NCG520072_Regional Office Historical File Pre 2018

%.a
y. .
Environmental
Quality
October 3, 2017
Mr. Lee Spangler
3530 Rube Spangler.Rd.
Lawndale, NC 28090
FL
Governors
MICHAEL S. REGAN
secretary
S. JAY ZIMMERMAN
Director
Subject: Compliance Evaluation Inspection
Lawndale Sand LLC.
Certificate of Coverage No. NCG520072
Cleveland County
Dear Mr. Spangler:
Enclosed is a copy of the Compliance Evaluation Inspection for the inspection conducted
at the subject facility October 2, 2017, by Ori Tuvia.
Since the last inspection, the facility had greatly improved in conducting and recording
bi-annual sampling.
If you have any questions, please contact Ori Tuvia at [phone], or via email at
[e-mail].
Sincerely,
Ori Tuvia, Environmental Engineer
Mooresville Regional Office
Division of Water Resources, DEQ
Mooresville Regional Office
Location: 610 East Center Ave., Suite 301 Mooresville, NC 28115
Phone: [phone] Fax: [phone] Customer Service:1.877-623-6748
Internet: www.ncwateraualitv.om

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fee Type
1 IN 1 2 15 1 3 I NCG520072 111 12 17/10/02 17 181,.1 19 I c I 20I
21111111 11111111111 1111111 1111111 11111111111 r6
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA . Reserved
67
1.0 701a I 71 itIN I 72 I N I 731 I 174 75
LJ I I I
80
Section B: FacilityDataL-1
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
11:35AM 17/10/02
16/06/24
Power Dam Sand
Exit Time/Date
Permit Expiration Date
3050 Rube Spangler Rd
12:30PM 17/10/02
20/07/31
Lawndale NC 28090
Name(s) of Onsite Representative(s)/ riUes(s)/Phone and Fax Number(s)
Other Facility Data
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Lee Spangler,3050 Rube Spangler Rd Lawndale NC 28090//704-538-9360/
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit Flow Measurement Operations & Maintenance Records/Reports
Self -Monitoring Program Facility Site Review Effluent/Receiving Waters
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Od A Tuvia MRO WQ//704-663-1699/
Signature of Management Q A ev' r Agency/Office/Phone and Fax Numbers Date
Wes Bell t MRO WQ//704-663-1699 Ext.21 �Q
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page#

'41
NPDES yr/mo/day Inspection Type 1
31 NCG520072 I11 121 17/10/02 117 18 ICI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Page# 2

Permit: NCG520072 Owner -Facility: Power Dam Sand
Inspection Date: 10/02/201.7 Inspection Type: Compliance Evaluation
Permit
Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new
❑
❑
M
❑
application?
Is the facility as described in the permit?
MIT
❑
❑
# Are there any special conditions for the permit?
❑
M
❑
❑
Is access'llo the plant site restricted to the general public?
0❑
❑
❑
Is the inspector granted access to all areas for inspection?
0
❑
❑
❑
Comment: The subject permit expires on 7/31/2020.
Record Keeping
Yes No NA NE
Are records kept and maintained as required by the permit?
0
❑
❑
❑
Is all required information readily available, complete and current?
0
❑
❑
❑
Are all records maintained for 3 years (lab. reg. required 5 years)?
0.
❑
❑
❑
Are analytical results consistent with data reported on DMRs?
❑
❑
❑
Is the chain -of -custody complete?
❑
❑
M
❑
Dates, times and location of sampling
❑
Name of individual performing the sampling
❑
Results of analysis and calibration
❑
Dates of analysis
❑
Name of person performing analyses
❑
Transported COCs
❑
Are DMRs complete: do they include all permit parameters?
❑
❑
M
❑
Has the facility submitted its annual compliance report to users and DWQ?
❑
❑
M
❑
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator
❑
❑
0
❑
on each shift?
Is the ORC visitation log available and current?
❑
❑
M
❑
Is the ORC certified at grade equal to or higher than the facility classification?
❑
❑
0
❑
Is the backup operator certified at one grade less or greater than the facility classification?
❑
❑
0
❑
Is a copy of the current NPDES permit available on site?
M
❑
❑
❑
Facility has copy of previous year's Annual Report on file for review?
❑
❑
M
❑
Comment: Turbidity and flow sampling were conducted bi-annually as required by the permit.
Operations & Maintenance
Is the plant generally clean with acceptable housekeeping?
Yes No NA NE
■ ❑ ❑ ❑
Page# 3

'14
Permit: NCG520072
Inspection Date: 10/02/2017
Owner -Facility: Power Dam Sand
Inspection Type: Compliance Evaluation
Operations & Maintenance
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment:
Flow Measurement - Effluent
# Is flow meter used for reporting?
Is flow meter calibrated annually?
Is the flow meter operational?
(If units.are separated) Does the chart recorder match the flow meter?
Comment: Flow. is estimated using the bucket and stopwatch method.
Effluent Pipe
Is right of way to the outfall properly maintained?
Are the receiving water free of foam other than trace amounts and other debris?
If effluent (diffuser pipes are, required) are they operating properly?
Comment:
Yes No NA NE
Yes No NA NE
❑
❑
M
❑.
❑
❑
■
❑
❑
❑
M
❑
Yes No NA NE
❑
❑
❑
❑
❑
❑
❑
❑
N
❑
Page# 4

