NCG020967_Application_20201102

Division of Energy, Mineral and Land Resources /
Land Quality Section — Stormwater Permitting Program
National Pollutant Discharge Elimination System
NCG020000
NOTICE OF INTENT — General Permit Application
16&2a
FOR AGENCY USE ONLY
Date Received
Year Month Day
D It
Certificate of Coverage A A
ICIGIO12101bifV`
Check # I Amount
v -7o It (oc?
Permit Assigned to
RECEIVE-D
National Pollutant Discharge Elimination System application for coverage under General PermjY0V 2 2020
NCG020000: 11
STORMWATER AND/OR WASTEWATER DISCHARGES associated with activities classified as .H LAND QUALITY
JWATER PERMITTING
SIC (Standard Industrial Classification) Code - 14XX Mineral Mining Industry (except as specified below) and
like activities
The following activities are included:
• Active or inactive mining operations (including borrow pits —except for NCDOT borrow pits) that discharge
stormwater contaminated with or that has come in contact with, any overburden, raw material, intermediate
products, finished products, byproducts or waste products located on the site of such operations',
• Stormwater from vehicle maintenance activities (VMA) at mining operations',
• Overflow from facilities that recycle process wastewater, and/or
• Mine dewatering (wastewater)
The following activities are specifically excluded from coverage under this General Permit:
• Stormwater discharges associated with peat mining, coal mining, and metal mining,
• Stormwater discharges from mining operations which are intermixed on site with stormwater from concrete
operations,
• Stormwater discharges associated with oil and gas extraction operations, and
• Stormwater discharges associated with tourist gem mines
• NCDOT borrow pits (covered under individual permit NCS000150)
The following discharges are covered by NPDES general permit NCG520000 instead of NCG020000:
Point source discharges of stormwater and wastewater from in -stream sand mining operations (sand dredging
or dipping operations) are covered instead by NPDES General Permit NCG520000, administered by the Division
of Water Resources NPDES Wastewater Permitting Program. Please contact DWR for more information.
Please print or type all entries in this application form.
1) Mailing address of owner/operator (official address to which all permit correspondence will be mailed):
Legal Owner Name Gary and Virqinia Dellinger
(Attach the most recent Annual Report to the NC Secretary of State showing the current legal name of the corporation or entity.
Alternatively this permit can be given to an individual or government authority. This name must be the same name as appears on the
Division of Energy, Mineral, and Land Resources' Mining Permit.)
Signee's Name (as signed for in question 41. at end): Gary and Virginia Dellinger
Street Address 965 Hopewell Church Road,
City Catawba State North Carolina ZIP Code 28069
Telephone No. 704-201-4079 E-mail GINIONETIME(a�gmail.com
Alternate Contact Name*
N/A E-mail (if different) N/A
Page 1 of 12
SWU-NCG02-NOI Last revised 9/10/2015

NCG020000 N.O.I.
Alternate Contact Telephone (if different) N/A
*Alternate contact should be affiliated with the Owner/Operator. Consultant information can be provided
in question 5.
2) Location of facility producing discharge:
Facility Name The Sand Pit
Facility Street Address 4429 Old Catawba Road,
Facility City Clearmont State: North Carolina ZIP Code 28609
Facility County Rowan
Facility Contact Gary Dellinger
Telephone No. 704-201-4079 Fax: N/A
Contact E-mail GINIONETIMEkgmail.com
3) Physical Location Information:
a
Please provide a narrative description of how to get to the facility (use street names, state road numbers, and
distance and direction from a roadway intersection: From MRO head towards NC HM 150 West towards
Sherrils Ford about 10.1 miles. Turn Risaht on Sherrills Ford Road about 8.2 mile. Turn Riizht onto
Lowrance Road about 2.7 miles that will become Rosenwald Shool Road and make a slight Right
towards 41h Ave. SW that will become Old Catawba School Road about a mile, and continue about
1.5 onto Old Catawba Road. Turn Left on Cindy Lane about 0.3 mile and site is on right side.
Facility Location Coordinats :
Latitude 35.707522 N Longitude-81.098127 W (degrees / minutes / seconds or decimal degrees)
Consultant Information (if applicable) :
Consultant: Samar Bou-Ghazale
Consulting Firm: _Environment Compliance & Permits, LLC
Mailing Address: 6076 Diamond Place,
City: Harrisburg
State: NC Zip Code: 28075
Phone:(704) _307-0660 Fax:( )
E-mail: [e-mail]
Permits:
5) This NPDES Permit Application applies to which of the following:
X New or Proposed Facility
❑ Existing
6) Standard Industrial Classification:
(Optional)
Staple Business Card Here
Date operation is to begin: 12/31/2020
Date began mining:
Provide the 4-digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility SIC Code: 1 4 9 9
7) Provide a description of the types of minerals mined at this facility: A borrow pit for dirt soil
8) Is this a PROCESSING -ONLY facility for materials mined elsewhere? X No ❑ Yes
9) Is this an inactive mine site?
X No
Page 2 of 12
SWU-NCG02-NOI Last revised 9/10/2015

NCG020000 N.O.I.
❑ Yes, If yes, have you certified to the Stormwater Permitting Program that all portions of the site where
clearing, grading, and/or excavation activities have occurred have been stabilized?
❑ No ❑ Yes (If yes, the site may be eligible for "Dormant Status" and reduced BMP
inspections. See the General Permit.)
10) Does this facility already have a valid Mining Permit from DEMLR's Land Quality Section?
X No
❑ Yes
If no, please indicate the status of the Mining Permit application: Applied for the permit
If yes, please provide the Mining Permit number:
the DEMLR Mining Permit with this NPDES application.
11) Does this facility have any other NPDES permits?
Also provide a copy of
X No
❑ Yes If yes, list the permit numbers for all current NPDES permits for this facility:
12) Are you applying for a discharge permit in the same location as a previously permitted mine?
X No
❑ Yes If yes, specify permit number and mine name if known:
13) Does this facility have any Non -Discharge permits from DWR (e.g., recycle permits)?
X No
❑ Yes If yes, list the permit numbers for all current Non -Discharge permits for this facility:
14) Does total area of this mine site include ready -mixed concrete plant and/or asphalt plant areas?
X No
❑ Yes If yes, do they have separate NPDES stormwater permits? ❑ No ❑ Yes (provide permit
number(s) )
If not owned by the same company, who is the owner?
Development Activities and Buffers:
15) Will this mining operation precede development activities at this site?
X No
❑ Yes
16) Is this mine located within one of the 20 Coastal Counties, and will it add more than 10,000 ft2 of
impervious surface?
❑ Yes (to both)
❑ No, this mine site IS in one of the 20 Coastal Counties but will NOT add 10,000 ft2 of impervious surface.
X No, this mine site is NOT in any of the 20 Coastal Counties.
If this site is in one of the 20 Coastal Counties, you may be required to apply for an additional State
Stormwater Permit. Check with your local Regional Office (see contact information and checklist below).
Page 3 of 12
SWU-NCG02-NOI Last revised 9/10/2015

NCG020000 N.O.I.
17) Is this mine located the Neuse, Tar -Pamlico, or Catawba River Basins, or the Randleman or Jordan
Water supply Watersheds?
X No
❑ Yes If yes, what size stream buffers are included on site? ft. You must show buffers on site
plans. Also include information and plans showing diffuse flow through buffers as required.
Discharge Points, Receiving Waters & Wetlands:
18) Receiving waters:
What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater
and/or wastewater discharges will end up in? McLin Creek
To find the waterbody, please see the "MAPS" tab on http://portal.ncdenr.org/web/wq for a map of NC
Surface Waterbody Classifications.
Receiving water classification(s) for the waters: WS IV
If the site will discharge to a separate storm sewer system, name the operator of the separate storm sewer
system (e.g. City of Raleigh municipal storm sewer). N/A
Discharge of wastewater to receiving waters classified as WS-II through WS-V, or SA, must be
approved by the Division of Water Resources (DWR) or Division of Marine Fisheries
(DMF). DEMLR cannot grant coverage under NCG020000 without that approval. Also be advised that
no new discharges of wastewater are permitted in receiving waters classified as WS-1 or
freshwater ORW. Wastewater discharges to saltwater ORW will not be approved under General Permit
NCG02 but may be eligible for an individual permit.
19) Will this mine site discharge wastewater or stormwater to waters classified as High Quality Waters
(HQW), Primary Nursery Areas (PNA), Trout (Tr) waters, or a class with a symbol like "+" or "@" that
denotes a special management strategy is in place?
X No
❑ Yes, PNA'
❑ Yes, HQW*
❑ Yes, Trout jr)
❑ Yes, includes "+" or "@"
20) Will this mine site discharge wastewater or stormwater to waters classified as Shellfish (SA) waters?
X No
❑ Yes, SA'
"For questions 19-20, be advised that the NCG02 General Permit limits the discharge volume of total combined
wastewaters to 50 percent of the receiving water in -stream flow under 7Q10 conditions in HQW waters (PNA and
SA waters are considered HQW by definition). You maybe required to contact USGS to obtain a 7Q10 flow.
Page 4 of 12
SWU-NCG02-NOI Last revised 9/10/2015

