NCG020783_MONITORING INFO_20190108

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STORMWATER DIVISION CODING SHEET �
NCG PERMITS
PERMIT NO.
DOC TYPE
❑HISTORICAL FILE
MONITORING REPORTS
HOC DATE
❑ l�� �j D I �
YYYYMMDD

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) - WASTEWATER
11 SUBMIT TO CENTRAL OFFICE* II
General Permit No. NCG020000
Calendar Year 2018
*Report ALL WASTEWATER monitoring data on this form (include "No Flow i"'No Discharge" and Limit Violations) from
the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG020783
Facility Name: Henrietta Quar
County: Rutherford
Phone Number: ( 828 ) 657-9331 Total no. of outfalls monitored 2
Certified Laboratory Pace Analytical Lab # 40
Lab #
Wastewater (WW) Discharge Outfall No. 001
Is this an industrial sand mine (See 40 CFR §436 Subpart D)?
Yes ❑
No ID
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 7Q10 flow rate? or Tidally influenced waters,
7Q10 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, cfs
pH,
SU
TSS,
mgll
SS,
mill
ifepplicabre
Discharge
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Fecal
Coliform,
coll100 ml
SA
Effluent
Limitations
Mo. Ave I Daily Mal,
HQW or ORW
50% of
7Q1 0
Indicate NO FLOW
if opplicabre
freshwater
6.0-9.0
saltwater
6.8-8.5
Industrial Sand
25145
HQW orORW
A
20l30
HOW or ORW
rind Tr or PNA
10l15
HQW, ORw,
SA, SB, PNA,
or any Trout
0.110.2
No Limit
circle Water
Quality Standard
that applies:
50/25/10
NIA
Water Quality
Standard applies
NIA
Water Quality
Standard applies
NIA
Date Sample
Collected,
molddlyr
MENEMM,
T �;
No
Discharge
JAN
0 8 2019
CEN11
AL
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG020783
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
Date // 7
Mail Annual Summary Wastewater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in DWR ([lot 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 10/112015 — 9/30/2020
Last Revised 10-2-2015

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
11 SUBMIT TO CENTRAL OFFICE* II
General Permit No. NCG020000
Calendar Year 2018
*Report ALL STORMWATER monitoring data on this form (include "No Flow"I"No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG020783
Facility Name: Henrietta Quarry
County: Rutherford
Phone Number: ( 828 ) 657-9331 Total no. of SDOs monitored 2
Certified Laboratory Pace Analytical Lab # 40
Lab #
Stormwater Discharge Outfall (SDO) No. 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? 1 IVED
Yes, enough consecutive samples below benchmarks to decrease frequency ❑ JA N 0 8 2019
Yes, received approval from DEMLR to reduce monitoring frequency ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑ CFN i'{`AL FILES
D1rIR SECTION
Other ❑
Outfall No.
001
Total
Rainfall,
inches
TSS,
mgll
SS ,
mill
Turbidity,Non-polar
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
O&G, mgll
(VMA)
New
Motor Oil
Usage
ailmo.
Stormwater
lndreere NO
FLOWN
a4
Circle
Benchmark
100150
0
Circle
Benchmark
50/25
NIA
Water le
andard app
NIA
Quality Water
Standard applies
15
>55gal1mo.
average requires
TSS and n�nBenchmarks
O&G monitoring
Date Sample
Collected,
molddl r
No
Discharge
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG020783
[@]=IMAIgAgo] :I
"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 ( CAAJF^ T
Date '1
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 10/112015 — 9/30/2020
Last Revised 10-2-2015

