NCG020072 DMR SW (3)

REPORT (DM'M e 810 WA hR _IAN T 9 17
GernarJE P mtt 6 ©0 .MC ©2©©©© NC DENR Raleigh Regional Office
CsEeltdr 1Y©aD'2©17
lop* • t 4" O,�F � p�krt-Agip, .,,7.n- d•la^ ) ;;:I�p��,�� °a;ell. F''a °'i�li• K31 haii0��aM` ms:4 , ?
.�.�.. ,—..-..��.....--.. (o.� ,..6 'Ie+iY�kcar AV'i M4 i V©I �a le,Aar a41ry�4�IP)� _ t.%I4a
Certificate of Coverage No. NCG020072
Facility N-r e: Butner Quarry
County: Pry nville
Phone Number: (9191669-6187 Total no..of SDOs monitored 10
Certified Laboratory Contest Lab#652
Lab#
Storm water Discharge Du MOO) No. _ t1 Vii Oatfa!D? Yes 0 No
Ds we.outf,DB cuff.-nay in Tier 2 for any parameter? Yes ® No
Was this culla!! ev-r 6:; Tier 2 during the past year? Yes 0 No %1
Of this o.. i 8D was in Tier 2 Oast year, was monthEy monitoring discontinued?
Yes,enough consecutive samples below benchmarks to decrease frequency '❑
Yes,received approval from Dt=6LR to reduce monitoring frequency 0
No,turbidity benchmark exceedances did not require monthly monitoring 0
Other ❑
Upstream Downstream New
i�9ao Total Tsg, gs, Turbidity, (LP)Turbidity, (0) Turbid y, I�fot�P©IWr
Outu` BD i�'Dotor ©i
1 r; �i�ff ,DD9 tg/l btro&&D NTT C 9TU RITU 080fl angit usage
inches (VMA) �Dli ©off
Stem water bread.NO BI T NIA NIH. .53
.e. .requires
Benehcearks ' woUwa8o 100/50 0:1 s vlrterQu.Iq- al.Na
► 1' # 'rit°" "°
reu�lRa
Date Sample
aRoddiddyr
Pio Flow
Permit Data 10/112015 m 9130d2020
Last Revised 10-2-2015

Certificate of Coverage No. NCGO2 0072
Additional OutfaCi -A,ttachonent (make copies as needed for additional outfalls)
Storni war Discharge OWN (30O)) H©. 2 VA a ail? Yes 0 No ►i1'
Cs this out an curreirgy On Tier 2 for any parameter? Yee 0 No
y^;as this©utfail odor On Tier 2 during the past year' Yes 0 No ►l'
If this Duffel!was in Tier 2 Op t year, was t ©rotf'9OSy monitoring discontinued?
Yes,enough consecutive samples below benchmarks to decrease frequency 0
Yes,receiv:td approval from DEMLR to reduce monitoring frequency ❑
No,turbidity benchmark excoedances did not require monthly monitoring ❑
Other ❑
TetaU�ytr®� t DownstreamHew
;.; 88 No. SS, '�i'l�rbiatrp (l)TurividGfcy, (®)Turbidity, AhmiD©OIr l r DOO
G zainfai0fl nIB inVp MTU NSM 6Th Opp
inches
WA Ni
amidount , 'Amp militia
henchnarkS '8®®/55 CAI 50825®9611i 's
®ate Sample
•
Collected,
rno/Jir /yr
No Flow
Worm water Discharge autfalli(SIO) No. 3 ANA©utM? Yes 0 No ►i
ou Ci currently In Tier 2 for arty parameter? Yes 0 No ►�i
Was this ;.Wei On Tier 2 during the past year? Yes 0 He fri
if this coital!wee in TV r 2 Oast year,was monthly monitoring discontinued?
Yes,enough consecutive samples below benchmadcs to decrease frequency
Yes,receiv:.;approval from DEMLR to reduce monitoring frequency ❑
No,turbidity benchmark exceedances did not require monthly monitoring ❑
Other
1 ,
Upstream Downstream
®u4 BB ®.
Total ri eso ase TTurbi lity4 (U) Turbidity, (0) Turbidity, O�orttppclar Motor Oil
C �in$�llo mo mill NTU ikrrNJ CJTM Gaza, moil usage
RC 11@e CVNAA) ai0co®.`
Si` water' Indy r ear N/A N/A
kea
Benchmarks �a urr a Baa x11449 and nim'
tre� 'i�5/5® ®off' S®/�5P1� �a era, n.. ��- �e®mans
[Oat u Sample
C©i'acted,
m@/chi
No Flow -
Permit®ate 10/1/2015®9!30!2020
Last Revised 10-2-2015