NCG020000 N.O.I.
21) Will this mine site discharge wastewater or stormwater to impaired waters, or to waters with an
approved "Total Maximum Daily Load" (TMDL)?
To find impaired waters, please see the "Impaired Waters" map on the "MAPS" tab on
http://Portal.ncdenr.org/web/wq.
To find approved TMDLs in North Carolina, please see DWR's Water Planning Section website:
http://portal.ncdenr.org/web/wq/ps/mtu/tmdl/tmdls.
X No
❑ Yes, these waters are impaired for (list pollutants):
❑ Yes, these waters have a TMDL for (list pollutants):
Page 5of12
SWU-NCG02-NOI Last revised 9/10/2015

NCG020000 N.O.I.
22) List discharge points (outfalls) that convey discharge from the mine site (both on -site and off -site) and
location coordinates. Attach additional sheets if necessary, or note that this information is specified
on the site plan. Include proposed maximum daily flow rate for each wastewater outfall.
You must show all discharge points clearly on the submitted site plan. Be advised
that NCDEQ may require you to apply for an individual permit, based on proposed
discharge rates and receiving stream conditions (low flows, impairments, etc.)
Stormwater
Stormwater Outfall No.
Latitude (degrees/minutes/seconds or decimal degrees):
Longitude (degrees/minutes/seconds or decimal degrees):
Stormwater Outfall No
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
Page 6 of 12
SWU-NCG02-NOI Last revised 9/10/2015

NCG020000 N.O.I.
Mine Dewatering
Mine Dewatering (Wastewater) Outfall No.
Proposed maximum flow rate:
Latitude (degrees/minutes/seconds or decimal degrees):
Longitude (degrees/minutes/seconds or decimal degrees):
N
W
Mine Dewatering (Wastewater) Outfall No.
Proposed maximum flow rate:
Latitude (degrees/minutes/seconds or decimal degrees): N
Longitude (degrees/minutes/seconds or decimal degrees): W
Mine Dewatering (Wastewater) Outfall No.
Proposed maximum flow rate:
Latitude (degrees/minutes/seconds or decimal degrees):
Longitude (degrees/minutes/seconds or decimal degrees):
Mine Dewatering (Wastewater) Outfall No.
Proposed maximum flow rate:
Latitude (degrees/minutes/seconds or decimal degrees):
Longitude (degrees/minutes/seconds or decimal degrees):
Process Wastewater
Process Wastewater Outfall No. Wastewater Description:
Proposed maximum flow rate:
Latitude (degrees/minutes/seconds or decimal degrees):
Longitude (degrees/minutes/seconds or decimal degrees):
Process Wastewater Outfall No. Wastewater Description:
Proposed maximum flow rate:
Latitude (degrees/minutes/seconds or decimal degrees):
Longitude (degrees/minutes/seconds or decimal degrees):
Process Wastewater Outfall No. Wastewater Description:
Proposed maximum flow rate:
Latitude (degrees/minutes/seconds or decimal degrees):
Longitude (degrees/minutes/seconds or decimal degrees):
Process Wastewater Outfall No. Wastewater Description:
Proposed maximum flow rate:
Latitude (degrees/minutes/seconds or decimal degrees):
Longitude (degrees/minutes/seconds or decimal degrees):
Process Wastewater Outfall No. Wastewater Description:
Proposed maximum flow rate:
Latitude (degrees/minutes/seconds or decimal degrees):
Longitude (degrees/minutes/seconds or decimal degrees):
N
W
N
W
N
W
N
W
N
W
N
W
Page 7of12
SWU-NCG02-NOI Last revised 9/10/2015

NCG020000 N.O.I.
23) Help us understand what will happen to the dewatering water at this mine site:
X N/A — this mine is not dewatering at all and will not dewater in the future.
a) Will this mine be dewatering and discharging to waters of the state? (Answer only if dewatering)
❑ No
❑ Yes If yes, where to? ❑ Surface Waters and/or Wetlands (on -site or off -site)
❑ Other (on -site or off -site) Describe:
b) Will this mine be dewatering but not discharging to waters of the state? (Answer only if dewatering)
❑ No
❑ Yes If yes, explain how you are dewatering, and where that water will be directed:
24) Are there wetlands or surface waters within 400' of the mine pit perimeter?
X No
❑ Yes If yes, what distance are they from the mine pit perimeter?
feet.
25) Will mining operations require dewatering near wetlands or other waterbodies, and will dewatering
potentially impact any wetlands or other waterbodies?
X No, dewatering will not occur near (within 400') of wetlands or other waterbodies (e.g., streams, lake, etc.)
❑ Yes, dewatering will be near wetlands or other waterbodies
Wetlands must be CLEARLY DELINEATED on the site plan. Mine dewatering activities that
have the potential to drain wetlands or otherwise impact surface water or groundwater MUST develop and
implement a Pumping Operation and Monitoring (POM) Plan that has been approved by the
Department.
For sites that may drain wetlands — approval of a POM Plan may be required prior to coverage under
this permit. The POM Plan should be submitted to the appropriate Regional Office and in all cases must be
approved prior to operation.
The plan shall include, but is not limited to: (1) Groundwater monitoring strategies to demonstrate the effect of
pumping and to establish any pumping regime necessary to reduce impacts, and (2) Detailed plans to maintain
surrounding hydrology and respective monitoring to demonstrate compliance. See checklist at the end of the
application. Contact the Regional Office for questions specific to your mine.
26) Have you been required to obtain 404/401 Certification permits?
X No
❑ Yes /f yes, please briefly describe below (include information such a required mitigation, BMPs,
setbacks, and/or O&M plans for on or off -site wetlands or other pertinent information). Attach other sheets as
necessary.
Page 8 of 12
SWU-NCG02-NOI Last revised 9/10/2015

NCG020000 N.O.I.
27) Have you been required to obtain a wetland delineation certified by the US Army Corps of Engineers?
X No ❑ Yes If yes, please attach to application submission.
Stormwater BMPs and Vehicle Maintenance:
28) Does this facility employ best management practices for stormwater control?
❑ No X Yes If yes, please briefly describe: _Stormwater Detention basin will be designed and
skimmer basin will be designed for the mine site.
29) Does this facility have a Stormwater Pollution Prevention Plan?
X No ❑ Yes If yes, when was it implemented?
30) Are vehicle maintenance activities (VMA) occurring or planned at this mine site?
X No ❑Yes, If yes, will VMA area runoff discharge into the wastewater treatment system(s)?
❑ No, VMA runoff will discharge separately through a stormwater outfall
❑ Yes, VMA runoff will drain back to the mine pit or other wastewater system
Wastewater Treatment Facilities:
31) Will mine dewatering occur? (Yes, we are asking about dewatering again.)
X No
❑ Yes If yes, will the mine discharge this water?
32) Will this facility wash mined materials?
X No
❑ Yes If yes, will the mine discharge this water?
33) Will discharges of process wastewater treatment systems occur (including possible recycle system
overflows)?
X No
❑ Yes If yes, describe what kind of systems:
34) Will this facility employ chemical additives to flocculate suspended solids?
X No
❑ Yes If yes, provide the name, manufacturer, and the quantity of average daily usage of the chemical
additive (if known):
Note: Please see our website for a list of evaluated polyacrylamide (PAMS) products for use in North
Carolina: http://Portal.ncdenr.org/web/Ir/construction-stormwater
35) Will any of the wastewater treatment facilities at this mine overflow only during rainfall events that
exceed the 10-yr, 24-hr rainfall event?
N/A
❑ Yes If yes, which treatment systems are those? N/A
Page 9of12
SWU-NCG02-NOI Last revised 9/10/2015

NCG020000 N.O.I.
❑ No, all wastewater treatment facilities will discharge more frequently (i.e., during smaller rain events)
36) Are wastewater treatment facilities (including recycle systems) planned in the 100-year flood plain?
X No
❑ Yes
Other:
37) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
X No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
X No ❑ Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
X No ❑ Yes
d) If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste:
How is material stored:
Where is material stored:
How many disposal shipments per year:
Name of transport / disposal vendor:
Vendor address:
38) Is your facility providing appropriate secondary containment for bulk storage of liquid materials? (See
permit text for secondary containment requirements.)
X No We are not planning to have a Bulk Storage or liquid material. If needed, we will provide secondary
containment.
❑ Yes
39) Does your site have an active landfill within the mining permit boundary?
X No
❑ Yes If yes, specify type: ❑ LCID (Land Clearing and Inert Debris) ❑ Other:
Final Checklist:
This application will be returned as incomplete unless all of the following items have been included and
initialed for. Please show that the following required information has been included by initialing in each
space below.
_X_ Fee of $100 made payable to NCDEQ.
_X_ Completed application and all supporting documents.
_X_ Copy of the valid approved mining permit (MP) for the facility or indication of MP application status.
_X_ Copy of a county map or other general location map that shows the mining site and nearest major roads.
_X_ Copy of USGS topographic map showing the mining site and surrounding areas, or other map that clearly
shows site location in relation to nearby streams, wetlands, and other waters, etc.
Page 10 of 12
SWU-NCG02-NOI Last revised 9/10/2015