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) - STORMWATER
SUBMIT TO CENTRAL OFFICE* RECRVED
General Permit No. NCG020000
JAN Q 2 2019
Calendar Year 2 o/ G CENT"wL FILES
DWR SECTION
"Report ALL STORMWATER monitoring data on this form (include "No Flow"Mo Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCO02 00 ❑?`
Facility Name: M 4EtLi4QV44rty T
County: W I k•:K VE S
Phone Number: (3 36) 49 4 - 4 b/a Total no. of SDOs monitored r3_
Certified Laboratory S 7'4T06VI1 E A,vgL yn6Q;ab # Q 4-b_-
Lab #
Stormwater Discharge Outfall (SDO) No. I VMA Outfall? Yes ❑ No [ '
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No Q�
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 ❑
Upstream Downstream New
Total TSS, SS, Turbidity, (U) Turbidity, (D) Turbidity, Non -polar Motor Oil
Outfall No. Rainfall, mg/l mIII NTU NTU NTU O&G, mgll Usage
—� --- inches (VMA) al/mo.
clrsl° Circle NIA NIA >66 gallmo.
Stormwater Indicate NO Benchmark Benchmark average requires
FLOWN >ka 1 D SO 0.1 (925110 Standard pplin
es Standard apPlles 15 WaterGuallty TO&G monitoring
Benchmarks ag
Date Sample
Collected,
molddl r
03 I S . 2- z 2. 41 z o. I D. G A114 NI A� /
z a3 4o 1. 4
Permit Date 101112015 — 9/3012020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ❑o 21[Y10
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 Rr
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.
Z
Total
Rainfall,
inches
TSS,
mgll
SS,
mI/I
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mgll
(VMA)
New
Motor Oil
Usage
al/mo.
Stormwater
Benchmarks
Indicate NO
applicable
�'""°NIA
nnehmeearN
1 v JOj]jencEhgm;ar.k
Standard applWater ies
NIA
Standard applies
>66 pa!lma.
average raqufias
TSS and G&G m nkorolar
irm
Date Sample
Collected;
molddl r'
03102115
2
/0,4
Od
14
NIA
N I 4
N/�4
l2 03 P13
16
-4 3 012,5
L o.
R
'V '9
All
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. 3 VMA Outfall?
Yes ❑ No [-�
Is this outfall currently in Tier 2 for any parameter?
Yes ❑ No [�t—
Was this outfall ever in Tier 2 during the past year?
Yes ❑ No D
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,
mIII
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mg/l
(VMA)
New
Motor Oil
Usage
allmo.
Stormwater
Benchmarks
indkate NO
aF�kaAls
C'""°
hmeeaiM
1Q JQ
0-1
Circle
(�Be�nchemark
`aL1M�`a110
NIA
Standard poles
NIA
StaaterQuality nd°rdap lea
A G
1a
'66 paumo,
average requlrea
TQ G monitoring Non -polar
Date Sample
Collected,
molddl r
07 1
, 2
C 3.10
G
.0:9
,✓/,
/
►2 03
4,129
LD. 1
2. U
�✓
N
Permit Date 101112015 - 9130/2020
Last Revised 10-2-2015

Certificate of Coverage No. N0002 ©0®t2
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 I 1 -11 ry
Date 1.2 -/3 -1'8
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 101112015 — 9/30/2020
Last Revised 10-2-2015

i
Coons.
cm
January 8, 2018
ROGERS GROUP, INC.
P.C. BOX 25250 Nashville, TN 37202-5250 Phone [phone]
Attn: Central Files
Division of Water Resources
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
RE: Rogers Group, Inc. - DMR Submittals
Henrietta Quarry — NCG020783
To Whom It May Concern:
RGI is submitting an original and one copy of stormwater and wastewater Annual
Summary Discharge Monitoring Reports for our Henrietta Quarry facility.
If you have any questions or need any additional information please do not hesitate to
contact me at [phone].
Sincerely,
�:' k ���
Erik Knowles
Sr. Environmental Engineer
Rogers Group, Inc.
JAN 11 2818
DIVISION OF WATa RESOURCES
Rpr,;:IIIEID
JAN 11 2ol$
11�>•ORk,1A DWR� E��Ip,�1
ON R SING UNIT
An Equal Opportunity Employer. M/F/V/D
www.rngersgroupinc.com

