NCG020934_Application_20180807

NORTH CAROLINA
NPDES PERMIT APPLICATION
Rountree Sand Mine
US 13-158
Eure, NC 27935
Gates County
State of North Carolina
RECEIVED
AUG 0 7 2016
DENR-LAND QUALITY
STORMWATER PERMITTING
Department of Environmental Quality
Division of Energy, Mineral, and Land Resources
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
[phone]
Revised: 2017

ELLIOTT CONSULTING
August 5, 2018
NC Department of Environmental Quality
Division of Energy, Mineral and Land Resources
Land Quality Section
1612 Mail Service Center
Raleigh, NC 27699-1612
To Whom It May Concern:
This NPDES NCG020 General Permit Application is a request by Mr. Daniel S. Rountree,
manager of DSR Investors, LLC to allow excavation and dewatering of three ponds totaling
4.56 acres, on property owned by Mr. Rountree off US 13-158, Eure, NC, in Gates County.
The proposed permit area is in a rolling, sandy, logged area, and will not present any problems
regarding runoff to adjacent areas when all proposed erosion and sediment control measures
are in place. The purpose of the excavation will be to serve as wildlife habitat and to increase
scenic value for the landowner.
The excavation area will be located geographically 650 feet from the nearest public
highway and will be accessible only by a privately -owned access road. Excavation activities
will be screened from public view on all sides by existing full growth woodland, vegetated sand
berms, and distance across logged areas. Public access to the permit area is limited by private
property, and gated private road access. There will be minimum 25 -ft wide unexcavated
buffers on all sides of the permit area, minimum 50 -ft wide undisturbed buffers between
mining activity and adjacent wetlands.
Upon receipt of the approved permits from NCDEQ, Mr. Rountree plans to excavate the
ponds to an average depth of 35 feet below natural ground level and will include construction
of proper cut slopes on all sides of the excavated area, as required in the permit. Reclamation
of the permit area will include grading, leveling, and grassing of all affected areas. The permit
is requested for a 10 -year period.
All adjacent landowners have been contacted and made aware of the proposed excavation
operation, and land entry agreements have been obtained. The excavation area will be well
marked with warning and keep out signs to prevent inadvertent public access.
Mr. Daniel S. Rountree does hereby request approval for this NPDES Permit application
and asks that it be expedited as soon as possible. Mr. Rountree appreciates your consideration
of this mine permit application.
Sincerely,
Ken Elliott RECEIVED
For Daniel S. Rountree
DSR Investors, LLC AUG 0 7 2018
GENA -LAND QUALITY
ST0rZM4'VATER PERMITTING
PO BOX 112 • AYDLETT, NORTH CAROLINA • 27916
PHONE: [phone] • EMAIL: KEN®KENOBX.COM

Division of Energy, Mineral and Land Resources /
Land Quality Section – Stormwater Permitting Program
National Pollutant Discharge Elimination System
NCG020000
NOTICE OF INTENT — General Permit Application
FOR AGENCY USE ONLY
Date Received
Year
Month
Day
Certificate of Coverage
NIC1610121
Check # Amount
Permit Assigned to
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG020000:
STORMWATER AND/OR WASTEWATER DISCHARGES associated with activities classified as:
SIC (Standard Industrial Classification) Code - 14XX Mineral Mining Industry (except as specified below) and
like activities
The following activities are included:
• Active or inactive mining operations (including borrow pits—except for NCDOT borrow pits) that discharge
stormwater contaminated with or that has come in contact with, any overburden, raw material, inteyRediate
products, finished products, byproducts or waste products located on the site of such operations; Fvt%.
• Stormwater from vehicle maintenance activities (VMA) at mining operations;
• Overflow from facilities that recycle process wastewater; and/or
• Mine dewatering wastewater G 0
The following activities are specifically excluded from coverage under this General Permit �q_44 NOQ
• Stormwater discharges associated with peat mining, coal mining, and metal mining;
• Stormwater discharges from mining operations which are intermixed on site with stormwater from concrete TT/�
operations;
• Stormwater discharges associated with oil and gas extraction operations; and
• Stormwater discharges associated with tourist gem mines
• NCDOT borrow pits (covered under individual permit NCS000150)
The following discharges are covered by NPDES general permit NCG520000 instead of NCG020000:
Point source discharges of stormwater and wastewater from in -stream sand mining operations (sand dredging
or dipping operations) are covered instead by NPDES General Permit NCG520000, administered by the Division
of Water Resources NPDES Wastewater Permitting Program. Please contact DWR for more information.
Please print or type all entries in this application form.
1) Mailing address of owner/operator (official address to which all permit correspondence will be mailed):
Legal Owner Name DSR Investors, LLC
(Attach the most recent Annual Report to the NC Secretary of State showing the current legal nameof the corporation or entity.
Alternatively this permit can be given to an individual or government authority. This name must be the same name as appears on the
Division of Energy, Mineral, and Land Resources' Mining Permit.)
Signee's Name (as signed for in question 41. at end) Daniel S. Rountree
Street Address PO Box 22
City Gatesville State NC ZIP Code 27938
Telephone No. [phone] E-mail [e-mail]
Alternate Contact Name* Rountree Engineering & Contracting E-mail (if different)
Alternate Contact Telephone (if different) Same
Same
*Alternate contact should be affiliated with the Owner/Operator. Consultant information can be provided
in question 5.
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2) Location of facility producing discharge:
Facility Name Rountree Sand Mine
Facility Street Address US 158,13
Facility City Eure State NC ZIP Code 27935
Facility County Gates
Facility Contact Dan Rountree / DSR Investors, LLC
Telephone No. [phone] Fax:
Contact E-mail danO-rountreecontracting.com
3) Physical Location Information:
Please provide a narrative description of how to get to the facility (use street names, state road numbers, and
distance and direction from a roadway intersection). 0.50 miles south of the intersection of US 158, 13 and
NC 137. dirt road access to mine area on the left/east side of US 158, 13.