NCG020000 N.O.I.
_X_ 2 copies of large-scale (minimum 24" x 36") site plan with topographical lines with
all outfalls, applicable buffers and wetlands clearly delineated, receiving waters, and
100-year flood plain line if applicable.
_X_ I have contacted my local regional office about a POM Plan.
Regional Office Contact: MRO Date contacted: 1/07/19
Certification: North Carolina General Statute 143-215.6 b (i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan, or other
document filed or required to be maintained under this Article or a rule implementing this Article, or who knowingly makes a false
statement of a material fad in a rulemaking proceeding or contested case under this Article; or who falsifies, tampers with, or knowingly
renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
[Environmental Management] Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine not to
exceed ten thousand dollars ($10,000).
41) Signatory Requirements (per 40 CFR 122.22)
All applications, reports, or information submitted to the Director shall be signed and certified.
a. All notices of intent to be covered under this General Permit shall be signed as follows:
(1) For a corporation: by a responsible corporate officer. For the purpose of this permit, a responsible corporate officer means: (a) a president,
secretary, treasurer or vice president of the corporation in charge of a principal business function, or any other person who performs similar
policy or decision making functions for the corporation, or (b) the manager of one or more manufacturing production or operating facilities
employing more than 250 persons or having gross annual sales or expenditures exceeding 25 million (in second quarter 1980 dollars), if
authority to sign documents has been assigned or delegated to the manager in accordance with corporate procedures.
(2) For a partnership or sole proprietorship: by a general partner or the proprietor, respectively; or
(3) For a municipality, state, federal, or other public agency: by either a principal executive officer or ranking elected official.
I hereby request coverage under the referenced General Permit. I understand that coverage under this permit will
constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an individual
permit.
I agree to abide by the following as a part of coverage under this General Permit:
1. I agree to abide by the approved Mining Permit for this mining activity. (A copy of the valid mining
permit must be attached to this request.)
2. 1 agree to not discharge any sanitary wastewater from this mining activity except under the
provisions of another NPDES permit specifically issued therefore.
3. 1 agree that bulk storage of petroleum products and other chemicals shall have adequate protection
so as to contain all spills on the site.
4. 1 agree that solid wastes will be disposed of in accordance with N.C. statutes and rules governing
solid waste disposal.
5. 1 agree that maintenance activities for vehicles and heavy equipment will be performed so as to not
result in contamination of the surface or ground waters.
I agree to abide by the provisions as listed above and recognize that the provisions are to be considered as
enforceable requirements of the General Permit.
I certify that I am familiar with the information contained in this application and that to the best of my knowledge
and belief such information is true, complete, and accurate.
Printed Name of Person Signing: Gary Dellinger and Virginia Dellinger
Title: Owner
of Applicant)
(Date Signed)
Page 11 of 12
SWU-NCG02-NOI Last revised 9/10/2015

NCG020000 N.O.I.
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to NCDEQ.
Mail the entire package to:
Stormwater Permitting Program
Division of Energy, Mineral and Land Resources
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Note
The submission of this document does not guarantee coverage under the NPDES
NCG02 General Permit. Upon review of the submittal, the Division may
determine that coverage under an individual permit is more appropriate. Also be
advised that renewed and continued coverage under NCG02 may be dependent
upon the permittee's compliance success and/or status of the receiving waters.
For questions, please contact the DEMLR/Land Quality Section Regional Office for your area.
DEMLR/Land Quality Section Regional Office Contact Information:
Asheville Office ......
[phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
[phone]
Washington Office ...
[phone]
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........
[phone]
Page 12 of 12
SWU-NCG02-NOI Last revised 9/10/2015

"`�` U.S. DEPARTMENT OF THE INTERIOR
��r..l�ti� U.S. GEOLOGICAL SURVEI'
GTAWRA QUADRANGLE
NO GROIINA
7_lbt !IE fiEJE6 ffOYOGRAVLOCI
Z;
19
ry �,V
C
4
r
�;•
It
((V
i
��
�
.T .��.
d'd
�
� 1,
7 )
a
•�
r
41,
r
. \
C
�
t r
Y
� .� •'�
t
/
I I
fi
nmr by to U■tl we.. G.ditl d S..w
o...I�r„ayuY�rNar.W�a1Y�W
.r�wra.szr m.�m �.x..�w •,.� III'
F*
scAlr: I:7N o00
RECEIVED
.`.,.,m ........,.. SEP i 0 Z68D
MBTORI'XIYDMIp1Y0 _
.... oro.rw
GTAW k 14C
on
i.wa■ is� .es.w �!

q ,
10/24/2020 4429 Old Catawba Rd, Claremont, NC 28610 to 610 E Center Ave, Mooresville, NC 28115 -Google Maps
Google Maps 4429 Old Catawba Rd, Claremont, NC 28610 to 610 Drive 27.1 miles, 43 min
E Center Ave, Mooresville, NC 28115
os,�r
8 a
EKI
J �"
HI&M FNn-M■� ulola O•', O
O s 9a■cY.we.n O .....°
c:�awoa c.,m.:.naQ r•w m.. O
o mro
o � �
H o.o o o ®® o0 o M„ emm000 ■..
0 cmN,mM iEHI
aD
O CO
0 0 0
Blrckpum .. ._ h 6 l7, bum, AwMb caa CUE
O '
EAKI
CD
o© oa o
If Moog. c`7„
L.
O M,itlen 0 I
o .,■�K .
MI
o o o
o o 0 0� o o MiM1�.
0 0 CDGoogle o
Map data 02020 2 mi ■
4429 Old Catawba Rd
Claremont, NC 28610
t 1. Head north on Cindi Ln toward Old Catawba Rd
1 min (0.3 mi)
Take Hudson Chapel Rd, Pineville Rd and E Monbo Rd to
Hicks Creek Rd in Fallstown
19 min (13.7 mi)
r► 2. Turn right onto Old Catawba Rd
1.5 mi
r► 3. Turn right onto 5th St NW
6.2 mi
r► 4. Turn right at the 1 st cross street onto W North
Carolina 10 W
0.2 mi
'7 5. Turn left onto Hudson Chapel Rd
5.7 mi
t 6. Continue onto Buffalo Shoals Rd
1.5 mi
https://www.google.com/maps/di r/4429+Old+Catawba+Rd,+Claremont,+NC+28610/610+E+Center+Ave,+Mooresville,+NC+28115/®35.6572163... 1 /2

10/24/2020 4429 Old Catawba Rd, Claremont, NC 28610 to 610 E Center Ave, Mooresville, NC 28115 - Google Maps
r' 7. Turn right onto Pineville Rd
2.5 mi
8. Turn left onto E Monbo Rd
2.1 mi
& 9. Turn right onto Hicks Creek Rd
3 min (2.0 mi)
Take Perth Rd and Cornelius Rd to E Statesville
Ave in
Mooresville
18 min (10.7 mi)
41
10.
Turn left onto State Park Rd
1.1 mi
r►
11.
Turn right onto Perth Rd
3.0 mi
12.
Turn left onto Judas Rd
1.2 mi
41
13.
Turn left onto Cornelius Rd
2.4 mi
t
14.
Continue onto Connector Rd
0.9 mi
r►
15.
Turn right onto NC-115 S
1.4 mi
'j
16.
Slight left onto W Statesville Ave
0.7 mi
Continue on E Statesville Ave to your destination
2 min (0.5 mi)
t 17. Continue straight onto E Statesville Ave
0.4 mi
*1 18. Turn left onto Carpenter Ave
194 ft
F* 19. Turn right
4D Destination will be on the right
305 ft
610 E Center Ave
Mooresville, NC 28115
These directions are for planning purposes only.
You may find that construction projects, traffic,
weather, or other events may cause conditions to
differ from the map results, and you should plan
your route accordingly. You must obey all signs or
notices regarding your route.
https://www.google.com/maps/di r/4429+Old+Catawba+Rd,+Claremont,+NC+28610/610+E+Center+Ave,+Mooresvi Ile,+NC+28115/@35.6572163... 2/2

APPLICATION FOR A MINING PERMIT
NORTH CAROLINA
MINING PERMIT APPLICATION
State of North Carolina
Department of Environmental Quality
Division of Energy, Mineral, and Land Resources
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
[phone]
Revised: 2017
—1—

