HomeMy WebLinkAboutNCG020766_MONITORING INFO_20191105AN i
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
n/CG U a O l44
DOC TYPE
❑ HISTORICAL FILE
LY MONITORING REPORTS
DOC DATE
❑
YYYYMMDD
PROCESS/MINE DEWATERING WASTEWATER DISCHARGE MONITORING REPORT (MR)
Please Mail Original And One Copy To Mailing Address Below
GENERAL PERMIT NO. NCGO20000
Pan A: Pocility Information
Samples Collected In Quarter: 2 4 (all samples shall be reported within 30 days following monitoring perlod)
Certificate Of Coverage No. NCCO2 C 7�T County of Facility
Facility Name . (� Name of Laboratory
Facility Contact 1 tisr.01, Lab Certification #
Facility Contact Phone No.
Part B: Process Wastewater and Mine Dewatering Wastewater Monitoring Requirements
4OUENED
V 05 P019
CENTRAL FILES
DWR SECTION
316_ r
Oamher
--`Recei.ineStrcam Name-
Date -- ..
Sample Collected-
p :..
v-•-50050 •'
-00400•
00530.. •-
-: 00076.= :
-., . ,- 00545-- -
Daily Flow -
pR
Total Suspended Solids
Turbidny
--
Settleable Solids -
- ..:.
mo/dd/rr ....
p1Ci) ...
.onil
.:
. m ...
NTUs
.. m111 ..
fVY
1 Meavured continuously wing a Dow measuring device or estimated caving manufacauer's pmnp saves sad pump logs_
Part C: 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 submi ed is, fo the best
of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for su l g f Ora . ' I,
including the possibility of fines and imprisonment for knowing violati
i
fSiPnA0e of Perini ee) (Date)
PartD: Mailing Address
Attic: Central Files, DENR, N.C. Division of Water Quality, 1617 Mall Service Center, Raleigh, NC 27699-1617
SWU-244-012005
'7T 1 hH tt`p+.►.a���..C.�to�-nGr t.L�t.(�. �"' Qafl .S1sxivy"' J:4Y' /sw`st" + `Go °�4... �+L�"