ILE
" . Pr
North Carolina Department of Environmental QuaFiti,
Pat McCrory Donald R. van der Vaart
Governor Secretary
October 1, 2015
Mr. Lee Spangler
3530 Rube Spangler Rd.
Lawndale, NC 28090
Subject: Notice of Deficiency
Compliance Evaluation Inspection
NOD-2015-PC-0234
Lawndale Sand LLC.
Certificate of Coverage No. NCG520072
County
Dear Mr. Spangler:
Please find enclosed the Compliance Evaluation Inspection for the site visit conducted on
September 30, 2015 by Mr. Ori Tuvia. Your cooperation during the site visit was much
appreciated.
The main area of concern that was identified during the site visit was that the semi-annual
effluent flow measurement is not being performed as required by the permit. Additionally,
records needs to be kept containing the flow measurement and the date it has been performed.
Records need to be retained for a minimum of 3 years. Please note that your prompt attention to
these issues will help avoid future compliance problems.
The report, attached, should be self-explanatory; however, should you have any questions
concerning this report, please do not hesitate to contact Ori Tuvia at [phone], or at
ori.tuviaCamcdenr. gov.
Sir}cere
,f
s�q_ Michael Parker, Regional Supervisor
Water Quality Regional Operations Section
Mooresville Regional Office, DWR
610 East Center Avenue, Suite 301, Mooresville, North Carolina 28115
Phone: [phone] \ Internet: www.ncdenr.gov
An Equal Opportunity \ Affirmative Action Employer -Made in part by recycled paper

United States Environmental Protection Agency
Form Approved.
/�
EPA Washington, D.C..20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 IN I 2 15 I 3 I NCG520072 I11 12 15/09/30 17 181 C 19 1 s I 20I
21III1II IIIIIIIII IIIIIIIII I IIIIII IIIIIIIIIII r6
Inspection. Work Days Facility Self -Monitoring Evaluation Rating B1 •QA ----Reserved —
67 70 1 z 1 71 L] 72 L N] 731 1 74 75I III I I I I80
LJ LJ I I
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES Permit Number)
09:40AM 15/09/30
12/08/01
Power Dam Sand
3050 Rube Spangler Rd
Exit Time/Date
Permit Expiration Date
Lawndale NC 28090
10:30AM 15/09/30
17/07/31
Name(s) of Onsite Representative(s)mtles(s)/Phone and Fax Number(s)
Other Facility Data
Lee Spangler//704-538-9360 /
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Lee Spangler,3050 Rube Spangler Rd Lawndale NC 28090//704-538-9360/
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit Flow Measurement Operations & Maintenance N Records/Reports
Facility Site Review Effluent/Receiving Waters Laboratory
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
ON A Tuvia �+ MRO WQW04-663-1699/
n 9 o f 0
Sig na ure f n�enteviewer Agency/Office/Phone and Fax Numbers Date
x.90 �tt)
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page#

NPDES
yr/mo/day
31 NCG520072 I11 121 15/09/30 117
Inspection Type
18 ICI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Page#
"41

Permit: NCG520072 Owner -Facility: Power Dam Sand
Inspection Date: 09/3012015 Inspection Type: Compliance Evaluation
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? ❑ ❑ ❑
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable ❑ ❑ 0 ❑
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment: At the time of the inspection the facility had not been operational for five months due to pump
failure, an alternative pump will be installed soon.
Permit
Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new
❑
❑
❑
application?
Is the facility as described in the permit?
❑
❑
❑
# Are there any special conditions for the permit?
❑
❑
❑
Is access to the plant site restricted to the general public?
M
❑
❑
❑
Is the inspector granted access to all areas for inspection?
❑
❑
❑
Comment:
Record Keeping
Yes No NA NE
Are records kept and maintained as required by the permit?
❑
M
❑
❑
Is all required information readily available, complete and current?
❑
0
❑
❑
Are all records maintained for 3 years (lab. reg. required 5 years)?
❑
❑
❑
Are analytical results consistent with data reported on DMRs?
❑
❑
M
❑
Is the chain -of -custody complete?
❑
❑
❑
Dates, times and location of sampling
❑
Name of individual performing the sampling
❑
Results of analysis and calibration
❑
Dates of analysis
❑
Name of person performing analyses
❑
Transported COCs
❑
Are DMRs complete: do they include all permit parameters?
❑
❑
❑
Has the facility submitted its annual compliance report to users and DWQ? .
❑
❑
• ❑
If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator
❑
❑
0
❑
on each shift?
Is the ORC visitation log available and current?
❑
❑
M
❑
Is the ORC certified at grade equal to or higher than the facility classification?
❑
❑
0
❑
Is the backup operator certified at one grade less or greater than the facility classification?
❑
❑
❑
Is a copy of the current NPDES permit available on site?
0
❑
❑
❑
Page#
3

Permit: NCG520072 Owner - Facility: Power Dam Sand
Inspection Date: 09/30/2015 Inspection Type: Compliance Evaluation
Record Keeping Yes No NA NE
Facility has copy of previous year's Annual Report on file for review?
❑ ❑ M ❑
Comment: No record keeping has been performed at the facility, no data from the past three years.
Effluent Pipe Yes No NA NE
Is right of way to the outfall properly maintained? M ❑ ❑ ❑
Are the receiving water free of foam other than trace amounts and other debris? ❑ ❑ 0 ❑
If effluent (diffuser pipes are required) are they operating properly? ❑ ❑ 0 ❑
Comment: At the time of the inspection there no discharge has been observed.
Flow Measurement - Effluent
Yes No NA NE
# Is flow meter used for reporting?
❑
❑
0
-❑
Is flow meter calibrated annually?
❑
❑
M
❑
Is the flow meter operational?
❑
❑
M
❑
(If units are separated) Does the chart recorder match the flow meter?
❑
❑
0
❑
Comment: The facility has not recorded flow for the outfall, required to do so twice a year.
Laboratory
Yes No NA NE
Are field parameters performed by certified personnel or laboratory?
❑
❑
W
❑
Are all other parameters(excluding field parameters) performed by a certified lab?
❑
❑
M
❑
# Is the facility using a contract lab?
❑
❑
N
❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees
❑
❑
0
❑
Celsius)?
Incubator (Fecal Coliform) set to 44.5 degrees Celsius+/- 0.2 degrees?
❑
❑
0
❑
Incubator (BOD) set to 20.0 degrees Celsius +/-1.0 degrees?
❑
❑
0
❑
Comment:
Page# 4