APPLICATION FOR A MINING PERMIT
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
APPLICATION FOR A MINING PERMIT
(PLEASE PRINT OR TYPE)
Name of Mine Sand Pit (Garland Virginia Dellinger County Catawba
River Basin Catawba
Latitude (decimal degrees to four places) 35.707522 N
Longitude (decimal degrees to four places)-81.098127 W
2. Name of Applicant* Gary and Virginia Dellinger
3. Permanent address for receipt of official mail** 965 Hopewell Church Road, Catawba NC 28609
Telephone [phone] Alternate No. ([phone]
4. Mine Office Address 965 Hopewell Church Road, Catawba NC 28069
Telephone ( 704) 201-4079
5. Mine Manager Gary Dellinger
6. E-mail Address: GINIONETIMEgamail.com
I certify that all details contained in this Permit Application are true and correct to the best of our
'knowledge. We fully understand that any willful misrepresentation of facts will be cause for permit
revocation.
* * * Signature,
Print Name Gary Dellinger
Title Managing Partner of Sand Pit, LLC
Date
This will be the name that the mining permit will be issued to and the name that must be indicated on the
reclamation bond (security) that corresponds to this site.
-2-

APPLICATION FOR A MINING PERMIT
* * The Division of Energy, Mineral, and Land Resources must be notified of any changes in the permanent address
or telephone number.
* * * Signature of company officer required.
G.S. 74-51 provides that the Department shall grant or deny an application for a permit within 60 days of receipt of a
complete application or, if a public hearing is held, within 30 days following the hearing and the filing of any
supplemental information required by the Department. All questions must be addressed and all required maps
provided before this application can be considered complete. Attach additional sheets as needed.
-3-

APPLICATION FOR A MINING PERMIT
NOTE: All of the following questions must be thoroughly answered regarding your mining operation for
the intended life of the mine. All responses must be clearly conveyed on a corresponding, detailed mine map.
A. GENERAL CHARACTERISTICS OF THE MINE
1. Answer all of the following that apply:
® If this is an application for a NEW permit, indicate the total acreage at the site to be covered by the
permit (this is the acreage that the "new permit" fee will be based upon): 5.38
Of this acreage, how much is owned and how much is leased? Acres owned: 5.38
Acres leased: 0 Property owner if leased: N/A
❑ If this is an application for a MODIFICATION to a mining permit, indicate the mining permit
number and the total (overall) acreage covered by the existing permit.
Mining Permit No.: Total permitted acreage:
Does the modification involve acreage within the previously approved permitted boundary?
Yes ❑ No ❑. If yes, indicate the acreage to be covered by this modification (this is the acreage
that the "major modification" fee will be based upon):
Does the modification involve acreage outside the previously approved permitted boundary?
Yes ❑ No ❑. If yes, indicate the additional acreage to be covered by this
modification: . (NOTE: you must complete all of Section F. of this application form
entitled Notification of Adjoining Landowners).
Of this acreage to be added to the permit, will any portion of this acreage be affected (i.e.: disturbed,
ground cover removed) by the mining operation? Yes ❑ No ❑ (If no, a "minor modification"
fee of $100.00 is required, despite the "undisturbed" acreage to be added). If yes, indicate the
acreage to be affected within the acreage to be added to the permit (the total acreage to be added to
the permit is the acreage that the "major modification" fee will be based upon):
❑ If this is an application for TRANSFER of a mining permit, indicate the mining permit number and
the total (overall) acreage covered by the existing permit.
Mining Permit No.: Total permitted acreage:
SEE THE FEE SCHEDULE AT THE END OF THIS FORM FOR THE PROPER FEE AMOUNT TO BE
PAID FOR THE REQUESTED PERMIT ACTIONS) AND CORRESPONDING ACREAGE NOTED
ABOVE
2. Name of all materials mined
3. Mining method:
Hydraulic. Dredge
Dragline & Truck
Other (explain):
Sand
H
Front-end Loader & Truck ❑ Shovel & Truck
Self -loading Scraper
4. a. Expected maximum depth of mine (feet) 6 Feet
Depth is relative to what benchmark? (e.g., natural ground level, mean sea level, road elevation, etc.)
Normal Water Level
b. Expected average depth of mine (feet) 6 Feet
5. Has any area(s) at this site been mined in the past? Yes ❑
If yes, when and by whom was this activity conducted?
MIN

APPLICATION FOR A MINING PERMIT
6. Number of years for which the permit is requested (Life of the Mining Operation or Life of Lease from
Public Entity): Life of Mining Operation
B. MAPS
Clearly mark and label the location of your mining operation on six (6) copies of a 7.5-minute quadrangle
and a county highway map. These maps, in addition to six (6) copies of all mine maps and reclamation
maps, must be submitted with each permit application.
7.5-minute quadrangles may be obtained from the N.C. Geological Survey:
Mailing Address: Physical Address:
1612 Mail Service Center OR 512 North Salisbury Street, 5t' Floor
Raleigh, North Carolina 27699-1612 Raleigh, North Carolina 27604
[phone]
http://portal.ncdenr.orp,/web/Ir/p,eoloszical home
County highway maps may be obtained from the N.C. Department of Transportation:
North Carolina Department of Transportation - Geographic Information Systems (GIS)
Mailing Address: Physical Address:
NCDOT GIS Unit NCDOT GIS Unit
1587 Mail Service Center 3401 Carl Sandburg Court
Raleigh, North Carolina 27699-1587 Raleigh, North Carolina 27610
[phone]
http://www.ncdot.org/it/gis/
Mine maps must be accurate and appropriately scaled drawings, aerial photographs or enlarged
topographic maps of the entire mine site. All aspects of the mine site must be clearly labeled on the
maps along with their corresponding (approximate) acreage. Thus, all mine and reclamation maps
must denote those activities that are intended to be conducted during the life of the mining permit.
All maps must be of a scale sufficient (see minimum requirements listed below) to clearly illustrate the
following, at a minimum:
a. Property lines of the tract or tracts of land on which the proposed mining activity is to be located
including easements and rights -of -way.
b. Existing or proposed permit boundaries.
c. Initial and ultimate limits of clearing and grading.
d. Outline and width of all buffer zones (both undisturbed and unexcavated).
e. Outline and acreage of all pits/excavations.
f. Outline and acreage of all stockpile areas.
g. Outline and acreage of all temporary and/or permanent overburden disposal areas.
h. Location and acreage of all processing plants (processing plants may be described as to location and
distance from mine if sufficiently far removed).
i. Locations and names of all streams, rivers and lakes.
j. Outline and acreage of all settling and/or processing wastewater ponds.
k. Location and acreage of all planned and existing access roads and on -site haul roads.
1. Location of planned and existing on -site buildings.
in. Location and dimensions of all proposed sediment and erosion control measures.
n. Location of 100-year floodplain limits and wetland boundaries.
o. Names of owners of record, both public and private, of all tracts of land that are adjoining the mining
permit boundary; if an adjoining tract is owned or leased by the applicant or is owned by the lessor of
the mine tract, names of owners of record of tracts adjoining these tracts, that are within 1,000 feet of
the mining permit boundary, must be provided on the mine map.
-5-

APPLICATION FOR A MINING PERMIT
p. Names of owners of record, both public and private, of all tracts of land that are adjoining the mining
permit boundary which lie directly across and are contiguous to any highway, creek, stream, river, or
other watercourse, railroad track, or utility or other public right-of-way. If an adjoining tract is owned
or leased by the applicant or is owned by the lessor of the mine tract, names of owners of record of
tracts adjoining these tracts, that are within 1,000 feet of the mining permit boundary, must be
provided on the mine map(s). NOTE: "Highway" means a road that has four lanes of travel or less
and is not designated as an Interstate Highway.
q. Map legend:
1. Name of applicant
2. Name of mine
3. North arrow
4. County
5. Scale
6. Symbols used and corresponding names
7. Date prepared and revised
8. Name and title of person preparing map
Map scales should meet the following guidelines:
PERMITTED ACREAGE
MAP SCALE
0-49 Acres
1 inch = 50 feet
50-199 Acres
1 inch= 100 feet
200+ Acres
1 inch = 200 feet
(NOTE: Smaller scaled maps may be acceptable if they clearly
illustrate the above items)

APPLICATION FOR A MINING PERMIT
A table/chart must be provided on the mine map that clearly lists the approximate acreage of tailings/sediment
ponds, stockpiles, wastepiles, processing area/haul roads, mine excavation and any other major aspect of the
mining operation that is proposed to be affected/disturbed during the life of the mining permit. A table/chart
similar to the following will be acceptable:
CATEGORY
AFFECTED ACREAGE
Tailings/Sediment Ponds
0
Stockpiles
1.96
Wastepiles
0
Processing Area/Haul Roads
0.52
Mine Excavation
2.90
Other (Explain)
0
["Total Disturbed Acreage
5.38
NOTE:
IN ADDITION TO THE ABOVE, THE MAPS MUST ALSO INCLUDE ANY SITE -SPECIFIC
INFORMATION THAT IS PROVIDED IN THE ANSWERS TO THE FOLLOWING QUESTIONS IN
THIS APPLICATION FORM (PLEASE NOTE THE ITALICIZED QUESTIONS/STATEMENTS
THROUGHOUT THE FORM). THIS APPLICATION WILL NOT BE CONSIDERED COMPLETE
WITHOUT ALL RELEVANT ITEMS BEING ADEQUATELY ADDRESSED ON THE MINE MAPS.
-7-