4) Facility Location Coordinates:
Latitude 36.428375 N
degrees)
N Longitude -76.894063 W W (degrees / minutes / seconds or decimal
5) Consultant Information (if applicable):
Consultant:
Ken Elliott
Consulting Firm:
Elliott Consulting
Mailing Address:
PO Box 112
City:
Aydlett
State:
NC Zip Code: 27916
Phone:( 252)
339-9021 Fax:( 88) 637-6241
E-mail: [e-mail]
Permits:
6) This NPDES Permit Application applies to which of the following:
(Optional)
Staple Business Card Here
® New or Proposed Facility Date operation is to begin: September 2018
❑ Existing Date began mining:
7) Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility SIC Code: 1 4 4 2
8) Provide a description of the types of minerals mined at this facility:
Sand and topsoil
9) Is this a PROCESSING -ONLY facility for materials mined elsewhere? ® No ❑ Yes
10) Is this an inactive mine site?
® No
❑ Yes If yes, have you certified to the Stormwater Permitting Program that all portions of the site where
clearing, grading, and/or excavation activities have occurred have been stabilized?
❑ No ❑ Yes (If yes, the site may be eligible for "Dormant Status" and reduced BMP
inspections. See the General Permit.)
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11) Does this facility already have a valid Mining Permit from DEMLR's Land Quality Section?
® No If no, please indicate the status of the Mining Permit application: New application submitted July 2018
❑ Yes If yes, please provide the Mining Permit number: Also provide a copy of
the DEMLR Mining Permit with this NPDES application.
12) Does this facility have any other NPDES permits?
® No
❑ Yes If yes, list the permit numbers for all current NPDES permits for this facility:
13) Are you applying for a discharge permit in the same location as a previously permitted mine?
® No
❑ Yes If yes, specify permit number and mine name if known:
14) Does this facility have any Non -Discharge permits from DWR (e.g., recycle permits)?
® No
❑ Yes If yes, list the permit numbers for all current Non -Discharge permits for this facility:
15) Does total area of this mine site include ready -mixed concrete plant and/or asphalt plant areas?
® No
❑ Yes If yes, do they have separate NPDES stormwater permits? ❑ No ❑ Yes (provide permit
number(s) )
If not owned by the same company, who is the owner?
Development Activities and Buffers:
16) Will this mining operation precede development activities at this site?
® No
❑ Yes
17) Is this mine located within one of the 20 Coastal Counties, and will it add more than 10,000 ft2 of
impervious surface?
❑ Yes (to both)
® No, this mine site IS in one of the 20 Coastal Counties but will NOT add 10,000 ft2 of impervious surface.
❑ No, this mine site is NOT in any of the 20 Coastal Counties.
if this site is in one of the 20 Coastal Counties, you may be required to apply for an additional State
Stormwater Permit. Check with your local Regional Office (see contact information and checklist below).
18) Is this mine located the Neuse, Tar -Pamlico, or Catawba River Basins, or the Randleman or Jordan
Water supply Watersheds?
® No
❑ Yes If yes, what size stream buffers are included on site? ft. You must show buffers on site
plans. Also include information and plans showing diffuse flow through buffers as required.
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Discharge Points, Receiving Waters & Wetlands:
19) Receiving waters:
What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater
and/or wastewater discharges will end up in? Buckhorn Creek to Chowan River
To find the waterbody, please see the "MAPS" tab on http://portal.ncdenr.org/web/wci for a map of NC
Surface Waterbody Classifications.
Receiving water classifications) for the waters: Bockhorn Creek - C -NSW Chowan River - B•NSW
If the site will discharge to a separate storm sewer system, name the operator of the separate storm sewer
system (e.g. City of Raleigh municipal storm sewer).
Discharge of wastewater to receiving waters classified as WS -II through WS -V, or SA, must be
approved by the Division of Water Resources (DWR) or Division of Marine Fisheries
(DMF). DEMLR cannot grant coverage under NCG020000 without that approval. Also be advised that
no new discharges of wastewater are permitted in receiving waters classified as WS -1 or
freshwater ORW. Wastewater discharges to saltwater ORW will not be approved under General Permit
NCG02 but may be eligible for an individual permit
20) Will this mine site discharge wastewater or stormwater to waters classified as High Quality Waters
(HQW), Primary Nursery Areas (PNA), Trout (Tr) waters, or a class with a symbol like "+" or "@" that
denotes a special management strategy is in place?
IN No ❑ Yes, HQW* ❑ Yes, includes "+" or
❑ Yes, PNA* ❑ Yes, Trout jr)
21) Will this mine site discharge wastewater or stormwater to waters classified as Shellfish (SA) waters?
® No
❑ Yes, SA*
*For questions 19-20, be advised that the NCG02 General Permit limits the discharge volume of total combined
wastewaters to 50 percent of the receiving water in -stream flow under 7Q10 conditions in HQW waters (PNA and
SA waters are considered HQW by definition). You maybe required to contact USGS to obtain a 7Q10 flow.
22) Will this mine site discharge wastewater or stormwater to impaired waters, or to waters with an
approved "Total Maximum Daily Load" (TMDL)?
To find impaired waters, please see the "Impaired Waters" map on the "MAPS" tab on
h ftp ://portal . n c d e n r. o ra /we blwg.
To find approved TMDLs in North Carolina, please see DWR's Water Planning Section website:
® No
❑ Yes, these waters are impaired for (list pollutants):
❑ Yes, these waters have a TMDL for (list pollutants):
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23) List discharge points (outfalls) that convey discharge from the mine site (both on-site and off-site) and
location coordinates. Attach additional sheets if necessary, or note that this information is specified
on the site plan. Include proposed maximum daily flow rate for each wastewater outfall.
You must show all discharge points clearly on the submitted site plan. Be advised
that NCDEQ may require you to apply for an individual permit, based on proposed
discharge rates and receiving stream conditions (low flows, impairments, etc.)
Stormwater
Stormwater Outfall No.
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
Mine Dewatering
Mine Dewatering (Wastewater) Outfall No. 1
Proposed maximum flow rate: 0.12 mgd
Latitude (degrees/minutes/seconds or decimal degrees): 36.429655
N
Longitude (degrees/minutes/seconds or decimal degrees): -76.894203
W
Mine Dewatering (Wastewater) Outfall No.
