NCG020437 DMR WW (2)

ANNUAL SUMMARY DMR - WASTEWATER
SEND TO CENTRAL OFFICE*
PROCESS MINE/DEWATERING WASTEWATER
GENERAL PERMIT NO. NCG020000
* 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 0 4 3 7 SAMPLE COLLECTION YEAR: 2015
FACILITY NAME: Hanson Brick - Sampson II Mine COUNTY: Sampson
PERSON COLLECTING SAMPLES: Martin Brown PHONE NO. 5gs-4128
CERTIFIED LABORATORY: K&W Laboratories Lab # NC 559 ADD TO LISTSERVE? YES ❑ NO[-] EMAIL:
Lab # `
LIMIT VIOLATIONS? YES ❑ NO X❑ INDUSTRIAL SAND'? ❑ DISCHAR W��a . ❑
Part A: Wastewater Monitoring Re uirements
MAR 0 2 2016
Outfall No.
Date Sample
Collected]
Total Flow
Total Suspended Turbidity3
Solids' Settleable Solids
CENTRAL
W T AL FILES
pH 'Fecal &liforms
-
mm/dd/yy
MG
mg/l ' NTU12 ' ml/I
Standard col/n '
NA
No Discharge
01/01/2015 to
03/31/2015
NA
No Discharge
04/01/2015 to
06/302015
NA
No Discharge
07/01/2015 to
09/302015
No Discharges from Process /Mine Dewatering
Occur at This ite
' All mines must monitor WW discharges for TSS. Only industrial sand mine discharges are subject to TSS limits.
2 If an effluent limit is exceeded, the permittee is required to institute monthly monitoring for that parameter for the remaining permit term.
3 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.
a Only facilities discharging to SA waters are required to monitor for Fecal coliforms.
Permit Date: 1/1/2010-12/31/2014 Last Revised 0 1 -2 1 -11
Page 1 of 2

-an a wn[utuea: vvastewater ivlomtorm$ Requirements
Date Sample Total Flow Total Suspended Turbidity'
Outfall No �V+•
t
Collected Solids 1 Settleable Solids p �H Fecal Coliforms.
" 1V
mm/dd/yr MG In NTU .' MIA2 Standard ` ;. Col/M12,4
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW" "NO DISCHARGE" & LIMIT
VIOLATIONS) BY MARCH 1 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."
(Signature of Permittee) at
Permit Date: 1/l/2010-12/31/2014 Last Revised 0 1 -2 1 -11
Page 2 of 2

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — WASTEWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year 2015
*Report ALL WASTEWATER monitoring data on this form (include "No Floyd'/"No Discharge" and Limit Violations) from
the previous calendar year to the DEQ by MARCH 1 of each vear.
Certificate of Coverage No. NCG02
Facility Name: Hanson Brick -Sampson II Mine
Daily Flow
Rate, cfs
pH,
SU
TSS,
mg/l.
County: Sampson
Discharge
Turbidity,
NTU.
Upstream
(U) Turbidity,
NTIJ
Downstream
(D) Turbidity,
NTU
Phone Number:9( 10 ) 525-4128 Total no. of outfalls monitoredGrr
Effluent
Limitations
Mo. Ave 1 Daily Max.
Certified Laboratory K&W Laboratories lab # NC559
freshveter
6.0-9.0
saltwater
6.8-8.5
Industrial Sand
25/45
,QWorORW
20130
HQW orORW
jU Tr or PNA
10/15
MAR
Lab #
N/A
Water Quality
standardappliea
N/A
WaterQuallty
Standard applies
N/A
Wastewater (WW) Discharge Outfall No. 1
l !I
1
E-3 FM 01
pWR l
Is this an industrial sand mine (See 40 CFR §436 Subpart D)?
Yes ❑
No
Does this outfall discharge WW to SA waters?
Yes ❑
No
Does this outfall discharge WW to SB or PNA waters?
Yes ❑
No
Does this outfall discharge WW to HQW or ORW waters?
Yes ❑
No ❑x
NO DISCHARC
If so, what is the 7Q10 flow rate? or Tidally influenced waters,
7Q10 not available ❑
Does this outfall discharge WW to Trout (Tr) designated waters?
Yes ❑
No 91
Were there any limit violations in the calendar year? '
Yes ❑
No,❑x
Outfall No.
1
Daily Flow
Rate, cfs
pH,
SU
TSS,
mg/l.
SS,
ml/I
Aapplicable
Discharge
Turbidity,
NTU.
Upstream
(U) Turbidity,
NTIJ
Downstream
(D) Turbidity,
NTU
Fecal
Coliform,
col/100 ml
SA
Effluent
Limitations
Mo. Ave 1 Daily Max.
HQW or ORW
60% of
7Q10
Indicate NO FLOW
if applicable
freshveter
6.0-9.0
saltwater
6.8-8.5
Industrial Sand
25/45
,QWorORW
20130
HQW orORW
jU Tr or PNA
10/15
HQW, ORW,
SA, Se, PNA,
or any Trout
0.1/0.2
No Limit
Circle Water
Qthati applieae�
50/25/10
N/A
Water Quality
standardappliea
N/A
WaterQuallty
Standard applies
N/A
Date Sample
Collected,
mo/dd/ r
l !I
1
I
i
0/1/15 to 12/31/15
NO DISCHARC
ES FROM PROCESS
/ M
NE DEWATERING
OCCURAT
THIS SITE
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015
2016
FILES
;TION

Certificate of Coverage No. NCG02 F2 ®NQ
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 Z -A
Mail Annual Summary Wastewater 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 1011/2015 — 913012020
Last Revised 10-2-2015