APPLICATION FOR A MINING PERMIT
C. PROTECTION OF NATURAL RESOURCES
Describe in detail the sequence of events for the development and operation of the mine and reference the
sequence to the mine map(s). Attach additional sheets as needed.
The diversion and stone filter outlet sections will first be constructed. The construction of the berms
generally will not require cleaning since these structures are primarily constructed on farmland.
Some trees will need to be removed and stumped. Along the riverbank, trees will need to be cut but
they will not be stumped. Excavation will then proceed in the river channel.
Describe specific erosion control measures to be installed prior to land disturbing activities and during
mining to prevent offsite sedimentation (include specific plans for sediment and erosion control for mine
excavation(s), waste piles, access/mine roads and process areas), and give a detailed sequence of
installation and schedule for maintenance of the measures. Locate and label all sediment and erosion
control measures on the mine map(s) and provide typical cross-sections/construction details of each
measure. Engineering designs and calculations are required to justify the adequacy of any proposed
measures.
Erosion Control will be provided by the installation of perimeter berms along the stockpile areas and
where the dragline will be located. Outlet for the perimeter berms will be stone filter sections.
3. a. Will the operation involve washing the material mined, recycling process water, or other waste water
handling? Yes ❑ No M. If yes, briefly describe all such processes including any chemicals to be used.
b. Will the operation involve discharging fresh or waste water from the mine or plant as a point discharge to
the waters of the State? Yes ❑ No ®. If yes, briefly describe the nature of the discharge and locate
all proposed discharge points (along with their method of stabilization) on your mine map(s).
The Riverbank slopes away from the channel. The filter sections will discharge away from the
channel on the farm field. The discharge water could possibly discharge to the river downstream of
the mine with the runoff from the farm field.

APPLICATION FOR A MINING PERMIT
Will any part of the proposed mine excavation(s) extend below the water table? Yes ❑ No ®.
If yes, do you intend to dewater the excavation(s)? Yes ❑ No ❑.
If yes, what impact, if any, will mine dewatering have on neighboring wells? Estimated withdrawal rate
in gallons per day: . Locate all existing wells on the mine map(s) that lie within
500 feet of the proposed excavation area. Provide data to support any conclusions or statements made,
including any monitoring well data, well construction data and current water withdrawal rates. Indicate
whether the proposed mine locale is served by a public water system or private wells.
d. If you answered yes to any of the above questions, provide evidence that you have applied for or
obtained the appropriate water quality permit(s) (i.e., non -discharge, NPDES, Stormwater, etc.) from the
Stormwater Program. In addition, the applicant is required to register water use with the Division of
Water Resources, Ground Water Management Branch, if the operation withdraws more than 10,000
gallons per day and needs a capacity use permit from the Division of Water Resources, Ground Water
Management Branch, if the operation lies in a capacity use area and withdraws more than 100,000
gallons per day.
The facility will have a Storm water Discharge permit.
4. a. Will the operation involve crushing or any other air contaminant emissions? Yes ❑ No ®.
If yes, indicate evidence that you have applied for or obtained an air quality permit issued by the
Division of Air Quality or local governing body.
b. How will dust from stockpiles, haul roads, etc., be controlled?
The stockpile will consist of wet sand with little potential for loss by wind erosion. The proposed
farm Road will be wetted as needed to control dust.

APPLICATION FOR A MINING PERMIT
a. A buffer will be required between any mining activity and any mining permit boundary or right-of-
way. It may be an unexcavated buffer (no excavation, but roadways, berms and erosion &
sedimentation control measures may be installed within it), an undisturbed buffer (no disturbance
within the buffer whatsoever), or a combination of the two, depending upon the site conditions. Note
that all buffers must be located within the mining permit boundaries.
How wide a buffer will be maintained between any mining activity and any mining permit boundary
or right-of-way at this site? A minimum buffer of 25 feet is recommended, although a wider buffer
may be needed depending on site conditions. Show all buffer locations and widths on the mine
map(s).
A 25-Feet unexcavated buffer with berms and filter sections installed in this buffer will be
provided. Mining is on'/2 of Mclin Creek.
b. A minimum 50 foot wide undisturbed buffer will be required between any land disturbing activities
within the mining permit boundaries and any natural watercourses and wetlands unless smaller
undisturbed buffers can be justified. Depending on site conditions, a buffer wider than 50 feet may
be needed.
How wide an undisturbed buffer will be maintained between any land disturbing activities within the
mining permit boundaries and any natural watercourses and wetlands at this site? Show all buffer
locations and widths on the mine map(s).
No Wetland areas are within the Mine Permit Limits. The excavation for sand is in McLin
Creek.
6. a. Describe methods to prevent landslide or slope instability adjacent to adjoining permit boundaries
during mining. Minimum 2 horizontal to 1 vertical slopes or flatter for clayey material and
minimum 3 horizontal to 1 vertical slopes or flatter for sandy material are generally required, unless
technical justification can be provided to allow steeper slopes.
Mining will occur only in the Mid- Section of the Creek so the integrity of the opposite bank
will not be jeopardized. Furthermore, mining will not undermine the creek bank within the
proposed permit boundaries and provisions are provided to stabilize the creek bank should
instability occur.
MKIZ

APPLICATION FOR A MINING PERMIT
b. Provide a cross-section on the mine map(s) for all fill slopes (berms, wastepiles, overburden
disposal areas, etc.), clearly indicating the intended side slope gradient, installation ofany benches
and/or slope drains (with supporting design information) if needed, and the method of final
stabilization.
The operation does not have any waste piles or overburden disposal areas. The berm at the
top of the creek bank will be approximately 3-4 feet high with 2:1 side slopes. See the Mine
map for cross sectional detail.
c. In excavation(s) of unconsolidated (non -rock) materials, specify the angle of all cut slopes including
specifications for benching and sloping. Cross -sections for all cut slopes must be provided on the
mine map(s).
Mining occurs in the creek bed to a depth of approximately 6 feet. Benching and sloping will
not be required.
d. In hardrock excavations, specify proposed bench widths and heights in feet. Provide cross -sections
of the mine excavation clearly noting the angles of the cut slopes, widths of all safety benches and
mine benches, and the expected maximum depth of the excavation.
N/A
7. Describe other methods to be taken during mining to prevent physical hazard to any neighboring dwelling
house, public road, public, commercial or industrial building from any mine excavation. Locate all such
structures on the mine map if they are within 300 feet of any proposed excavation.
No Structure are within 300-feet of the mine.
8. Describe what kind of barricade will be used to prevent inadvertent public access along any high wall area
and when it will be implemented. Vegetated earthen berms, appropriate fencing and adequate boulder
barriers may be acceptable high wall barricades. A construction detail/cross-section and location of each
type of barricade to be used must be indicated on the mine map(s).
High walls will not be created by this operation. The locked gate will be provided to prevent any
access.
-11-

APPLICATION FOR A MINING PERMIT
9. Are acid producing minerals or soils present? Yes ❑ No E.
If yes, how will acid water pollution from the excavation, stockpiles and waste areas be controlled?
10. a. Describe specific plans (including a schedule of implementation) for screening the operation from
public view such as maintaining or planting trees, bushes or other vegetation, building berms or other
measures. Show the location of all visual screening on the mine map(s) and provide cross -sections
through all proposed berms or proposed spacing, sizes and species for tree plantings.
The site is far back from the state Road and is surrounded by Agricultural Land. Therefore,
no screening is needed.
b. Could the operation have a significantly adverse effect on the purposes of a publicly owned park,
forest or recreation area? If so, how will such effects (i.e., noise, visibility, etc.) be mitigated?
Im
11. Will explosives be used? Yes ❑ No M.
If yes, specify the types of explosive(s) and describe what precaution(s) will be used to prevent physical
hazard to persons or neighboring property from flying rocks or excessive air blasts or ground vibrations.
Depending on the mine's location to nearby structures, more detailed technical information may be
required on the blasting program (such as a third -party blasting study). Locate the nearest offsite occupied
structure(s) to the proposed excavation(s) on the mine map and indicate its approximate distance to the
proposed excavation.
12. Will fuel tanks, solvents, or other chemical reagents be stored on -site? Yes ❑ No M.
Ifyes, describe these materials, how they will be stored and method of containment in case ofspill. Indicate
the location(s) of all storage facilities on the mine map(s).
No Solvent will be stored on the site. A portable petroleum tank on a truck will be used to fill
excavation equipment.
-12-

