NCG020839_COMPLETE FILE - HISTORICAL_20180820

STORMWATER DIVISION CODING SHEET
RESCISSIONS
PERMIT NO.
N�! 3e7
DOC TYPE
❑COMPLETE FILE -HISTORICAL
DATE OF
RESCISSION
❑ o�-U%�(>��
YYYYMMDD I.

l�CG 0 9-0 83 (�
Energy, Mineral
and Land Resources
ENVIRONMENTAL QUALITY
August 20, 2018
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
7015 0640 0007 9831 3958
Mr. William Kelly
K & K Sand Company Inc.
1574 Blacks Chapel Road
Sanford, North Carolina 27350
RE: Black's Chapel Road Mine
Permit No. 53-25
Lee County
Cape Fear River Basin
Dear Mr. Kelly:
ROY COOPER
(;wernw,
N110ElAIs1- S. REGAN
SeCrernrl,
WHAAAM E.-VINSON Jr.
Im rim I )Irecurr
An inspection was made of the above mine on July 31, 2018 in accordance with G.S:
74-56 of the Mining Act of 1971.
The mine was found to be satisfactorily reclaimed. Therefore, your company is
released from further reclamation responsibility for this site with respect to the Mining Act of
1971.
Thank you for your cooperation in this matter.
Sincerely, -�
David Miller, PE
State Mining Engineer
DMljw
cc: Mr. Bill Denton, PE
Ms. Laura Alexander
Mr. William Gerringer-DOL, Mine and Quarry Bureau
Stale of North Carolina I Htiviromuntal Quality I Energy, Mineral and Land Resources
1012 Mail Service Center 1 512 N. Salisbury St. j Raleigh, NC 27699
919 707 9220

• 1i S
Energy, Mineral
and Land Resources
ENV$RONMENTAL QUALITY
K & K Sand Company LI_C
Attn: Lce Kelly
PO Box 9
Cameron, NC 28326
December 9, 2015
PAT MCCkORY
Siri-rrr0t
DONALD R. VAN D1:R VAART
Subject: NPDES Stormwater Permit Coverage Renewal COC #NCG020839
Dear Permittee:
sr r, r
TRACY DAVIS
1 rrrrrir,r
For coverage under NPDES General Permit NCG020000, the Division of Energy. ,Mineral and Land
Resources (DEMLR) is forwarding herewith the. reissued Certificate of Coverage and
Stormwater/Wastewater General Permit. This permit is reissued pursuant to (he requirements ol' North
Carolina General Statute 143-215.1 and the Memorandum of Agreement between the state of North
Carolina and the U.S. Environmental Protection Agency, dated October 15, 2007 (or as subsequently
amended.) The following information is included with your permit package:
• New Certificate of Coverage
• S(ormwater/Wastewater General Permit
• Technical Bulletin for the General Permit
• Discharge Monitoring Report (I)MR) Forms
• Annual Discharge Monitoring Report Forms
• Qualitative Monitoring Report Forms
The General Permit authorizes discharges of stormwater and/or wastewater (as applicable to your site).
and it SpccifieS your obligations with respect to discharge controls, management, monitoring and record
keeping. Please review the new permit to familiarize yourself with all changes in the reissued permit.
Significant changes to the General Permit are outlined in the Technical Bulletin.
Your coverage under the General Permit is transferable only through the specific action of DEMI_R. This
permit does not affect the legal requirements to obtain other permits which may be required by the N.C.
Department of Environmental Quality, nor does it relieve the per•mittee from responsibility for
compliance with any other applicable federal, state, or local law, rule, standard, ordinance, order,
judgment or decree.
If you have any questions regarding this permit package please contact the DEMI,R Stormwater
Permitting Program at 919-707-9220.
Sincerely,
for Tracy E. Davis. P.E.. C.P.M
Cc: Stormwater Permitting Files
SWICe 4 NOrlh CU01ina I I:m'ilunmerial Qu: lhy I linergy. Mineral and land Res, umcvs
1612 Mail Service Ccmer 1 512 North Saliyhury Slrecl I Raleigh. NC 27699-1612
919 707 921HI T

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
GENERAL PERMIT NO. NCG020000
CERTIFICATE OF COVERAGE No. NCG020839
STORMWATER AND WASTEWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
K & K Sand Company LLC
is hereby authorized to operate approved wastewater treatment system(s) and discharge
stormwater and/or wastewater, as approved in the original permit/application or
subsequent permit modification, from a facility located at:
Black's Chapel Mine
1574 Blacks Chapel Rd
Sanford
Lee County
to receiving waters designated as Run Branch, a class C water in the Cape Fear River Basin,
in accordance with the effluent limitations, monitoring requirements, and other conditions
set forth in Parts I,11, II1, and IV of General Permit No. NCG020000 as attached.
This certificate of coverage shall become effective October 1, 2015.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day October 1, 2015.
bLiy 8.1 11c'-
for Tracy E. Davis, P.E., CPM
Director, Division of Energy, Mineral and Land Resources
By the Authority of the Environmental Management Commission

=*A
- ,�...
NC®ENR
North Carolina Department of Environment and
Division of Water Quality
Pat McCrory Charles Wakild, P. E.
Governor Director
April 12, 2013
Lee Edward Kelly
K and K Sand Company, LLC
P.O. Box 9
Cameron, NC 28326
Natural Resources
John E. Skvarla, III
Secretary
Subject: General Permit No. NCG020000
Black's Chapel Mine
COC NCG020839
Lee County
Dear Mr. Kelly:
In accordance with your application for a discharge permit received on January 3,
2013, we are forwarding herewith the subject certificate of coverage to discharge under the
subject state -- NPDES general permit. This permit is issued pursuant to the requirements
of North Carolina General Statute 143-215.1 and the.Memorandum of Agreement between
North Carolina and the US Environmental Protection Agency dated October 15, 2007 (or as
subsequently amended).
Please take notice that this certificate of coverage is not transferable except after
notice to the Division of Water Quality. The Division of Water Quality may require
modification or revocation and reissuance of the certificate of coverage.
Please note that mine dewatering wastewater includes wet pit overflows caused
solely_by-direct rainfall and groundwater seepage for this type of mining operation. Any
discharge of this water (and any stormwater commingled with it) is subject to the effluent
limitations in this permit.
This permit does not affect the legal requirements to obtain other permits which
may be required by the Division of Water Quality or permits required by the Division of
Land Resources, Coastal Area Management Act or any other federal or local governmental
permit that may be required.
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N, Salisbury St. Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone]
Internet: www.ncwaterouality.org
NorthCarolina
,Naturally
An Equal Opportunity 1 Affumalive Action Employer

Lee Kelly
April 12, 2013
Page 2 of 2
If you have any questions concerning this permit, please contact Bethany
Georgoulias at telephone number [phone], or at [e-mail].
Sincerely,
ORIGINAL SIGNED BY
BETHANY GEORGOULIAS
for Charles Wakild, P.E.
cc: Raleigh Regional Office, Dave Parnell
Central Files
Judy Wehner — NCDENR-DEMLR
Stormwater Permitting Unit Files

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG020000
CERTIFICATE OF COVERAGE No. NCG020839
STORMWATER AND WASTEWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
K and K Sand Company, LLC
is hereby authorized to discharge stormwater and wastewater from a facility located at
Black's Chapel Mine
1574 Black's Chapel Road
Sanford, NC
Lee County
to receiving waters designated as Run Branch, a class C water in the Cape Fear River Basin,
in accordance with the effluent limitations, monitoring requirements, and other conditions
set forth in Parts I, II, III, IV, V, and VI of General Permit No. NCG020000 as attached.
This certificate of coverage shall become effective April 12, 2013.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day April 12, 2013.
ORIGINAL SIGNED BY
BETHANY GEORGOULIAS
for Charles Wakild, P.E., Director
Division of Water Quality
By the Authority of the Environmental Management Commission

N00020839
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K and K Sand Company, LLC
Black's Chapel Mine
Latitude: 350 20' 20" N
Longitude: 790 11' 48" W
County: Lee
Receiving Stream: Run Branch
Stream Class: C
Sub -basin: 03-06-13 (Cape Fear River Basin)
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Facility Location

A MkPIa
NC®ENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Lee Edward Kelly
K and K Sand Company, LLC
P.O. Box 9
Cameron, NC 28326
Dear Mr. Kelly:
Division of Water Quality
Charles Wakild, P. E.
Director
April 12, 2013
John E. Skvarla, III
Secretary
Subject: General Permit No. NCG020000
Black's Chapel Mine -
COC NCG020839
Lee County
In accordance with your application for a discharge permit received on January 3,
2013, we are forwarding herewith the subject certificate of coverage to discharge under the
subject state - NPDES general permit. This permit is issued pursuant to the requirements
of North Carolina General Statute 143-215.1 and the Memorandum of Agreement between
North Carolina and the US Environmental Protection Agency dated October 15, 2007 (or as
subsequently amended).
Please take notice that this certificate of coverage is not transferable except after
notice to the Division of Water Quality. The Division of Water Quality may require
modification or revocation and reissuance of the certificate of coverage.
Please note that mine dewatering wastewater includes wet pit overflows caused
solely by direct rainfall and groundwater seepage for this type of mining operation. Any
discharge of this water (and any stormwater commingled with it) is subject to the effluent
limitations in this permit.
This permit does not affect the legal requirements to obtain other permits which
may be required by the Division of Water Quality or permits required by the Division of
Land Resources, Coastal Area Management Act or any other federal or local governmental
permit that may be required.
1617 Mail Service Center, Raleigh, North Carolina 2709-1617
Location: 512 IN, Salisbury St. Raleigh, North Carolina 27604
Phone: 91H07.63001 FAX: [phone]
Internet: www.ncwatemuality.om
None
rthCarolina
Vatura!!y
An Equal Opportunity 1 Affirmative Action Employer

Lee Kelly
April 12, 2013
Page 2 of 2
If you have any questions concerning this permit, please contact Bethany
Georgoulias at telephone number [phone], or at [e-mail].
Sincerely,
ORIGINAL SIGNED BY
BETHANY GEORGOULeS
for Charles Wakild, P.�
cc: Raleigh Regional Office, Dave Parnell
Central Files
Judy Wehner - NCDENR-DEMLR
Stormwater Permitting Unit Files

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG020WQ
CERTIFICATE OF COVERAGE No. NCGO20839
STORMWATER AND WASTEWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION -SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
K and K Sand Company, LLC
is hereby authorized to discharge stormwater and wastewater from a facility located at
Black's Chapel Mine
1574 Black's Chapel Road
Sanford, NC
Lee County
to receiving waters designated as Run Branch, a class C water in the Cape Fear River Basin,
in accordance with the effluent limitations, monitoring requirements, and other conditions
set forth in Parts I, 11, III, IV, V, and VI of General Permit No. NCG020000 as attached.
This certificate of coverage shall become effective April 12, 2013.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day April 12, 2013.
ORIGINAL SIGNED BY
BETHANY GEORGOULIAS
for Charles Wakild, P.E., Director
Division of Water Quality
By the Authority of the Environmental Management Commission

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K and K Sand Company, LLC
Black's Chapel Mine
Latitude: 350 20' 20" N
Longitude: 790 11' 48" W
County: Lee
Receiving Stream: Run Branch
Stream Class: C
Sub -basin: 03-06-13 (Cape Fear River Basin)
Facility Location
R1111

(1-2�s--D
Georgoulias, Bethany
From: Wehner, Judy
Sent: Wednesday, April 10, 2013 10:18 AM
To: Georgoulias, Bethany
Subject: RE: Mine renewal status: 53-25
It hasn't been signed yet but is very close. You are reading it right. Its okay to issue the DWQ renewal.
From: Georgoulias, Bethany
Sent: Wednesday, April 10, 2013 10:01 AM
To: Wehner, Judy
Subject: Mine renewal status: 53-25
Hi Judy,
I'm just following up on a Mine Renewal. It's for Black's Chapel Pit in Lee County. I'm not sure I'm reading IBEAM right,
but I think the renewal is still pending. Is that correct? Are we okay to go ahead and issue the Water Quality discharge
permit? Our Raleigh Regional Office is okay with it. A screen shot of IBEAM is below.
Thanks,
Bethany
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Bethany Georgoulias
Environmental Engineer
NCDENR I DWQ I Stormwater Permitting Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
512 N. Salisbury St, Raleigh, NC 27604
Phone: [phone]
Fax: [phone]
NEW Website: http:llportal.ncdenr.org/web/wglws/su

E-mail correspondence to and from this address may be subject to the North Carolina Public
Records Law and may be disclosed to third parties.