Certificate of Coverage No. NCGO2 0072
Additional Outran Aftach,rrra.-nt(make copies as needed for additional®utfalls)
St®reg ear ,ter[Discharge Dutfail (SOO) No. 4 V., O il? Yes 0 N® !►1
Is this outfall currently in Thr 2 for any parameter? Yes ❑ Flo ►%
Was this is outtffaii ever in Ter 2 during the past year? Yes 0 No ►�.
if this out Al was in Tier 2 gnat 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 ❑
T®tal Tommie l Upstream Downstream New
®SBI Hca Ts% SS, t (U) Turbidity, (D)Ttar,�ldllty, Non-polar ,,.,toe Oil
r4,AmffaBl, Eo{/g tkrou NTM 0,G9 6V11 g U age
trochee OG.MA) aYmoe
Storm waiter; o a.Ka, i + ,� _ NIA, " ma
Benchmarks; 100/0 0.10 , 50/25/10` a't;dp'tt a'" a « • 15'il T ct' '
Date Sempl o■o momma"
Coiled
ma/did/yr
No Flow
Stein water Discharge Outran (S®®) l , 5 VMA Outfall? Yes 0 No i;%
1 ,tkl�i
outiall currently in Tier 2 for arty parameter? Yes ❑ No 0'
;as this our all ever in Ti sir 2 during the past year? Yes 0 No ►i
tiff this •utfali was in Tier 2 East year,was morally m illitaring discontinued?
Yes,enough consecutive samples below benchmarks to decrease frequency 0
Yes,received approval from DEMLR to reduce monitoring frequency 0
No,turbidity benchmark ettceedances did not require monthly monitoring
Other 0
Upateeain Downstream New
f,
Ora,: ::IB 1 ®0 TOWTOWTag, Se, Turbidity, (U)Turbidity, (D)I�,;.,I� , °reeler Motor Oil
Rt_inf rig, Emig BuoI/g NTh NTM NTM 0. , E'r Usage
inchesi )
'�' (gal/mo.)
Storm water, moyr+n.nrb s.nory anonniu� NIA, 1 NIA ': s66p.L�it1a:
rr tw.a 11,1014aro. x`15 rsa !rronp,
Benchmarks; R.ow,� 100/50 0.1 50125110 ,,... „=d oaomonlimina_
Date Sample
CoBBeotedi,
mo/did/yr
No Flow
Permit Date 10/1/2015®9/30/2020
Last Revised 10-2-2015

