HomeMy WebLinkAboutNCG020766_MONITORING INFO_20200114Vv 1 �, 0
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
IV U& b o b 1p
DOC TYPE
❑ HISTORICAL FILE
E� MONITORING REPORTS
DOC DATE
❑ a <DI I y
YYYYMMDD
DOC TYPE I ❑ HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE I ❑
YYYYM M DD
+' "• -PROCESS/MINE DEWATERING WASTEWATER DISCIURGE MONITORING REPORT (DMR)
Please Mail Original And One Copy To Mailing Address Below
RECEIVED
JAN 14 2020
GENERAL PERMIT NO. NCG020000,
' CENTRAL FILES
Pot A: Facility Information - - '. DWR SECTION
Samples Collected In'Quarter: 10 20 30 00 (nil samples shall be reported within 30doys following monitoring period)
tees. a.d /
Certificate Of Coverage No. NCG02_ 074:G t��. County -of Facility
Facility Name- S%ff)-/ri 5�i o pp Name of Laboratory
FacilityGoatact H• ne,.10 �,�•� �4v3nl.alsy. Lab,Certi(icadon#
Facility Contact Phone No.
Part B: Process Wastewater and Mine Drwatering Wastewater Monitoring Requirements %: •::. , "
ReceivmgStream Nnme
i)atc-_.y..-50050
Sample Collected
-:00400'1
00630 .. ....--
-: '00076::':
06545-.. .,
Rally Flow'
pH i
TOW Suspended Solids
Turbidity
'Setdea¢le$ol1 9 '
.
' .,. .. ...
. `mo/dd r ....
MCT) -
'unit
' m / '-a'..
NTU9 i.'
.'. .. mifl .
I Measured continuously using a flow measuring device or esimated wing menufactuter's pump cmver and pump.iogs..: - .
Pot C Certiftcation
"1 certify; under penalty of law, that this document and all attachments were prepared under my direction or super4lslon in accordance with a
-- 'system designedto assure that qualified personnel properly gather andevaluateghe Information submitted. Based on my inquiry of the person
" of persous'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. I am aware that there are significant penalti tar su mitties false information,
Including the possibility of fines and imprisonment for knowing violatt
(Date)
Pot D: Mailing Address
'Attu: Cenira4Fites,'DENR, N.C. Division of Water Quality, 1617 Mall Service Center, Raleigh, NC 2769SLI617
SWU-244-012005
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