Georgoulias, Bethany
From: Parnell, David
Sent: Monday, April 08, 2013 11:15 AM
To: Georgoulias, Bethany
Subject: RE: K & K Sand Company - Lee
After further review, No 0 & M plan will be required at this time.
Dave
From: Georgoulias, Bethany
Sent: Wednesday, March 27, 2013 10:46 AM
To: Parnell, David
Cc: Smith, Danny
Subject: RE: K & K Sand Company - Lee
Hi Dave,
haven't forgotten about this, and I wanted to thank you for following up on it! I am working on preparing the four
renewal general permits for notice before vacation next week.
I take it Raleigh is okay with our moving forward with the COC for NCG02 for this site, as long as DEMLR is okay with
it?
Also, could you help answer the questions in the original request below? (Any 0&M Plan needs and Mining Review
Sheet). Thanks! -Bethany
From: Georgoulias, Bethany
Sent: Monday, March 04, 2013 1:54 PM
To: Smith, Danny
Subject: NOI for NCG020000 Mining Permit from K and K Sand Company, Lee County
Hi Danny,
Attached is an NOI application from K and K Sand Company, LLC. for Black's Chapel Mine in Lee County.
They're requesting coverage under NCG02 (stormwater and wastewater) for this sand mine. It appears to be
an existing mine that recently renewed (or applied for renewal/modification of) their Mining Permit with
DMLR (#t53-25, formerly #t43-43).
They mine sand, clay, and topsoil. Discharges are to Run Branch (Class Q in the Cape Fear Basin. I'm sending
copies of the larger Mining Plan and other maps/Mining Permit applications separately via interoffice mail, so
those should arrive soon. From the mining plan, there are several pockets of wetlands delineated on the site.
Please d0he us abou yWether.'an O&MTldn is neces'sdr „ and whether or not we should hold off issuing the
COC until you all approve that plan. The application says that there are only stormwater discharges (no
dewatering), but there are three streams crossing the property. The only named one is Run Branch, so that's
what I've got listed so far). This mine has been around since 2002, so I'm not sure whether RRO has any
history with it or not, or whether any streams/wetlands have been impacted by prior activities there. Also,
since it's an industrial sand mine, overflows of pits are considered wastewater regardless.

Does the Raleigh Regional Office have any concerns with issuing a COC for this site? poSirou want us to'hald
ff uriti,l" au et an O&IVI Pfan. It's hard to tell whether much pumping is involved, but I usually assume there
is, even if the application doesn't state it explicitly.
Also, did kAd,ever ` A a bWQ-DM7L Mining Review sheet�for this project? I can't find a copy.
. .. -
The application came in January P, so I'd like to get this one issued as quickly as possible (though it's my fault
for being behind!). If you all could let us know anything by March 22"d, that would be great. Please feel free
to request more time for review if that's not sufficient, though.
Thanks so much! I'll put the accompanying application materials in the mail today.
Bethany
Bethany Georgoulias
Environmental Engineer
NCDENR I DWQ I Stormwater Permitting Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
512 N. Salisbury St, Raleigh, NC 27604
Phone: [phone]
Fax: [phone]
NEW Website: http:Ilportal.ncdenr.org/web/wq/ws/su
E-mail correspondence to and from this address may be subject to the North Carolina Public
Records Law and may be disclosed to third parties.
From: Parnell, David
Sent: Wednesday, March 20, 2013 2:04 PM
To: Georgoulias, Bethany
Cc: Smith, Danny
Subject: K & K Sand Company - Lee
Bethany,
I visited the site in Lee County yesterday (3/19). Lee Kelly showed me around the site. They are moving
in the direction of reclaiming the site and finishing it out in about 2 years. There are three streams and
areas of wetlands shown on the plan and I observed all of them. There are no impacts to them from this
site that I could tell. Lee states that the uphill neighbor changed the course of one of the streams and
flooded two holes that resulted in two shallow ponds. One pond has a high water overflow pipe that
leads to a stream. Lee states that the pond will be use for the recycling of sand wash water, but no
discharge to the stream or wetlands will result. He is planning to move the wash equipment the other
pond at a later date. That pond does not have a high water overflow pipe. To eliminate the chance of a
discharge to the stream from the recycling system, I would recommend the removal of the high water
overflow pipe for the pond now being used for recycling. The water level was well below the pipe. I also
observed the sediment traps and recommended improvements to make them more effective. The two
fuel tanks have secondary containment.
Lee Kelly said that John Holley of DLR had visited the site recently.

1
hope this information is helpful. I did not find a current permit for this site, but talked with Lee about
requirements of the NCG02,
Dave Parnell
E'nvironmentai Senior Specialist
Division of Water Quality
Surface Water Protection Section
3800 Barrett Drive
Raleigh, NC 27609
(iavid.parEiell@ncdeni•.gov
919-791-4260
919-788-7159 Fax
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law
and may be disclosed to third parties.

NCG02 Stormwater Permit: Mining Permit Review
Permit Number: NCG020839 Reviewer: BAG
Mine Name: Black's Chapel Mine
Summary
• Receiving Stream: Run Branch
• Classification: C
• River Basin: Cape Fear
• County: Lee
• Notes:
Regional Information
• Office:
o
❑ARO
Contact:
o
❑FRO
Contact:
o
❑MRO
Contact:
o
®RRO
Contact: Dave Parnell
o
❑WaRO
Contact:
o
❑WiRO
Contact:
o
❑WSRO
Contact:
• Dates:
o
Approval requested:
3/4/2013
o
Approval received:
4/8/2013
o
"No wetland impact"
determination, (15A NCAC 02B .023 1 (b)(5)(f) requires the
Division to preserve the water levels of wetlands. We can require engineering plans
to ensure that this is the case.)
o
Inspection:
3/19/2013
• Notes:
RRO advised Pumping
O&M Plan not necessary at this time.
Other Agency Information
• DLR
o
Have a valid Mining Permit?
®yes ❑no
o
Is our application owner the same name
as the DLR permit? (This is a requirement
and a permit condition).
®yes Ono
o
Permit Number
#53-25
o
Application submitted date:
12/7/2012
o
Approved date:
Pending; see 4/9 e-mail from_J. W_ chner,
o
Have you added the DLR permit # to BIMS under "Related Permits"? ®yes ❑no
o
DWQ/DLR review sheet reviewed?
Dyes ®no
■ (see S: \Stormwater Permitting Unit\Mines - DWQ RO Mine Reviews for DLR)
o
DWQ/DLR review sheet stipulates holding DLR permit? Dyes ®no
Why?
o
Notes: No DW -/DLR Review Sheet Available
• DEH (if WS)
o
Needed?
Oyes ®no
o
Application submitted date:
N/A
o
Approved date:
N/A
• Shellfish
Sanitation (if SA)
o
Needed?
Dyes ®no
o
Application submitted date:
N/A
o
Approved date:
N/A
Paget of 4

NCG02 Stormwater Permit: Mining Permit Review
• 401 /404 Certification / Wetlands Info
o Is a 40I Required? Dyes ®no
0 401 Written Concurrence Required? [-]yes ®no
o Are there offsite wetlands? Dyes ❑no
o If yes above, does a 401 require an O &M for offsite wetlands? Explain:
o If 404, Application submitted & approved date: N/A
o If 401 Approved submitted & approved date: N/A
o Have you requested a USACE wetlands delineation? ❑yes ®no
Notes: Wetlands delineation appears on Mining Plan
Application Review
a) The permit application
• Signed:
®yes
❑no
• Is signature by correct person?
®yes
❑no
• Complete:
Dyes
❑no
• SIC Code: SIC 1442
i. Describes activities:
®yes
❑no
ii. Covered by permit:
®yes
❑no
b) Mine Type:
• Quarry:
❑
• Sand:
• Clay:
❑
• Are there other activities at site (i.e.
asphalt or concrete)?
Dyes ®no
• Notes: Sand, clay, and topsoil
c) Mine Size:
• Pit Acreage (estimate if not known)
110.5
• Screening Acreage
• Concrete Acreage
• Asphalt Acreage
• Screening / Processing Acreage
0_2
• Other Acreage
0
• Tailings/Sediment Pond Acreage
5_0
• Stockpile Acreage
16.1
• Waste pile Acreage
0
• Haul Roads
0.72
• Total Acreage
132.5
• Notes:
d) New Coastal Rules:
• Is the mine in one of the 20 Coastal Counties? Dyes ®no
• Does the mine have > 10,000 square feet of BUA? []yes ®no
[If the answer is "Yes" to both of the above, please notify permittee they will need a state
SW permit and notify the Wi or Wa Regional Office].
e) Buffers;
• Is the mine in the Neuse, Tar -Pam, Randleman, Catawba River Basin or Jordan
Lake watershed? ❑yes ®no
• Are the appropriate buffers maintained away from streams and waterbodies?
Page 2 of 4

Z
NCG02 Stormwater Permit: Mining Permit Review
®yes Ono
f) Phase H
• Is the mine in a Phase II area? ❑yes ®no
• Does the permittee need a Phase II permit from DWQ? Dyes ®no
• State or Local? N/A
• Have you sent this to the appropriate permitting authority? ❑yes Ono ®NA
g) Wastewater:
• Type
- Mine dewatering:
®yes
Ono
- Stamped by PE?
®yes
❑no
- If clay & dewatering, ATC?
Dyes
Ono (required)
- Process wastewater produced:
Dyes
®no
- Stamped by PE?
❑yes
❑no
- If recycle & not closed, ATC?
Oyes
Ono (required)
• Wastewater and ORW Waters Requirements
- New/expanding wastewater to ORW?
Dyes
®no (not allowed)
- New/expanding wastewater to
Dyes
®no (special limits)
upstream of ORW?
- Notes:
• Wastewater HWQ/PNA water requirements
- What is the flow rate?
- PNA has special limits for WW TSS.
h) Dewatering:
• Is the permittce impacting wetlands / require Pumping O&M Plan? Dyes ®no
• Date request letter sent
• Date sent to the RO
3/4/2013
• Date approved
4/8/2013
• Did the RO request an O&M before approval?
Oyes
®no
i) Other:
• Does this facility have other NPDES permits? Oyes ®no
• Hazardous waste activities onsite? Dyes ®no
• Is there an LCID or other landfill on site? []yes ®no
• Notes:
Signatory Requirements
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 officer. For the purpose of this
Section, 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 who performs 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
Page 3 of 4

r
NCG02 Stormwater Permit: Mining Permit Review
or expenditures exceeding 25 million (in second quarter 1980 dollars), 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.
b. All reports required by the General Permit and other information requested by the Director shall
be signed by a person described above or by a duly authorized representative of that person. A
person is a duly authorized representative only if:
(1) The authorization is made in writing by a person described above;
(2) The authorization specified either an individual or a position having responsibility
for the overall operation of the regulated facility or activity, such as the position of
plant manager, operator of a well or well field, superintendent, a position of
equivalent responsibility, or an individual or position having overall responsibility
for environmental matters for the company. (A duly authorized representative may
thus be either a named individual or any individual occupying a named position.);
and
(3) The written authorization is submitted to the Director.
Communication logs
Date Item
Page 4 of 4