Proposed maximum flow rate:
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
Process Wastewater
Process Wastewater Outfall No. Wastewater Description:
Proposed maximum flow rate:
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
Process Wastewater Outfall No. Wastewater Description:
Proposed maximum flow rate:
Latitude (degrees/minutes/seconds or decimal degrees):
N
Longitude (degrees/minutes/seconds or decimal degrees):
W
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24) Help us understand what will happen to the dewatering water at this mine site:
❑ N/A — this mine is not dewatering at all and will not dewater in the future.
a) Will this mine be dewatering and discharging to waters of the state? (Answer only if dewatering)
❑ No
® Yes If yes, where to? ® Surface Waters and/or Wetlands (on-site or off-site)
❑ Other (on-site or off-site) Describe:
b) Will this mine be dewatering but not discharging to waters of the state? (Answer only if dewatering)
® No
❑ Yes If yes, explain how you are dewatering, and where that water will be directed:
25) Are there wetlands or surface waters within 400' of the mine pit perimeter?
❑ No
® Yes If yes, what distance are they from the mine pit perimeter? 75 feet.
26) Will mining operations require dewatering near wetlands or other waterbodies, and will dewatering
potentially impact any wetlands or other waterbodies?
❑ No, dewatering will not occur near (within 400') of wetlands or other waterbodies (e.g., streams, lake, etc.)
® Yes, dewatering will be near wetlands or other waterbodies
Wetlands must be CLEARLY DELINEATED on the site plan. Mine dewatering activities that
have the potential to drain wetlands or otherwise impact surface water or groundwater MUST develop and
implement a Pumping Operation and Monitoring (POM) Plan that has been approved by the
Department.
For sites that may drain wetlands — approval of a POM Plan may be required prior to coverage under
this permit. The POM Plan should be submitted to the appropriate Regional Office and in all cases must be
approved prior to operation.
The plan shall include, but is not limited to: (1) Groundwater monitoring strategies to demonstrate the effect of
pumping and to establish any pumping regime necessary to reduce impacts, and (2) Detailed plans to maintain
surrounding hydrology and respective monitoring to demonstrate compliance. See checklist at the end of the
application. Contact the Regional Office for questions specific to your mine.
27) Have you been required to obtain 404/401 Certification permits?
® No
❑ Yes If yes, please briefly describe below (include information such a required mitigation, BMPs,
setbacks, and/or O&M plans for on or off-site wetlands or other pertinent information). Attach other sheets as
necessary:
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28) Have you been required to obtain a wetland delineation certified by the US Army Corps of Engineers?
❑ No ® Yes If yes, please attach to application submission.
Stormwater BMPs and Vehicle Maintenance:
29) Does this facility employ best management practices for stormwater control?
❑ No M Yes If yes, please briefly describe: Operator will construct TT x 12'W berm around
entire affected area, all stormwater will drain intemally to mine, all excess stormwater will exit facility through
sedimentation pond and riprap protected outfall, discharge water to be monitored monthly for sediment.
30) Does this facility have a Stormwater Pollution Prevention Plan?
® No ❑ Yes If yes, when was it implemented?
31) Are vehicle maintenance activities (VMA) occurring or planned at this mine site?
M No ❑Yes, If yes, will VMA area runoff discharge into the wastewater treatment system(s)?
❑ No, VMA runoff will discharge separately through a stormwater outfall
❑ Yes, VMA runoff will drain back to the mine pit or other wastewater system
Wastewater Treatment Facilities:
32) Will mine dewatering occur? (Yes, we are asking about dewatering again.)
❑ No
IN Yes If yes, will the mine discharge this water? Discharge through sedimentation pond.
33) Will this facility wash mined materials?
IX No
❑ Yes If yes, will the mine discharge this water?
34) Will discharges of process wastewater treatment systems occur (including possible recycle system
overflows)?
M No
❑ Yes If yes, describe what kind of systems:
35) Will this facility employ chemical additives to flocculate suspended solids?
IN No
❑ Yes If yes, provide the name, manufacturer, and the quantity of average daily usage of the chemical
additive (if known):
Note: Please see our website for a list of evaluated polyacrylamide (PAMS) products for use in North
Carolina: hfp://portal.ncdenr.org/web/Ir/construction-stormwater
36) Will any of the wastewater treatment facilities at this mine overflow only during rainfall events that
exceed the 10 -yr, 24 -hr rainfall event?
❑ Yes If yes, which treatment systems are those?
IN No, all wastewater treatment facilities will discharge more frequently (i.e., during smaller rain events)
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37) Are wastewater treatment facilities (including recycle systems) planned in the 100 -year flood plain?
® No
❑ Yes
38) A WaSteWater treatment alternatives reviewis required by 15A NCAC 2H.0105 (c)(2)
for any new or expanding water pollution control facility discharges in North Carolina. You may
attach additional sheets. List the types of wastewater this mine site will discharge:
IN Mine Dewatering
❑ Process Wastewater (such as washing or recycle system overflows, other mining activity wastewater)
a) What wastewaters were considered for this alternatives review? [N Dewatering ❑ Process WW
b) Connection to a Municipal or Regional Sewer Collection System:
i) Are there existing sewer lines within a one -mile radius? ..................................... ❑ Yes ® No
(1) If Yes, will the wastewater treatment plant (WWTP) accept the wastewater? .... ❑ Yes ❑ No
(a) If No, please attach a letter documenting that the WWTP will not accept the wastewater.
(b) If Yes, is it feasible to connect to the WWTP? Why or why not?*
c) Closed-loop Recycle System (meets design requirements of 15A NCAC 2T.1000):
I) Are you already proposing a closed-loop recycle system (CLRS)? ......................... ❑ Yes ® No
(1) If Yes, for what type of wastewater at this mine site? ❑ Dewatering ❑ Process WW
(2) If No, is this option technologically feasible (possible)? Why or why not?*
Low freeboard of normal groundwater level, not enough room to add water from separate dewate
pond. Operator would be required to use dredge, not available. Not enough room for two separai
ponds for dewatering between.
(3) If No, is it otherwise feasible to build a CLRS at this site? Why or why not?*
Not enough room for added water from separate pond.
