Time Customer _ # Time Sampled " Date Sampled `° . # c +� a A+latrix parameters re uested for analysis 4 y Sample INLa .�D 'h. (Grab Only) (Grab Only) smdye w ww - 3 kl(1 Lrl C �� - .,. _ � � <.s„.. ! �1 .,� 1 '�e.1 C, •. ti _ .,`.Y"~ r Qt Relinquished by ,� .Time f`:� '..��arnpm Date S/)('7 Sampled 6' ^ =.I' 1 ' F17 Received-by':'.f Tlme -," am m 1 ��J p Date — �l Transported by _ Relinquished by U i Time. a am, pm Date' Holdingjimes.met _I Received by ' t�;., Time:f am, pm Date'' — Compliance work. Composite Sampling'#1 1i f . ! Time begin am, pm Date 1�/ _ r' ' Non-compliance' work Time end- am, pin. DateiE- Lab Comments: Composite Sampllri'g A. . Time beginsam, pm. -Date f >s n'* -,Date ;Time end ram; prrm Date f�a,e IC11 l-a•wW ai�.:�:i:�.f.w .. . l • •� 1 � � n .. r - ) - r � • � , � � ..1: z"., . er.� . _. ...: F.•r_.. , _