APPLICATION FOR A MINING PERMIT
D. RECLAMATION PLAN
Describe your intended plan for the final reclamation and subsequent use of all affected lands and indicate
the sequence and general methods to be used in reclaiming this land. This must include the method of
reclamation of settling ponds and/or sediment control basins and the method of restoration or establishment
of any permanent drainage channels to a condition minimizing erosion, siltation and other pollution. This
information must be illustrated on a reclamation map and must correspond directly with the information
provided on the mine map(s). In addition, design information, including typical cross -sections, of any
permanent channels to be constructed as part of the reclamation plan and the location(s) of allpermanent
channels must be indicated on the reclamation map.
The stockpile area will be graded for positive drainage and vegetated. This area will be used for
Agricultural purposes after mining has ceased.
Any areas along the bank within the permitted boundaries experiencing accelerated erosion due to
the mining activity will be stabilized.
2. Is an excavated or impounded body of water to be left as a part of the reclamation? Yes ❑ No M.
If yes, illustrate the location of the body(s) of water on the reclamation map and provide a scaled
cross-section(s) through the proposed body(s) of water. The minimum water depth must be at least 4 feet,
measured from the normal low water table elevation, unless information is provided to indicate that a more
shallow- water body will be productive and beneficial at this site.
Will the body(s) of water be stocked with fish? Yes ❑ No ❑
If yes, specify species.
N/A
3. Describe provisions for safety to persons and to adjoining property in all completed excavations in rock
including what kind of permanent barricade will be left. Acceptable permanent barricades are appropriate
fencing, large boulders placed end -to -end, etc. Construction details and locations of all permanent
barricades must be shown on the reclamation map.
N/A
-13-

APPLICATION FOR A MINING PERMIT
4. Indicate the method(s) of reclamation of overburden, refuse, spoil banks or other such on -site mine waste
areas, including specifications for benching and sloping. Final cross -sections and locations for such
areas must be provided on the reclamation map.
No such areas exist or anticipated within the mining permit boundaries. Stockpiles will be depleted,
then the surrounding disturbed areas graded and vegetated. The ground will be sloped away from the
riverbank as per pre-existing conditions.
5. a. Describe reclamation of processing facilities, stockpile areas, and on -site roadways.
Stockpiles will be depleted, then the surrounding disturbed areas graded and vegetated.
The collection perimeter berms will be removed by spreading the soils composing the berms on the
ground. The stone filter outlet sections will be spread evenly on the ground.
b. Will any on -site roadways be left as part of the reclamation? Yes ® No ❑.
If yes, identify such roadways.on the reclamation map and provide details on permanent road and ditch
line stabilization.
The proposed haul road will be left. The road is flush with the natural ground elevation with no
ditches along the road.
6. Describe the method of control of contaminants and disposal of scrap metal, junk machinery, cables, or
other such waste products of miring. (Note definition of refuse in The Mining Act of 1971.)
No off -site generated waste shall be disposed of on the mine site without prior written approval
from the NC Department of Environmental Quality, Division of Energy, Mineral, and Land
Resources and either the Division of Waste Management (DWM) or local governing body. If a
disposal permit has been issued by DWM for the site, a copy of said permit must be attached to
this application. All temporary and permanent refuse disposal areas must be clearly delineated on the
mine map(s) and reclamation map, along with a list of items to be disposed in said areas.
All Waste products will be hauled off -site and properly disposed.
-14-

APPLICATION FOR A MINING PERMIT
7. Describe your plan for revegetation or other surface treatment of the affected areas. This plan must
include recommendations for year-round seeding, including the time of seeding and the amount and type
of seed, fertilizer, lime and mulch per acre. The recommendations must include general seeding
instructions for both permanent and temporary revegetation. Revegetation utilizing only tree plantings is
not acceptable. Recommendations can be sought from:
a. Authorized representatives of the local Soil and Water Conservation District;
b. Authorized representatives of the NC Forest Service, Department of Agriculture and Consumer
Services;
c. Authorized county representatives of the North Carolina Cooperative Extension Service, specialists
and research faculty with the Colleges of Agriculture and Life Sciences and Forest Resources at
North Carolina State University;
d. North Carolina licensed landscape architects;
e. Private consulting foresters referred by the NC Forest Service, Department of Agriculture and
Consumer Services;
f. N.C. Erosion and Sedimentation Control Planning and Design Manual;
g. N.C. Surface Mining Manual: A Guide for Permitting, Operation and Reclamation;
h. Others as may be approved by the Department.
LIME - RATE OF APPLICATION (tons/acre):
FERTILIZER - ANALYSIS AND RATE OF APPLICATION (pounds/acre):
SEED - TYPE(S) AND RATE(S) OF APPLICATION INCLUDING YEAR-ROUND SEEDING
SCHEDULE (pounds/acre): [NOTE: Include Legumes]
Seed Types: Seeding Dates: Seeding Rates:
Revegetation will be per the Erosion and Sediment Control Planning and Design Manual. (See
Attached).
MULCH - TYPE AND RATE OF APPLICATION (pounds/acre) AND METHOD OF ANCHORING:
OTHER VEGETATIVE COVERS - TYPE (S) AND RATE (S) OF APPLICATION INCLUDING
SEEDING SCHEDULE (pounds/acre, trees/acre, spacing of trees/shrubs, etc):
Revegetation and/or reforestation plan approved by:
Signature NC Surface Mining Manual Date
Print Name
Title
Agency
-15-

APPLICATION FOR A MINING PERMIT
Vegetation Plan
1. Spread topsoil over disturbed areas and leave surface reasonably smooth and uniform.
2. Scarify surface to prepare a seedbed four to six inches deep. Use such equipment as tilling,
discing, tracing, or the teeth on a front end loader.
3. Mix lime and fertilizer with the soil during seedbed preparation.
4. Seed on freshly prepared seedbed following the application rates, for the appropriate season.
5. Mulch all seeded areas immediately.
6. Tack mulch on slopes 3:1 (Horizontal: Vertical) or steeper by spraying with emulsified asphalt.
Use an anchoring tool such as a farming disc set in a vertical position on slopes less than 3:1.
Mulch netting may also be used on slopes.
7. Inspect seeded areas and make repairs within the planting season. If vegetation is over 60 %
damaged, repeat steps 2 through 5.
8. Permanent revegetation shall be accomplished at the spefied times of the year. Temporary
vegetation shall be applied outside of the optimal times for establishment of permanent
vegetation.
9. Seeding Schedule.
Temporary Seeding Schedule
Seeding Date: February 15 to May 15
August 15 to December 15
Seed Type
Rate
Rye (Grain)
1201bs./Acre
10-10-10 Fertilizer
1,000 lbs./Acre
Lime
20001bs./Acre
Mulch
4,000 lbs./Acre
SEEDING DATE: May 15 to August 15
Seed Type
Rate
German Millet
40 lbs./Acre
10-10-10 Fertilizer
7501bs./Acre
Lime
2000 lbs./Acre
Mulch
4,000 lbs./Acre
-16-

APPLICATION FOR A MINING PERMIT
Seeding Date: February 1 to April 15
August 20 to October 25
Tall Fescue
Sericea Lespedeza
Kobe Lespedeza
10-10-10 Fertilizer
Lime
Mulch
100 lbs./Acre
20 lbs./Acre
10 lbs./Acre
1,000 lbs./Acre
4000 lbs./Acre
4,000 lbs./Acre
Note 1: Fertilizer and Lime application rates may deviate from above if soils are analyzed for
optimum rates.
Note 2: Use unscarified Sericea seed after August 15. After August 15 add 10 lbs./Acre of German
Millet or 15 lbs./Acre of Sudan Grass. Prior to May 1 or after August 15, add 40 lbs./Acre
Rye (Grain).
Revegetation Plan Approved by:
Signature: ------------------------------------ Date -----------------
Note: Permanent and Temporary revegetation plan based on
guidelines in Erosion and Sediment Control Planning and
Design Manual.