(4) What is the feasibility of building a CLRS compared to direct surface water discharge?*
Little or none.
d) Surface or Subsurface Disposal System (e.g., spray irrigation):
i) Is a surface or subsurface disposal technologically feasible (possible)? ..................... ❑ Yes ® No
Why or Why not?* l lnnhip to uap spray irrigation hprausp disrharep,qigintity would he Ipss than
required to dewater pond.
ii) Is a surface or subsurface disposal system otherwise feasible to implement?*............ ❑ Yes ® No
Why or Why not?* Unable to use spray irrigation because discharge quantity would be less than
required to dewater pond.
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iii) What is the feasibility of employing a subsurface or surface discharge as compared to a direct
discharge to surface waters?*
Little or none.
e) Direct Discharge to Surface Waters: Is discharge to surface waters the most environmentally sound
alternative of all reasonably cost-effective options for the wastewaters being considered?*
® Yes ❑ No
f) If this review included all wastewater discharge types, would excluding some types (e.g. mine
dewatering) make any of the above non -discharge options feasible for some of the wastewaters?
❑ Yes ® No
* Feasibility should take into account initial and recurring costs. You may be asked to provide
further information to support your answers to these questions after the initial review.
Other:
39) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
® No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
® No ❑ Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
IX No ❑ Yes
d) If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste:
How is material stored:
Where is material stored:
How many disposal shipments per year:
Name of transport / disposal vendor:
Vendor address:
40) Is your facility providing appropriate secondary containment for bulk storage of liquid materials? (See
permit text for secondary containment requirements.)
® No No onsite storage of liquid materials.
❑ Yes
41) Does your site have an active landfill within the mining permit boundary?
® No
❑ Yes If yes, specify type: ❑ LCID (Land Clearing and Inert Debris) ❑ Other:
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Final Checklist:
'—� This application will be returned as incomplete unless all of the following items have been included and
1 - initialed for. Please show that the following required information has been included by initialing in each
space below.
KCE Fee of $100 made payable to NCDEQ.
KCE Completed application and all supporting documents.
KCE Copy of the valid approved mining permit (MP) for the facility or indication of MP application status.
KCE Copy of a county map or other general location map that shows the mining site and nearest major roads.
KCE Copy of USGS topographic map showing the mining site and surrounding areas, or other map that clearly
shows site location in relation to nearby streams, wetlands, and other waters, etc.
KCE 2 copies of large-scale (minimum 24" x 36") site plan with topographical lines with
all outfalls, applicable buffers and wetlands clearly delineated, receiving waters, and
100 -year flood plain line if applicable.
KCE A copy of your US Army Corps -approved wetland delineation if you marked "yes" to question 27 above.
KCE A line drawing of the water flow through the facility or block flow diagram. A pictorial description of the
nature of any sources of water and any collection and treatment measures.
KCE If mine site is in one of the 20 Coastal Counties:
• Applicant has checked with the appropriate regional office to verify the need for a Coastal State
Stormwater permit. Indicate the Regional Office Contact: Thom Edgerton, WARO
• Applicant has included a detailed list of impervious surface areas and percentages, sub -drainage
areas, and total drainage area.
KCE If the mine is dewatering and near wetlands, or may otherwise impact surface waters or groundwater,
include the following and contact your local regional office about a Pumping Operation and
Monitoring (POM) Plan. An approved POM plan may be required priorto NCG02 issuance.
KCE2 copies of detailed Full Size Plans (at least 24" x 36") delineating areas on the
plans and listin4 acrea_ae (including: wetlands, ditches, well -placements, pits,
borrow areas, overburden storage, stormwater controls/BMPs, vehicle
maintenance areas, settling basins, product process (such as screening,
stockpiles, waste piles), total drainage area, impervious surface percentages (if
state SW programs apply), applicable buffers, and access and/or haul roads).
KCEPump dewatering size and information on its specifications.
Well information (design, depths, maintenance).
KCEPhysical monitoring for the wetlands areas.
KCESettling pond sizing information, if applicable.
Level spreader design, if applicable.
KCEDetails about dewatering method.
Cone of influence calculations.
!tea
KCEDescription of measures to prevent erosion and flooding.
Description and information about 401/404 permits that have been obtained.
KCECopy of US Army Corps of Engineers wetland delineations or approved wetland delineation (if
applicable).
KCEI have contacted my local regional office about a POM Plan.
Regional Office Contact: Thom Edgerton, WARD. Date contacted: July 16, 2018
I will not impact any nearby wetlands, surface waters, or groundwaters by dewatering.
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Certification: North Carolina General Statute 143-215.6 b (i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan or other
document filed or required to be maintained under this Article or a rule implementing this Article; or wto knowingly makes a false
statement of a material fact in a rulemaking proceeding or contested case under this Article; or who falsifies, tampers with,or knowingly
renders inaccurate any recording or monitoring device or method required to be operated ormaintained under this Article or rules of the
[Environmental Management] Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include afine not to
exceed ten thousand dollars ($10,000).
41) Signatory Requirements (per 40 CFR 122.22)
All applications, reports, or information submitted to the Director shall be signed and certified.
a. All notices of intent to be covered under this General Permit shall be signed as follows:
(1) For a corporation: by a responsible corporate oficer. For the purpose of this permit, a responsible corporate officer means: (a) a president,
secretary, treasurer or vice president of the corporation in charge of a principal business function, or any other person whcperfonns similar
policy or decision making functions for the corporation, or (b) the manager of one or more manufacturing production or operating facilities
employing more than 250 persons or having gross annual sales or expenditures exceeding 25 million (in second quarter 1980 ddl3rs), if
authority to sign documents has been assigned or delegated to the manager in accordance with corporate procedures.
(2) For a partnership or sole proprietorship: by a general partner or the proprietor, respectively; or
(3) For a municipality, state, federal, or other public agency: by either a principal executive officer or ranking elected official.
I hereby request coverage under the referenced General Permit. I understand that coverage under this permit will
constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an individual
permit.
I agree to abide by the following as a part of coverage under this General Permit:
1. I agree to abide by the approved Mining Permit for this mining activity. (A copy of the valid mining
permit must be attached to this request.)