Georgoulias, Bethany
�rw, � irri ur, a mi i� ir�i
From: Georgoulias, Bethany
Sent: Monday, March 04, 2013 1:54 PM
To: Smith, Danny
Subject: NOI for NCG020000 Mining Permit from K and K Sand Company, Lee County
Attachments: NCG020839_NOI.pdf
Hi Danny,
Attached is an NOI application from K and K Sand Company, LLC. for Black's Chapel Mine in Lee County. They're
requesting coverage under NCG02 (stormwater and wastewater) for this sand mine. It appears to be an existing mine
that recently renewed (or applied for renewal/modification of) their Mining Permit with DMLR (#53-25, formerly #43-
43).
They mine sand, clay, and topsoil. Discharges are to Run Branch (Class Q in the Cape Fear Basin. I'm sending copies of
the larger Mining Plan and other maps/Mining Permit applications separately via interoffice mail, so those should arrive
soon. From the mining plan, there are several pockets of wetlands delineated on the site. Please advise us about
whether an O&M Plan is necessary, and whether or not we should hold off issuing the COC until you all approve that
plan. The application says that there are only stormwater discharges (no dewatering), but there are three streams
crossing the property. The only named one is Run Branch, so that's what I've got listed so far). This mine has been
around since 2002, so I'm not sure whether RRO has any history with it or not, or whether any streams/wetlands have
been impacted by prior activities there. Also, since it's an industrial sand mine, overflows of pits are considered
wastewater regardless.
Does the Raleigh Regional Office have any concerns with issuing a COC for this site? Do you want us to hold off until
you get an O&M Plan? It's hard to tell whether much pumping is involved, but I usually assume there is, even if the
application doesn't state it explicitly.
Also, did RRO ever see a DWQ-DMLR Mining Review sheet for this project? I can't find a copy.
The application came in January 3rd, so I'd like to get this one issued as quickly as possible (though it's my fault for being
behind!). If you all could let us know anything by March 22"d, that would be great. Please feel free to request more time
for review if that's not sufficient, though.
Thanks so much! I'll put the accompanying application materials in the mail today.
Bethany
Bethany Georgoulias
Environmental Engineer
NCDENR I DWQ I Stormwater Permitting Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
512 N. Salisbury St, Raleigh, NC 27604
Phone: [phone]
Fax: [phone]
NEW Website: http://portal.ncdenr.org/web/wq/ws/su
E-mail correspondence to and from this address may be subject to the North Carolina Public
Records Law and may be disclosed to third parties.

Ap
Division of Water Quality / Surface Water Protection
NC®ENR National Pollutant Discharge Elimination System
ok..+N C-0— tkw..+o¢r.r a
iH+n•o�.rcr.r u.o Hrvuaw. r�sw•cr�
NCG020000
NOTICE Of INTENT
FOR AGENCY USE ONLY
Dale Received
Year Month
Day
Certificate of Curera e
REZEF
Check p
AMOLIM
Permi Assi gned to
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG020000:
STORMWATER DISCHARGES associated with activities classified as:
SIC (Standard Industrial Classification) Code - 14XX Mineral Mining Industry (except as specified below)
The following activities are also 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, intermediate
products, finished products, byproducts or waste products located on the site of such operations;
• Stormwater from vehicle maintenance activities at mining operations;
• Overflow from facilities that recycle process wastewater; and/or
• Mine dewatering (wastewater)
The following activities are specifically excluded from coverage under this General P
• Stormwater discharges associated with peat mining, coal mining, and metal mining;
• Stormwater discharges from mining operations which are intermixed on site with stor wa er from asp
operations and/or concrete operations; AA/ 0
• Stormwater discharges associated with oil and gas extraction operations; and p�N 2013
• Stormwater discharges associated with tourist gem mines R Wq
• NCDOT borrow pits are covered under 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 (i.e., sand
dredging or dipping operations).
• Please contact the NPDES Wastewater Point -Source Group for more information on coverage under this
permit.
Please Print or tvne all entries in this application form.
1) Mailing address of owner/operator (official address to which all permit correspondence will be malledl
Legal Owner Name )< rkn� k CQrr10an1 I LLB
(Attach the most recent Annual Report to the NC Secretary of State Aowinw current legal name of 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 Land Resources' Mining Permit.) f.
Signee's Name (as signed for in permit signature at bottom) Le e- Jwal-r,
P o BOY 1!
Street Address 1614 4'45 ('Y�Qpel U sa , iary N c '2-7 7� 3 �
City rr' etgn m I State NC ZIP Code 1 ,� �
Telephone No. °t1 q"_ ? a Email icell�sgrit w'et�ssrc�+n�11�`t'
Alternate Contact Name — Ross _YAftefSon Email (if different) f;uSS� OA. erso.�er,
Alternate Contact Telephone (if different) °iiq' 774-3770
Page 1 of 8
SWU-NCG02-NOI last revised 9/5/2012
apt , cayn

NCG020000 N.O.I.
2) Location of facility producing discharge:
Facility Namefct��CS
�.hCS Pf
Facility Street Address
Facility City
Facility County
_ L-e
Facility Contact
L e k e f f
1 W OP Ij
Telephone No.
3 �_.
State NG ZIP Code D-7 33 _�L
Fax:
Contact E-mail Kelly S4rndcc
3) Physical Location Information:
Please provide a narrative description of how to get to the facility (us street names, state road numbers, and
distance and direction from a roadway intersection). Fran HC E7 4-ake- NC. 27 Lucs+- 2.5m err,
Ttro r lii oi i3G�i1 G�� to + �,+. IiXrt R; +an d .On+ , lurrt 1c Bl
4) Latitude N 3,; ° M� xb1 f Longitude W 79' f t � 4R" (degrees', minute �ope X�.b cands) ance "" R 6J +
Permits:
5) This NPDES Permit Application applies to which of the following:
❑ New or Proposed Facility Date operation is to begin:
Existing Date began mining: 00i-
6) 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-
7) Provide a narrative description of the types of minerals mined at this facility: Sg'id , C lqt a h )
-Lo oSo+
6) Is this mine an inactive mine site?
® No
❑ Yes If yes, do you posses an "Inactive Renewal' from DEMLR and notified the DWQ Regional Office or
have you certified to the DWO that the site has been stabilized? ❑ No ❑ Yes
9) Does this facility already have a valid Mining Permit from the Division of Energy, Mineral and Land Resources
(DEMLR) [formerly DLR]?
❑ No It No, please indicate the status of the Mining Permit_ application: _
�1 Yes If yes, please provide the Minir3g Permit number: S S
copy of your DEMLR Mining Permit with this DWO application.
Please also provide a
Note: DWO cannot issue a COC for the MCGO20000 Genera! Permit until a Mining Permit is issued or
renewed by the DEMLR.
10) Does this facility have any other NPDES permits?
t No
❑ Yes 11 yes, list the permit numbers for all current NPDES permits for this facility:
Page 2 of 8
5WU•NCG02-NOI Last revised 9/5/2012

NCG020000 N.O.I.
11) Are you applying for a mining permit in the same location as a previously permitted mine?
M No
❑ Yes If yes, specify permit number and name if known:
12) Does this facility have any Non -Discharge permits (ex: recycle permits)?
W No
❑ Yes If yes, list the permit numbers for all current Non -Discharge permits for this facility:
13) Does total area of this mine site include ready -mix and asphalt areas?
iK No
❑ Yes If yes, do they have DWQ stormwater permits (if owned by the same company)? ❑ No ❑ Yes
(provide permit number )
If not owned by the same company, who is the owner?
14) Will this mining operation precede development activities at this site?
$$J No
❑ Yes
15) Is this mine located within one of the 20 Coastal Counties and will it add more than 10,000 ft2 of impervious
surface?
5n No
❑ Yes If yes, you may be required to apply for an additional state stormwater permit. Check with your
local Regional Office. See contact information and checklist below.
16) 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. Please show buffers in site plans.
If yes, please include information and plans showing diffuse flow through buffers as required.
Discharge Points Receiving Waters & Wetlands:
17) Receiving waters:
What is the name of the body or bodies of waterkcreek, stream river, lake, etc.) that the facility stormwater
and/or wastewater discharges end up in? KU>1 B ra nL'k
If the site stormwater discharges to a separate storm sewer system, name the operator of the separate storm
sewer system (e.g. City of Raleigh municipal storm sewer).
Receiving water classification (if known): C
Note: Discharge of industrial wastewater to receiving waters classified as WS-II to WS-V, or 5A, must
be approved by the Div. of Water Resources, or Div. of Marine Fisheries. If DWR or DMF does
not approve, coverage under NCG020000 cannot be granted. No new discharges of wastewater
are permitted in receiving waters classified as WS-I or freshwater ORW. Wastewater
discharges to Saltwater ORW will not be approved under the NCG02 General Permit.
18) If your facility has wastewater discharges and they are to NWO and/or PNA waters (Primary Nursery Areas)
waters, what is the proposed flow rate? (See
http://www.ncdmf.neUmaps/FNA maps/index.html, for map)
Page 3 of 8
SWLI-NCG02-NOI Last revised 9/5/2012

NCG020000 N.0.1.
19) Discharge Points:
Number of discharge points (ditches, pipes, channels, etc. that convey discharges from the property):
Onsite: Stormwater. G Mine dewatering: Process Wastewater Overflow:,
Otfsite: Stormwater: Mine dewatering: Process Wastewater Overflow:
Discharge points should be clearly marked on the submitted site plan.
Please provide shorn narrative description of discharges: r"122C ('fmsrd /r s.
Q Or:"t` 6S +"e 1 20rj bra •IL 'a �, ("!FF%iS 7r J r', Aftf� tr r'r
h e jn u, 2 41p a oscaf err s -' sed:mnn-i- dpvices +h +
0 cr o5s -Ike A(ger+ •_. L� I
a) is your mine dewalering and discharging? (Answer only if you are dewatering)
59 No
❑ Yes If yes, where to? Surface Waters and/or Wetlands (on -site or off -site)
Other (on -site or off -site) Describe:
b) Are you dewatering but not discharging? (Answer only if you are dewatering)
No
❑ Yes If Yes, please explain how you are dewatering, and where that water will be directed:
20) Will :Wining operations require dewatering near wetlands or impact any stream, groundwater, or wetlands?
f9 No
❑ Yes
Note: 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 (0&M) Plan that has been approved by the
Division.
For sites that may drain wetlands — approval of a Pumping O&flan may be required prior to
coverage under this general permit. The Pumping O&M Plan should be submitted to the
appropriate Regional Office and 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 end of document. Contact your local Regional Office for questions specific to your mine.
21) If you are dewatering, 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? feet.
22) Have you been required to obtain a 404/401 Certification permits?
;1 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. -
Page 4 of 8
SWU-NCG02-NOI Last revised 9/5/2012