COMPLIANCE EVALUATION INSPECTION CHECKLIST
DATE: v l f j 6 ORC: . 76 fi(' S
ENTRY TIME: Ll 0 NPDES PERMIT NO: NC00
EXIT TIME: 10 1 FACILITY NAME:
COUNTY:
N.iE T WILTH ON -SITE:
PERMIT: EFFECTIVE DATE: EXPIRATION DATE:
FLOW MEAPUREMENT: INSTANTANEO
OUS-
EFFLUENT/RECEIVING STREAM: STREAM NAME: IS'- Li--o q, j
SLUDGE DISPOSAL: NON -DISCHARGE PERMIT #:(If Applicable)
RECORD KEEPING:
40 /%-c J
ALIZER (IN PERMIT)
LABORATORY: CERTIFICATION (FIELD) #. (pH, TRC, DO, Temp., SS, Cond.)
OPERATION TENANCE/FACILITY SITE REVIEW:
6-3"& k �-S J cc v' -k < jc"-1_Z'

SELF -MONITORING PROGRAM:
Sample Type (Composite or Grab) end cl rl/► I
DMR REVIEW: TIME PEPIOD through

LAWNDALE SAND, LLC
804-C N. Lafayette St.
Shelby, NC 28150
Phone [phone]
Fax [phone].
September 2, 2010
Ms. Marcia Allocco
Surface Water Protection
NC. Water Quality Section
610 East Center Ave., Suite 301
Mooresville, NC 28815 .
Subject: NOV-2010-PC-0946
RECEIVED
DIVISION OF WATER QUALITY
SEP 1.3 2010
SWP SECTION
MOORESVfLLE REGIONAL OFFICE
Dear Ms... Allocco,.,
Since receiving your letter of August 12, 2010 we have ceased our sand pumping activities at
the.power,dam. Obviously from your. report and photographs, we were: overdue both
maintenance of our pipelines and lagoon maintenance.
We have lost the copy of our perrriit, would.you please e-mail me a copy at
IfletcherCabtgsengineers.com We were in compliance when we started. up and the permit was
kept at the sand plant. At this time we are unable to locate it. We were not aware that.
monitoring'was mandatory for.the site. We Will however begin monitoring to make sure that
we stay in compliance with our permit. "
At this time we are in the process of cleaning'our lagoons.and replacing our pipes that 'are. in
need of repair. After we review our permit, We are going to redesign the lagoons -and outfall
piping to make sure that we meet .the permit criteria.. We will also begin monitoring our
effluentand keeping. records to' make sure we stay in compliance.
We hope these actions are satisfactory to your office. If you require any other actions before
we. begin pumping please let us know.
Sincerely,
Leonard G. Fletc er PE
Lawndale Sand, LLC
Member Manager

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
August 12, 2010
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
7008 1140 0002 2716 1411
Leonard G. Fletcher, Manager
Lawndale Sand, LLC
804-C N. Lafayette Street
Shelby, NC 28150
Subject: NOTICE OF VIOLATION
NOV-2010-PC-0946
Compliance Evaluation Inspection
Power Dam Sand
NPDES General Permit NCG520072
Cleveland County, North Carolina
Dear Mr. Fletcher:
Enclosed please find a copy of the Compliance Evaluation. Inspection Report for the inspection conducted at the
subject facility on August 5, 2010, by Ms. Donna Hood and Mr. Wes Bell of this Office.
This report is being issued as a Notice of Violation (NOV) because of the violations of the subject NPDES
permit and North Carolina General Statute (G.S.) 143-215.1 as detailed in the Record Keepin,2, Operation and
Maintenance , and Effluent Pipe Sections of the attached report. Pursuant to G.S. 143-215.6A, a civil penalty of
not more than twenty five -thousand dollars (25,000.00) per violation per day may be assessed against any person
who violates or fails to act in accordance with the terms, conditions, or requirements of any permit issued pursuant
to G.S. 143-215.1.
It is requested that a written response be submitted to this Office by September 10, 2010, addressing the
violations noted in the Record Keeping, Operation and Maintenance, and Effluent Pipe Sections of the
report. In responding, please address your comments to the attention of Ms. Marcia Allocco.
Mooresville Regional Office
Location: 610 East Center Ave., Suite 301 Mooresville, NC 28115 One
Phone: [phone] Fax: [phone] Customer Service: 1-877-623-6748 Noi ChCarolilla
Internet: www.ncwaterquality.org

F I
NOV-2010-PC-0946
Mr. Leonard Fletcher
Lawndale Sand LLC
August 12, 2010
This report should be self-explanatory; however, should you have any questions concerning the report, please do
not hesitate to contact Ms. Hood or me at [phone].
Sincerely,
Robert B. Krebs
Surface Water Protection Regional Supervisor
Enclosure
DH

United States Environmental Protection Agency
Form Approved.
E P ^/C.� Washington, D.C.20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 I NI 2 1 51 31 NCG520072 111 121 10/08/05 117 181 CI 191 SIl1 201 1I
Remarks
211111111111111111111111111111111111111111111111 16
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 OA-------------------Reserved--------- -- —
67 I. 169 70111 711 I 721 N 1 731 74 751 1 1 1 1 1 Li 80
Section 6: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
10:00 AM 10/08/05
10/06/18
Power Dam Sand
Exit Time/Date
Permit Expiration Date
3050 Rube Spangler Rd
Lawndale NC 28090
12:00 PM 10/08/05
12/07/31
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Lee Spangler,3050 Rube Spangler Rd Lawndale NC 28090//704-538-9360/ No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit ® Flow Measurement ® Operations & Maintenance ® Records/Reports
Self -Monitoring Program ® Facility Site Review ® Effluent/Receiving Waters ® Laboratory
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and S' ure(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Dat
Donna od MRO WQ//704-663-1699 Ext.2193/ J
pign.a,ture of Management Q A eview r Agency/Office/Phone and Fax Numbers Date
Allocco MRO WQ//704-663-1699 Ext.2204/
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page # 1