2. 1 agree to not discharge any sanitary wastewater from this mining activity except under the
provisions of another NPDES permit specifically issued therefore.
3. 1 agree that bulk storage of petroleum products and other chemicals shall have adequate protection
so as to contain all spills on the site.
4. 1 agree that solid wastes will be disposed of in accordance with N.C. statutes and rules governing
solid waste disposal.
5. 1 agree that maintenance activities for vehicles and heavy equipment will be performed so as to not
result in contamination of the surface or ground waters.
I agree to abide by the provisions as listed above and recognize that the provisions are to be considered as
enforceable requirements of the General Permit.
I certify that I am familiar with the information contained in this application and that to the best of my knowledge
and belief such information is true, complete, and accurate.
Printed Name of Person Signing:
Daniel S. Rountree
Title: Manager of DSR Ir)kestors,LLC; Landowner.
�- July 27, 2018
of Applicant) (Date Signed)
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to NCDEQ.
Page 11 of 12
SWU-NCG02-NOI Last revised 9/10/2015

NCG020000 N.O.I.
Mail the entire package to:
Stormwater Permitting Program
Division of Energy, Mineral and Land Resources
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Note
The submission of this document does not guarantee coverage under the NPDES
NCG02 General Permit. Upon review of the submittal, the Division may
determine that coverage under an individual permit is more appropriate. Also be
advised that renewed and continued coverage under NCG02 may be dependent
upon the permittee's compliance success and/or status of the receiving waters.
For questions, please contact the DEMLR/Land Quality Section Regional Office for your area.
DEMLR/Land Quality Section Regional Office Contact Information:
Asheville Office ...... [phone]
Fayetteville Office
... [phone]
Mooresville Office
... [phone]
Raleigh Office ........
[phone]
Washington Office
...[phone]
Wilmington Office
... [phone]
Winston-Salem ......
[phone]
Central Office .........(919)
707-9220
Page 12 of 12
SWU-NCG02-NOI Last revised 9/10/2015

OPERATION AND MAINTENANCE PLAN
SAND MINE DEWATERING AND WATER LEVEL CONTROL STRUCTURE
ROUNTREE SAND MINE, EURE, NC
Operator: Dan Rountree, DSR Investors, LLC, PO Box 22, Gatesville, NC 27938
Job Location: US 158, 13, Eure, NC 27935
County: Gates County
Prepared by: Ken Elliott, consulting
Date: July 23, 2018
This plan defines responsibilities for operating, inspecting, and maintaining equipment and structures
used for constructing and dewatering the Rountree Sand Mine safely, and that dewatering will not
degrade or negatively impact any wetlands or waters of the state.
Description and Operation of the Rountree Sand Mine:
The Rountree Sand Mine is a proposed 7.19 -acre sand mine excavation operated by Dan Rountree,
landowner of the site parcel, in a 19.13 -acre permit area located at 580 US 158, approximately 1.2 miles
west of Eure, NC, in Tyrrell County. The permit area is on medium-high sandy land and is currently a
logged -over field owned by Dan Rountree and DSR Investors. Currently Mr. Rountree is applying to the
NCDEQ Division of Energy, Mineral and Land Resources for a mining permit to construct the sand mine
and begin operation in September 2018. Mr. Rountree is also applying for a Special Use Permit from the
Gates County Planning Department for construction of this mine.
Sand Mine Dewatering:
It will be necessary to dewater the excavation as it is being excavated to allow excavating equipment to
enter the excavated area in order to safely and efficiently remove the sand from the pond bottom to its
full permitted depth. This will allow for full depth excavation and proper reclamation of the edges of the
pond. It is the intention of Mr. Rountree to only dewater the excavation as needed, which will not entail
full-time dewatering.
For excavation purposes, dewatering will occur roughly every 30 days which will allow excavating
equipment to remove approximately 150 loads of sand up to ground level where it will be stockpiled for
later use. When the stockpile is depleted from usage, the excavation area will again be dewatered, and
another quantity of sand will be excavated.
The operator initially plans to construct a 0.57 -acre excavated pond as a sedimentation pond located
inside the north end of the main excavation area. Once this excavation has been completed, excavation
of the 6.62 -acre main pond will begin approximately 30 feet south of the sediment pond. The edge of the
sediment pond excavation and main excavation will be 75 feet from the nearest wetland swamp. Use of
the sediment pond will forcibly hydrate the nearby wetlands located east and west of the sediment pond
and excavation and will minimize dehydration of the wetland forest.

The operator will install a 6 -inch dewatering pump between the main pond and sediment pond at the
north end of the main excavation. Discharge from the dewatering pump will enter the sediment pond
on its south end, and there will be a constructed water height control device (see attached diagram)
discharge point located on the north end of the sediment pond. The discharge point will release clear
water by pipe to an existing 75 -foot -long riprap-protected ditch, leading to an existing field irrigation
and drainage ditch draining to the Buckhorn Creek wetlands, and then 5.0 miles to the Chowan River.
Water will be pumped from the main pond to the sediment pond by the 6 -in gasoline -powered transfer
pump operating at idle speed. Estimated maximum flow from the pump will be 1200 gallons/hour,
operating an average of 10 hours per day, 0.120-mgd. It is the intention of Mr. Rountree to drop the
water level in the main pond approximately 20 - 25 feet below normal ground level when needed.
The overflow from the sediment pond will be controlled by a water height control device constructed in
the northern bank of the sediment pond. This control structure will allow water to flow through the
baffle into a 25ft long x 15" wide buried PVC pipe leading northeast 25 feet to a 6ft wide field drainage
swale running north to an existing property drainage ditch, and then on to Buckhorn Creek and Chowan
River. For erosion control, the overflow water will exit the water height control discharge pipe onto a
20ft long riprap-lined apron in the ditch.