Ceith9catce of Coverage No. NCGO2 0072
AddGt onaG Outs fd Attachment(make copies as needed for additional outwits)
Mom watt Discharge Oat a66 Q8®4p Mo. 6 MTM ©WAR? Yes ® m© ii
is this culla ourrp®rt lyI ura Thr 2 for any parameter? Yes 0 X60 ►i
Was this oatfa06 ever En Mr 2 during Me past year? Yes 0 f>Z© ►i
Off this ©Wan W8S 6rt nor 2 East year, was monthOy r on6aorrbng discontinued?
Yes,enough consecutive samples below benchmarks to decrease frequency
Yes,received approval from D MLR to reduce monitoring frequency
No,tu N idity benchmark exc_.:ances did not require monthly monitoring •
Other
Upstream ©oranstrr€wn New
NOME No. 6'AW MS, OS, TugtEdEt 9 BSI Turbidity, (F)�'urz6ia6c�76fyo to ropoOar7 Motor®66
Qa6nffa6Q9 i vI6 m➢/6 "rLY NM NM Oa10D mg/i mg®
Mottos P9i il ) 2 Alm.
a >f6eS�Wait!', Benchmark BSirc mac ` NIA� r� y.
�,,Y"l,Benchmarks :La,. , 106650 OA50/2501® 1 ' ; se 'pIA
,
Cate Sarrpi� _ _
c©OO t
rolcd6d; r
62-08-2616 . 0 18 MD 12 M 4, MA MA NA
60-30-2616 0 600 MO MA MA MA MA N..
1246-2616 © Mfg ND 3.8 MA 'MA MA
• pan*Dame 106193015—a/3MM
Leer?Revised 10-2-2015

Certificate of Coverage No. NCGO2 0072
Additional ®Wail Attachment (make c•.ies as needed for additional outfalls)
Worm water Discharge©Una (SEEM No. 7 VIM O eQ➢7 Yes G Kg©
Is this outffail Cirrim➢iy in Tier 2 for any pairameteYes 0 No
Was this outrall ever in Tier 2 during the past year? Yos 0 No .
if tiros ©Wail was in MN'2 Bast ye.:,r,was monthly monitoring discontinued?
Yes,eno •;h consecutive samples below,benchmarits to decrease frequency El
Yes, received approval from DEMLR to reduce monitoring frequency
No,turbidity benchmarK exceedances did not require monthly monitoring
Other
9 Upstream Downstream NewTotal ma, T�, ty ( � rbcTurbidity, QDTurbidity,�9 �©�= ®8si Motor©
i®ut�ai➢ No.
7 Rainfall, tg/B rayl NTJ N M 1 TM ® g9 lingii Usage
inches ,,ap ) (alit©.)
c�
-o water.. e er„D mai- P@ WA_ Kam.
avaraan4CWk VY'atsgcc ul TBit ni,d+ Vr
odrae
Date Sampi4
B�E►/��1kfi�3�� 100/50 0.71 00!25/70 .., ,z., �„�,,, ',��
Collected,
n o%died/yr
No Flew
Storm wager Discharge irge Outfall(30*) No. 8 WM©ifail? Yes 0 No
Is f .01 ctctrrettliy in Tier 2 for any paraetietee? Yea 0 No ►moi
Was this outfall ever in Tier 2 dent the past year? Yes 0 No ►=i
if this ouifaiii was In Tier 2 last year, was monthly monitoring discontinued?
Yes,enough consecutive samples below benchmarks to decrease frequency
Yes,received approval from .•,EMLR to reduce monitoring frequency
No,turbidity benchmark exceedances did not require monthly monitoring
Over
Upstream Downst r©ate New
Gutfall ©. T©5 Tas, se, ' Tilrbid1fys (U) Turbidity, QC/Turbidity, Non-Polar , ©t©r©ii
�a6wffa0Dfl ifgii min TU N M N U 0E69 Ba li Usage
inches (V A) (gal/oto.)
�t WAFT aA w+ � warm WA r iraifmo.
kes
BenchmarlaR 100/50 0.1 50125!10 :� as .'o 75 Tse.na liar,
Date Sample
OBS3 mannasiniLL
C;.,Elected,
me/did/yr
flow
Permit Date 10/112015 m x/30/2020
Last Revised 10-22015