NPDES yr/mo/day Inspection Type
3I NCGS20072 I11 12I 10/08/05 1
17 18ICI
(cont.) 1
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
The inspection was performed in response to a citizen complaint concerning the turbidity in the First Broad
River. On the day of the inspection the facility was releasing very turbid water. The permittee was advised
to perform lagoon maintenance to increase detention time for more complete settling of particulate matter.
The permittee was also advised, per permit requirements, that 75% total suspended solids removal was
required to be achieved by the lagoon. The permittee was also advised that the stream standard for
turbidity was 50 ntu.
Page # 2

Permit: NCG520072
Inspection Date: 08/03/2010
Owner -Facility: Power Dam Sand
Inspection Type: Compliance Evaluation
(If the present permit expires in 6 months or less). Has the permittee submitted a new application?
Is the facility as described in the permit?
# Are there any special conditions for the permit?
Is access to the plant site restricted to the general public?
Is the inspector granted access to all areas for inspection?
Comment: The staff report describes 2 single cell settling ponds, the first for tailings
and silt, and the second for final settling. Only one pond was observed on the day of
the inspection.
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? n ® ❑ ❑
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids, pH, DO, Sludge fl n M
Judge, and other that are applicable?
Comment: The facility needs to perform repairs to leaking pipes/pumps to prevent
additional discharges to the First Broad River, as well as eliminating some outfalls that
have already formed from the leaks.
Record Keeping
Yes
No
NA
NE
Are records kept and maintained as required by the permit?
n
®
n
n
Is all required information readily available, complete and current?
n
®
n
n
Are all records maintained for 3 years (lab. reg. required 5 years)?
n
®
n
n
Are analytical results consistent with data reported on DMRs?
n
®
n
n
Is the chain -of -custody complete?
❑
®
❑
n
Dates, times and location of sampling
n
Name of individual performing the sampling
n
Results of analysis and calibration
n
Dates of analysis
n
Name of person performing analyses
n
Transported COCs
n
Are DMRs complete: do they include all permit parameters?
n
®
n
n
Has the facility submitted its annual compliance report to users and DWQ? ❑ ❑ is n
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified operator on each shift? ❑ ❑ ® ❑
Is the ORC visitation log available and current? n n
no
Is the ORC certified at grade equal to or higher than the facility classification? ❑ ❑ ® ❑
Page # 3

Permit: NCG520072 Owner - Facility: Power Dam Sand
Inspection Date: 08/03/2010 Inspection Type: Compliance Evaluation
Record Keeping
Yes
No
NA
NE
Is the backup operator certified at one grade less or greater than the facility classification?
0
❑
■
❑
Is a copy of the current NPDES permit available on site?
n
■
n
n
Facility has copy of previous year's Annual Report on file for review?
❑
❑
■
❑
Comment: No record keeping has been performed at the facility.
Laboratory
Yes
No
NA
NE
Are field parameters performed by certified personnel or laboratory?
n
n
■
n
Are all other parameters (excluding field parameters) performed by a certified lab?
❑
Cl
■
❑
# Is the facility using a contract lab?
n
n
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees Celsius)?
n
n
®
n
Incubator (Fecal Coliform) set to 44.5 degrees Celsius+/- 0.2 degrees?
n
n
®
n
Incubator (BOD) set to 20.0 degrees Celsius +/- 1.0 degrees?
Comment:
Flow Measurement - Effluent
Yes
No
NA
NE
# Is flow meter used for reporting?
❑
❑
■
Is flow meter calibrated annually?
n
n
■
❑
Is the flow meter operational?
p
n
(If units are separated) Does the chart recorder match the flow meter?
❑
❑
■
❑
Comment: The facility has not recorded flow for any of the outfalls since the original
permit was issued.
Effluent Sampling
Yes
No
NA
NE
Is composite sampling flow proportional?
❑
❑
■
Is sample collected below all treatment units?
n
n
Is proper volume collected?
❑
Q
IN
Q
Is the tubing clean?
n
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees Celsius)?
❑
❑
■
Is the facility sampling performed as required by the permit (frequency, sampling type representative)?
❑
n
Comment: No sampling has occurred at the facility to confirm the 75% removal rate.
Effluent Pipe
Yes
No
NA
NE
Is right of way to the outfall properly maintained?
®
n
n
n
Are the receiving water free of foam other than trace amounts and other debris?
n
IM
00
Page # 4

Permit: NCG520072
Inspection Date: 08/03/2010
Effluent Pipe
If effluent (diffuser pipes are required)' are they operating properly
Owner - Facility: Power Dam Sand
Inspection Type: Compliance Evaluation
Comment: Highly turbid water was discharging from the settling lagoon at the time of
the inspection. See enclosed pictures.
Yes No NA NE
❑❑M0
Page # 5

