NCG020120 DMR SW

I ANNUAL SUMMARY DMR - STORMWATER 11
SEND TO CENTRAL OFFICE RECEIVED
STORMWATER DISCHARGE OUTFALLS (SDO) MAR 0 2 2016
GENERAL PERMIT NO. NCG020000
CENiRA1 FILES
*Report ALL STORMWATER Monitoring Data on this form (including No Flow and No Discharge and Permit Limit Violations) by MARCH I of ac year:
CERTIFICATE OF COVERAGE NO. NCG02 0 1 2 0
FACILITY NAME: Hanson Brick - Anson County Mine
PERSON COLLECTING SAMPLES Jason Smith
CERTIFIED LABORATORY K&W Laboratories Lab # NC 559
Lab #
Part A: Stormwater Monitoring Requirements
SAMPLE COLLECTION YEAR: 2015
COUNTY Anson
PHONE NO. ( 704 ) 261-2160
ADD TO LISTSERVE? YES ❑ NO ❑ EMAIL:
Outfall
No.
Date Sample
Collected
(mo/dd/yr OR
NO FLOW)
In Tier 2
Monthly
Monitoring?
(y/n)
# of Months in
Tier 2 Total Flow
Sampling (MG)
Total Suspended
Solids
(mg/1)
Turbidit a Settleable Total Event
y
(NTU)Solids (mUl) Rainfall Duration
(in) (minutes)
-
-
-
- -
1001,4
See Footnote 3,5 0.1
S-001
No Discharge
01/01/2015 to
06/30/2015
S-001
No Discharge
07/01/2015 to
09/30/2015
' If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here and the Date Range.
2 Per NCG02: Tier 2 Monthly 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/l except in ORW, HWQ, trout, and PNA waters where they are 50 mg/l.
5 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 Activitv Monitorins Requirements for facilities using > 55 gal of new motor oil/month on averase
Outfall
No.
Date Sample In Tier 2
Collected Monthly
(mo/dd/yr OR Monitoring?
NO FLOW) (y/n)
# of Months
in Tier 2
Sampling'
New Motor
Oil Usage
(al/month)
Total Flow TPH using method
(MG) 1664A SGT -HEM
(Ing/1)
Total Suspended pH Total Event
Solids (Standard Rainfall Duration
(mg/1) Units) (in) (minutes)
_
_ 15
100,7 6-9
S-001
01/01/2015 to 06/30/2015
No Dischar
<55
S-001
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 91
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 l 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
violations."
(Sigifature of Permittee)
Permit Date: 1/1/2010-12/31/2014
(Date)
Last Revised 0 1 -2 1 -11
Page 2 of 2

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year 2015
"Report ALL STORMWATER monitoring data on this form (include "No Flow"rNo Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 7 of each year.
Certificate of Coverage No. NCG02
Facility Name: Hanson Brick - Anson County Mine
County: Anson
Phone Number:7( 04 ) 261-2160 Total no. of SDOs monitored 1
Certified Laboratory K&W Laboratories lab # IVC 559
Lab #
Stormwater Discharge Outfall (SDO) No. 001 VMA Outfall? Yes ❑ No
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 0 MRECEIVEI
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑ MAR 0 2 2016
Yes, received approval from DEMLR to reduce monitoring frequency ❑ CENTRAL FILEc
No, turbidity benchmark exceedances did not require monthly monitoring ❑ DWR SECTION
Other ❑
00011 No.
Total
Rainfall,
inches
TSS,
mg/I
SS, Turbidity,
ml/I NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mg/I
(VMA)
New
Motor Oil
Usage
aumo.
Stormwater
lndicateNO
FLOWN
Circle
Benchmark
100/50
circle
Benchmark
. 50/25/10
N/A
Water
ardpplies
N/A
Standard p
adp
1S_Tnori
>55 gaUmo.
average requires
TSS and
Non -polar
moit
Date Sample
Collected,
mo/dd/ r j
10/1/15 to 12/31/15
NO DISCHA RGE
< 55 gal/mo
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ®n1 QQo
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 §122.221
Signature
Date V
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