NCG020285 DMR WW

PROCESS/MINE DEWATERING WASTEWATER DISCHARGE MONITORING REPORT (DMR)
Part A: Facility Information
Samples Collected In Quarter:
Certificate' Of Coverage No,
Faclllty Name
Facility Contact
Facility Contact Phone No,
Please Mail Original And One Copy To Mailing Address Below
GENERAL PERMTT NO. NCG020000
II samples shall be reported within 30 days following monitoring period)
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Part 8: Process Wastewater and Mine Dewatering Wastewater Monitoring Requirements
County of Facility le i %J(j n
Name of Laboratory W 4 ki - e�.k► hs
Lab Certification # SIC)
I Measured continuously using a Clow measuring device or estimated using manufacturer's pump curves and pump logs.
Part C: Certification
0 8 2015
CENTRAL FILES
DWR SECTION
"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 persons directly responsible for gathering the information, the information submltted is, to the best
of my knowledge and belief, true, accurate, and complete, I am aware that there are significant pe alties for submitting false information,
including the possibility of fines and Imprisonment for knowing violation "
(Signature of Permittee) (Date)
Part D: Mailing Address
Attn: Central Files, DENR, N.C. Division of Water Quality, 1617 Mail Service Center, Raleigh, NC 27699.1617
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I Measured continuously using a Clow measuring device or estimated using manufacturer's pump curves and pump logs.
Part C: Certification
0 8 2015
CENTRAL FILES
DWR SECTION
"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 persons directly responsible for gathering the information, the information submltted is, to the best
of my knowledge and belief, true, accurate, and complete, I am aware that there are significant pe alties for submitting false information,
including the possibility of fines and Imprisonment for knowing violation "
(Signature of Permittee) (Date)
Part D: Mailing Address
Attn: Central Files, DENR, N.C. Division of Water Quality, 1617 Mail Service Center, Raleigh, NC 27699.1617
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STORMWATER DISCHARGE OUTFALL DO)
ANNUAL SUMMARY DATA MONITORING REP RT (DMR
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General Permit No. NCG160000
Certificate of Coverage No. N664fi e ❑❑ NCS 0 Z
is monitoring mportsummary6s due to the ©WQ RegFonalOce no than 30 -days from she date
fact7ity receives /aboratorysampting results from the �it�t sample of a calendar year
Phone Number: 74Db 36 = -e yl l Total no. o SDOs monitored I
®4"1 No. i
Isathis outfall currently in Tier 2 (monitored monthly)? yes ❑ No E
Wps this outfall ever in Tier 2 (monitored monthly) during the past year? yes ❑ No
It this outfall was in Tier 2 last year, why was monthly. monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWO to reduce monitoring frequency ❑
Other -- - - - -- IF
Last Revised 7-14,016
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Last Revised 7-14,016