Effluent turbidity plume in the First Broad River on the day of the inspection

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue, Coleen H. Sullins Dee Freeman
Governor Director - Secretary
June 18, 2010 ;
Mr. Leonard G. Fletcher
Lawndale Sand, LLC 2 $ 2Q]�
804-C North Lafayette St j U N
Shelby, NC 28150
Subject: Renewal of coverage / General Permit+NCG520000
Power Dam Rd site,.
Certificate of Coverage'"NCG520072"
Cleveland County
Dear Permittee:
In accordance with your renewal application [received on June 17, 2010], the. Division is renewing
Certificate of Coverage (CoC)1NICG520072 to discharge under NCG520000. This CoC is issued pursuant to
the requirements of North Carolina General Statue 143-215.1 and the Memorandum of Agreement between
North Carolina and the US Environmental Protection agency dated,October 15, 2007 [or as subsequently
amended].
If any parts, measurement frequencies or sampling requirements contained in this General Permit
are unacceptable to you, you have the right to request an individual permit by submitting an individual
permit application. Unless such demand is made, the certificate of coverage shall be final and binding.
Please take notice that this Certificate of Coverage is not transferable except after notice to the
Division. The Division may require modification or revocation and reissuance of the certificate of coverage:
Contact the Mooresville Regional Office prior to any sale or transfer of the permitted facility.
Regional Office staff will assist you in documenting the transfer of this CoC.
This permit does not affect the legal requirements to obtain other permits which may be required by
the Division of Water Quality or permits required by the Division of Land Resources, Coastal Area
Management Act or any other Federal or Local governmental permit that may be required.
If you have any questions concerning the requirements of the General Permit, please contact Bob
Guerra [919 807-6387 or [e-mail].
Sincerely,
for �Coleen H. Sullins
cc: Central Files
ooresville Reg n C)fficea,Surfa_ce Water.P:rotection
NPDES file
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 One
512 North Salisbury Street, Raleigh, North Carolina 27604 NorthCarolina
Phone: [phone] FAX [phone] / Internet: http://portal.ncdenr.orglweb/wq � Natzonally
'
An Equal Opportunity/Affirmative Action Employer-50% Recycled/10% Post Consumer Paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NCG520000
. CERTIFICATE OF COVERAGE NC.G5200.72 ,
DISCHARGE OF INSTREAM MINING WASTEWATER, ASSOCIATED. STORMWATER AND
SIMILAR DISCHARGES UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and
the Federal Water Pollution Control Act, as amended,
Lawndale Sand, LLC
is hereby authorized to discharge instream mining wastewater from the following facility:
Power Dam Rd site
Power Dam Rd
Lawndale
Cleveland County
to receiving waters designated as the Broad River, a class WS-IV stream in subbasin 03-08-04 of
the Broad River Basin. All discharges shall be in accordance with the effluent limitations,
monitoring requirements, and other conditions set forth in Parts I, II, III and IV hereof.
This certificate of coverage shall become effective June 18, 2010.
This Certificate of Coverage shall remain in effect until July. 31, 2012.
Signed this day June 18, 2010
Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission
J
I. na..

A7, :0i,
RCDENR-
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NARJ RESOURCES
Division of Water Quality / Water Quality Section
National Pollutant Discharge Elimination System
NCG520000
FOR AGENCY USE ONLY
Date Received
Year
Month
Da
Certificate of Coverage
NCG
Check #
Amount
Permit Assigned to
NOTICE OF RENEWAL INTENT — Certificate of Coverage -
(Correct items I and 2 as necessary. Please print or type answers to tie"other questions.)
1) Mailing address* of owner/operator: —1
Company Name JUN 1 $ 2Mo
Owner Name tt—o flK k-)
Address; K. «� .
Telephone No. _7U 4 4:?iu -- Utn Fax: '104
e-mail address
* Address to which all permit correspondence will be mailed
2) Location of facility producing discharge:
Facility Name ; p tjU/ VPAA Qp. Ally 151.
-16cc4
Facility Contact _i 3't '�PM�S LPX'k uzc- �.
Street Address'`
City State Wit: ZIP Code IP-V)u
CountyL�+>
Telephone No. Fax: -IDA 4-%o -uuz,4
3) Description of Discharge:
a) Is the discharge directly to the receiving water? ❑ Yes t %\No
b) Number of discharge points (ditches, pipes, channels, etc. that convey wastewater from the
property):
c) Is there any treatment being applied to the wastewater before discharge (check the type of
treatment in use).
Settling pond ❑ Lagoon ❑None
❑Other:
4) Discharge Frequency:
a) The discharge is: ❑ Continuous Intermittent ❑ Seasonal
i) If the discharge is intermittent, describe when the discharge will occur:
V)UlziW' i me'ktN((z ��6t'G;i�c7l
Page 1 of 2

NCG550000 renewal form
b)
c)
ii) If seasonal check the month(s) the discharge occurs: ❑ Jan. ❑ Feb. ❑ Mar. ❑ Apr. ❑ May ❑
Jun. ❑ Jul. ❑ Aug. ❑ Sept. ❑ Oct. ❑ Nov. ❑ Dec.
How many days per week is there a discharge? 1-3
Please check the days discharge occurs:
❑ Saturday ❑ Sunday Monday XTuesday Wednesday Thursday ';14 Friday
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.
PrintedNameof Person Signing: ? gvsPNIID T-4UCk9EF-
Title: , UVVt w
of Apply rdht)
North Carolina General Statute 143-215.6 b (i) provides that:
(Date Signed)
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 Article 21 or regulations of the Environmental Management Commission
implementing that Article, or who falsifies, tampers with or knowingly renders inaccurate any recording or monitoring device or
method required to be operated or maintained under Article 21 or regulations of the Environmental Management Commission
implementing that Article, shall be guilty of a misdemeanor punishable by a fine not to exceed $25,000, or by imprisonment not to
exceed six months, or by both. (18 U.S.C. Section 1001 provides a punishment by a fine of not more than $25,000 or imprisonment
not more than 5 years, or both, for a similar offense.)
Mail this COMPLETED form to:
Mr. Charles H. Weaver
NC DENR ; DWQ / NPDES
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Page 2 of 2