Additional 1utfffIi Attt=.chimera (make copies as needed for additional outfalls)
lama water Discharge Makin MOO) No. g VidA Ouffaii?? Yes 0 Ho ►l
Qs this autfali carrettiy in Tier 2 for say parameter?etern? Yes 0 No %i
Ma this Dull every in Tier 2 during the past year? Yee 0 MC)
if this ©Wall kvae in Fier 2 mast year, was monthiy ma/Waring discontinued?
Yes,enough consecutive samples below benchmarks to decrease tr!•q ency 9
Yes,received approval from DIEWUlLR to r_.ince monitoring frequency
turbidity benchmark exceedances did not require monthly monitoring
Oth;r
Upstream Downstream New
©ull o0 4 Total] �'es 88, Turbidity, (E Tr f iditt`y, VD)Tu bids j, V oompow Motor DQE
Rainfall,
inches �/i INN l 4i� ESM 6`.9TI1I ®g G �/i Usage
-_ ' se— — A
afarafarRII' �u,Rg1�1 `+ �IW'tf1 ! NliakNIA ', 1e_r-..-
Behawk Ftc " 100150 ®.,1' 5®/25/416 ' ° Y ' R Hf . la - Ts` 811vem11r"
4—. 431730
Date SaMpi@
C®QQcc�ted, -
a®/didivF
No Row
Storm water Discharge©aka (819©),Non _40 VSA Outran?? Yes 0 No ►i'
is this outlfaih curre itiy in Tier 2 for any parameter? Yes 0 No ►�,t
Was this©Wait ever in Tier 2 during h ®past year?? Yes 0 Geo ►
if this oc JE Was in Ther 2 Peat year,was monthly monitoring discontinued?
Yes,enough consecutive samples below benchmarks to decrease frequency 0
Yes,received -2 oproval from DIERfiLR to reduce monitoring frequency 0
No,twrr.idlty nchmark exceedances did not require monthly monitoring
Other
Upstreanl DOMEftgreaER New
©r 66 N©o D Tata 88, 88, Turbidity, (U),Tur iidi n, (D)` urbidi , Mcnigo0ar Rotor©ii
10ii Remail, nig/i ifD/i It\1Th WU RETU 082a, i�, g#B Mage
inches
��ad' v wa>PiG° a r > g NIA, *vamp Mort oras
Bonahmerkk_ 100/50 ' ®01' 50126/101' a Zd m��ica . . r - 1 1osm
Date Saimpie
Collected, i `
neo/didiyr
02-05-2016 0 42 NO 49 NA NA NA ND
06-30=201,5 0 72 ND NA NA NA NA ND
0oos0=` 041s° 0 56 ND 511 NA NA NA ND
1249-2010 00 BSD ND 179 ' NA ,J;• NA ND
Permit®ate 10/1/20105 m MO i x'020
Last Revised 10=2-2015

clitificate of Cover ge No. NCG020072
CERTFECATDOU
"I certify, and r penalty of Iew, that this d;:oument and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified p�=rsonn&l properly gather arid
avalu eta the information submitted. Based on my inquiry cf the person or persons who manage the sy/st=m, or
those p--sons directly responsible for gatherinn; Ins information,.the inform:tion submitted is, to the best of my
knowledge and belief,true, accurate, and complete. B am aware that VI:re :are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Required by 40 CFR§122.22]
Signator
Date / 20 —r6
Mail Annual Summary Storm water EAR to the MOM® Central lee:
Note the address is correct m Centre!Files is housed in DWR(not DEME R)
N.C. Dep DepaHment©ff Environmental 0ualit (DEM
Division of Viler i es©urr'oee
Amo D 1 Central Files
1617 6 ail Service Center
Raleigh, NC 2760001617
C ntral Files Telephone(919) v07-6300
Questions? Contact ID LR Storm water Permitting Staff in the Central !

