NCG020628 DMR WW

ANNUAL SUMMARY DMR - WASTEWATER
SEND TO CENTRAL OFFICE*
PROCESS MINEMEWATERING WASTEWATER
GENERAL PERMIT NO. NCG020000
* Report All Wastewater discharge monitoring data on this form (including No Flow and No Discharge and Permit Limit Violations) by MARCH 1 of each year. If
you have limit violations, you must also have turned in a Limit Violation DMR to your local Regional Office within 30 days of receiving sample results from a lab.
CERTIFICATE OF COVERAGE NO. NCG02 0 G Z �
FACILITY NAME: 5,1 ,0550x) 1Dt5,yasZ InlAlc-
PERSON COLLECTING SAMPLES: Do,v f577 5
CERTIFIED LABORATORY:_�.4Gc .4„r�Yn� Lab # 6 -;2
Lab #
LIMIT VIOLATIONS? YES ❑ NO 9
Part A: Wastewater Monitoring Reauirements
SAMPLE COLLECTION YEAR:
COUNTY: /`,Wleroltl
PHONE NO. 9/ 0 5-2- 5' -
ADD
--ADD TO LISTSERVE? YES ❑ NO(9 EMAIL:
INDUSTRIAL SAND'? ❑ DISCHARGING TO SA WATERS°? ❑
Outfall No. ;.
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Total Flow
Total Suspended
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Turbidity3
Settleable Solids
pH
Fecal Coliforms
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All mines must monitor WW discharges for TSS. Only industrial sand mine discharges are subject to TSS limits.
2 I an effluent limit is exceeded, the permittee is required to institute monthly monitoring for that parameter for the remaining permit term.
The discharge shall not cause an instantaneous measurement of the turbidity of the receiving water to exceed: 10 NTU for freshwater streams, lakes, and reservoirs
designated as trout waters; 25 NTU for all lakes and reservoirs, and all salt waters; 50 NTU for all other streams and surface waters. Turbidity may be monitored at the
Stormwater Discharge Outfall. Alternatively, the permittee may choose to monitor turbidity in the receiving water, directly upstream and downstream of the discharge.
Only facilities discharging to SA waters are required to monitor for Fecal coliforms.
Permit Date: 1/1/2010-12/31/2014 Last Revised 0 1 -21 -11
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w._._ I]oRIGINA r AND ON, COPX OF THIS ANNUAL SUMMARY aNCLUDING ALL "NO FLOW". "NO DISCHARGE" & L Mi__T_
VIOLATIONS) BY MARCH I OF EACH YEAR TO:
Division of Water Quality
Attn: DWQ Central Piles
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SWIN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"1 certify, under penalty of low, that this document and all attachments were prepared under my direction or supervision in tteeordanee with a system designed to
assure that qualified personnel properly gather and evaluate the Information submitted. Based on my inquiry of the person or persons who manage the system, or
those persona dIr4y responsible for gathering the Information, the Information submitted Is, to Uro best of my knowledge and belid, true, accurate, and complete.
1 om aw t ere are significant penalties for submitting raise information, Including the possibility of fines and imprisonment for knowing violations."
ca -u�
(Signature of Permittee) (Date)
Perot Date: 1/ 1/2010-12/31/2014 I aSt Revised 01.21-11
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