Loading...
HomeMy WebLinkAboutNCG060319_COMPLETE FILE - HISTORICAL_20101118STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT N0. I /l/ C& 0 (Q U 31 DOC TYPE I �K HISTORICAL FILE ❑ MONITORING REPORTS DOC DATE ❑ 0610 11 13 YYYYMM DD i NCDENR North Carolina Department of Environment and Natural Resources Division of Water Quality Beverly Eaves Perdue Coleen H. Sullins Governor Director November 18, 2010 Mr. Clay Howard House of Raeford Farms, Inc. P.O. Box 40 Rose Hill, NC 28458 Subject: General Permit No. NCG060000 House of Raeford Farms, Inc. Rose Hill Facility 3333 US Highway 117 South COC NCG060319 Duplin County Dear tvlr. Howard: Dee -Freeman Secretary The Division of hater Quality received your initial application for storniwater general permit NCG060000 on September 8, 2010- I spoke with you on September 22, 20-10 and. requested an updated Notice of Intent (NOI), our application form. I left another message at your facility requesting the same information in October of 2010 at the number you provided on your application: MO)-289-6952. In ordi--r to process your request for a l eneral permit NCG060000 we must obtain some additional information. Please provide the following information on your updated NOL 1) please write use the legal corporation name as the owner name. The only corporation listed for your address on the Secretary of State's Corporation website is "I-1(;use of Raeford Farms, Inc." 501�1_ 2) Your facility discharges to both Sit e k and Cabin Branch. Please update the NOL L--�7 3) The signatory authority for the application is as follows: a. 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 or expenditures exceeding 25 Wetlands and S[crmwater Branch 1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Location: 512 N. Salisbury St. Ralegh, North Carolina 27604 Phone: 919-807-6300 k FAX: 919-807-64941 Custorier Service: 1-877-623-6748 Internet: ww.v.ncwateryuaRy.org One NonliCat-ol ina Artti l-al!J rvti: �.t�ty nvwatu House of Raeford Farms, Im.—NCG060319 y -,November 18, 2010 million (in second quarter 1980 doIlars), if authority to sign documents izas been assigned or delegated to the manager in accordance with corporate procedures. Please send the above requested information by December 18, 2010. If you cannot return the requested information by December 18, 2010, write to us requesting additional time. If the above information is not received by that date, or you do not respond in writing before that date, your application will be returned as incomplete. If you have any questions concerning this permit, please contact me at telephone number (919) 807-6379 or jennifer.jones i-icdenr.gov. Sincerely, Jennifer Jones cc: Wilmington Regional Office, Linda Willis Central Files Stormwater Permitting Unit Files NOS % JZN5 Jones, Jennifer From: Willis, Linda Sent: Wednesday, September 29, 2010 10:26 AM To: Jones, Jennifer Subject: RE: NCG060319 - October 22, 2010 Yes, thanks. Iw From: Jones, Jennifer Sent: Tuesday, September 28, 2010 11:16 AM To: Willis, Linda Cc: Jones, Jennifer Subject: RE: NCG060319 - October 22, 2010 Sounds good —will change the COC and map to reflect both streams. They should do fecal monitoring if they are a meat processing plant — which sounds like they are, With that change, do you want me to go ahead and issue the permit so we can get them covered? Thanks, Jen From: Willis, Linda Sent: Friday, September 24, 2010 2:41 PM To: Jones, Jennifer Subject: RE: NCG060319 - October 22, 2010 The site next to Beaverdam is Parker Bark, but come to think of it, you are correct that the site drains to both Beaverdam Creek and Cabin Branch. Any spill from their wastewater lagoons would go directly to Cabin Branch. The stormwater from the plant area on the northside of their plant would drain to Beaverdam Branch the area on the soutside would drain to Cabin Branch. The general permit will suffice as long as we ensure they have to do the fecal monitoring. From: Jones, Jennifer Sent: Wednesday, September 22, 2010 11:42 AM To: Willis, Linda Subject: RE: NCG060319 - October 22, 2010 Oh lord. The creek looks thick. I could see the bubbles/foam on one of the lagoons from the satellite image so I knew it must be thick but I had no idea about the creek — wow. Geez. Oh sorry I didn't realize they were going