NCG050454_Application_20220308

FOR AGENCY USE ONLY
NCG050 i,5 Lt ,/
Assignedto: .0 Ol
ARO FRO MRO RRO WARO WIRO WSRO
Division of Energy, Mineral, and Land Resources Land Quality Section
National Pollutant Discharge Elimination System
NCG050000 Notice of Intent
This General Permit covers STORMWATER DISCHARGES associated with activities under the following Standard
Industrial Classifications: SIC 23 [Apparel and Other Finished Products Made from Fabrics and Similar Materials],
SIC165 [Paperboard Containers and Boxes], SIC 267 [Converted Paper and Paperboard Products], SIC 27 [Printing,
Publishing and Allied Industries], SIC30 [Rubber and Miscellaneous Products —except as specified below], SIC 31
[Leather and Leather Products — except as specified below], and SIC39 [Miscellaneous Manufacturing Industries],
and other like activities deemed by DEMLR to be similar in the process and/or the exposure of raw materials,
products, by-products, or waste materials. SIC 301 [Tires and Inner Tubes] and SIC 311 [Leather Tanning and
Finishing] are specifically excluded from coverage under this General Permit. you can find information on the
DEMLR Stormwater Program at deq.nc.gov/SW.
Directions: Print or type all entries on this application. Send the original, signed application with all required
items listed in Item (6) below to: NCDEMLR Stormwater Program, 1612 MSC, Raleigh, NC 27699-1612. The
submission of this application does not guarantee coverage under the General Permit. Prior to coverage under
this General Permit a site inspection will be conducted.
1. Owner/Operator (to whom all permit correspondence will be mailed):
Name of legal organizational entity:
Legally responsible person as signed in Item (7) below:
LTR Products, LLC
Frank DeCado, General Counsel
Street address:
City:
State:
Zip Code:
600 River Ave, Suite 300
Pittsburgh
PA
15212
Telephone number:
Email address:
[phone]
[e-mail]
Type of Ownership:
�i E n A -
Government
,
13County I3FederaI OMunicipal [3State
MAR 08 2021
Non -government
oBusiness (If ownership is business, a copy of NCSOS report must be included with this application)
DENT -LAND QUALI
pindividual
STORMWATERPERM1
2. Industrial Facility (facility being permitted):
Facility name:
Facility environmental contact:
LTR Products, LLC - Sanford Facility
Tony Brown, General Manager
Street address:
City:
State:
Zip Code:
6015 Enterprise Park Drive
Sanford
NC
27330
Parcel Identification Number (PIN):
County:
9655-07-7826-00
Lee
Telephone number:
Email address:
843-910-4876
[e-mail]
4-digit SIC code:
Facility is:
Date operation is to begin or began:
3069
1 0New I3Proposed 13Existing
03/01/2022
Latitude of entrance:
Longitude of entrance:
35.5576174657
-79.1639696698
Page 1 of 5
'ING

3.
Brief description of the types of industrial activities and products manufactured at this facility:
Storage, processing, and painting of scrap tire chips to create rubber mulch final product.
If the stormwater discharges to a municipal separate storm sewer system (MS4), name the operator of the MS4:
© N/A
Consultant (if applicable)
Name of consultant: Consulting firm:
Bernie Garrett, P.E. Garrett and Moon:, Inc.
Street address: City: State: Zip code:
1029 W South Street Raleigh INC 27603
Telephone number: Email address:
919-792-1902 [e-mail]
4. Outfall(s) (at least one outfall is required to be eligible for coverage):
3-4 digit identifier:
Name of receiving water:
Classification:
This water is impaired.
001
unnamed tributary of Gum Fork
WS-IV
p This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
35.5552849139
-79.1644893611
Brief description of the industrial activities that drain to this outfall:
Scrap fire chip and rubber mulch storage
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? E3Yes 0 No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
3-4 digit identifier:
N/A
Name of receiving water:
I
Classification:
O This water is impaired.
I E3 This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
Brief description of the industrial activities that drain to this outfall:
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? O Yes O No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
3-4 digit identifier:
N/A
Name of receiving water:
1
Classification:
O This water is impaired.
1 O This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
Brief description of the industrial activities that drain to this outfall:
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? Oyes O No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
All outfalls must be listed and at least one outfall is required. Additional outfalls may be added in the section
"Additional Outfalls" found on the last page of this NO1.
Page 2 of 5