APPLICATION FOR A MINING PERMIT
E. DETERMINATION OF AFFECTED ACREAGE AND BOND
The following bond calculation worksheet is to be used to establish an appropriate bond (based upon a range
of $500 to $5, 000 per affected acre) for each permitted mine site based upon the acreage approved by the
Department to be affected during the life of the mining permit. Please insert the approximate acreage, for each
aspect ofthe mining operation, that you intend to affect durinz the life ofthis minin-apermit (in addition. please
insert the appropriate reclamation cost/acre for each category from the Schedule of Reclamation Costs
provided with this application form) OR you can defer to the Department to calculate vour hond for you haled
AFFECTED
RECLAMATION
RECLAMATION
CATEGORY
ACREAGE
COST/ACRE*
COST
Tailings/Sediment Ponds:
0.0
Ac.
X
$
/Ac.
_ $
Stockpiles:
1.96
Ac.
X
$ 1,800.00
/Ac.
_ $ 3,528.00
Wastepiles:
0.0
Ac.
X
$
/Ac.
_ $
Processing Area/Haul Roads:
0.52
Ac.
X
$ 1,800
/Ac.
_ $ 936.00
Mine Excavation:
2.90
Ac.
X
$ 2000.00
/Ac.
_ $ 5,800.00
Other:
Ac.
X
$
/Ac.
_ $
TOTAL AFFECTED AC.:
5.38 Ac.
(TOTAL PERMITTED AC.: 5.38 Ac.)
Temporary & Permanent Sedimentation & Erosion Control Measures:
Divide the TOTAL AFFECTED AC. above into the following two categories: a) affected acres that drain into
proposed/existing excavation and/or b) affected acres that will be graded for positive drainage where measures will
be needed to prevent offsite sedimentation and sedimentation to onsite watercourses and wetlands.
a) Internal Drainage 2.90 Ac.
b) Positive Drainage 2.48 Ac. X $1,500.00 = $ 3,720.00
SUBTOTAL COST: $ 13,984.00
Inflation Factor:
0.02 X SUBTOTAL COST: $ 13,984.00 X Permit Life Provided by Applicant (Life of the Mining Operation or
Life of Lease from Public Entity (in Years)): For Life
INFLATION COST: $ 2,796.00
Total Cost = Subtotal Cost + INFLATION COST: $ 16,780.00
Total Reclamation Bond Cost: $__ 16,800.00
(round down to the nearest $100.00)
(NOTE: The reclamation bond cannot exceed $1 million per GS 74-54)

APPLICATION FOR A MINING PERMIT
F. NOTIFICATION OF ADJOINING LANDOWNERS
The "Notice" form, or a facsimile thereof, attached to this application must be sent certified or registered mail,
return receipt requested, to:
(1) . the chief administrative officer of each county and municipality in which any part of the permitted
area is located as indicated on the mine map(s);
(2) all owners of record, both public and private, of all tracts of land that are adjoining the mining
permit boundary; if an adjoining tract is owned or leased by the applicant or is owned by the lessor
of the mine tract, all owners of record of tracts adjoining these tracts must be notified (that are
within 1,000 feet of the mining permit boundary) as indicated on the mine map(s); and
(3) all owners of record, both public and private, of all tracts of land that are adjoining the mining
permit boundary which lie directly across and are contiguous to any highway, creek, stream, river,
or other watercourse, railroad track, or utility or other public right-of-way. If an adjoining tract is
owned or leased by the applicant or is owned by the lessor of the mine tract, all owners of record of
tracts adjoining these tracts must be notified (that are within 1,000 feet of the mining permit
boundary) as indicated on the mine map(s). "Highway" means a road that has four lanes of travel
or less and is not designated as an Interstate Highway.
The only exception to the above method of giving notice is if another means of notice is approved in advance by
the Director, Division of Energy, Mineral, and Land Resources.
A copy of a tax map (or other alternative acceptable to the Department) must be mailed with the completed
"Notice" form (the proposed overall permit boundaries and the names and locations of all owners of
record of lands adjoining said boundaries must be clearly denoted on the tax map).
The "Affidavit of Notification" attached to this application must be completed, notarized and submitted to the
Department, with the remainder of the completed application form, before the application will be considered
complete.
N TE
THIS SECTION MUST BE COMPLETED FOR ALL APPLICATIONS FOR NEW MINING PERMITS
AND ALL MODIFICATIONS OF A MINING PERMIT TO ADD LAND TO THE PERMITTED AREA, AS
REQUIRED BY NCGS 74-50(bl).
SEE THE NEXT TWO PAGES FOR THE "NOTICE" FORM AND THE "AFFIDAVIT OF
NOTIFICATION"
-19-

NOTICE
Pursuant to provisions G.S. 74-50(bl) of The Mining Act of 1971, Notice is hereby given that
Gary and Virginia Dellinger has applied on 4429 Old Catawba Road, (SR 1722), Claremont, 28610
(Applicant Name)
to the Division of Energy, Mineral, and Land Resources, North Carolina Department of Environmental Quality,
1612 Mail Service Center, Raleigh, North Carolina 27699-1612, for (check one):
® a new surface mining permit,
❑ a modification of an existing surface mining permit to add land to the permitted area; or
❑ a modification of an existing surface mining permit to add land to the permitted area with no disturbance
in the area proposed. Please note that future modification(s) may be submitted by the applicant to
allow disturbance within this area without re -notification of adjoining landowners.
The applicant proposes to mine Sand on 5.38 acres located on 4429 Old Catawba Road
(Mineral, Ore) (Number)
*SEE ATTACHED MAP FOR PROPOSED PERMIT BOUNDARIES AND CORRESPONDING
ADJOINING LANDOWNER NAMES AND LOCATIONS*
In accordance with G.S. 74-50(bl), the mine operator is required to make a reasonable effort, satisfactory to the
Department, to notify all owners of record, both public and private, of all tracts of land that are adjoining the mining
permit boundary; if an adjoining tract is owned or leased by the applicant or is owned by the lessor of the mine tract,
all owners of record of tracts adjoining these tracts must be notified (that are within 1,000 feet of the mining permit
boundary). In addition, the mine operator must also notify the chief administrative officer of the county or
municipality in which any part of the permitted area is located. Any person may file written comment(s) to the
Department at the above address within thirty (30) days of the issuance of this Notice or the filing of the application
for a permit, whichever is later. Should the Department determine that a significant public interest exists relative to
G.S. 74-51, a public hearing will be held within 60 days of the end of the 30-day comment period specified above.
A copy of the permit application materials is on file and available for public review during normal business
hours at the above listed address as well as at the appropriate regional office. For information regarding
-4079 . For information on the mining permit application review process, please contact
ing Program staff at [phone]. Please note that the Department will consider M relevant written
its/documentation within the provisions of the Mining Act of 1971 throughout the application review
until a final decision is made on the application.
Mr. Gary Dellinger, 965 Hopewell Church Road, Catawba, NC 28609
(Addressee/Owner of Record's (Name and Address)
Samar Bou-Ghazale, Environmental Compliance and Permits, 6076 Diamond Place, Harrisburg, NC 28075
Name of Applicant: Include Contact Person & Company Name, if Applicable)
December 30, 2020 965 Hopewell Church Road, Catawba, NC 28609_
(Date of Issuance of this Notice/ (Address of Applicant)
Mailed to Addressee/Owner of Record)
-20-

APPLICATION FOR A MINING PERMIT
AFFIDAVIT OF NOTIFICATION
I, Gary Dellinger , an applicant, or an agent, or employee of an
applicant, for a new Mining Permit, or a modification of an existing Mining Permit to add land to the permitted area,
from the N.C. Department of Environmental Quality, being first duly sworn, do hereby attest that the following are
all known owners of record, both public and private, of all tracts of land that are adjoining the mining permit
boundary (including, where an adjoining tract is owned or leased by the applicant or is owned by the lessor of the
mine tract, all owners of record of tracts adjoining these tracts, that are within 1,000 feet of the mining permit
boundary) and that notice of the pending application has been caused to be mailed, by certified or registered mail,
return receipt requested, to said owners of record at their addresses shown below, such notice being given on a form
provided by the Department:
(Adjoining Landowner Name) (Address)
Ronald & Traci Blasco 7836 Highway 73, Ste., A Stanley, NC 28164
Charles & Joann Taylor 1426 Falcon Drive, Newton, NC 28658
Bruce & Brenda Rhyne 2052 Pinetop Ridge Road, Catawba, NC 28609
(Attach additional list if necessary)
I do also attest that the following individual is the chief administrative officer of the county or municipality in which
any part of the permitted area is located and that notice of the pending application has been caused to be mailed, by
certified or registered mail, return receipt requested, to said office at the following address:
(Chief Administrative Officer Name)
[i.e.: City Manager, County Manager, Mayor, etc.]
Shawn R. Brown, Mayor of Claremont
(Address)
3288 East Main Street, Claremont, NC 28610
The above attestation was made by me while under oath to provide proof satisfactory to the Department that a
reasonable effort has been made to notify all known owners of record, both public and private, of all tracts of land
that are adjoining the mining permit boundary (including, where an adjoining tract is owned or leased by the
applicant or is owned by the lessor of the mine tract, all owners of record of tracts adjoining these tracts, that are
within 1,000 feet of the mining permit boundary) and the chief administrative officer of the county or municipality in
which any part of the permitted area is located in compliance with N.C.G.S. 74-50(b1) and 15A NCAC 5B .0004(d).
I understand that it is the responsibility of the applicant to retain the receipts of mailing showing that the above
notices were caused to be mailed and to provide them to the Department upon request.
Signature of Applicant or Agent
Date
If person executing Affidavit is an agent or employee of an applicant, provide the following information:
Name of applicant: Gary Dellinger
Title of person executing Affidavit Managing Partner
I,
a Notary Public of the County of
State of North Carolina, do hereby certify that
appeared before me this day and under oath acknowledged that the above Affidavit was made by him/her.
Witness my hand and notarial seal, this
Notary:
day of 20
my Commission expires:
-21-