NCG020000 N.O.I.
23) 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:
24) Does this facility employ any best management practices for stormwater control?
❑ No Yes 1 If yes, please briefly describe: 5'961 tl',9114- +M4 Q ti� bq s�
�fr ef1y ntIC 6') i CyCof .�rtltl
�n �.(t'ra�; W}-,rrC h9ins^c� I7a5 bcc�n <6vr,Q1l�-c' ,
25) Does this facility have a Stormwater Pollution Prevention Plan?
IA No ❑ Yes
If yes, when was it implemented?
26) Will vehicle maintenance activities occur at this facility?
No ❑ Yes
Wastewater Treatment Facilities:
27) Will mine dewatering discharges occur?
'P No
❑ Yes
28) Will discharges of overflows from process wastewater treatment systems occur?
3D No
❑ Yes If yes,
a. Does this facility employ chemical additives to flocculate suspended solids? ❑ No ❑ Yes
If yes, please state the name, manufacturer and the quantity of average daily usage of the chemical additive
Note: Please see our website for a list of evaluated polyacryiamide (PAMS) products for use in North Carolina:
hno,//portal.ncdenr.orQ/web/wa/ws/su/nodessw
b. Does this facility overflow only during rainfall events exceeding the t 0-yr, 24-hr rainfall event?
❑ No ❑ Yes
29) Are wastewater treatment facilities (including recycle systems) planned in the 100-year flood plain?
�1 No
❑ Yes
30) Is your facility washing mined materials?
❑ No
1 Yes If Yes, are you discharging this water? N6 A6h WG16114A)' !n OA51�a
fr']t'(�1fik�rd�-, �6ri�$, l�1Qg1��;,� 4fCUfs
Page 5 of 8
SW U-NCG02-NOI ILast revised 9/5/2012

NCG020000 N.0.1.
Other:
31) 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?
Ig No ❑ Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
0 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:
32) Is your facility providing appropriate secondary containment for bulk storage of liquid materials? See permit
text for secondary containment requirements.
❑ No
Yes
YV
33) Does your site have an active landfill within the mining permit boundary?
X No
❑ Yes If yes, specify type: ❑ LCID ❑ Other:
Final Checklist:
This application will be returned as incomplete unless all of the followings items have been included and
initialed for. Please show that the following required information has been Included by initialing in each
space below.
+� Fee of $100 made payable to NCDENR.
Completed application and all supporting documents.
yCopy of the valid approved mining permit (MP) for the facility or indication of MP application status.
Copy of a county map or other general location map that shows the mining site and nearest major roads.
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.
2 copies of large-scale (minimum 24" x 36") site plan with topographical lines with all outfalls, applicable
buffers and wetlands clearly delineated, and 100-year flood plain line if applicable.
A copy of your DEMLR mining permit.
l A copy of your US Army Corps -approved wetland delineation if you marked "yes" to question 23 above.
7 A line drawing of the water flow through the facility. A pictorial description of the nature and amount of any
sources of water and any collection and treatment measures.
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. Regional Office Contact:
Page 6 of 8
SW U-NCG02-NOI Last revised 9/5/2012

NCG020000 N.O.I.
• Applicant has included a detailed list of impervious surface areas and percentages, sub -drainage
areas and total drainage area.
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 O&M Plan (see below
for contact information). You may be required to provide an approved Pumping O&M Man priorto
NCG02 issuance.
2 copies of detailed Full Size Plans (at least 24" x 36") delineating areas on the clans and listing
acre ease (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 (it state sw
programs apply), applicable buffers, and access and/or haul roads).
Pump dewatering size and information on its specifications.
Well information (design, depths, maintenance).
Physical monitoring for the wetlands areas.
Settling pond sizing information, if applicable.
Level spreader design, if applicable.
Details about dewatering method.
Cone of influence calculations.
Description of measures to prevent erosion and flooding.
Description & information about 401/404 permits that have been obtained.
Copy of US Army Corps of Engineers wetland delineations or approved wetland delineation (if
applicable).
I have contacted my local regional office about a Pumping O&M Plan.
Regional Office Contact: mate contacted:
OR-
YI will not any impact nearby wetlands, surface waters or groundwater by dewatering.
Certification: North Carolina General Statute 143-215.6 b (1) 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 who knowingly makes a false
statement of a material tact 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 or maintained under this Article or rules of the
fEnvironmental Management] Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine not to
exceed ten thousand dollars ($10,000).
33) 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 officer. 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 who performs 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 19130 dollars), 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. 1 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.
Page 7 o1 8
SWU-NCG02-NOI Last revised 9/5/2012

NCG020000 N.O.I.
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. I agree that bull< 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, # 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 l am familiar with the information contained in this application and that to 1he best of my knowledge
and beliel such information is true, complete, and accurate. f j
Printed Name of Person Signing: — _ _f_. G� cllcxr Ifj
Title: (8 r
(Signatur of Applicant) _ (Date Signed)
Notice of intent must be accompanied by a check or money order far $100.OD made payable to NCDENR.
Mail the entire package to:
Stormwater and General Permits Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Note
The submission of this document does not guarantee the issuance of an NPDES permit.
For questions, please contact the DWQ Regional Office for your area.
DW© Regional Office Contact fnformation:
Asheville Office ......
[phone]
Fayetteville Office
.,. [phone]
Mooresville Office
... [phone]
Raleigh Office ........
[phone]
Washington Office
...[phone]
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........(919)
807-6300
Page 8 of 8
SW U•NCG02-NOI Last revised 915/2012

LETTER OF TRANSMITTAL
a Clayton Engineering
Civil & Environmental
TO:
DATE: January 3, 2013
PROJECT No: 150009
Stormwater and General Permits Unit
Re: K & K Sand Co., Inc.
Division of Water Quality
Black's Chapel Pit
1617Mail Service Center
NCG 020000 Notice of Intent
Raleigh NC 27699-1617
TRANSMITTAL NO: 1
PAGE 1 OF 1
WE ARE SENDING: ❑ Originals ® Prints ❑ Shop Drawings ❑ Samples
❑ Specifications ❑ Calculations ® Other: NOI form, check, permit
Quantity
Drawing No.
Rev.
Description
Status
1
-
-
NPDES Permit 020000 Notice of Intent form
G
1
-
-
Check for $100
G
1
SW
-
Stormwater Plan
G
1
3
-
Lee County Maintenance Map
G
1
Murchisontown,
NC
-
USGS 7.5 minute quadrangle
G
1
-
-
Mining permit
G
1
-
-
Mining permit renewal application
G
Issue Status Code: A. Preliminary B. Fabrication Only C. For Information D. Bid
E. Construction F. For Review & Comments G. For Approval H. See Remarks
REMARKS:
cc: K& K Sand Co. J.A N 0 3 2 01.3
Russ Patterson
DEKR - WATER CIUAL TY
isranch
46 W. Washington St., COATS, NC 27521 PHONE: [phone] FAX: [phone]
C. T. Clayton, Sr., PE, Inc. dba C. T. Clayton Engineering
Signed
w,:�/-f,�L��A
William L. "Bill" Faucette
P:1150 Patterson Exploration1150009 Kelly Sand Blacks Chapel\Correspondence\LOT 13 0103 Stormwater Permits N01 WLF 150009.docx

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APPLICATION FOR A MINING PERMIT
'2013 Re
S.
NORTH CAROLINA
MINING PERMIT APPLICATION
K & K Sand Company, Inc.
Blacks Chapel Mine # 53-25
State of North Carolina
Department of Environment
and Natural Resources
Division of Land Resources
Land Quality Section
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
[phone]
Revised: February 24, 2012
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT
AND NATURAL RESOURCES
LAND QUALITY SECTION
APPLICATION FOR A MINING PERMIT
(PLEASE PRINT OR TYPE)

APPLICATION FOR A MINING PERMIT
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT
AND NATURAL RESOURCES
LAND QUALITY SECTION
APPLICATION FOR A MINING PERMIT
(PLEASE PRINT OR TYPE)
Name of Mine: Blacks Chapel Mine County: Lee
River Basin: Cape Fear
Latitude (decimal degrees to four places): 35" 19' 59.27" N
Longitude (decimal degrees to four places): 79011' 51.48" W
2. Name of Applicant*: K & K Sand Company, Inc.
3. Permanent address for receipt, of official mail**: P.O. Box 9, Cameron, NC 28326
Telephone: [phone] Alternate No.
4. Mine Office Address: 1574.Blacks Chapel Road, Sanford, NC 2733
5
Telephone: (919) 499=9279
5. Mine Manager: Lee Kelly
We hereby certify that all details contained in -this, Permit. Application are true and correct to -the best of bur
knowledge. We fully ' understand that any willful misrepresentation of facts will be cause for permit
revocation.
***Signature Date b 701-1—
Print Name: Lee Kelly
Title: Mine Manager & Owner
* This will be the name that the mining permit will be issued to and the name that must be indicated on the
reclamation bond (security) that corresponds to this site.
** The Land Quality Section must be notified of any changes in the permanent address or telephone number.
*** Signature of company oflicer required.
G.S. 74-51 provides that the Department shall grant or deny an application for a permit within 60 days of receipt of
complete application or, if a public hearing is held, within 30 days following the hearing and the filing of any
supplemental_ information required by the Department. All questions must be addressed and all required maps
provided before this application can be considered complete. Attach additional sheets as needed.

