NCG020013_MONITORING INFO_20080414

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
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V
DOC TYPE
� ISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ aWMwq
YYYYMMDD

PROCESS/MINE DEWATERING WASTEWATER DISCHARGE MONTFORING REPORT (DMR)
Please Mail Original and One Copy to Mailing Address Below
A: Facility Information
Collected in Quarter.
rte of Coverage No.
Name
Contact
Contact Phone No.
GENERAL PERMIT NO. NCGO20000
IQ 2Q 3Q 4 (all samples shall be reported within 30 days following monitoring period)
(Cinle one)
NCGO200013 County of Facility
ASHEBORO QUARRY Name of Laboratory
DOYLE CARSLILE Lab Certification #
[phone]
B: Process Wastewater and Mine f lastetvater Monitoring Requirements
RANDOLPH
PACE ANALYTICAL
12
tfall
umber
Receiving Stream Name
Date
Sample Collected
50050
00400
00530
00076
00545
•Daily Flow l
pH
Total Suspended Solids
Turbidity
Settleable Solids''.
mo/dd/yr
MGD
unit
m
NTUs
mill
001
UT of Back Creek
1/11I08
0.48
7.80
2.6
ND
continuously using a flow measuring device or estimated using manufactu &s pump curves and pump logs.
C: Certification
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person
or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best
of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violation."
U
4/14/08
(Si tore of Fermi (Date)
D; MailingAddress
Attn: Central Files, DENR, N.C. Division of Water Quality,1617 Mail Service Center, Raleigh, N.C. 27699-1617
SWU-244-012005