NCG020206 DMR SW

ANNUAL SUMMARY DISCHARGE MONITORING
S(JBMIT��TO:CENTRAL OFFICE,*�A,�,�I�
General Permit No. NCG020000 MAR 01 2016
Calendar Year 2015 rrZKrr,—
MML HLE
Report ALL STORMWATER monitonng data on this form,(mclude No FIovW'I No;D scharge� and BenchrriaIr flOf!
Ezceedancesj from;the previous,calentlar yearto the;DEQ by,MARCH,1 of each' year..:'..
Certificate of Coverage No. NCG02 ❑ 2❑❑©
Facility Name: DAVIDSON MINE
County: DAVIDSON
Phone Number: (3 3 6 ) 857-6202 Total no. of SDOs monitored 1
Certified Laboratory ACCUTEST LABORATORIES Lab # 573
Lab #
Stormwater Discharge Outfall (SDO) No. 1 VMA Outfall? Yes ❑ . No
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No [n
Was this outfall ever in Tier 2 during the past year? Yes ❑ No
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 ❑
Permit Date 10/1/2015 - 9/30/2020
Last Revised 10-2-2015

31
Certificate of Coverage No. N00020❑ 2❑ o❑©
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 `% r
Date 2-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