to cabin creek. But looking at the map I wondered if they discharging SW to both? Because the topo lines look like it may be direct to both streams (Beaverdam also runs next to their site). Also on their N01 they claim they discharge to Beaverdam Branch. j STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT GENERAL PERMIT NO. NCG030000 CERTIFICATE OF COVERAGE NO. NCG030326' FACILITY NAME Carolina Steel Group, LLC (Hirschfeld_ Industries -Bridge) PERSON COLLECTING SAMPLE(S) Roger Breeden CERTIFIED LABORATORY(S) Microbac Lab # 21 Lab# Part A: Specif Monitoring Requirements SAMPLES COLLECTED DURING CALENDAR YEAR: 2010 (This monitoring report shall be received by the Division no later than 30 da s from the date the facility receives the sampling results from the laboratory.) / COUNTY_ _Nash NO. (252) 459-711 SIGNATURE OF PERMITTEE OR DESIGI EE By this signature, I certify that this report inaccurate and complete to the best of my knowledge. Outfall No. bee Sample\ Collected \\ 50050 00530 00400 00556 01051 78141 Total Flow Total Suspended Solids pH Oil and Grease Lead Total Toxic Organics' mo/dd/yr MG m I units m /I mg/1 mg/1 #1 7/18/10 0.08 <12.5 5.59 <5.00 0.0332 -N/A #2 7/18/10 \\0.008 <12.5`\ 5.41 <5.00 0.0328 IN/A \\ \ W Does this facility erform Vehicle Maintenance Activities using more than 55 allons of new motor oil per month? es x no Yp g g p yes (if yes, complete Part B) Part B: Vehicle Maintenance Activity Monitoring Requirements Outfall No. Date Sample Collected' 50050 00556 \\ 00530 '\, 00400 Total Flow Oil and Grease \ '-,Total Suspended-, "�'-Solids pH New Motor Oil Usage STORM EVENT CHARACTERISTICS: Date 7/18/10 Total Event Precipitation (inches): 0.18 Event Duration (hours): 24 (if more than one storm event was sampled) Date Total Event Precipitation (inches): Event Duration (hours): Division of Water Attn: Central'Files 1617 Mail Service Raleigh, North Cai to: 7699-1617 SWU-245-120399 Page 1 of 2 But again I haven't been there so let me know. We can put both on the general permit COC and map. Do you feel the general permit is appropriate and protective enough? Let me know & thanks, Jen From: Willis, Linda Sent: Wednesday, September 22, 2010 11:32 AM To: Jones, Jennifer Subject: RE: NCG060319 - October 22, 2010 They actually discharge into Cabin Branch.. Stream Index 18-74-24-1-1-1 Class C Sw and is tributary to Beaverdam Branch Stream Index 18-74-24-1-1. This is the site that had an environmental incident in the creek behind their lagoons, but fear not, according to their ORC, that sludge did not come from them but rather the 6 cows that reside in the pasture next door! Linda From: Jones, Jennifer Sent: Wednesday, September 22, 2010 10:52 AM To: Willis, Linda Cc: Jones, Jennifer Subject: NCG060319 - October 22, 2010 Hi Linda, We've received an NOI from House of Raeford Farms, Inc / House of Raeford — Rose Hill. for their chicken processing facility in Rose Hill (Duplin County) for coverage under NCG06 (food & kindred permit). The site discharges stormwater into Beaverdam Branch (C, Sw). The map and NOI are attached. As far as the SW permit goes it seems well, pretty normal. But it looks like from the site that there are massive lagoons and chicken processing areas (see satellite image below — wow). They will be required to measure TSS, COD, 0&G pH and fecal so it sounds like the genera permit is pretty appropriate — but I haven't been there obviously. Does the Wilmington Regional Office have any concerns about issuing this facility a COC for this general permit? If we don't receive any objections, we'll issue the COC in 30 days. Thanks Linda! Jen 1 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semi -conductors, manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31). Facilities'that develop a solvent management plan to be incorporated into the Stormwater Pollution Prevention Plan may make a request to DWQ that monitoring of total toxic organics -be waived. The solvent management plan shall include a list of the total toxic organic compounds used; the method of disposal used instead of dumping, such as reclamation, contract hauling,• or incineration; and the procedures for assuring that total toxic organics do not routinely spill or leak into stormwater. For those facilities allowed such a waiver, the