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
}r. - ri tt �
.,SUBMIT,,ENTRaL OFFICE* nS
nl "� l ..n 4 iir� 4. 1 - f� 1' k' 1;i•
General Permit No. NCG020000
Calendar Year 2017
"Report ALL' STORMWATER moriit(jing ,data op thRstform I jinclude 'No'Flow Ir No�Di§bhbrg6 4�and Benchfnark �
Ezceedances);ifrom°theiprevlous;calendar.yearto the:DEQ�by'NIARCH:i;of,:eachtyear.
Certificate of Coverage No. NCG020783
Facility Name: Henrietta Quarry
County: Rutherford
Phone Number: ( 828) 657-9331_ Total no. of SDOs monitored 2
Certified Laboratory Pace Analytical _ Lab # 40
Lab #
Stormwater Discharge Outfall (SDO) No. 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 ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑
Other ❑
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Water Quality
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average requires.,
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No
Discharge
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG020783
**1411I3ra=r1111119R]
" 1 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 r
Date ) % z h 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 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBNl1T'T4; CENTR4L OFFICE* , ; -
General Permit No. NCG020000
Calendar Year 2016
Report ALL STORMWATER.monitoring data:on this 4orinh-(include "No=Tlow'T'NoIDischarge`',:and,Be rich mark'.
Exceedandes) from the. previous,calendar;year to the DEQ by 0ARCHf.;;,1 of.eath year.
Certificate of Coverage No. NCG020783
Facility Name: Henrietta Quarry
County: Rutherford
Phone Number: ( 828 ) 657-9331 Total no. of SDOs monitored 2
Certified Laboratory Pace Analytical _ .__ Lab # 40
Lab #
Stormwater Discharge Outfall (SDO) No. 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 ® pF(;PNE1..►
If this outfall was in Tier 2 last year, was monthly monitoring discontinued? Z07
Yes, enough consecutive samples below benchmarks to decrease frequency ❑ �A�
Yes, received approval from DEMt_R to reduce monitoring frequency ❑ CrNTRAI FIl E`
T10N
No, turbidity benchmark exceedances did not require monthly monitoring ❑
DW,a StrC
Other ❑
rLl 1
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a r
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Iry'.1
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w T 7
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t "�% ,
1
FLOWYI1
applicable
}
4
Circla
Benchmark
I I
••
a
water Quality
Standard al
O&G monitoring
- •
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s 4»a1 ,{114�4ot1tS
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No
Discharge
---_
Permit Date 10/1/2015 — 9/3012020
Last Revised 10-2-2015

Certificate of Coverage No. NCG020783
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
Signe
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 [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

�---.--� � at

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) —WASTEWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year 2016
*Report ALL WASTEWATER monitoring data on this form,,(include "No Flow'T'No Discharge" and Limit Violations) from
the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG020783
Facility Name: Henrietta Quarry
County: Rutherford
Phone Number: ( 828 657-9331 Total no. of outfalls monitored 2
Certified Laboratory Pace Analytical Lab # 40
Lab #
Wastewater (WW) Discharge Outfall No. 001
Is this an industrial sand mine (See 40 CFR §436 Subpart D)?
Yes ❑
No
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 HOW or ORW waters?
Yes ❑
No
If so, what is the 7Q10 flow rate? or Tidally influenced
waters,
7Q10 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
Outfall No '.,+
001.
Da,ily Flow,
Rate, cfs I
pH, ,i
SU ,
cFl
1, TSS;,,
,5, rnglI s y
a ��:,��
SS,,,- :
;, , mill.,_,
,i1fapplicabre
Discharge
J4T bidity,
t, ;NTU
Upstream.. ,•;
(U)Turbidity;,,
NTU :�t-
Downstream
JD) Turbidity,
,•NTU� -
Fecal
Coliform,•
.,colll00 ml
SA `l
Effluent
Limitations
Mo. Ave ! Daily Max.
HOW or ORW
50%of
7Q10
Indicate NO FLOW
u applicable
freshwater
6.0.9.0
sallttwaaler
6.$-$.5
Industrial Sand,
25145
HQWorORW
20130
HQWorORW
to Tr or PNA
10115
HOW, ORW,
SA, SB,PNA,
or any �Tlrout
U.1 I0.2
_
No Limit
Gircla Water
Quality Standard
that�afpplies:
SAIL 511 0
5
NIA
Water Quality
Standard applies
NIA
Water Quality
Standard applies
N/A
Date•Samole
Collected, mold
W1,
No
Discharge
Permit Date 10/112015 - 9/3012020
Last Revised 10-2-2015