APPLICATION FOR A MINING PERMIT
NOTE: All of the following questions must be thoroughly answered regarding your mining operation for
the intended life of the mine. All responses must be clearly conveyed on a corresponding, detailed mine map.
A. GENERAL CHARACTERISTICS OF THE MINE
1. Answer all of the following that apply:
❑ If this is an application for a NEW permit, indicate the total acreage at the site to be covered by the
permit (this is the acreage that the "new permit" fee will be based upon):
F1
1
100
Of this acreage, how much is owned and how much is leased? Acres owned:
Acres leased: Property owner if leased:
If this is an application for RENEWAL of a mining permit, indicate the mining permit number and
the total (overall) acreage covered by the existing permit: Mining Permit No.: 53-25
Total permitted acreage (this is the acreage that the "renewal" fee will be based upon): 175.28
If this is an application for a MODIFICATION to a mining permit,
number and the total (overall) acreage covered by the existing permit.
Mining Permit No.: Total permitted acreage:
indicate the mining permit
Does the modification involve acreage within the previously approved permitted boundary?
Yes ❑ No ❑. If yes, indicate the acreage to be covered by this modification (this is the acreage
that the "major modification" fee will be based upon):
Does the modification involve acreage outside the previously approved permitted boundary?
Yes ❑ No F. If yes, indicate the additional acreage to be covered by this
modification: . (NOTE: you must complete all of Section F. of this application form
entitled Notification of Adjoining Landowners).
Of this acreage to be added to the permit, will any portion of this acreage be affected (i.e.: disturbed,
ground cover removed) by the mining operation? Yes ❑ No ❑ (if no, a "minor modification"
fee of $100.00 is required, despite the "undisturbed" acreage to be added). If yes, indicate the
acreage to be affected within the acreage to be added to the permit (the total acreage to be added to
the permit is the acreage that the "major modification" fee will be based upon):
If this is an application for TRANSFER of a mining permit, indicate the mining permit number and
the total (overall) acreage covered by the existing permit.
Mining Permit No.: Total permitted acreage:
SEE THE FEE SCHEDULE AT THE END OF THIS FORM FOR THE PROPER FEE AMOUNT TO BE
PAID FOR THE REQUESTED PERMIT ACTION(S) AND CORRESPONDING ACREAGE NOTED
ABOVE
2. Name of all materials mined: Sand
3. Mining method:
❑Hydraulic Dredge X Front-end Loader & Truck ❑ Shovel & Truck
Dragline & Truck ❑ Self -loading Scraper
Other (explain): Hydraulic Excavator & Truck
4. a. Expected maximum depth of mine (feet): 20
Depth is relative to what benchmark? (e.g., natural ground level, mean sea level, road elevation,
etc.): Natural Ground level
b. Expected average depth of mine (feet): 15

APPLICATION FOR A MINING PERMIT
5. Has any area(s) at this site been mined in the past? Yes X No ❑
If yes, when and by whom was this activity conducted? Kelly Sand Company, over the past 10 years
6. Number of years for which the permit is requested (10 years maximum):10
B. MAPS
Clearly mark and label the location of your mining operation on six (6) copies of 7.5-minute quadrangle
and a county highway map. These maps, in addition to six (6) copies of all mine maps and reclamation
maps, must be submitted with each permit application.
7.5-minute quadrangles may be obtained from the N.C. Geological Survey:
Mailing Address: Physical Address:
1612 Mail Service Center OR 512 North Salisbury Street, 5"' Floor
Raleigh, North Carolina 27699-1612 Raleigh, North Carolina 27604
[phone]
httn://Dortal.ncdenr.ore/web/lr/p-eoloeical home
County highway maps may be obtained from the N.C. Department of Transportation:
North Carolina Department of Transportation — Geographic Information Systems (GIS)
Mailine Address:
NCDOT GIS Unit
1587 Mail Service Center
Raleigh, North Carolina 27699-1587
Physical Address:
NCDOT GIS Unit
3401 Carl Sandburg Court
Raleigh, North Carolina 27610
[phone]
http://www.nedot.org/it/gis/
2. Mine maps must be accurate and appropriately scaled drawings, aerial photographs or enlarged
topographic maps of the entire mine site. All aspects of the mine site must be clearly labeled on the
maps along with their corresponding (approximate) acreage. As a reminder, mining permits can
only be issued for up to 10 years; thus, all mine and reclamation maps must only denote those
activities that are intended to be conducted during the life of the mining permit. All maps must be
of a scale sufficient (see minimum requirements listed below) to clearly illustrate the following, at a
minimum:
a. Property lines of the tract or tracts of land on which the proposed mining activity is to be located
including easements and rights -of -way.
b. Existing or proposed permit boundaries.
c. Initial and ultimate limits of clearing and grading.
d. Outline and width of all buffer zones (both undisturbed and unexcavated).
c. Outline and acreage of all pits/excavations.
f. Outline and acreage of all stockpile areas.
g. Outline and acreage of all temporary and/or permanent overburden disposal areas.
h. Location and acreage of all processing plants (processing plants may be described as to location and
distance from mine if sufficiently far removed).
i. Locations and names of all streams, rivers and lakes.
j. Outline and acreage of all settling and/or processing wastewater ponds.
k. Location and acreage of all planned and existing access roads and on -site haul roads.
1. Location of planned and existing on -site buildings.
m. Location and dimensions of all proposed sediment and erosion control measures.
n. Location of 100-year floodplain limits and wetland boundaries.
o. Names of owners of record, both public and private, of all tracts of land that are adjoining the
mining permit boundary; if an adjoining tract is owned or leased by the applicant or is owned by the
lessor of the mine tract, names of owners of record of tracts adjoining these tracts, that are within
1,000 feet of the mining permit boundary, must be provided on the mine map.

APPLICATION FOR A MINING PERMIT
p. Names of owners of record, both public and private, of all tracts of land that are adjoining the
mining permit boundary which lie directly across and are contiguous to any highway, creek, stream,
river, or other watercourse, railroad track, or utility or other public right-of-way. If an adjoining tract
is owned or ]eased by the applicant or is owned by the lessor of the mine tract, names of owners of
record of tracts adjoining these tracts, that are within 1,000 feet of the mining permit boundary, must
be provided on the mine map(s). NOTE: "Highway" means a road that has four lanes of travel or
less and is not designated as an Interstate Highway.
y. Map legend:
l . Name of applicant
2. Name of mine
3. North arrow
4. County
5. Scale
b. Symbols used and corresponding names
7. Date prepared and revised
8. Name and title of person preparing map
Map scales should meet the following guidelines:
PERMITTED ACREAGE MAP SCALE
0-49 Acres 1 inch = 50 feet
50-199 Acres 1 inch = 100 feet
200-+- Acres 1 inch = 200 feet
(NOTE: Smaller scaled maps may be acceptable if they clearly illustrate the above items)

APPLICATION FOR A MINING PERMIT
A table/chart must be provided on the mine map that clearly lists the approximate acreage of tailings/sediment
ponds, stockpiles, wastepiles, processing area/haul roads, mine excavation and any other major aspect of the
mining operation that is proposed to be affected/disturbed during the life of the mining permit. A table/chart
similar to the following will be acceptable:
CATEGORY
AFFECTED ACREAGE
Tailings/Sediment Ponds
4.98
Stockpiles
16.11
Wastepiles
0.00
Processing Area/Haul Roads
0.92
Mine Excavation
110.47
Other (Explain)
0.00
Total Disturbed Acreage
132.48
NOTE:
IN ADDITION TO THE ABOVE, THE MAPS MUST ALSO INCLUDE ANY SITE -SPECIFIC
INFORMATION THAT IS PROVIDED IN THE ANSWERS TO THE FOLLOWING QUESTIONS IN
THIS APPLICATION FORM {PLEASE NOTE THE ITALICIZED QUESTIONS/STATEMENTS
THROUGHOUT THE FORM). THIS APPLICATION WILL NOT BE CONSIDERED COMPLETE
WITHOUT ALL RELEVANT ITEMS BEING ADEQUATELY ADDRESSED ON THE MINE MAPS.

APPLICATION FOR A MINING PERMIT
C. PROTECTION OF NATURAL RESOURCES
Describe in detail the sequence of events for the development and operation of the mine and reference the
sequence to the mine map(s). Attach additional sheets as needed.
The property is in the final stages of mining and is being actively reclaimed. Material in stockpiles
is being processed for sale. Material will be brought in from the Claude White Mine for processing
on site.
Most of the site will be reclaimed over the next five years except for the area processing the Claude
White Mine material.
Existing erosion control measures (see Mine Map) will remain in place until reclamation is
complete in those areas.
2. Describe specific erosion control measures to be installed prior to land disturbing activities and during
mining to prevent offsite sedimentation (include specific plansfor sediment and erosion control for mine
excavation(s), waste piles, access/mine roads and process areas), and give a detailed sequence of
installation and schedule for maintenance of the measures. Locate and label all sediment and erosion
control measures on the mine map(v) and provide typical cross-sections/construction details of each
measure. Engineering designs and calculations are required to justify the adequacy of any proposed
measures.
Existing and established perimeter berms prevent offsite sedimentation and direct runoff into
sediment control measures as shown on the Mine Map.
Existing sediment control measures allow sediment to settle out before discharge.
Existing stream crossings prevent sedimentation into streams and allow normal stream flow.
'Three new sediment basins/traps as shown on the Mime Map will be constructed to handle runoff
during site reclamation.
3. a. Will the operation involve washing the material mined, recycling process water, or other waste water
handling? Yes X No ❑. If yes, briefly describe all such processes including any chemicals to be
used.
A small quantity of washed sand is produced on site from time to time. Water from one of the
excavations is recycled through the wash plant and back into the excavation. There is no discharge
to streams from this minor, intermittent operation. No chemicals are used in this process.
b. Will the operation involve discharging fresh or wastewater from the mine or plant as a point discharge to
the waters of the State? Yes X No ❑. If yes, briefly describe the nature of the discharge and locate
all proposed discharge points (along with their method of stabilization) on your mine map(s).
No waste water is discharged from the site, only storm water. All storm water passes through
sediment control measures before discharge, if any.
c. Will any part of the proposed mine excavation(s) extend below the water table? Yes X No ❑.
If yes, do you intend to dewater the excavation(s)? Yes ❑ No X.

APPLICATION FOR A MINING PERMIT
f yes, what impact, if any, will mine dewatering have on neighboring wells? Estimated withdrawal rate
in gallons per day: . Locate all existing wells on the mine map(5) that lie within
500feet of the proposed excavation area. Provide data to support any conclusions or statements made,
including any monitoring well data, well construction data and current water withdrawal rates. Indicate
whether the proposed mine locale is served by a public water system or private wells.
No mine dewatering is planned as the mining (excavation) of the site is almost complete.
Therefore, the operation will not impact any neighboring wells. The area is served by both private
wells and municipal water.
d. If you answered yes to any of the above questions, provide evidence that you have applied for or
obtained the appropriate water quality permit(s) (Le., non -discharge, NPDES, Stormwater, etc.) from the
Division of Water Quality, Water Quality Section. In addition, the applicant is required to register water
use with the Division of Water Resources if the operation withdraws more than 10,000 gallons per day
and needs a capacity use permit from the Division of Water Resources if the operation lies in a capacity
use area and withdraws more than 100,000 gallons per day.
The Blacks Chapel Mine does not have a NPDES permit. One has been applied for (attached
application).
4. a. Will the operation involve crushing or any other air contaminant emissions? Yes ❑ No X.
If yes, indicate evidence that you have applied for or obtained an air quality permit issued by the
Division of Air Quality or local governing body.
b. How will dust from stockpiles, haul roads, etc., be controlled?
Periodic spray with water as necessary.

APPLICATION FOR A MINING PERMIT
5. a. A buffer will be required between any mining activity and any mining permit boundary or right-of-
way. It may be an unexcavated buffer (no excavation, but roadways, berms and erosion &
sedimentation control measures may be installed within it), an undisturbed buffer (no disturbance
within the buffer whatsoever), or a combination of the two, depending upon the site conditions.
Note that all buffers must be located within the mining permit boundaries.
How wide a buffer will be maintained between any mining activity and any mining pen -nit boundary
or right-of-way at this site? A minimum buffer of 25 feet is recommended, although a wider buffer
may be needed depending on site conditions. Show all buffer locations and widths on the mine
map(.$).
A 25 foot buffer will be maintained between any disturbed area and the permit boundary.
b. A minimum 50 foot wide undisturbed buffer will be required between any land disturbing activities
within the mining permit boundaries and any natural watercourses and wetlands unless smaller
undisturbed buffers can be justified. Depending on site conditions, a buffer wider than 50 feet may
be needed.
How wide an undisturbed buffer will be maintained between any land disturbing activities within the
mining permit boundaries and any natural watercourses and wetlands at this site? Show all buffer
locations and widths on the mine map(s).
A 50 foot buffer will be maintained between any disturbed area and wetlands or water courses.
6. a. Describe methods to prevent landslide or slope instability adjacent to adjoining permit boundaries
during mining. Minimum 2 horizontal to I vertical slopes or flatter for clayey material and
minimum 3 horizontal to 1 vertical slopes or flatter for sandy material are generally required, unless
technical justification can be provided to allow steeper slopes.
A slope of 3:1 or flatter will be established at mining limits.