5. Other Facility Conditions (check all that apply and explain accordingly):
❑ This facility has other NPDES permits.
If checked, list the permit numbers for all current NPDES permits:
❑ This facility has Non -Discharge permits (e.g. recycle permit).
If checked, list the permit numbers for all current Non -Discharge permits:
0 This facility uses best management practices or structural stormwater control measures.
If checked, briefly describe the practices/measures and show on site diagram:
Wet Pond with skimmer and riser barrel outlet structure (Pond #001) and Rip -rap outlet protection
O This facility has a Stormwater Pollution Prevention Plan (SWPPP).
If checked, please list the date the SWPPP was implemented:
03/01/2022
❑ This facility stores hazardous waste in the 100-year floodplain.
If checked, describe how the area is protected from flooding:
❑ This facility is a (mark all that apply)
❑ Hazardous Waste Generation Facility
❑ Hazardous Waste Treatment Facility
❑ Hazardous Waste Storage Facility
❑ Hazardous Waste Disposal Facility
If checked, indicate:
Kilograms of waste generated each month:
Type(s) of waste:
How material is stored:
Where material is stored:
Number of waste shipments per year:
Name of transport/disposal vendor:
Transport/disposal vendor EPA ID:
Vendor address:
❑ This facility is located on a Brownfield or Superfund site
If checked, briefly describe the site conditions
6. Required Items (Application will be returned unless all of the following items have been included):
O
Check for $100 made payable to NCDEQ
❑+
Copy of most recent Annual Report to the NC Secretary of State
O This completed application and any supporting documentation
m
A site diagram showing, at a minimum, existing and proposed:
a)
outline of drainage areas
b)
surface waters
c)
stormwater management structures
d)
location of stormwater outfalls corresponding to the drainage areas
e)
runoff conveyance features
f)
areas where industrial process materials are stored
g)
impervious areas
h)
site property lines
O
Copy of county map or USGS quad sheet with the location of the facility clearly marked
Page 3 of 5

Applicant Certification:
North Carolina General Statute 143-215.6B (i) provides that: Any person who knowingly makes any false statement,
representation, or certification in any application, record, report, plan, or other document filed or required to be maintained
under this Article or a rule implementing this Article ... shall be guilty of a Class 2 misdemeanor which may include a fine not
to exceed ten thousand dollars ($50,000).
Under penalty of law, I certify that:
E+ I am the person responsible for the permitted industrial activity, for satisfying the requirements of this permit, and for any
civil or criminal penalties incurred due to violations of this permit.
0 The information submitted in this N01 is, to the best of my knowledge and belief, true, accurate, and complete based on
my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the
information.
0 1 will abide by all conditions of the NCGO50000 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.
O 1 hereby request coverage under the NCG050000 General Permit.
Printed Name of Applicant: Frank J. DeCarlo
Title: General Counsel and
d&� Z
(Signature of pplicant)
3/12022
(Date Signed)
Mail the entire package to: DEMLR —Stormwater Program
Department of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
Page 4 of 5

Additional Outfalls
3-4 digit identifier:
N/A
Name of receiving water:
1
Classification:
❑ This water is impaired.
1 0 This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
Brief description of the industrial activities that drain to this outfall:
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? O Yes O No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
3-4 digit identifier:
N/A
Name of receiving water:
Classification:
O This water is impaired.
This watershed has a TMDL
Latitude of outfall:
Longitude of outfall:
Brief description of the industrial activities that drain to this outfall:
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? O Yes O No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
3A digit identifier:
N/A
Name of receiving water:
I
Classification:
I
❑ This water is impaired.
1 ❑ This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
Brief description of the industrial activities that drain to this outfall:
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? OYes O No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
3-4 digit identifier:
N/A
Name of receiving water:
Classification:
❑ This water is impaired.
1 O This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
Brief description of the industrial activities that drain to this outfall:
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? Yes O No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
3-4 digit identifier:
N/A
Name of receiving water:
Classification:
O This water is impaired.
1 O This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
Brief description of the industrial activities that drain to this outfall:
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? O Yes O No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
Page 5 of 5

