NCG020701 DMR WW

11 ANNUAL SUMMARY DMR - WASTEWATER
II SEND TO CENTRAL OFFICE* 11
PROCESS MINE/DEWATERING 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 I 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 D _? © /
FACILITY NAME: - 01lNr t5f2-tG1f7- SA-/IP2 &)
PERSON COLLECTING SAM LES: R 4? 4jo 7d ieES
CERTIFIED LABORATORY:J �N.V/ L4943 Lab # 1)4 -000Y -d
Lab #
LIMITS VIOLATIONS? YES ❑ NO ❑
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR:
COUNTY: dU XA(rVe-kf
PHONE NO. ( 7W —1578'A3
ADD TO LISTERVE? YES ❑ NO❑ EMAIL: R)/A1ZCXb �YeP4ZS LOXOL,160?6-7
INDUSTRIAL SAND'? ❑ DISCHARGING TO SA WATERS4. ❑
Date Sample
Outfall No. Collected
50050
Total Flow
00530 00400 00545 00400 31616
Total Suspended Turbidity3
Solids'- Settleable Solids pH Fecal Coliforms
- mm/dd/yr
MG
mg/I''2 NTU2'3 MU12 Standard coUm12,4
All mines must monitor WW discharges for TSS. Only industrial sand mine discharges are subject=to TSS limits.
2 If an effluent limit is exceeded, the permittee is required to institute monthly monitoring for that parameter for the remaining permit term.
3 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.
4 Only facilities discharging to SA waters are required to monitor for Fecal coliforms.
Permit Date: 1/1/2010-12/31/2014 Last Revised 01-05-10
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Part A Continued: Wastewater Monitoring Requirements
Outfall No. Date Sample
Collected
50050 00530
Total Flow Total Suspended
Solids
00400
Turbidity3
00545 00400 31616
Settleable Solids pH Fecal Coliforms
- mm/dd/yr
MG mg/l1,2
NTU2,3
ml/12 Standard col/m12,4
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW". "NO DISCHARGE" & LIMIT
VIOLATIONS) BY MARCH I OF EACH YEAR TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those per ns directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am 4rP '
a that t . � lties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Date)
Permit Date: 1/1/2010-12/31/2014 Last Revised 01-05-10
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