Time and distance will allow all sedimentation to occur to acceptable levels before the overflow water
reaches outfall and then the waters of the State. Water will have to travel a minimum of 240 feet in the
sediment pond to reach the overflow point which will give enough surface area to allow sufficient
sedimentation to occur. There will be a minimum 2 feet of freeboard between the water surface in the
sediment pond and the top of the sediment pond bank. Stormwater drainage will be unable to enter
the sediment area and damage the sediment pond rates, due to the height of a surrounding 2 -ft tall
sediment pond berm. All stormwater in the affected area will first drain internally to the main
excavation and only exit the affected areas of the permit area through the sedimentation pond.
Sedimentation and Erosion Control
There are designated palustrine forested seasonal saturated wetlands northeast and southwest of the
proposed excavation, located 75 feet from the excavation edge and running parallel to the eastern and
western permit area boundary. The operator will establish a 50 -ft wide undisturbed buffer (no
disturbance of any kind), adjacent to, and inside of, the permit boundary. This buffer will be maintained
by the operator as grass and shrub ground cover.
In addition, there will be a 25 -ft wide unexcavated buffer (may contain roadways, stockpiles, and
sediment & erosion control devices) around the entire excavation area, between the excavation and the
undisturbed buffer.
The operator will construct a 3 -ft tall by 12 -ft wide berm inside the unexcavated buffer around the
north, east, south and west sides of the working areas of the mine, between the mine and adjacent

wetland areas, to maintain positive, internal drainage of all stormwater to the pit area. All dewatering
wastewater and excess stormwater will exit the mine area by pumping into and discharging from the
sediment pond.
Sediment pond overflow will drain into an existing operator -maintained 6ft wide field drainage swale
running north to an existing property drainage ditch, and then on to Buckhorn Creek and Chowan River.
For erosion control, the overflow water will exit the water height control discharge pipe onto a 20ft long
riprap-lined apron in the ditch (see diagram).
During mining operations and dewatering, most of the water leaving the excavation will remain inside of
the permit area and will only overflow through the sediment pond occasionally. The sediment pond will
be approximately 6 feet deep, and there is a sand layer below the bottom of the area. The porosity of
the soil under the sediment pond will allow most of the water pumped into the pond from dewatering
to seep back into the ground naturally. Any excess water overflowing from the sediment pond will flow
downstream 5.0 miles to the Chowan River.
The operator will proceed with excavation of the main pond, dewatering the pond into the sediment pond
and overflowing into the field drainage ditches at the single discharge point, along with construction of
3:1 and 2:1 slopes as needed.
When final excavation of the main pond is complete, dewatering will be discontinued, and pump shut
down & removed. Groundwater will refill the excavation to normal seasonal high groundwater level.
Operator will then excavate & remove the land between the excavation and sediment pond to maximum
depth feasible without dewatering the excavation, allowing formation of one pond totaling 7.19 acres.
Maintaining the Sediment Pond Overflow Control Structure, Settlement Pond and Ditches
Inspections and maintenance are required to obtain the intended function of safely dewatering the sand
mine, and to maintain the life of any adjacent wetlands or waters of the State. Items to inspect and
maintain during the anticipated 10 -year life of the mine dewatering permit are:
• Inspect the water control structures regularly, especially following heavy rains and runoff, or
during periods of operation of the structure.
• Remove accumulated debris from the overflow control structure.
• Inspect the structure for excessive settlement or seepage.
• Inspect all components of the structure, including appurtenances, and repair or replace any
damaged items as needed.
• Inspect embankments, berms and appurtenant structures, and repair as needed.
• Repair any damage to vegetated areas or berms with compacted earth fill, reshaping, sodding,
reseeding and mulching as needed.
• Inspect riprap outlet stabilization structures in ditches regularly, replace dislodged rock as
necessary.
• Promptly repair all leaks in delivery facilities by replacing valves, fittings, gaskets, and worn or
damaged parts.

• Maintain all screens, filters, valves, timers and other electrical and mechanical equipment in
good operating condition, following manufacturer's recommendations
Monitoring the Process and Effects of Dewatering
Analytical and qualitative monitoring of mine dewatering wastewater will be in accordance with the
NCG020000 permit, as follows:
• All ponds in the Rountree Sand Mine permit area will be inspected daily by the operator to
identify any abnormal conditions.
• All berms and erosion control and sedimentation control structures will be inspected for
damages monthly and within 24 hours after every storm event greater than 1.5 inches, and all
structures will be repaired immediately.
• Special inspections will be conducted immediately following severe storms, vandalism, and
other significant events.
• Dewatering process will be inspected daily during periods of dewatering the excavation.
• Overflow of wastewater process will be inspected daily during periods of dewatering the
excavation.
• Outflow of dewatering wastewater will be monitored quarterly at the overflow exit stabilization
structure for pH, settleable solids, turbidity, and total flow. Samples will be collected and tested
onsite for pH, and the remainder will be tested for the remaining parameters by a North
Carolina certified lab.
• Rain gauge data will be collected by monitoring rain gauge data monthly and after each rain
event.
Records
Data will be collected as follows:
• Data will be collected from samples taken from the wastewater point source discharge in
operation at the time.
• Point source discharge data: data from the site taken quarterly, date & time, general weather
conditions, pH of sample, status of process at point source, inlet or outlet, other DWQ required
data.
• Visual monitoring of adjacent wetlands and farmland for potential dehydration during mining or
dewatering activities will take place weekly. Solutions to any degradation caused by any mining
activity will include alteration of dewatering process. DWQ will be consulted as needed;
alterations to process will be recorded.
• Elliott Consulting will maintain the following records in a permanent file at the Elliott Consulting
office at PO Box 112, 202 Elliott Road, Aydlett, NC 27916: a record of all significant actions
taken; as -built drawings; permits; analytical results from sampling; and related material. Copies

of all inspections, monitoring reports and lab analyses shall be provided to NCDWQ on a regular
basis and as requested.
BMP Conditions
• The permittee will utilize best management practices to ensure that dewatering the Rountree
Sand Mine will not degrade or negatively impact any wetlands or waters of the State. BMP's will
include:
o Sediment pond outlet structure with flashboard riser located at edge of pond for ease of
maintenance.
o All berms and erosion control and sedimentation control structures will be inspected for
damages monthly and within 24 hours after every storm event greater than 1.5 inches,
and all structures will be repaired immediately.
o Sediment pond outlet ditch will have rock lining or riprap stone layer to prevent erosion,
scour or sloughing of embankment
• The permittee shall obtain authorization from the Director of the NCDEMLR and the Stormwater
Program chief prior to utilizing any chemical flocculants at the Rountree Sand Mine.