APPLICATION FOR A MINING PERMIT
b. Provide a cross-section on the mine map(s) for all fill slopes (berms, wastepiles, overburden
disposal areas, etc), clearly indicating the intended side slope gradient, installation r f any benches
and/or slope drains (with .supporting design information) rf needed, and the method offinal
stabilization.
See Mine Map
c. In excavation(s) of unconsolidated (non -rock) materials, specify the angle of all cut slopes including;
specifications for benching and sloping. Cross-sectionsfor all cut slopes must be provided on the
mine map(s).
Final slopes above water will be 3:1 or flatter.
d. In hardrock excavations, specify proposed bench widths and heights in feet. Provide cross -sections
of the mine excavation clearly noting the angles of'the cut slopes, widths of all safety' benches and
mine benches, and the expected maximum depth of the excavation.
NIA
7. Describe other methods to be taken during mining to prevent physical hazard to any neighboring dwelling
house, public road, public, commercial or industrial building from any mine excavation. Locate all such
structures on the mine map !f they are within 300 feet of any proposed excavation.
The operation will pose no physical hazard to any neighboring house, road, etc. There are no
houses within 300 feet of operations. Blacks Chapel Road is located along the southern boundary.
8. Describe what kind of barricade will be used to prevent inadvertent public access along any high wall area
and when it will be implemented. Vegetated earthen berms, appropriate fencing; and adequate boulder
barriers may be acceptable high wall barricades. A construction detail/cross-section and location of each
type of barricade to be used must be indicated on the mine map(s).
The 6 foot property line fence, front gate, and perimeter berm and vegetative buffer will prevent
inadvertent public access.

APPLICATION FOR A MINING PERMIT
9. Are acid producing minerals or soils present? Yes ❑ No X.
If yes, how will acid water pollution from the excavation, stockpiles and waste areas be controlled?
10, a. Describe specific plans (including a schedule of implementation) for screening the operation from
public view such as maintaining or planting trees, bushes or other vegetation, building berms or
other measures. Show the location of all visual screening on the mine map(v) and provide cross -
sections through all proposed berms or proposed .Spacing, .sizes and Species for tree plantings.
Existing vegetation and topography screen the operation from public view except for an area
along Blacks Chapel Road.
b. Could the operation have a significantly adverse effect on the purposes of a publicly owned park,
forest or recreation area? If so, how will such effects (i.e., noise, visibility, etc.) be mitigated?
91341
11. Will explosives be used? Yes ❑ No X.
If yes, specify the types of explosive(s) and describe what precaution(s) will be used to prevent physical
hazard to persons or neighboring property from flying rocks or excessive air blasts or ground vibrations.
Depending on the mine's location to nearby structures, more detailed technical information may be
required on the blasting program (such as a third -party blasting study), locate the nearest offsite occupied
structure(.~) to the proposed excavation(s) on the mine map and indicate its approximate distance to the
proposed excavation.
12. Will fuel tanks, solvents, or other chemical reagents be stored on -site? Yes X No ❑.
If yes, describe these materials, how they will be stored and method of containment in case of spill. Indicate
the location(s) of all storage facilities on the mine map(s).
Fuel tanks have secondary containment.

APPLICATION FOR A MINING PERMIT
D. RECLAMATION PLAN
Describe your intended plan for the final reclamation and subsequent use of all affected lands and indicate
the sequence and general methods to be used in reclaiming this land. This must include the method of
reclamation of settling ponds and/or sediment control basins and the method of restoration or establishment
of any permanent drainage channels to a condition minimizing erosion, siltation and other pollution. This
nformalion must be illustrated on a reclaillotioll Map and must correspond directly 14111 the ilfornlalioll
provided on the mine map(v). In addition, design information, including typical cross -sections, of any
permanent channels to be constructed as part of the reclamation plan and the location(5) of all permanent
channels must be indicated on the reclamation map.
All slopes above water level will be graded to 3:1 or flatter slope and seeded. Any other disturbed
areas will be seeded according to the seeding schedule. Sediment basins will be cleaned out and
maintained until vegetation is established.
2. Is an excavated or impounded body of water to be left as a part of the reclamation? Yes ❑ No ❑.
If yes, illustrate the location of the body(.$) of water on the reclamation map and provide a scaled
cross -sections) through the proposed body(s) of water. The minimum water depth must be at least 4 feet,
measured from the normal low water table elevation, unless information is provided to indicate that a more
shallow water body will be productive and beneficial at this site.
Will the body(s) of water be stocked with fish? Yes X No ❑
If yes, specify species.
Bass & Bluegill or as directed by NC Wildlife Resources Commission.
3. Describe provisions for safety to persons and to adjoining property in all completed excavations in rock
including what kind of permanent barricade will be left. Acceptable permanent barricades are appropriate
fencing, large boulders placed end -to -end, etc. Construction details and locations of all permanent
barricades must be shown on the reclamation map.
NIA

APPLICATION FOR A MINING PERMIT
4. Indicate the method(s) of reclamation of overburden, refuse, spoil banks or other such on -site mine
waste areas, including specifications for benching and sloping. Final cross -sections and locations far
such areas must be provided on the reclamation map.
Any such areas will be graded to 3:1 or flatter slope and seeded.
a. Describe reclamation of processing facilities, stockpile areas, and on -site roadways.
These areas will be graded to allow proper drainage then seeded in accordance with the seeding
schedule.
b. Will any on -site roadways be left as part of the reclamation? Yes ❑ No X.
If yes, identify such roadways on the reclamation map and provide details on permanent road and ditch
line stabilization.
6. Describe the method of control of contaminants and disposal of scrap metal, junk machinery, cables, or
other such waste products of mining. (Note definition of refuse in The Mining Act of 1971.)
No off -site generated waste shall be disposed of on the mine site without prior written approval
from the NC Department of Environment and Natural Resources, Land Quality Section and either
the Division of Waste Management (DWM) or local governing body. If a disposal permit has been
issued by DWM for the site, a copy of said permit must be attached to this application. All
temporary and permanent refuse disposal areas must he clearly delineated on the mine map() and
reclamation map, along with a list oJ'items to be disposed in said areas.
Any such material will be removed from the site.

APPLICATION FOR A MINING PERMIT
7. Describe your plan for revegetation or other surface treatment of the affected areas. This plan must
include recommendations foryear-round seeding, including the time of seeding and the amount and type
of seed, fertilizer, lime and mulch per acre. The recommendations must include general seeding
instructions for both permanent and temporary revegetation. Revegetation utilizing only tree plantings is
not acceptable. Recommendations can be sought from:
a. Authorized representatives of the local Soil and Water Conservation District;
b. Authorized representatives of the Division of Forest Resources, Department of Environment and
Natural Resources;
c. Authorized county representatives of the North Carolina Cooperative Extension Service, specialists
and research faculty with the Colleges of Agriculture and Life Sciences and Forest Resources at
North Carolina State University;
d. North Carolina licensed landscape architects;
e. Private consulting foresters referred by the Division of Forest Resources, Department of
Environment and Natural Resources;
f. N.C. Erosion and Sedimentation Control Planning.and Design Manual;
g. N.C. Surface Mining Manual: A Guide for Permitting, Operation and Reclamation;
h. Others as may be approved by the Department.
LIME - RATE OF APPLICATION (tons/acre):
According to soil tests, or 3000#/acre. ground Lime
FERTILIZER - ANALYSIS•AND RATE OF APPLICATION (pounds/acre):
According to soil tests. or 1000#/acre 10-16-10 Fertilizer
SEED - TYPE(S) AND RATE(S) OF APPLICATION INCLUDING YEAR-ROUND SEEDING
SCHEDULE (pounds/acre): [NOTE: Include Legumes]
Seed -Types- Seeding Dates: Seeding.Rates:
Common Bermuda Grass April •1.tl July•15 1W#/acre` Servcea Lespedeza April 1— July 15 30 0/sere
Rye,,as Temporary Cover Dec. 1.—April 15 120 #_/acre
July 15 —Dec. 30
MULCH - TYPE AND RATE OF APPLICATION (pounds/acre) AND METHOD OF ANCHORING:
4000 #acre Straw anchored -by crimping or w/ asphalt; or cellulose hydro seeded
OTHER VEGETATIVE COVERS -- TYPE (S) AND RATE (S) OF APPLICATION INCLUDING
SEEDING SCHEDULE (pounds/acre, trees/acre, spacing of trees/shrubs, etc):
Revegetation and/or eforestation plan approved by:
Signature: Date: November 19, 2012
Print Name: O. F. Patterson, III
Title: Geologist & Farmer Agency: Patterson Exploration Services
-B-

APPLICATION FOR A MINING PERMIT
E. DETERMINATION OF AFFECTED ACREAGE AND BOND
The following hoed calculation worksheet is to he used to establish an appropriale bond (based upon a range
of $500 to $5,000 per affected acre) fin- each permitted mine site based upon the acreage approved by the
Department to he affected during the life of the mining permit. Please insert the approximate acreage, for each
aspect of the mining operation, that you intend to affect during the lire of this mining permit (in addition, please
insert the appropriate reclamation cost/acre for each cafe 2 h•om the Schedule of Reclamation Casts
provided with this application form) OR you can defer to the Department to calculate your bond for you based
Mon your maps and standard reclamation costs:
AFFECTED RECLAMATION RECLAMATION
CATEGORY ACREAGE COSTIACRE* COST
Tailings/Sediment Ponds: 4.98 Ac. X $ 1,500.00 /Ac. — $ 79470.00
Stockpiles: 16.11 Ac. X $ 1,800.00 /Ac. _ $ 28,998.00
Wastepiles: 0.00 Ac
Processing Area/Haul Roads: 0.92 Ac.
Mine Excavation: 110.47 Ac.
Other: 0.00 Ac.
TOTAL AFFECTED AC.: 132.48 Ac.
(TOTAL PERMITTED AC.: 175.28 Ac.)
X
$
0.00
/Ac. _
$ 0.00
X
$
19800.00
/Ac. _
$ 1,656.00
X
$
2,000.00
/Ac. _
$220,940.00
X
$
0.00
/Ac. _
$ 0.00
Temporary & Permanent Sedimentation & Erosion Control Measures:
Divide the TOTAL AFFECTED AC. above into the following two categories: a) affected acres that drain into
proposed/existing excavation and/orb) affected acres that will be graded for positive drainage where measures will
be needed to prevent offsite sedimentation and sedimentation to onsite watercourses and wetlands.
a) Internal Drainage: 4.98 Ac.
b) Positive Drainage: 127.50 Ac. X $1,500.00 = $ 1919250.00
SUBTOTAL COST: $ 450,314.00
Inflation Factor:
0.02 X SUBTOTAL COST: $9,006.28 X Permit Life (1 to 10 years): $ 90,062.80
INFLATION COST: $ 90 062.80
TOTAL COST = SUBTOTAL COST + INFLATION COST = $540,376.80
Total Reclamation Bond Cost: $540,300.00
(round down to the nearest $100.00)
- 15 -