.
DISCHARGE MONITORING REPORT ,D R• ®'WASTE ATL R
Fla \
General Permit No. NCGO20000
1
R
�r��.-ate � �` � .z��Y; ;�'' j��� �� - v 1,,-.)+7,-,..., - .,._, - _ _
'...; .� 3 1,15171:fyf i��,i D >�f t 7:146 a rf i . ,'1 j�� 4: L.,-e -- -
Certificate of Coverage No. NCG 2 0072
facility Name: Carolina Sunros- , LLC- utn r tb,uarry Sample Collection Period: Qtr 11 ra Qtr 2 tri Qtr 3 F/4 Qtr 4 iii Calendar.Year 2016
County: Granville It Monthly Monitoring: Mon[
Phone Number:f 91g)576-6010 Person Collectl,,• S<_rrnples:Scott "satire.;
Certified L;.4,0 ratory: Contest Lab#652
Lab
Os this an Incest .l sand Baine? Yes 0 No afesoharge to NOW or*RIM waters? Yes 0 No [e
Misch,rge ft®6A raters? Yee 0 NO ►11 Discharge tv Tr I;rout) .
nisei&rge to SB r PN ,water? 0 No ►/ if li t-W.what is the 70)16 flow-rate?
Wastewater 1r,®e��®we�g : -; �6r n:.� or Tidal, Pole not available /
Da' R S-mple Daily`1 iow pH, (�Suspee�..(a�a(�l S f Seabl Disc,r U� �qwn cpm
Collected rate, offs SU Solids��71�J�9 tJW./l®.r�]'�9 Turbidity,� ®�� (�+.' 11��� ®W'F!F/99���c t'd 3 V 1 Fecal
® 4 41Grease ream B®➢Turbidity, ©t llifvrm,
mgdl at�9dl NTU
No. W (mOnD (U5) N� ®00i®®eel
Thr l ISA)
d'e'- 9
H •
�QAWpa/e0 T t,a a .'S Mea- 1 w r ,. ,www. -, -\- �4�
infloiddiyr 1 '
- ear' FLOW' BQig '4 '° ' 3 �o� r� . k a' �/� '. r` �1/A
la 6246-2616 0.66 S.62 42 ND 19 •
N® aw . „
i0 66464616 0.60 7.66 - 72 ND NA ND la 69-294616 09-294616 0.60 6.14 65 ND el ND
10 1246-2016 N®Flow 72 N® ND 0.79 ND
Perm*®ate l00192013 s BOS0t2020
Lest Revised 11-18-2015
Page 9 of 3

•
' a+ate®ywaterMonitoring r-•:,uhregraen1+.
0,,tr 5 Ample Daily F0 mle pit Suspended Settleabffe Discharge 000 & Mpst Dome: L.tram F®ce0
C c n,cted Rats, ds SU Sends(T55)Q &Ads, Turbidity, grraas�) ream (0)TurbiTik, © ,1affivm,
Dugan
I m D ii MTV ��
Nig D (U) N� ��1 6� , a
Turb0 MAD
dsty9
0A Vit '' �� ET °`
_ . . _�1f1
e GrDastv(� - ----+ 1 --
i7t©/dti'�yi' 60�a� � 261419 oar er ..�
or"NO id/yr7Q10 1 � ..P �a s� k �Ietit� ii'k NIA WA t 'WA
,,: 201 .1 .,-: os,/ - t . '�'i , 'ftaragrel, WA
ev, 407 ,10110 ' .601 R10-tiletaPF 1'i �. ,
6 02=06°2010 0.20 7.7 -
16 ND 12 NA
6 O0a30=2016 020 0.9 0.0 ND NA NA
0 09-29-2010 020 7.76 10 ND 12 NA
0 12-20-2016 0.20 7.9 ND ND 3.8 1 NA
•
Permit Date 10/1/2010—9/30/2020
Last Revised 11-18-2015
Page 2 of 3