Signed,
Ken Elliott
for Dan Rountree / DSR Investors LLC
July 23, 2018

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW -2018-00448 County: Gates U.S.G.S. Quad: Tarheel
NOTIFICATION OF JURISDICTIONAL DETERMINATION
Property Owner/Applicant: Dan Rountree
Address: PO Box 22
Gatesville, NC 27938
Size (acres) 43 acres
Nearest Waterway Chowan River
USGS HUC 03010203
Nearest Town Winton
River Basin Chowan
Coordinates Latitude: 36.427781 N
Longitude: -76.894567 W
Location description: Property is an approximate 42 -acre tract located on Small Lane, east of US 13, near Winton, in Gates
County, North Carolina. The project area has been clear cut and consists of upland ridges and headwater wetlands. Gates
County PTN# 10-0144.
Indicate Which of the Following Apply:
A. Preliminary Determination
X There are waters, including wetlands, on the above described property that may be subject to Section 404 of the Clean
Water Act (CWA)(33 USC § 1344) and/or Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403). The
waters, including wetlands, have been delineated, and the delineation has been verified by the Corps to be sufficiently
accurate and reliable. Therefore this preliminary jurisdiction determination may be used in the permit evaluation process,
including determining compensatory mitigation. For purposes of computation of impacts, compensatory mitigation
requirements, and other resource protection measures, a permit decision made on the basis of a preliminary JD will treat all
waters and wetlands that would be affected in any way by the permitted activity on the site as if they are jurisdictional
waters of the U.S. This preliminary determination is not an appealable action under the Regulatory Program
Administrative Appeal Process (Reference 33 CFR Part 331). However, you may request an approved JD, which is an
appealable action, by contacting the Corps district for further instruction.
_ There are wetlands on the above described property, that may be subject to Section 404 of the Clean Water Act
(CWA)(33 USC § 1344) and/or Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403). However, since the
waters, including wetlands, have not been properly delineated, this preliminary jurisdiction determination may not be
used in the permit evaluation process. Without a verified wetland delineation, this preliminary determination is merely an
effective presumption of CWA/RHA jurisdiction overall of the waters, including wetlands, at the project area, which is
not sufficiently accurate and reliable to support an enforceable permit decision. We recommend that you have the
waters of the U.S. on your property delineated. As the Corps may not be able to accomplish this wetland delineation in a
timely manner, you may wish to obtain a consultant to conduct a delineation that can be verified by the Corps.
B. Approved Determination
_ There are Navigable Waters of the United States within the above described property subject to the permit requirements of
Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403) and Section 404 of the Clean Water Act (CWA)(33 USC
§ 1344). Unless there is a change in law or our published regulations, this determination may be relied upon for a period
not to exceed five years from the date of this notification.
There are waters of the U.S., including wetlands, on the above described property subject to the permit requirements of
Section 404 of the Clean Water Act (CWA) (33 USC § 1344). Unless there is a change in the law or our published
regulations, this determination may be relied upon for a period not to exceed five years from the date of this notification.
_ We recommend you have the waters of the U.S. on your property delineated. As the Corps may not be able to
accomplish this wetland delineation in a timely manner, you may wish to obtain a consultant to conduct a delineation that
can be verified by the Corps.
_ The waters of the U.S., including wetlands, on your project area have been delineated and the delineation has been
verified by the Corps. If you wish to have the delineation surveyed, the Corps can review and verify the survey upon
Page 1 of 5

SAW -2018-00448 Rountree JD
completion. Once verified, this survey will provide an accurate depiction of all areas subject to CWA and/or RHA
jurisdiction on your property which, provided there is no change in the law or our published regulations, may be relied
upon for a period not to exceed five years.
The waters of the U.S., including wetlands, have been delineated and surveyed and are accurately depicted on the plat
signed by the Corps Regulatory Official identified below on Date: Unless there is a change in the law or our published
regulations, this determination may be relied upon for a period not to exceed five years from the date of this notification.
_ There are no waters of the U.S., to include wetlands, present on the above described property which are subject to the
permit requirements of Section 404 of the Clean Water Act (33 USC 1344). Unless there is a change in the law or our
published regulations, this determination may be relied upon for a period not to exceed five years from the date of this
notification.
X The property is located in one of the 20 Coastal Counties subject to regulation under the Coastal Area Management Act
(CAMA). You should contact the Division of Coastal Management in Washington, NC at 252-946-6481 to determine
their requirements.
Placement of dredged or fill material within waters of the US, including wetlands, without a Department of the Army permit
may constitute a violation of Section 301 of the Clean Water Act (33 USC § 1311). Placement of dredged or fill material,
construction or placement of structures, or work within navigable waters of the United States without a Department of the
Army permit may constitute a violation of Sections 9 and/or 10 of the Rivers and Harbors Act (33 USC § 401 and/or 403). if
you have any questions regarding this determination and/or the Corps regulatory program, please contact Josh Pelletier, at
(910) 2514605 or iosh.r.pelletier(a usace.army.mil.
C. Basis For Determination: The delineated wetlands on this site meets the wetland criteria as described in the
1987 Corps Wetland Delineation Manual and the Atlantic and Gulf Coastal Plain Regional Supplement to the 1987
Wetland Delineation Manual. The wetlands are a part of a broad continium of wetlands connected to the Chowan
River.
D. Remarks: Department of the Army authorization is required to work within any jurisdictional waters
and or wetlands on the property.
E. Attention USDA Program Participants
This delineation/determination has been conducted to identify the limits of Corps' Clean Water Act jurisdiction for the
particular site identified in this request. The delineation/determination may not be valid for the wetland conservation
provisions of the Food Security Act of 1985. If you or your tenant are USDA Program participants, or anticipate participation
in USDA programs, you should request a certified wetland determination from the local office of the Natural Resources
Conservation Service, prior to starting work.