APPLICATION FOR A MINING PERMIT
G. LAND ENTRY AGREEMENT
We hereby grant to the Department or its appointed representatives the right of entry and travel upon our lands
or operation during regular business hours for the purpose of making necessary field inspections or investigations as
may be reasonably required in the administration of the Mining Act of 1971 pursuant to G.S. 74-56.
We further grant to the Department or its appointed representatives the right to make whatever entries on the
land as may be reasonably necessary and to take whatever actions as may be reasonably necessary in order to carry
out reclamation which the operator has failed to complete in the event a bond forfeiture is ordered pursuant to G.S.
74-59,
LANDOWNER: APPLICANT:
andowner and Applicant are same.
Signature: % 'IF I
Signature:* �
Print Name: Lee Kelly
(Title, if applicable) Owner/Manager
Company: K & K Sand Company, Inc.
(If applicable)
Address: P.O. Box 9
Cameron, NC 27326
Telephone: [phone]
Print Name: Lee Kelly
Title: Owner/Manager
Company: K & K Sand Company, Inc.
Mine Name: Blacks Chapel Mine # 53-25
Telephone: [phone]
Date Signed: �� ,}e -ZIP rL Date Signed:
*Signature must be the same as the individual who signed Page 1 of this application_
and ;reclamation maps, and the appropriate -processing fee (see next page foir fee schedule) i.i the foi=tii a check
or money order payable to the North Carolina Department of Environment and Natural Resources must be
sent to the Land Quality Section Central Office at the address listed on the front cover of this application
form.
Inquiries regarding the status of the review of this application should be directed to the Mining Program staff at
[phone].
SCE

Al',`�A
WMENR
North Carolina Department of Environment and Natural Resources
Division of Energy, Mineral, and Land Resources
Land Quality Section
Tracy E. Davis, PE, CPM
Director
Mr, Lee Kelly
K & K Sand Company, Inc.
PC 5cx 9
Cameron, North Carolina 28326
RE: Claude White Mine
Harnett County
Cape Fear River Basin
Dear Mr. Kelly:
Beverly Eaves Perdue, Governor
December 19, 2012 Dee Freeman, Secretary
The application for a mining permit for the above referenced mine site has been found
to meet the requirements of G.S. 74-51 of The Mining Act of 1971. As your company has a
blanket bond sufficient to cover this application, I am enclosing the mining permit.
The conditions of Mining Permit No. 43-43 were based primarily upon information
supplied in the application with conditions added as necessary to insure compliance with The
Mining Act of 1971. This permit expires on December 19L2022. G.S. 74-65 states that the
issuance of a mining permit does not supersede or otherwise affect or prevent the enforcement
of any zoning regulation or ordinance duly adopted by an incorporated city or county or by any
agency or department of the State of North Carolina.
As a reminder, your permitted acreage and affected acreage for this site are both 32.76
acres, as indicated in the application and on the mine map last revised September 19, 2012.
_Please review the permit and contact Judy Wehner, Assistant State Mining Specialist, at
- ,. ..�- tr �^�i1•��t1 �1'!� Ni �RTl rr l^� nl�r'+,�C�^1',ri t4'9� Tp'-.'jC ,�� the .. �~�'_
Sincerely,
TSate
t S. Boyer, PE
Mining Specialist
Quality Section
JSB/jw
Enclosures
CC'. Mr. Brad Cole, PE
Ms. Shannon Deaton -WRC, w/permit
Mr. William Gerringer-DOL., Mine and Quarry Bureau, w/o enclosures
US Fish and Wildlife Service, wl permit
1612 Mail Service Center, Raleigh, North Carolina 27699.1612 • Telephone [phone] FAX: 919-7$3-2876
512 North Salisbury Street, Raleigh, North Carolina 27604 • lntsrnei: http://portal.nedenr.org/web,'IrPard-ouali'.-.,
An Equal Opportunity 1 Affirmative Action Employer - 50% Recycled i 10% Post Consurr:r Psc sr
ZO 39ad 00 QNCS A-n371 9EEb-66h-6T5 Zb:Ei ETBZ/E9/i9

DEPARTMENT OF ENVIRONMENT
AND NATURAL RESOURCES
DIVISION OF LAND RESOURCES
LAND QUALITY SECTION
PERMIT
For the operation of a mining activity
In accordance with the provisions of G.S. 74-46 through 68, " The Mining
Act of 1971," Mining Permit Rule 15A NCAC 5 B, and other applicable
laws, rules and regulations
Permission is hereby granted to:
K & K Sand Company, Inc.
Claude White Mine
Harnett County — Permit No. 43-43
for the operation of a
Sand and Topsoil Mine
Which shall provide that the usefulness, productivity, and scenic values of
all lands a.nd waters affected by this mining operation will receive the
greatest practical degree of protection and restoration.
MINING PERMIT EXPIRATION DATE December 19 2022
E0 39vd 00 QNVS A-1-13A DEEP-66P-616 Zb:Ei EL9Z/E9/i0

Page 2
In accordance with the application for this mining permit, which is hereby approved by the
Department of Environment and Natural Resources, hereinafter referred to as the Department,
and in conformity with the approved Reclamation Plan attached to and incorporated as part of
this permit, provisions must be made for the protection of the surrounding environment and for
reclamation of the land and water affected by the permitted mining operation, This permit is
expressly conditioned upon compliance with all the requirements of the approved Reclamation
Plan. However, completed performance of the approved Reclamation Plan is a separable
obligation, secured by the bond or other security on file with the Department, and may survive
the expiration, revocation, or suspension of this permit.
This permit is not transferable by the permittee with the following exception: If another
operator succeeds to the interest of the permittee in the permitted mining operation, by virtue
of a sale, lease, assignment or otherwise, the Department may release the permittee from the
duties imposed upon him by the conditions of his permit and by the Mining Act with reference
to the permitted operation, and transfer the permit to the successor operator, provided that
both operators have complied with the requirements of the Mining Act and that the successor
Operator agrees to assume the duties of the permittee with reference to reclamation of the
affected land and posts a suitable bond or other security.
In the event that the Department determines that the permittee or permittee's successor is not
complying with the Reclamation Plan or'other terms and conditions of this permit, or is failing
to achieve the purposes and requirements of the Mining Act, the Department may give the
operator written notice of its intent to modify, revolve or suspend the permit, or its intent to
modify the Reclamation Plan as incorporated in the permit. The operator shall have right to a
hearing at the designated time and place on any proposed modification, revocation or
suspension by the Department. Alternatively and in addition to the above, the Department
may institute other enforcement procedures authorized by law.
Definitions
Whenever used or referred to in this permit, unless the context clearly indicates otherwise,
terms shall have the same meaning as supplied by the Mining Act, N.C.G.S. 74-49.
Expiration Date
This permit shall be effective from the date of its issuance until December 19, 2022,
Conditions
This permit shall be subject to the provisions of the Mining Act, N.C.G.S. 74-46, et. seq., and to
the following conditions and limitations:
OPERATING CONDITIONS:
1, A. Any wastewater processing or mine dewatering shall be in accordance with the
permitting requirements and rules promulgated by the N.G. Environmental
Management Commission.
b0 39dd 00 QNCS A-MM OEEV-660-616 ZV:61 EZOZ/EO/iO

Page 3
B. Any stormwater runoff from the affected areas at the site shall be in accordance
with any applicable permit requirements and regulations promulgated by the
Environmental Management Commission. It shall be the permittee's responsibility
to contact the Division of Water Quality to secure any necessary stormwater
permits or other approval documents.
2. A. Any mining process producing air contamination emissions shall be subject to the
permitting requirements and rules promulgated by the N.C. Environmental
Management Commission and enforced by the Division of Air Quality.
B. During mining operations, water trucks or other means that may be necessary shall
be utilized to prevent dust from leaving the permitted area.
3. A. Sufficient buffer shall be maintained between any affected land and any adjoining
waterway or wetland to prevent sedimentation of that waterway or wetland from
erosion of the affected land and to preserve the integrity of the natural watercourse
or wetland.
B. Any mining activity affecting waters of the State, water of the U. S., or wetlands
shall be in accordance with the requirements and regulations promulgated and
enforced by the N. C, Environmental Management Commission.
4. A. Adequate mechanical barriers including but not limited to diversions, earthen dikes,
check dams, sediment retarding structures, rip rap pits, or ditches shall be provided
in the initial stages of any land disturbance and maintained to prevent sediment
from discharging onto adjacent surface areas or into any lake, wetland or natural
watercourse in proximity to the affected land,
B. Mining activities, Including the installation and maintenance of the approved
sediment basins and associated diversion berms, shall be conducted as indicated
on the Mine Maps, Sheets 2, 6 and 8 of 8 last revised September 19, 2012 and
Sheets 1, 3, 5, and 7 of 8 dated July 5, 2012 and the supplemental information
received June 12, 2012, August 10, 2012, October 25, 2012 and September 20,
2012.
5. All mine permit boundaries (32.75 acres) shall be permanently marled at the site on
100-foot intervals unless the line of sight allows for larger spacing intervals.
6. The angle for graded slopes and fills shall be no greater than the angle which can be
retained by vegetative cover or other adequate erosion control measure, structure, or
device. In any event, exposed slopes or any excavated channels, the erosion of which
may cause off -site damage because of siltation, shall be planted or otherwise provided
with ground cover, devices or structures sufficient to restrain such erosion.
7. The affected land shall be graded so as to prevent collection of pools of water that are,
or likely to become, noxious or foul. Necessary structures such as drainage ditches or
conduits shall be constructed or installed when required to prevent such conditions.
90 39d8 00 QNVS A-1-13A OEEb--66b-616 ZV:ET E10Z/E0/T0

Page 4
8. Existing vegetation or vegetated earthen berms shall be maintained between the mine
and public thoroughfares whenever practical to screen the operation from the public.
9. A. Sufficient buffer shall be maintained between any excavation and any mining
permit boundary or right-of-way to protect adjacent property.
B. Buffers shall be maintained as indicated on the Mine Map, Sheet 2 of 8, last
revised September 19, 2012.
10. A physical barrier consisting of a fence or earthen berm, etc., shall be maintained
around the perimeter of any highwall.
11. A. No on -site disposal of refuse or other solid waste that is generated outside of the
mining permit area shall be allowed within the boundaries of the mining permit
area unless authorization to conduct said disposal has first been obtained from
both the Division of Waste Management and the Land Quality Section,
Department of Environment and Natural Resources. The method of disposal
shall be consistent with the approved reclamation plan.
B. Mining refuse defined by G.S. 74-49 (14) of The Mining Act of 1971 generated
on -site and directly associated with the mining activity may be disposed of in a
designated refuse area. All other waste products must be disposed of in a
disposal facility approved by the Division of Waste Management. No petroleum
products, acids, solvents or their storage containers or any other material that
may be considered hazardous shall be disposed of within the permitted area.
C. For the purposes of this permit, the Division of Land Resources considers the
following materials to be "mining refuse" (in addition to those specifically listed
under G.S. 74-49 (14) of the N.C. Mining Act of 1971):
1. on -site generated land clearing debris
2. conveyor belts
3. wire cables
4. v-belts
5. steel reinforced air hoses
6. drill steel
D. If mining refuse is to be permanently disposed within the mining boundary, the
following information must be provided to and approved by the Division of Land
Resources prior to commencement of such disposal:
1. the approximate boundaries and size of the refuse disposal area;
2, a list of refuse items to be disposed;
3. verification that a minimum of 4 feet of cover will be provided over the
refuse;
90 30Vd 00 QNd5 Al 13A 0££b-66b-6T6 Zb:£T 6TOZ/£0/T0

