NCG020513 DMR WW

ANNUAL SUMMARY DMR -WASTEWATER
SEND TO. CENTRAL OFFICE*
PROCESS MINE/DEWATERING WASTEWATER
GENERAL PERMIT No. NC'.C:O200; 00
RECEIVED
MAR.15 2016
1 EhI TRAL FILES
uvvR SECTIO
* Report All Wastewater discharge monitoring data on this form (including No Flow and No Discharge and Permit Limit Violations) by MARCH 1 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 „5
FACILITY NAME:
PERSON COLLECTING SAMPLES: SSL% �jZ'Z3
CERTIFIED LABORATORY: fif,4 Lab #
Lab #
LIMIT VIOLATIONS? YES ❑ N04
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: ©Z O
COUNTY: SU R R
PHONE NO. (,336 ) - %
ADD TO LISTSERVE? YES NOF] EMAIL:
INDUSTRIAL SAND? ❑ DISCHARGING TO SA WATERS'? ❑
Date Sample
Outfall No. l
Collected
Total Flow
Total Suspended Turbidity3.
Solids
Settleable Solids.. pH
Fecal Coliforms .
- mm/dd/yr
MG
mg/11' '3
2 Standard
coUml ,
�T dl -I
35
Nw,V5 rf o/- -i
, q 1
OFF 1 G -19-1-5
zz
I
0, 1
STRFArn G -IS -1
, 30
NWNSTRft IQ - I
5.00
u . -15
b;iJAUTP,619M- - !
(Q.
' All mores must mon tor WW discharges for TSS. Only industrial sand mine discharges are subject to TSS limits.
z If an effluent limit is exceeded, the permittee is required to institute monthly monitoring for that parameter for the remaining permit term.
'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.
' Only facilities discharging to SA waters are required to monitor for Fecal coliforms.
Permit Date: 1/1/2010-12/31/2014 Last Revised 02-02-11
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l
art A t onrinuea: wastewater monitoring Requirements
Date Sample Total Flow Total Suspended Turbidrty3
Outfall No.. 1 i Settleable Solids H Fecal Coliforms
Collected Solids p
a.
mm/dd/yr MG mg/1 ,,NTU ml/I. Standardz col/ml"'
a
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 ANYINFORMATIONREPORTED:
"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 away � hat there ark significant penalties for submitting false information, including the, possibility of fines and imprisonment for knowing violations."
(Signa of Permittee (Date)
Permit Date: 1/1/2010-12/31/2014 Last Revised 02-02-11
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