F. Appeals Information (This information applies only to approved jurisdictional determinations as indicated in
B. above)
This correspondence constitutes an approved jurisdictional determination for the above described site. If you object to this
determination, you may request an administrative appeal under Corps regulations at 33 CFR Part 331. Enclosed you will find a
Notification of Appeal Process (NAP) fact sheet and request for appeal (RFA) form. If you request to appeal this
determination you must submit a completed RFA form to the following address:
US Army Corps of Engineers
South Atlantic Division
Attn: Jason Steele, Review Officer
60 Forsyth Street SW, Room 10M 15
Atlanta, Georgia 30303-8801
In order for an RFA to be accepted by the Corps, the Corps must determine that it is complete, that it meets the criteria for
appeal under 33 CFR part 331.5, and that it has been received by the Division Office within 60 days of the date of the NAP.
Should you decide to submit an RFA form, it must be received at the above address by XXXXXXX.
**It is not necessary to submit an RFA form to the Division Office if you do not object to the determination in this
correspondence.
Page 2 of 5

Digitally signed by PELEWRJOSH.R.1271483267
SAW-2018-00448 Rountree JD PELLETIERJOSH.R.1271483267 1-1ILLE7IERJOSH.R.1 271483267 DoD, ou=PKl, —USA,
Corps Regulatory Official: Date: 2018.05.1708: S3 S7-"00•
Date: May 17, 2018 Expiration Date: N/A for PJD
The Wilmington District is committed to providing the highest level of support to the public. To help us ensure we
continue to do so, please complete our Customer Satisfaction Survey, located online at
http://colpsmapu.usace.army.mil/cm apex/f?p=136:4:0.
Copy Furnished: CESAW/RG-W/Pelletier
Page 3 of 5

Applicant: Dan Rountree
File Number: SAW 2018-00 1 May 17, 2018
Attached is: See Section below
❑ INITIAL PROFFERED PERMIT Standard Permit or Letter ofpermission) A
❑ PROFFERED PERMIT Standard Permit or Letter ofpermission) B
❑ PERMIT DENIAL C
❑ APPROVED JURISDICTIONAL DETERMINATION D
M1 PRELIMINARY JURISDICTIONAL DETERMINATION E
tttaid l % .ttttlsr of
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A: INITIAL PROFFERED PERMIT: You may accept or object to the permit.
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• OBJECT: If you object to the permit (Standard or LOP) because of certain terms and conditions therein, you may request
that the permit be modified accordingly. You must complete Section 11 of this form and return the form to the district
engineer. Your objections must be received by the district engineer within 60 days of the date of this notice, or you will
forfeit your -right to appeal the permit in the future. Upon receipt of your letter, the district engineer will evaluate your
objections and may: (a) modify the permit to address all of your concerns, (b) modify the permit to address some of your
objections, or (c) not modify the permit having determined that the permit should be issued as previously written. After
evaluating your objections, the district engineer will send you a proffered permit for your reconsideration, as indicated in
Section B below.
B: PROFFERED PERMIT: You may accept or appeal the permit
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• APPEAL: If you.choose to decline the proffered permit (Standard or LOP) because of certain terms and conditions therein,
you may appeal the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section II of
this form and sending the form to the division engineer. This form must be received by the division engineer within 60 days
of the date of this notice.
C: PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative Appeal Process by
completing Section II of this form and sending the form to the division engineer. This form must be received by the division
engineer within 60 days of the date of this notice.
D: APPROVED JURISDICTIONAL DETERMINATION: You may accept or appeal the approved JD or provide new
information.
• ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify the Corps within 60 days of the
date of this notice, means that you accept the approved JD in its entirety, and waive all rights to appeal the approved JD.
• APPEAL: If you disagree with the approved JD, you may appeal the approved JD under the Corps of Engineers
Administrative Appeal Process by completing Section II of this form and sending the form to the district engineer. This form
must be received by the division engineer within 60 days of the date of this notice.
Page 4 of 5

E: PRELIMINARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps regarding the
preliminary JD. The Preliminary JD is not appealable. If you wish, you may request an approved JD (which may be appealed),
by contacting the Corps district for further instruction. Also you may provide new information for further consideration by the
Corps to reevaluate the JD.
REASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision or your objections to an initial
proffered permit in clear concise statements. You may attach additional information to this form to clarify where your reasons or
objections are addressed in the administrative record.)
ADDITIONAL INFORMATION: The appeal is limited to a review of the administrative record, the Corps memorandum for the
record of the appeal conference or meeting, and any supplemental information that the review officer has determined is needed to
clarify the administrative record. Neither the appellant nor the Corps may add new information or analyses to the record.
However, you may provide additional information to clarify the location of information that is already in the administrative
record.
If you have questions regarding this decision and/or the
appeal process you may contact:
District Engineer, Wilmington Regulatory Division,
Attn: Josh Pelletier
2407 West 5" Street
Washington, North Carolina 27889
910-2524558
If you only have questions regarding the appeal process you may
also contact:
Mr. Jason Steele, Administrative Appeal Review Officer
CESAD-PDO
U.S. Army Corps of Engineers, South Atlantic Division
60 Forsyth Street, Room l OM 15
Atlanta, Georgia 30303-8801
Phone: [phone]
IRIGHT OF ENTRY: Your signature below grants the right of entry to Corps of Engineers personnel, and any government I
consultants, to conduct investigations of the project site during the course of the appeal process. You will be provided a 15 day
notice of anv site investieation. and will have the onnortunity to narticinate in all site investieations.
Date: I Telephone number:
of appellant or
For appeals on Initial Proffered Permits send this form to:
District Engineer, Wilmington Regulatory Division, Josh Pelletier, 2407 West 5" Street
Washington, North Carolina 27889
For Permit denials, Proffered Permits and approved Jurisdictional Determinations send this form to:
Division Engineer, Commander, U.S. Army Engineer Division, South Atlantic, Attn: Mr. Jason Steele,
Administrative Appeal Officer, CESAD-PDO, 60 Forsyth Street, Room 10M15, Atlanta, Georgia 30303-8801
Phone: [phone]
Page 5 of 5