NCG020437 DMR SW (2)

ANNUAL SUMMARY DMR - STORMWATER
II SEND TO CENTRAL OFFICE * II
STORMWATER DISCHARGE OUTFALLS (SDO)
GENERAL PERMIT NO. NCG020000
*Report ALL STORMWA TER Monitoring Data on this form (including No Flow and No Discharge and Permit Limit Violations) by MARCH 1 of each year.
CERTIFICATE OF COVERAGE NO. NCG02 0 4 3 7.
FACILITY NAME: Hanson Brick - Sampson II Mine
PERSON COLLECTING SAMPLES Martin Brown
CERTIFIED LABORATORY K&W Laboratories Lab # NC 559
Lab #
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 2015
COUNTY Sampson
PHONE NO. ( 910 ) 525-4128
ADD TO LISTSERVE? YES ❑ NO ❑ EMAIL:
.Outfall
No:
Date Sample
Collected'
(mo/dd/yr OR.
NO FLOW)
In Tier 2
� Monthly
Monitoring?
g'
, (y!n)
# o f Months in
Tier 2 Total Flow
Sampling (MG)
Total Suspended a Total • Event
Turbidity: Settleable
Solids Rainfall Duration
(m" (NTU) Solids (ml/1) (in) (minutes)
om)
-
E
-
100 ' See Footnote3' 0.1
S-003
No Discharge
01/01/2015 to
06/30/2015
S-003
No Discharge
07/01/201.5 to
09/30/2015
i "NU FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here and the Date Range.
2 Per NCG02: Tier 2Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range
3 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier -1 or Tier.2 responses in the General Permit. -
4 TSS benchmark values are 100 mg/I except in ORW, HWQ, trout, and PNA waters where they are 50 mg/l.
s 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 SDO.
Alternatively, the permittee may choose to monitor turbidity in the receiving water, directly upstream and downstream of the SDO.
Permit Date: 1/1/2010-12/31/2014
Last Revised 0 1 -2 1 -11
Page 1 of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month on average
Date Sample
Outfall
Outfall
Collected
No.
(NO FLOW) R
in2
# of Months
Monthly
1 in Tier 2
Moll (Y�n) ng. Samplingz
New Motor
Oil Usage
(al/month)
Total Flow
(MG)
TPH using method
I664A SGT -HEM
(m )
Total Suspended pH Total Event
Solids (Standard Rainfall Duration
(mg/1) Units) (in) (minutes).
153
100 6-9
S-003 01/01/2015 to
06/30/2015 No Discharge
<55
S-003 07/01/2015 to
09/30/2015 No Discharge
<55
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES
AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO ❑X
HAVE YOU CONTACTED THE REGION? YES ❑ NO
WHO AT THE REGION HAVE YOU SPOKEN WITH?
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
[phone]
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 persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing
-1...1..45...-- 11
(Sigdature of Permittee)
Permit Date: 1/1/2010-12/31/2014
Z Z4cZO/u
ate)
Last Revised 0 1 -2 1 -11
Page 2 of 2

r
ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year 2015
I "Report ALL STORMWATER monitoring data on this form (include "No Flow"/"No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each vear.
Certificate of Coverage No. NCG02
Facility Name: Hanson Brick - Sampson 11 Mine
County: Sampson
Phone Number: 9( 10 )525-4128 Total no. of SDOs monitored 1
Certified Laboratory K&W Laboratories lab #NC559
Lab #
Stormwater Discharge Outfall (SDO) No. 1 VMA Outfall? Yes ❑ No 0
Is this outfall currently in Tier 2 for any parameter Yes ❑ No
Was this outfall ever in Tier 2 during the past year? Yes ❑ No ❑x
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑
Other ❑
Outfall No.
1
Total
Rainfall,
inches
TSS,
mg/l
SS,
ml/l
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mg/I
(VMA)
New
Motor Oil
Usage
al/mo.
StormwaterO1rcle
Benchmarks
indicate No
aFLO ee
Benchmark
100/50
circle
Benchmark
50/25/10
N/A
Water0.1
staaddappOes
NIA
stuality andard pp
15
>E6 gal/mo.
averagerecidres
TSS andri`
monitoring
Date Sample - r
Collected,
mo/dd/ r i
til
I,
J�
- — - -
- - -
- _
--_
10/1/15 to 12/31/15
NO DISCHA GE
<55 gal/mo
Permit Date 10/112015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 Or]Q 30 70
CERTIFICATION
" 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 submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
[Required by 40 CFR §122.22]
Signature
Date L/l,
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015