O�O� W AT �RpG
O 'C
Leonard G. Fletcher, Manager
Lawndale Sand LLC
804-C N. Lafayette St.
Shelby, NC 28150
Dear Mr. Fletcher:
Michael F. Easley
Governor
©� William G. Ross, Jr., Secretary
NCDENR North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E., Director
Division of Water Quality
June 27, 2005 �� 1
I
J
'Vr -'nNR RILEIGH REGIDN, l if) if E-:
Subject: General Permit No. NCG520000-'--.."
Certificate of Coverage NCG520072
Lawndale Sand LLC
Cleveland County
In accordance with your application for discharge, the Division is forwarding herewith the subject Certificate of
Coverage to discharge under the subject state-NPDES general permit. This permit is issued pursuant to the
requirements of North Carolina General Statue 143-215 .1 and the Memorandum of Agreement between North
Carolina and the US Environmental Protection agency dated May 9, 1994 (or as subsequently amended).
The following information is included with your permit package:
■ A copy of the Certificate of Coverage for your treatment facility
■ A copy of General Sand Mining Discharge Permit NCG520000
■ A copy of a Technical Bulletin for General Sand Mining Discharge Permit NCG520000
If any parts, measurement frequencies or sampling requirements contained in this general permit are unacceptable to
you, you have the right to request an individual permit by submitting an individual permit application. Unless such
demand is made, the certificate of coverage shall be final and binding.
Settling pond and settling basin shall be maintained properly in order to prevent excessive accumulation of
tailings and silt. The trapping efficiency should be greater than 75%.
Please take notice that this Certificate of Coverage is not transferable except after notice to the Division of Water
Quality. The Division of Water Quality may require modification or revocation and reissuance of the certificate of
coverage. This permit does not affect the legal requirements to obtain other permits which may be required by the
Division of Water Quality or permits required by the Division of Land Resources, Coastal Area Management Act or
any other Federal or Local governmental permit that may be required.
If you have any questions concerning this permit, please contact Sergei Chemikov at telephone number 919/733-
5083, extension 594.
( PT.
^ou'? i wb�Jar
Sinc rely, sty t,'.3� , URAL RE.SODI:CR-8
Un Klimek, P.E.
CEP 0 1
cc: ;CdntraITiles :g
NPDES General Permit Files
Mooresville Regional Office, Surface Water Protection Section P i . , ..1, , -
N. C. Division of Water Quality / NPDES Unit Phone: [phone]
1617 Mail Service Center, Raleigh, NC 27699-1617 fax: [phone]
Internet: h2o.enr.state.nc.us DENR Customer Service Center: 1 800 623-7748

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG520000
CERTIFICATE OF COVERAGE NO. NCG520072
TO DISCHARGE SAND DREDGING WASTEWATER AND SIMILAR WASTEWATERS
UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
Lawndale Sand LLC
is hereby authorized to operate a treatment system consisting of a sediment basin and discharge
channel with the discharge of treated wastewater from a facility located at
Power Dam Sand
3050 Rube Spangler Road
Lawndale
Cleveland County
to receiving waters designated as Broad River in the Broad River Basin in accordance with the
effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II, III and
IV hereof.
This certificate of coverage shall become effective June 27, 2005.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day June 27, 2005.
A an Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

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PROPOSED SAND MINE SITE.
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448 (SHELBY) METC4LF !.I A4L `32'300 451 452 0 it
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0 1000 2000 3000 4000 5000 6000 7000 FEET hard surface_._.
1 .5 0 1 KILOMETER Secondary hig
hard surface__.

To: NPDES Unit
Water Quality Section
Attention: Sergei Chernikov
SOC PRIORITY PROJECT: No
Date: June 10, 2005
NPDES STAFF REPORT AND RECOMMENDATIONS
County: Cleveland
NPDES Permit No.: NCG520072
MRO No.: 05-52
PART I - GENERAL INFORMATION
Facility and address: Lawndale Sand, LLC
804-C North Lafayette Street
Shelby, NC 28150
2. Date of investigation: June 7, 2005
3. Report prepared by: Michael L. Parker, Environmental Engineer H
4. Person contacted and telephone number: Leonard Fletcher, [phone]
5. Directions to site: From the jet. of Hwy. 182 and Shelby Road (SR 1813), travel
southwest on Shelby Road = 0.75 mile to the jet. with Rule Spangler Rd. (SR 1811).
Bear left on Rule Spangler Rd. and travel = 0.8 miles to the jet. with Old Power Dam Rd.
(No SR number). The mine site is at the end of this road.
6. Discharge point(s), List for all discharge points: -
Latitude: 350 23' 43"
Longitude: 810 33' 10"
Attach a USGS Map Extract and indicate treatment plant site and discharge point on map.
USGS Quad No.: F12NE
7. Site size and expansion area consistent with application: Yes. There is sufficient area for
the construction of the proposed WWT facilities.
8. Topography (relationship to flood plain included): The site is immediately adjacent to the
First Broad River, and is likely a part of the river's flood plain. Considering that this
project is a sand dredging operation, and that the dredged material is to be removed from
the river, this Office is unclear as to whether flood plain proximity plays a significant role
in the location of the proposed treatment works.

P6k
Page Two
a
10.
Location of nearest dwelling: Approx. 1000+ feet from the proposed WWTP site.
Receiving stream or affected surface waters: First Broad River
a. Classification: WS-IV
b. River Basin and Subbasin No.: Broad 030804
C. Describe receiving stream features and pertinent downstream uses: There is a
considerable amount of flow in the receiving stream at the proposed point of
discharge. Downstream uses are primarily agriculture, with some secondary
recreation. Several miles downstream there is a municipal water intake (see Part
IV).
PART II - DESCRIPTION OF DISCHARGE AND TREATMENT WOKS
1.
2.
93
a. Volume of wastewater: 0.960 MGD (Design Capacity)
b. What is the current permitted capacity: New facility
C. Actual treatment capacity of current facility (current design capacity): New
Facility
d. Date(s) and construction activities allowed by previous ATCs issued in the
previous two years: There have been no ATCs issued to this facility in the past
two years.
e. Description of existing or substantially constructed WWT facilities: There are no
existing WWT facilities.
f. Description of proposed WWT facilities: The applicant proposes to construct two
single cell settling ponds, one for tailings and silt, and the second to be used as a
final settling pond prior to discharge across a 10-foot wide weir.
g. Possible toxic impacts to surface waters: There are no toxic impacts expected.
h. Pretreatment Program (POTWs only): Not Needed.
Residual handling and utilization/disposal scheme: Residuals (sand) will be classified and
then stockpiled for future sale.
Treatment plant classification: Based on the proposed WWT components, this facility
does not meet Class I criteria.
4. SIC Code(s): 5211 Wastewater Code(s): 43 MTU Code(s): 50000