Certificate of Coverage No. NCG020783
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
Signa
Date
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 — 9/3012020
Last Revised 10-2-2015

�------�:�o.

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 Fiow'1"No Discharge" and Limit Violations) from
the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG020783
Facility Name: Henrietta Quarry
County: Rutherford
Phone Number. ( 828 ) 657-9331 Total no. of outfalls monitored 2
Certified Laboratory Pace Analytical Lab # 44
Lab #
Wastewater (WW) Discharge Outfall No. 001
Is this an industrial sand mine (See 40 CFR §436 Subpart D)?
Yes ❑
No N
Does this outfall discharge WW to SA waters?
Yes ❑
No
Does this outfall discharge WW to SIB or PNA waters?
Yes ❑
No N
Does this outfall discharge WW to HQW or ORW waters?
Yes ❑
No N
If so, what is the 7010 flow rate? or Tidally influenced waters,
7Q10 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 N
Outfall No.
001
Daily Flow
Rate, cfs
pH,
SU
TSS,
mg/1
SS,
mill
Nappiicablo
Discharge
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Fecal
Coliform,
co11100 ml
SA
Effluent
Limitations
Mo. Ave 1 Daily Max.
HOW or 0RW
50% of
7010
indicate NO FLOW
if appficabte
freshwater
6.0-9.0
saltwater
6.8'8.5
Industrial Sand
25145
HOWorORW
20130
HOW or ORW
ApA Tr or PNA
10115
HOW, ORW,
SA, SB,PNA,
or any Trout
0.110.2
No Limit
circle water
Quality Standard
that applies:
V L
5Q125110
NIA
Water Quality
Standard applies
NIA
water Quality
Standard applies
N/A
Date Sample
Collected,
molddl r
No
Discharge
Permit Date 101112015 — 9/30/2020
Last Revised 10-2-2015

01
Certificate of Coverage No. NCG020783
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]
Sign
Date
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

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"1"No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG020783
Facility Name: Henrietta Quarry
County: Rutherford
Phone Number: (_828 ) 657-9331 Total no. of SDOs monitored 2
Certified Laboratory Pace Analytical Lab # 40
Lab #
Stormwater Discharge Outfall (SDO) No. 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 ❑ REECE V
Yes, received approval from DEMLR to reduce monitoring frequency El�❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑ JAN 1.9 ?Oil -
Other ❑
r,. ,
vvV rk �)!:UTi()Nf
Outfall No.
001
Total
Rainfall,
inches
TSS,
mgll
SS,
m111
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mgll
(VMA)
New
Motor Oil
Usage
allmo.
Stormwater
Benchmarks
Indicate NO
FLOa
applicablee
Circle
Benchmark
100150
0.1
Circle
Benchmark
50/25/10
NIA
andard applies
S Water le
NIA
Water Quality
Standard applies
1
>55 gallmo.
average requires
TSS and Non -polar
o&G monitoring
Date Sample
Collected,
molddl r
No
Discharge
Permit Date 10/112015 — 9/3012020
Last Revised 10-2-2015

Certificate of Coverage No. NCG020783
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 / /8 7a/G,
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 10/112015 — 9/30/2020
Last Revised 10-2-2015