Certificate of Coir-rage No. NCGO2OO72
"I certify, under penalty of law, that this document and all attachments were
p :pared under my direction or supe ,isi®n in accordance with a system
design=ed to assure that qualified personnel properly gather and evaluate the information sulornittedl. cased 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 knowledg,: and
belief, true, accurate, and complete. I a-:-, aware that there are significant penalties fcr submitting false information, including the possibility of fines and
imprison!, nt for knowing violations? [Required by 40 CFR§122.22]
Signature
,,, ,..„(---",.2 ..
i�
Date r—2-631 -- /6-
Mall NM b Your®EFL egl.,r l ice Land Amalfi'', Section':
ASHIPIVILLE REGIONAL %MICE I'AYETT MLLE ;: 'Gfi'rNAL 1WIC 1 11,0 ESVILITY.i{ GIO AL OF'' CIE
2090 US Highway 70 225 Green Street 610 East Center Avenue/Suite 301
Swsnnanoa,NC 28778 Systel Building Suite 714 Mooresville,NC 28115
[phone] - Fayetteville,NC 28301-5043 ' (704)663-11699
[phone]
IRA Elq:, REGIONAL OleittlICE WASHINGTON REGIONAL OFFICE WHIVLINGT13N REGIONAL 141Ir'(CE
38I;a I:,arrett Drive 943 Westin, ;.,n Square M.11 :
" 1 NC 27609 Washington, � Il27 Com'` �''1 Drive Extension
I..:lei:* NC 27889 Wilmington,NC 2:,05-2845
[phone] [phone] - [phone]
MUST,LN-SQA M R EGXifNAL CENTRAL I& E
O14leACIE - SR�
450 Hanes Mill Road, Suite 300 ; Questions for The Central Office
W. rBmmwater Permitting t
Sto
` .'atom-Salem,NC 27103 , z a`+,. - a 4 �, , .:
(336) 776-98��,+�, (9Il9)707-9220t' .;�v �, � �:�
// , � ... . :R '��y1, .,f .. X11
L ".; 'a!t '^ "L -_ n,. f—"`y
_1+.. , . . $ i ""-..f -.r,-
'`C'' 'm' -4 p�
"•-G
Permit Date 10/1/2015—9/30/2020
Las/ evised 99-9 .-2095
Page 3 of 3

-7�
57S7717
ANNUAL SUMMARY DISCHARGE MONITORIN (40 (IA
REPORT DMR — STORMWATER JAN 7NC
General Permit No. NCG020000 DgNR Rei fiend Clfi'ic
Calendar Year 2016
`., r " gitT "'°mom(DO b y t?� J?i v'7 S9 D LEA9:111.17 rA )1'9igu.A -
Certificate of Coverage No. NCG020722
Facility Name: Woodsdale Quarry
County: Person
Phone Number:f 336)599-4147 Total no. of SDOs monitored 1
Certified Laboratory Contest Lab#652
Lab#
Stormwater Discharge Outfall (SDO)No.6 VMA Outfall? Yes 0 No ►/
Is this outfall currently in Tier 2 for any parameter? Yes❑ No e
Was this outfall ever in Tier 2 during the past year? Yes 0 No ►tet
If this outfall was in Tier 2 last year,was monthly monitoring discontinued?
Yes,enough consecutive samples below benchmarks to decrease frequency 0
Yes,received approval from DEMLR to reduce monitoring frequency ❑
No,turbidity benchmark exceedances did not require monthly monitoring 0
Other ❑
Upstream Downstream New
Outfall No. Total TSS, SS, Turbidity, (U)Turbidity, (0)Turbidity, Non-polar Motor Oil
6 Rainfall, mg/I ml/l NTU NTU NTU 084G, mg/1 Usage
inches (VMA) (gal/mo.)
StOrmwater _ i►crc n Na ®« ® Circle 14/AN1A. oa1!"�0
swrape on.po
BenchMa-4A' -0v .900!50 0 9 , 50/25110 ; suwna °'�'•v�'i $ 1p7
Date Sample
Collected,
mo/ddlyr
No Flow
Permit Date 10/1/2015—9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG020722
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 022.22)
Signature �� --
Date / - .0C) - /7
Mall 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 10/112015-9/3012020
Last Revised 10-2-2015