Page Three
PART III - OTHER PERTINENT INFORMATION
1. Is this facility being constructed with Construction Grant Funds or are any public monies
involved (municipals only)? No public monies were used in the construction of this
facility.
2. Special monitoring or limitations (including toxicity) requests: None at this time.
3. Important SOC/JOC or Compliance Schedule dates: N/A
4. Alternative analysis evaluation
a. Spray Irrigation: Insufficient area for the amount of wastewater generated.
b. Connect to regional sewer system: None available to the site.
C. Subsurface: Insufficient area for the amount of wastewater generated.
d. Other disposal options: None that we are aware.
PART IV - EVALUATION AND RECOMMENDATIONS
The applicant has applied for issuance of a GP for the excavation (dredging) of sand in
the First Broad River. The sand will be pumped from the river and stockpiled onsite where
tailings and silt are allowed to drain into a 1.43 acre settling pond. The discharge from this pond
will be directed to a smaller (12,000 f13) settling basin, and then the effluent will be discharged
back to the river across a 10-foot wide weir. Such being the case, this Office recommends that
language be included either in the permit or permit cover letter relative to the maintenance of the
settling basins. The language should specifically address the need for basin maintenance in order
to prevent the accumulation of tailings and silt that would diminsh settling efficiency and
potentially result in short-circuiting of the effluent.
There is a municipal water intake a few miles below this proposed outfall. Staff with the
MRO Public Water Supply Section (PWS) have provided comments on the potential influence of
this dredging operation on the operation of existing WTP. The PWS staff did not feel that the
proposed sand dredging operation would have a negative impact on the either the quantity or
quality of water available to the municipality, and they offered no objection to permit issuance.
Pending a final review of this request by the NPDES Unit, permit issuance is
recommended.
Water Quality Rei6nal Supervisor Date
h AdsrWsr05Uawndale.dsr

F wArF
` O�O �pG Michael F. Easley
Governor
C/) r William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan Klimek, P.E.
Acting Director
Division of Water Quality
WX
April 22, 2005
Leonard G. Fletcher, Manager
Lawndale Sand LLC
804-C N. Lafayette St.
Shelby, NC 28150
Subject: Application No. NCG520072
Lawndale Sand LLC
Cleveland County
Dear Mr. Fletcher:
This is to acknowledge receipt of the following documents on April 20, 2005:
X Completed Notice of Intent (Application form),
Engineering Proposal (for proposed control facilities),
Request for certificate of coverage
X Application processing fee of $80.00.
Engineering Economics Alternatives Analysis,
X Engineering Plans and Specifications
Local Government Signoff,
Source Reduction and Recycling,
Interbasin Transfer,
The items checked below are needed before review can begin:
Completed Notice of Intent (Application Form),
Engineering proposal (see attachment),
Application Processing Fee of $50.00,
Delegation of Authority (see attached),
Biocide Sheet (see attached),
Engineering Economics Alternatives Analysis,
Engineering Plans and Specifications
Local Government Signoff,
Source Reduction and Recycling,
Interbasin Transfer,
Other:
® '
NCDENR
Customer Service
1 ROn 623_7748
•rho ��� , . ,. r:.i i'iell..'�?„�l nEv� �
APR 2 6 2005
Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 [phone]

F WATF.
Michael F. Easley
Governor
rWilliam G. Ross Jr., Secretary
> North Carolina Department of Environment and Natural Resources
Alan Klimek, P-E.
Acting Director
Division of Water Quality
This application has been assigned to Sergei Chernikov (919/733-5083) Ext. 594 of our NPDES Unit for review. You will
be advised of any comments, recommendations, questions or other information necessary for the review of the
application.
am, by copy of this letter, requesting that our Regional Office Supervisor prepare a staff report and recommendations
regarding this discharge. If you have any questions regarding this application, please contact the review person listed
above.
cc: Mooresville. Regional. -Office
1Permit Application File
Sincerely,
tI Sergei Chernikov, Ph.D.
vt' NPDES-West
NCDENR
Customer Service
1 800 623-7748
Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 [phone]

R1 ECE3 IVE D
,.. I. 2005
DENR - WATER QUALITY
WETLANDS AND STORMWATER BRANCH
"Tia Division of Water Quality / Water Quality Section
r�
NCDENR National Pollutant Discharge Elimination System
No CMoum DEMARTMENr of
EN RONML ANC Nm Rmoiw
NCG520000
NOTICE OF INTENT
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG520000: In -stream sand mining wastewater, associated stonnwater and similar wastewaters
(Please print or type)
1) Mailing address of owner/operator:
Company Name: Lawndale Sand LLC
Contact Person: T. e o n a d F jet C h _e
Street Address: 8 0 4—C N . Lafayette St. _
City: Shelby ` State: NC_ ZIP Code: 28150
Telephone No.: 704 476-0003 Fax: [phone]
2) Location of facility producing discharge:
Facility Name: Power Dam Sand
Contact Person: Lee Spangler
Street Address: 3050 Rube Spangler Rd.
City: Lawndale _ State: NC ZIP Code: 28090
County: Cleveland
Telephone No.: 704 538-9360 Fax:
3) Permit Contact (complete this section if permit contact is different from facility contact) :
Contact Person:
Street Address:
City:
County:
Telephone No.:
4) Physical location information:
State: _ ZIP Code:
Fax:
A copy of an USGS quad map or county map with the facility clearly located on the map IS REQUIRED to
be submitted with "this application.
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 i n t e r s e c- t i o n -3id-y�7a2_ a n d SR 1813
travel in a southerly direction ± 0.75 mile to SR 1811 bear left to
south, then travel 0.8 mile to Old Power Dam Rd. turn left, mine @ end
5) This NPDES permit application applies to which of the following:
® New or Proposed ❑ Modification
Please describe the modification:
❑ Renewal
Please specify existing permit number and original issue date:
Page 1 of 4
SWU-214-080102