LIMITED LIABILITY COMPANY ANNUAL REPORT
rancor
NAME OF LIMITED LIABILITY COMPANY: LTR Products, LLC
SECRETARY OF STATE ID NUMBER: 1764434 STATE OF FORMATION: DE
REPORT FOR THE CALENDAR YEAR: 2020
SECTION A. REGISTERED AGENTS INFORMATION
1. NAME OF REGISTERED AGENT: Corporation Service Company
2. SIGNATURE OF THE NEW REGISTERED AGENT:
E - Filed Annual
Report
1754434
SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT
3. REGISTERED AGENT OFFICE STREET ADDRESS & COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS
2626 Glenwood Ave Ste 550
2626 Glenwood Ave Ste 550
Raleigh, NC 27608 Wake County Raleigh, NC 27608
SECTION B: PRINCIPAL OFFICE INFORMATION
1. DESCRIPTION OF NATURE OF BUSINESS: production and sale of rubber mulch and playground material from recycled tires
2. PRINCIPAL OFFICE PHONE NUMBER: [phone] 3. PRINCIPAL OFFICE EMAIL: Privacy Redaction
4. PRINCIPAL OFFICE STREET ADDRESS 5. PRINCIPAL OFFICE MAILING ADDRESS
600 River Avenue, 3rd Floor 600 River Avenue, 3rd Floor
Pittsburgh, PA 15212 Pittsburgh, PA 15212
6. Select one of the following If applicable. (Optional see Instructions)
❑ The company is a veteran -owned small business
❑ The company is a service -disabled veteran -owned small business
SECTION C: COMPANY OFFICIALS (Enter additional company officials in Section E.)
NAME: Frank J. DeCarlo
NAME: Thomas A. Womble
NAME: Dale, B MikuS
TITLE: Manager TITLE: Manager TITLE: Manager
ADDRESS:
ADDRESS:
ADDRESS:
600 River Avenue, 3rd Floor 600 River Avenue, 3rd Floor 3rd Floor 600 River Avenue
Pittsburgh, PA 15212 Pittsburgh, PA 15212 Pittsburgh, PA 15212
SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business entity.
Frank J. DeCarlo 4/9/2021
SIGNATURE DATE
Form must be signed by a Company official listed under Section C of This form.
Frank J. DeCarlo Manager
Print or Type Name of Company Official Print or Type Title of Company Official
SUBMIT THIS ANNUAL REPORT WITH THE REQUIRED FILING FEE OF $200.00
MAIL TO: Secretary of State, Business Registration Division, Post Office Box 29525, Raleigh, NC 27626-0525

SECTION E: ADDITIONAL COMPANY OFFICIALS
NAME: Liberty/Lakin National Tire Recycling, LLC NAME:
TITLE: Member TITLE:
ADDRESS: ADDRESS:
3rd Floor 600 River Avenue
Pittsburgh, PA 15212
NAME:
TITLE:
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RECEIVED
MAR 0810,'?
March 1, 2022 DENR-LAND QUALITY
STORMWATER PERMITTING
Via USPS Next Day Delivery
DEMLR — Stormwater Program
NC Department of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
Re: NCG050000 Notice of Intent
LTR Products, LLC — Sanford Facility
6015 Enterprise Park Drive, Sanford, NC
To Stormwater Program:
40 Uberty
7 TIRE RECYCLING
Enclosed please find NCG050000 Notice of Intent for stormwater discharges for the LTR
Products, LLC facility located in Sanford, NC. In addition, check #21278 in the amount of $100
is included as payment for the permit fee.
Please feel free to contact Tony Brown, General Manager, at [phone] or me at (412) 471-
2486 with any questions or comments.
Thank you.
LTR Products, LLC
Angela FoealDirector of Environmental Compliance
Enclosures
cc: T. Brown, LTR
B. Holder, LTR
Liberty Tire Recycling, LLC
600 River Avenue, 311 Floor, Pittsburgh 15212-5994
Phone: [phone] - Fax: [phone] • www.libertytire.com

LTR PRODUCTS, LLC
GARRETT
SANFORD
2
SWPPP
MOOREngi�dng
STORMWATER POLLUTION
e
a&
for the Power and e Indus
g
c
PREVENTION PLAN
1029 worth Caronoh
Raleigh,North Carolinaa 27603
www.Oa.Gartett-Moore.com