NCG020243 DMR WW (5)

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PROCESS/MINE DEWATERING WASTEWATER DISCHARGE MONITORING REPORT (DMR)
Please Mail Orignial And One Copy To Mailing Address Below
GEN F, ltAl. PERMIT NO. NCG020000
Purt.l. Facilitylnfn-mation
Samples Collected In Quarter: .10 2 3 n dQ- (all samples shall be reported within 30 days following monitoring period)
C vrtifleate Of Covera e No. N(.�f ' `%/�� f
r. , r r - , Cnanh of i acility
'll([, "Vance �9aq n �O/J��6jX--� C u� �r/�i/Je �u�t'B i i/ � ,, ir,_ ? :1 ,• ,t ,
i .colic; COWUCt /%!//� /� GN�G�1 Lab CertHication F
F,loility (nnt•tct Phone
a ."Ioc,!'.; 1F•ashni-caer and Mine Dewaterm - l finlltul llltr itequirem nti
C)utfall
ltunbor Receiving Stream iV:une
50050 1 00400 1 00530
APR 11 2" I:r
CENTRAL BILES
DWR SECTION
,/, 5" — _3'? 411?
00076 1 00545
Sauuple Collected I D-dly Flowi I )if I rotal Suspended Solids I Turbidity I Settleable Solids
//9 mo/dd'yl-XlffTx/ I unit m /1 _^
/J1'11• ml/l
/l///...)/�J' _ i �� �L�� , i�--•, ---- � � / � 1 ani U -- , � Q�
I �lca,ur d cununuuutily a ;lu'.;' nwa.swing devico or ,,tnn,a0d tumg m.mw.tuur.:r, pump curve., .ind pwnp lop
Par/ C. Cel-tl/reation
"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 toy 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. 1 am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations."
7 yIlr G
(Signature of Permittee) (Date)
Parr L) - Marling Address
Attn: Central Files, DENIi, N.C. Division of Nater Quality. 1617 Mail Set -vice Center, Raleigh, NC 27699-1617
SWI1-241- )11 Nl 3