NCG020895_DMR Upload Review_20220423 (2)

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 2/7/2022 7:33:47 PM (DMR Submittal)
Submit by Clark, Paul B 4/23/2022 12:04:37 PM (DMR Submittal Review)
• Georgoulias, Bethany A reassigned the task to Clark, Paul B 4/21/2022 11:33 AM
• The task was assigned to DEMLR SW Admin 2/7/2022 7:33 PM

DMR Submittal from 2/7/2022
Permit and Facility Information:
Permit Number*
Enter COC or Individual Permit Number
NCG020895
Must begin with NCS or NCG
Facility Name: *
Aurelian Springs Mine
County: *
Halifax
Note: Facility name and county are used to help the reviewer verify the permit number entered, and to display the
Regional Office address on the submitter's form (not here). These metadata details will be pulled from current BIMS
information after the DMR(s) are filed. If the submittal is accepted, simply note any errors in the reviewer's comments.
Monitoring Period Information:
Monitoring Period What is the YEAR of the sample date(s)?
Year:* 2021
DMR Upload* Click the upload button or drag and drop files here to attach document.
A Springs DMR.pdf 427.8KB
Only PDFs are accepted.
Comments: The DMR is for the 4th Quarter 2021. The project has yet to start, so no inudstrial
activity has occurred at the site. The new permit requires quarterly and an annual
DMR. During the last permit, we were instructed to only submit an annual DMR, but
we are unsure if that is still valid within the eDMR system so we are catching up the
last two quarters.
* By checking the box and signing box below, I certify that:
• I have given true, accurate, and complete information on this form;
• I agree that submission of this Discharge Monitoring Report (DMR) Upload form is a "transaction" subject to Chapter 66,
Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
o I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes
(the "Uniform Electronic Transactions Act");
• I understand that an electronic signature on this upload form has the same legal effect and can be enforced in the same
way as a written signature; AND
• I intend to electronically sign and submit this DMR Upload form.
Full Name:* David Kevin Rideout
Name of person submitting this form
Email Address:* [e-mail]
Phone Number:* 804-721-7312

Signature:
��Gl�c�IGC-
Date: * 02/07/2022

Review
Review Date: 04/23/2022
Confirm Permit No.* Correct the permit ID number if needed.
NCG020895
Confirm DMR Year* 2021
Multiple DMRs will be automatically filed in a subfolder denoting the sampling year entered above.
Can submittal be Yes
accepted?* No (Explain why below)
Do Central Office No
staff need to be Yes
alerted? *
Do Regional Office No
staff need to be Yes
alerted?
Type of Permit* General
Ensures DMR(s) filed correctly.