DISCHARGE MONITORING REPORT DMR -WASTEWATER
I _ - gD-131-ifirr776 it /r caffi-,7-2.
___ , __________ _...._. 1
General Permit No. NCG020000
ewef-=,-;-=�(�r rt r Wit, ftled/ , ,^ �
- ... ���J� � Tiea� i f. 6 1 ... L6J✓�� M Gy A� s fir 0�• /' 1 l� = r=f 4 � OY".
Certificate of Coverage No. NCG020722
Facility Name: Woodsdale Quarry Sample Collection Period: Qtr 1 0 Qtr 2❑ Qtr 3 0 Qtr 4❑ Calendar Year 2016
County: Person If Monthly Monitoring: Month
Phone Number. [phone] Person Collecting Samples: Scott Martino
Certified Laboratory: Contest Lab#652
Lab#
Is this an industrial sand mine? Yes ❑ No C.1 Discharge to HQW or ORW waters? Yes 0 No ►4
Discharge to SA waters? Yes❑ No CI Discharge to Tr(Trout)waters? Yes 0 No I
Discharge to SB or PNA waters? Yes❑ No e If HOW,what is the 7010 flow rate? or Tidal, 7Q10 not available❑
Wastewater Monitoring Requirements
Total
Date Sample Daily Flow pH, Suspended Settleable Discharge Upstream(U) Downstream Fecal
Outfall Collected Rate, cfs SU Solids (TSS), Solids, Turbidity, NTU Turbidity, (D) Turbidity, Coliform,
No.
mg/I mill NTU NTU co11100 ml
watt (SA),
Industrial Sand -
HQW nraRW fraahwatsr
mo/ddlyr 50%of 6.0-9.0' Norar4
wattw NPNl1,w�-'aWi�y,Tratq' No Limit NIA N/A
- - or"NO FLOW" 7Q10 °a""aaar 20/30 0.1/0.2Wa�r°"a9 rt and Wat r,„ r watero r NIA °
6.8'6.5 NM'or ORW Tr or PNA
thaE SRP etandaeu a�piw sta„aad app9ks,
FLOWindicate NCO ff airwlicable10!15 50/25!10,
6 NO Flow 1stQ 0
6 NO Flow 2"d Q 0
6 NO Flow 3rd Q 0
6 NO Flow 4t''Q 0
Permit Date 10/1/2015—913012020 Last Revised 11-18-2015
Page 1 of 3

Certificate of Coverage No. NCG020722
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 L_
Date / -.-?O —//
Mail Limit Violation DMR to Your DEMLR Regional Office Land Quality Section:
ASHEVILLE REGIONAL OFFICE FAYETTEVILLE REGIONAL OFFICE' MOORESVILLE REGIONAL OFFICE
2090 US Highway 70 225 Green Street 610 East Center Avenue/Suite 301
Swannanoa,NC 28778 Systel Building Suite 714 Mooresville,NC 28115
[phone] Fayetteville,NC 28301-5043 [phone]
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RALEIGH REGIONAL OFFICE WASHINGTON REGIONAL tiFFICE WILMINGTON REGIONAL OFFICE
3800 Barrett Drive 943 Washington Square Mall 127 Cardinal Drive Extension
Raleigh,NC 27609 Washington,NC 27889 Wilmington,NC 28405-2845
[phone] [phone] [phone]
WINSTON-SALEM REGIONAL CENTRAL OFFICE --
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Questions for The Central Office , . ,511
450 Hanes Mill Road, Suite 300 � -. � - _.---- � ,.�-
Winston-Salem,NC 27103 Stormwater Permitting Program?
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Permit Date 1 0111201 5-9/30/2020 Last Revised 11-18-2015
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