Page 5
4. verification that the refuse will be disposed at least 4 feet above the
seasonally high water table; and
5. verification that a permanent vegetative groundcover will be established.
12. An annual Reclamation Report shall be submitted on a form supplied by the Department
by February 1 of each year until reclamation is completed and approved.
13. The operator shall notify the Department in writing of the desire to delete, modify or
otherwise change any part of the mining, reclamation, or erosion/sediment control plan
contained in the approved application for a mining permit and any approved revisions to
it. Approval to implement such changes must be obtained from the Department prior to
on -site implementation of the revisions.
14. The security, which was posted pursuant to N.C.G.S. 74-54 in the form of a $500,000,00
blanket bond, is sufficient to cover the operation as indicated in the approved
application, This security must remain in force for this permit to be valid. The total
affected land shall not exceed the bonded acreage.
15. A. Authorized representatives of the Division of Archives and History shall be
granted access to the site to determine the presence of significant archaeological
resources.
B. Pursuant to N. C. G. S. 70 Article 3, "The Unmarked Human Burial and Human
Skeletal Remains Protection Act, " should the operator or any person in his
employ encounter human skeletal remains, immediate notification shall be
provided to the county medical examiner and the chief archaeologist, North
Carolina Division of Archives and History.
L0 30Vd 00 GNVS A173A OEEb-660-6T6 Lb:ET ETOZ/E0/TO

Page 6
APPROVED RECLAMATION PLAN
The Mining Permit incorporates this Reclamation Plan, the performance of which is a condition
on the continuing validity of that Mining Permit. Additionally, the Reclamation Plan is a
separable obligation of the permittee, which continues beyond the terms of the Mining Permit.
The approved plan provides:
Minimum Standards As Provided By G.S. 74-53
The final slopes in all excavations in soil, sand, gravel and other unconsolidated
materials shall be at such an angle as to minimize the possibility of slides and be
consistent with the future use of the land.
2. Provisions for safety to persons and to adjoining property must be provided in all
excavations in rock.
3. All overburden and spoil shall be left in a configuration which is in accordance with
accepted conservation practices and which is suitable for the proposed subsequent use
of the land.
4. No small pools of water shall be allowed to collect or remain on the mined area that are,
or likely to become noxious, odious or foul.
5. The revegetation plan shall conform to accepted and recommended agronomic and
reforestation practices as established by the North Carolina Agricultural Experiment
Station and the North Carolina Forest Service.
6. Permittee shall conduct reclamation activities pursuant to the Reclamation Plan herein
incorporated. These activities shall be conducted according to the time schedule
included in the plan, which shall to the extent feasible provide reclamation simultaneous
with mining operations and In any event, provide reclamation at the earliest practicable
time after completion or termination of mining on any segment of the permit area and
shall be completed within two years after completion or termination of mining.
RECLAMATION CO DiTIONS:
Provided further, and subject to the Reclamation schedule, the planned reclamation
shall be to regrade and satisfactorily revegetate any disturbed areas.
2. The specifications for surface gradient restoration to a surface suitable for planned
future use are as follows:
A. All the final perimeter sideslopes shall be graded to a 3 horizontal to 1 vertical or
flatter slope.
80 30Vd 00 QNVS A 13>i 0££b-660-616 Z17:£1 £Z0Z/£0/i0

Page 7
B. Any settling ponds or sediment basins shall be backfilled and stabilized.
C. The processing, stockpile, and other disturbed areas neighboring the mine
excavation shall be leveled and smoothed.
D. Compacted surfaces shall be disced, subsoiled or otherwise prepared before
revegetation.
E. No contaminants shall be permanently disposed of at the mine site. On -site
disposal of waste shall be in accordance with Operating Condition 1 1A through D.
F. The affected land shall be graded to prevent the collection of noxious or foul
water.
3. Revegetation Plan:
After site preparation, all disturbed land areas shall be revegetated as per the following:
Permanent Seeding Specifications
Dates Species Rate, Lbs/Acre
February 15 —April 1 Kobe Lespedeza 10
Bahiagrass 50
Redtop 1
Winter rye (grain) 15
April 1 — July 31 Common Bermuda 50
August 1 — October 25 Lespedeza (unscarified) 30
German millet 40
October 25—February 15 Rye (grain — temporary) 120
Soil Amendments
Lime- 2000 lbs/acre or follow recommendations from a soil test.
Fertilizer- 1000 Ibs/acre 8-8-8 or 10-10-10, or follow recommendations from a
soil test.
Mulch All seeded areas shall be mulched using small grain straw at a rate
of 2000 Ibs/acre and anchored appropriately.
60 39Cd 00 QNdS A 13A 0£EP-660-616 Zb:£T £TOZ/E0/T0

4.
Page 8
Whenever possible, disturbed areas should be vegetated with native warm season
grasses such as switch grass, Indian grass, bluestem and gamma grass.
In addition, the permittee shall consult with a professional wildlife biologist with the N.G.
Wildlife Resources Commission to enhance post -project wildlife habitat at the site.
Reclamation Plan:
Reclamation shall be conducted simultaneously with mining to the extent feasible. In
any event, reclamation shall be initiated as soon as feasible after completion or
termination of mining of any mine segment under permit. Final reclamation, including
revegetation, shall be completed within two years of completion or termination of mining.
Permit issued this 19th day of December, 2012.
-Tracy y E. Davis, Director
Division Energy, Mineral and Land Resources
By Authority of the Secretary
Of the Department of Environment and Natural Resources
01 39dd 00 QNGS 1_113X OEEb-66b-616 Zb:ET ETOZ/EO/TO

NOTICE OF ISSUANCE OF
MINING PERMIT
You have previously expressed an interest and/or are listed as an adjoining landowner
in the application for a mining permit filed by K & K Sand Company, Inc. (Kelly Sand Company,
Inc.) to conduct mining activities off SR 1001 (Claude White Road) in Harnett County. The
mining permit (no. 43-43) was issued on December 19, 2012.
North Carolina law allows persons aggrieved by the issuance of a mining permit to
contest the decision by filing a petition for a contested case in the Office of Administrative
Hearings pursuant to N.C.G.S. 1508-23 of the Administrative Procedure Act (APA).
If you believe that you are an aggrieved party within the meaning of the APA, a petition
for a contested case must be filed in the Office of Administrative Hearings within Sip 60
days of the mailing of this notice to you.
If you file a contested case petition, it must be in writing and in the form prescribed by
N.C. General Statutes 150E-23. File the original petition and one copy with the Office of
Administrative Hearings, 6714 Mail Service Center, Raleigh, NC 27699-6714.
Any questions about filing a petition may be directed to the Clerk of the Office of
Administrative Hearings by telephoning [phone].
You must serve the Department of Environment and Natural Resources by mailing a
copy of the petition to Mr. William Cary, Registered Agent and General Counsel, Department
of Environment and Natural Resources, 1601 Mail Service Center, Raleigh, NC 27699.1601.
cy E. Davis
I actor
ision of Energy, Mineral and Land Resources
North Carolina Department of Environment and
Natural Resources
This notice was mailed on Jo2/c2p
Brenda Harris
Mining Program Secretary
it 39vd 00 QNVS Al 13A OEEP-660-616 Zb:ET ETOZ/EO/10

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— — —
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x x
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- T 11���
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+ + + \
-
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- _
TOPSOIL STOCKPILE
SURFACE WATER
FLOW DIRECTION
DISTURBED AREA
CATEGORY -
AFFECTED ACREAGE
TAILINGS/SEDIMENT PONDS
4,98
STOCKPILES -
16.11
WASTEPILES
0
HAUL ROADS
0.72
PROCESSING PLANT
.20
MINE EXCAVATION
110.47
OTHER (MISC. EXCAVATION)
0
TOTAL DISTURBED ACREAGE
132.48
MINE OPERATOR AND APPLICANT
K & K SAND COMPANY, INC.
PO BOX 9
CAMERON, NC 28326
[phone]
ATTN: LEE EDWARD KELLY
GRAPHIC SCALE
200 400
( IN FEET )
I inch = 200 ft
General Notes
EXISTING TOPOGRAPHIC INFORMATION
FROM A SURVEY BY STREAMLINE LAND
SURVEYING, INC., DATED 12/27/2012.
PERMIT DRAWING
NOT RELEASED FOR CONSTRUCTION
No. I Revision/Issue
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Date
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Signaturzf
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Date
G'hytof, Sr., F E.
CIVIL & ENVIRONMENTAL ENGINEERING
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46 WEST WASHINGTON STREET
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COATS, NORTH CAROLINA 27521
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PHONE: [phone] FAX:[phone]
License No, C-2570 www.ciclayton.00m
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K & K SAND COMPANY, INC. F-
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BLACKS CHAPEL PIT
GREENWOOD TOWNSHIP
LEE COUNTY, NORTH CAROLINA
Project No: 150009 File Name: 150009. MAS.dwg
Designed By: CTG Jr I Drawn By: WLF
Checked By; Proj. Eng.:
CTC Jr. CTG Jr
Sheet Title
STORMWATER MAP
Date 1/3/13 Sheet
Scale Sw
1" = 200'

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79'
35°22'30"
11151o11m
3!
20
MURCHISONTOWN QUADRANGLE
U.S. DEPARTMENT OF THE INTERIOR The National Map NORTH CAROUNA
`USGS U. S. GEOLOGICAL SURVEY 04,US Top 7.5-MINUTE SERIES
science for a changing world �n, 79°07'0"
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79°15'
Produced by the United States Geological Survey
North Arrg scan Daum of 1983 (NAD83)
World Geodetic System of 1984 (WGS84)- P-*Cli- and
1 000-ureter grid: Universal Transverse Mercatar.Zone175
10 000400t ticks: North Carolina Coordinate SysZo f1983
I-asm..................................................NAIP, July 2008
Roads ....... ....................................... C200&2010 Teie Atlas
Names..........................................._.................GNIS, 2008
Hydrography .................National Hydrography Dataset, 2008
Contours...........................National Elec0tian Dataset, 2008
8' 24'
149 I
1. 3'
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SCALE 1: 24 000
0.5 © IWAEIERS 1 2
1000 500 0 N7fERS 1000 2000
1
1 0.5
!LES
1000 0 low 2000 3000 4000 5000 6000_ 7000 0000 90000 10000
:E7
CONTOUR iii.ERVAL 10 FEET
NORTH AMERICAN V9?T1CAL DATUM OF 1988
This map was produced to cc -.form with version 0.5.10 of the
draft USGS Standards for -.5-Minute Quadrangle Maps.
A metadata. file associated with Uhis product is draft version 0.5.11
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