NCG020200 DMR WW (2)

II ANNUAL SUMMARY DMR - WASTEWATER II
SEND TO CENTRAL OFFICE
PROCESS MINE/DEWATERING WASTEWATER
GENERAL PERMIT NO. NCG020000
*Report All Wasteivater discharge monitoring data on this form (including No Floiv and No Discharge and Permit Limit Violations) by MARCH I 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 N166 02Q2`0.0 SAMPLE COLLECTION YEAR: 2015
FACILITY NAME: Pollocksville Quarry COUNTY: Jones
PERSON COLLECTING SAMPLES: PHONE NO. 919-781-4550
CERTIFIED LABORATORY: PACE ANALYTICAL Lab #67 ADD TO LISTERVE? YES NO EMAIL:
LIMITS VIOLATIONS? YES ®O INDUSTRIAL SAND'? No DISCHARGE TO SA WATERS49 1,L o
Part A_ Wastewater Mnnitnrina Remdremenk
Outfall No.
Date Sample Total Flow Total Suspended
Collected' Solids'
Turbidity3 Settleable Solids pH Fecal Coliforms
-
mm/dd/yr MG mg/I''2
NTU 2,3 ml/12 Standard'- col/m12,4
No discharge for 2015
Site is not in operation
This is a greenfield site
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'All mines must monitor WW discharges for TSS Only industrial sand mine discharges are subject to TSS hunts
2 I an effluent limit is exceeded, the permittee is required to institute monthly monitoring for that parameter for the remaining permit term
3The 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 receiveing water, directly upstream and downstream of the discharge
4Only facilities discharging to SA waters are required to monitor for Fecal coliforms
Permit Date 1/1/2010-12/31/2014 Last Revised 0 1 -21 -11
Page 1 of 2

Part A: Continued: Wastewater Monitoring Requirements
Outfall No. Date Sample Total Flow Total Suspended Turbidity3 Settleable Solids pH Fecal Coliforms
Collected' Solids'
mm/dd/yr MG m 1''2 NTU2,3 mull Standard col/m12,4
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 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 sumbitted. 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 imprisionment for knowing violations."
/ C�s+.ti✓�� �j�v v..�.� �_ 2/3/16
(Signature of Perry
Permit Date 1/1/2010-12/31/2014
(Date)
Last Revised 0 1 -21 -11
Page 2 of 2
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