APPLICATION FOR A MINING PERMIT
G. LAND ENTRY AGREEMENT
We hereby grant to the Department or its appointed representatives the right of entry and travel upon our lands
or operation during regular business hours for the purpose of making necessary field inspections or investigations as
may be reasonably required in the administration of the Mining Act of 1971 pursuant to G.S. 74-56.
We further grant to the Department or its appointed representatives the right to make whatever entries on the
land as may be reasonably necessary and to take whatever actions as may be reasonably necessary in order to carry
out reclamation which the operator has failed to complete in the event a bond forfeiture is ordered pursuant to G.S.
74-59.
LANDOWNER:
Signature:
Print Name: Gary Dellinger
(Title, if applicable)
Company Sand Pit LLC
(If applicable)
Address: 965 Hopewell Church Road
Catawba, NC 28609
Telephone: [phone]
Date Signed:
APPLICANT:
Signature:*
Print Name: Gary Dellinger
Title:
President
Company: Sand Pit, LLC
Mine Name: Sand Pit (Gary and Virginia Dellinger
Telephone: [phone]
Date Signed:
*Signature must be the same as the individual who signed Page 1 of this application.
One original and five (5) copies of the completed application, six (6) conies of all location mans, mine mans
and reclamation maps, and the appropriate processing fee (see next page for fee schedule) in the form a check
or money order payable to the North Carolina Department of Environmental Quality must be sent to the
Raleigh Central Office at the address listed on the front cover of this application form.
Inquiries regarding the status of the review of this application should be directed to the Mining Program staff at
[phone].
-22-

APPLICATION FOR A MINING PERMIT
MINING FEE SCHEDULE
A nonrefundable permit application processing fee when filing for a new mining permit, permit modification or transferred permit is
required as follows:
0-25 acres
26+acres
New Permit Applications
$3,750.00
$51000.00
Permit Modifications
$750.00
$11,000.00
Permit Transfers
$100.00
$100.00
Annual Operating Fee
$400.00
$400.00
Acres for new permits means the total acreage at the site. Acres for modification of permits means that area of land affected by the modification within the permitted mine
area, or any additional land that is to be disturbed and added to an existing permitted area, or both.
- 23 -

APPLICATION FOR A MINING PERMIT
There are seven Division of Energy, Mineral, and Land Resources (DEMLR) Regional Offices. Use the map below to
locate the Regional Office serving your county.
Asheville Regional Office
• Counties: Avery, Buncombe, Burke, Caldwell, Cherokee, Clay, Graham, Haywood, Henderson, Jackson,
Macon, Madison, McDowell, Mitchell, Polk, Rutherford, Swain, Transylvania, Yancey
• Address: 2090 U.S. Highway 70, Swannanoa, NC 28778
• Voice:828.296.4500
• FAX:[phone]
Fayetteville Regional Office
Counties: Anson, Bladen, Cumberland, Harnett, Hoke, Montgomery, Moore, Richmond, Robeson, Sampson,
Scotland
• Address: 225 Green Street, (Systel Building), Suite 714, Fayetteville, NC 28301-5094
• Voice:910.433.3300
• FAX:[phone]
Mooresville Regional Office
• Counties: Alexander, Cabarrus, Catawba, Cleveland, Gaston, Iredell, Lincoln, Mecklenburg, Rowan, Stanly,
Union
• Address: 610 East Center Ave., Suite 301, Mooresville, NC 28115
• Voice:704.663.1699
• FAX:[phone]
Raleigh Regional Office
• Counties: Chatham, Durham, Edgecombe, Franklin, Granville, Halifax, Johnston, Lee, Nash, Northampton,
Orange, Person, Vance, Wake, Warren, Wilson
• Address: 1628 Mail Service Center, Raleigh, NC 27699-1628 or 3800 Barrett Drive, Raleigh, NC 27609
• Voice:919.791.4200
• FAX:[phone]
Washington Regional Office
Counties: Beaufort, Bertie, Camden, Chowan, Craven, Currituck, Dare, Gates, Greene, Hertford, Hyde, Jones,
Lenoir, Martin, Pamlico, Pasquotank, Perquimans, Pitt, Tyrrell, Washington, Wayne
• Address: 943 Washington Square Mall, Washington, NC 27889
• Voice:252.946.6481
• FAX:[phone]
- 24 -

APPLICATION FOR A MINING PERMIT
LAND QUALITY REGIONAL OFFICES (continued)
Wilmington Regional Office
• Counties: Brunswick, Carteret, Columbus, Duplin, New Hanover, Onslow, Pender
• Address: 127 Cardinal Drive Extension, Wilmington, NC 28405
• Voice:910.796.7215
• FAX:[phone]
Winston-Salem Regional Office
• Counties: Alamance, Alleghany, Ashe, Caswell, Davidson, Davie, Forsyth, Guilford, Rockingham. Randolph,
Stokes, Surry, Watauga, Wilkes, Yadkin
• Address: 1450 Hanes Mill Road, Suite 300, Winston-Salem, NC 27103
• Voice:336.776.9800
• FAX:[phone]
-25-

APPLICATION FOR A MINING PERMIT
SCHEDULE OF RECLAMATION COSTS
(Based upon range of $500 - $5,000 per affected acre)
COMMODITY CODES: SG = Sand and/or Gravel, GS = Gemstone, Borrow = Borrow/fill dirt, CS = Crushed Stone,
DS = Dimension Stone, FS = Feldspar, MI = Mica, LI = Lithium, PF = Pyrophyllite, OL = Olivine,
KY = Kyanite/Sillimanite/Andalusite, PH = Phosphate, CL = Clay/Shale, PE = Peat, AU = Gold, TI = Titanium, and OT
= Other
Type
T/S Ponds
S.piles
W.piles
P.area/H.R.
Mine Ezcay.
SG, GS,
$500/ac.(L)
$1800/ac.
$2000/ac.
$1800/ac.
$500/ac.(L)
Borrow
1500(FI)
$2000(PD)
CS, DS,
500(L)
1800
2000
2000
500(L)
FS, MI,
1500(FI)
2500(PD)
LI, PF, OL, KY
PH
1000(L)
2500
5000
5000
2000(L)
2500(FI)
5000(PD)
CL
1000(L)
2500
5000
5000
2000(L)
2500(FI)
3700(PD)
PE, AU,
1000(L)
2500
3000
3500
2000(L)
TI, OT
2500(FI)
5000(PD)
(L) = reclamation to a lake and revegetating sideslopes
(FI) = reclamation by filling in and revegetating
(PD) = reclamation by grading for positive drainage & revegetating
AS PER NCAC 15A 5B.0003, IF YOU DISAGREE WITH THE BOND AMOUNT DETERMINED BY THE
BOND CALCULATION WORKSHEET, YOU MAY SUBMIT AN ESTIMATE OF RECLAMATION COSTS
FROM A THIRD PARTY CONTRACTOR. SAID ESTIMATE MUST BE PROVIDED WITHIN 30 DAYS TO
THE FOLLOWING ADDRESS: Mining Program,1612 Mail Service Center, Raleigh, North Carolina 27699-1612
ALL ESTIMATES MUST INCLUDE THE FOLLOWING, AS A MINIMUM:
• FINAL GRADING COSTS PER ACRE
• LIME AND FERTILIZER COSTS PER ACRE
• YEAR-ROUND SEEDING MIXTURE COSTS PER ACRE (FROM APPROVED REVEGETATION
PLAN IN APPLICATION/PERMIT DOCUMENT)
• MULCH AND ANCHORING COSTS PER ACRE
• ANY OTHER RECLAMATION COSTS NECESSARY TO COMPLY WITH THE APPROVED
RECLAMATION PLAN FOR THE SITE IN QUESTION
YOU WILL BE NOTIFIED AS SOON AS POSSIBLE OF THE DIRECTOR'S FINAL BOND DETERMINATION.
-26-

A17RofmEfiTA91
oompiicnce &
neani&
6076 Diamond Place
Harrisburg, NC 28075
ECPLLC49(u,gmail.com
Tel# [phone]
October 30, 2020
Attn: Annette Lucas, Supervisor
Stormwater Permitting Program
Division of Energy, Mineral and Land Resources
1612 Mail Service Center
Raleigh, NC 27699-1612
Hi Annette,
I hope you are doing very well.
O�NR-LqN
�TGRMWATER P RMIT vG
I am enclosing for your attention a completed permit application (including $100.00 permit application
fee) for a sand dipping operation.
Please note that no point source discharge at the sand dipping site and may not require a stormwater
permit. I have been out for a while and I don't know if anything has changed. Also, I have enclosed a
mining permit application (but not signed) just to show you that we did already applied for a mining
permit.
Please let me know if you need any additional information.
Take Care!!
S/ a�u-Ghazale
/2zs��w
Environmental Compliance & Permits, LLC • 704-307-0660 • www.ecpllc.us
6076 Diamond Place, Suite E. Harrisburg, NC 28075