NCG520000 N.0.1.
6) Does this facility have any other NPDES permits, including stormwater general permits?
® No ❑ Yes
If yes, list the permit numbers for this facility:
7) Description of Discharge:
a) Will stormwater also be discharged? ® Yes ❑ No
If yes, does stormwater drain to a settling pond prior to discharge? 13 Yes ❑ No
b) Is the sand washed or rinsed on the bank after removal from the stream? ❑ Yes F0 No
c) Is the discharge directly to the receiving water? ❑ Yes ® No
If no, submit a site map with the pathway to the potential receiving waters clearly marked. This
includes tracing the pathway of the storm sewer to the discharge point, if the storm sewer is the only
viable means of discharge.
d) Number of discharge points (ditches, pipes, channels, etc. that convey wastewater from the property):
e) Volume of discharge per each discharge point (in GPD):
#1: 960,000gal/day#2:storm drainagd/3: #4
f) Please describe the type of process the sand dredging wastewater is being discharged from, be
specific. _Sand is to be pumped from river, screened and
classfied.
g) Is there any treatment being applied to the wastewater before discharge (check the type of treatment
in use).
K] Settling pond ❑ Lagoon ❑Other ❑None
(Please describe "Other") ______
h) How much of the volume discharged is treated (state in percent)? All water pump-e-d--goes to ,
i) If any box in item (e) above, other than none, was checked, please include design specifics (i.e., spots��ng
design volume, retention time, surface area, etc.) with submittal package. Existing treatment facilities
should be described in detail. Design criteria and/ operational data (including calculations) should be
provided to ensure that the facility can comply with the requirements of the General Permit. The
treatment shall be sufficient to meet with the limits set by the general permits. The trapping efficiency
should be greater than 75%. The surface area should be as large as possible to insure sedimentation
occurs. To secure optimum efficiency the flow length of the basin to the basin width should have a
ratio of 2:1
Note: Construction of any wastewater treatment facilities requires submission of three (3) sets of
plans and specifications along with the application. Design of treatment facilities must comply
with requirements of 15A NCAC 2H .0138. If construction applies to this discharge, include
the three sets of plans and specifications with this application.
8) Discharge Frequency:
a) The discharge is: ❑ Continuous 12 Intermittent ❑ Seasonal
i) If the discharge is intermittent, describe when the discharge will occur: Discharge to occur
between 7:00am and 7:OODm_
ii) If seasonal check the month(s) the discharge occurs: ❑ Jan. ❑ Feb. ❑ Mar. ❑ Apr.
❑ May ❑ Jun. ❑ Jul. ❑ Aug. ❑ Sept. ❑ Oct. ❑ Nov. ❑ Dec.
Page 2 of 4
SW U-214-080102

NCG520000 N.O.I.
b) Please check the days discharge occurs:
ER Sat. ❑ Sun. ® Mon. [&Tue. ® Wed. IX Thu. 13 Fri.
9) Receiving waters:
a) What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility
wastewater discharges end up in? If the site wastewater discharges to a separate storm sewer
system (4S), name the operator of the 4S (e.g. City of Raleigh). _road R ; vPr
b) Stream Classification (WS-IV, C, etc.):
10) Alternatives to Direct Discharge:
WS-IV
Address the feasibility of implementing each of the following non -discharge alternatives
a) Connection to a Regional Sewer Collection System not possible
b) Subsurface disposal (including nitrification field, infiltration gallery, injection wells, etc.) not practical
c) Spray irrigation not practical
The alternatives to discharge analysis should include boring logs and/or other information indicating that a
subsurface system is neither feasible nor practical as well as written confirmation indicating that
connection to a POTW is not an option. It should also include a present value of costs analysis as outlined
in the Division's "Guidance For the Evaluation of Wastewater Disposal Alternatives"
11) Additional Application Requirements:
For new or proposed discharges, the following information must be included in triplicate with this
application or it will be returned as incomplete.
X a) 7.5 minute series USGS topographic map (or a photocopied portion thereof) with discharge location
clearly indicated.
X b) Site map, if the discharge is not directly to a stream, the pathway to the receiving stream must be
clearly indicated. This includes tracing the pathway of a storm sewer to its discharge point.
c) If this application is being submitted by a consulting engineer (or engineering firm), include
documentation from the applicant showing that the engineer (Or firm) submitting the application has
been designated an authorized Representative of the applicant.
d) Final plans for the treatment system (if applicable). The plans must be signed and sealed by a North
Carolina registered Professional Engineer and stamped -"Final Design -Not released for construction".
e) Final specifications for all major treatment components (if applicable). The specifications must be
signed and sealed by a North Carolina registered Professional Engineer and shall include a narrative
description of the treatment system to be constructed.
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:_ Leonard G. Fletcher
(Signature of Applicant) (Date Signed)
Page 3 of 4
SWU-214-080102

NCG520000 N.O.I.
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 Article 21 or regulations of
the Environmental Management Commission implementing that Article, or who falsifies, tampers with or
knowingly renders inaccurate any recording or monitoring device or method required to be operated or
maintained under Article 21 or regulations of the Environmental Management Commission implementing
that Article, shall be guilty of a misdemeanor punishable by -a fine not to exceed $10,000, or by
imprisonment not to exceed six months, or by both. (18 U.S.C. Section 1001 provides a punishment by a
fine of not more than $10,000 or imprisonment not more than 5 years, or both, for a similar offense.)
Notice of Intent must be accompanied by a check or money order for $80.00 made payable to:
NCDENR
Mail three (3) copies of the entire package to:
Stormwater and General Permits Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Final Checklist
This application will be returned as incomplete unless all of the following items have been
included:
❑ Check for $80 made payable to NCDENR
❑ 3 copies of county map or USGS quad sheet with location of facility clearly marked on map
❑ 3 copies of this completed application and all supporting documents
❑ 3 sets of plans and specifications signed and sealed by a North Carolina P.E. (if applicable)
❑ Alternatives analysis including present value of costs for all alternatives
Note
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SWU-214-080102

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SCALE 1:24000 - ROAD CLASSIFICATION
- - - - 1 MILE'. .. .
z o Primary highway; Light duty road, hard c
0 1000 2000 3000 4000 5000 5000 7000 FEET hard surface ......................... improved surface.._..--
1 . . _ . ..5 Q. 1- KILOMETER .-. . . . . . . nda Ceighvvay, - - .........--
. . - . . .. - .. .. .. .. ..--...........
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hard'sur Unimproved road
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