discharger shall include the following signed certification statement on the discharge monitoring report: "Based upon my,inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TTO), I certify alai fo.the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the solvent management plan included'ib,the Stormwater Pollution Prevention Plan." Roger Breeden _ ^_ Name (Print name) Plant Manager Title (Rrin title) A, a . , (Signs ure) (Date) . "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the; information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." X (Signature of Permittee) $-- 3 -/-0 (hate) SWU-245-120399 Page 2 of 2 � r house of raeford rose hill, ,., x maps,googfe.corn/maps?hl=ena.q=house+of+raeford+rose+hill&urrr=l ie-1 F•-S55a=N&tab=�,vl o� Google ZWeb Mail — —_-- — Web Images Videos Maps News Sho"irrrr Gmail more v Goode maps house of raeford rose hill, nc - r -4, ._ a .•. ` ' t - r .�` + t-1'.M• r .t .r � �! J�.t o - f � r _. � � ■ f`+ 4A�-r vl Ff E'!�' .. ^�. y�-�;s i�f♦ y'.is .,. ti Y�y��b 1' r+ U ;4S. I ! JA 't* _ ,�+`s� rr-,,,'r 'r" �` ■ � � r �.fi !N L � i . Tel �- r.A +-G r• •;�4$_'�(� ��a'v t y, �; � ��'r'x I}�-1 ,� Y'a` `'�� ��f�T .,� s. 1i•• �C 1. t... rt'Sr �3f i � l.�/±ie. ���' � 'p 'A+,yr.••_ -- k,�r F 7 I`r `�. ( -?. _ s - .`� 4_r a 1.- 17 • -� r'. '�r;_y� �� 'it,�r�j���'.i�a. ��_r� `,�.-7."C �r�-r�i:�. 3A�iL,«���.:;��•, �� } rf����}{�/��4-!'��•, ,�"' }['�y.� �4s,%. ■ t }�c[i"J�l}?` ti� 3" s���, � r -�,�� ,,��•Ya��,[�."��;3 f; ' y �+i.`'�ri+a-Ott ��#'y'�' {*i'i.�iw •'-'�lf/h - t -�a�yf S . �1'ai�"•e���Y ,tiz f ',>., �'c'^�'a�t'�. ,ru,•' "* � � �ar"�+' f �'Y�, Tl 711, � "'�Y,Vk ' � �^ t - �r.r.�}rc,:. rY� 7[ }:' ` Y.� i71.{��I ■�"p�041OP to ,} _ jC" 1 ■ - • i �,sS1 Jp i {�: +....,.i,i� 1�. 1. }a. .-J:"!:� ~. �'.-..s�,��.-�. Ly �-�j �3 S�'r r -�"� '°1"P"a :'f�L►"f'r' 'P'�'" �t-��_.. 'M, r�, F .s - Fri � °Yy,!� «t 731�. ,iR+� ri _'_Y•'W e-/'rS ",1, h s ��4i+� S +,b ��`91 'r ` ��r .✓, r,,.+"�+' -"^ h[t.i. a.r �r�, �.�r. d5` rF^Nix-^ '1r., ✓^d'�'a'-,,. 1' ■+ `�'. �. r1�' t.t}.ai^•. rt� -�3 � te+b�xy! � •.iSJ' . i y y,k ;-- �ij'k , '� �k �-�'�3?' _ "1'�-s '�r �� 17 01 e %Y4 t�. - r r ��# ! •y'' 1`'y' .wr' +i ;gS'- r if g� ?'!- R:a"' T�� , . M � �+. w;�4•+ h`-',.rX,'' .�,yk. xt �.`• �t ,i iY aj AS` 'f'-•a ! :a • ' c.�° .-�!-i,: yid-..Yr l a.a" �°• ,, ar a �. •}. 'ja, ,a4,. i ,may r�' `�'.y. '` ' f+ +'y ..'�-+ � •.\ r i "�..� . +�` •��...q,� '� i �� -v ,5� �� ��^- �,� ,r,.,.+.^��'" 1'�-�"'r��r Y� "' ,. .� , � �`7'�i"�,�r�T~ ¢ •'� �F. i?�7 ,#, yti„ �.+�i'1 i, , y� i : i'u. -{ �•..-....1 r„ , +?7- -F.� C'' ;' -_s :- '!; _Y 7 z�.. �r +' f. �y a'4�_F f;r�•.=4 �gys s �° vri .: rr .. �a" rr. 3 STORNINVATER DISC:II.ARGE, OU'TFALL (SIM) MONITORING REPORT GENERAL PE-RA-11IT NO. NCC030000 CERTIFICATE OF COVERAGE NO. NCG03`:l' FACILITY NAME 1'I lttit 1' COI,I.Ir;CTING SAMPLES L , i, F r; , t�r,.�•� (,:}?R"I'1 '}1?D I,ARt)11A'fOIZY TY4 t- 1 T I.,ah fI I C 3 Lath # Pm -( A: Specltic. 19onitoring; Require►ncots SAMPLES COLLEL.TED DURING CALENDAR VEAR: l (This monitoring report is due at the Division no later than 30 days from the date the facility receives the sampling results from the lahoratory.) COUN I )' PHONE NO. (c-t PLEASE SIGN ONTin,' REVERSE 4 Outfall No. \\Date Sample Collected, mo/dd/ r 00530 00400 01051 00556 78141 Total Suspended Solids, m /I., pH, Standard units Lead, mgfL Oil and Grease,I. to= Total Toxic Organics , m Benchmark - \ \ 100 Within 6.0 — 9.0 0.033 30 1 )(1. 7 r'li :• L- �. c 4- v L) 5 l'I L jy . ` rh .. /L %� If cs � It r c4 O Nate: If you rcporl a sampled value in excess of the bCllel1111a1'k value, 0r outside the benchnl:o k range lbr pf 1, YOU MUM implement E'ier 1 or `Pier 2 responses. See (icncral Pel'nlil teal. Uid this facility per101"111 Vehielc 1 -billlellance Aenvitles'llsing 111o1'e than 55 gallons of I1cw 111010i' oil per nlollth? _ yes X no (if'y-es, cilnlplctc Part ]3) Part It: Vehicle 1lainlenance Activity i\lonitorin g Re u►rements, Outfall No. Date Sample Collected, mo/dd/vr 00556 \ 00530 00400 Oil and Grease, m Total Suspended Solids, m' L pH, Standard units New Motor Oil Usage, Annual average al/mo Benchniark - 30 \ 100 6.0 — 9.0 - Vote: If you report a sampled value in excess of the benchmark value, or outside the benchmark ialii SCc, (icncral Permit text. STOR[1'I Is'�'I?N'1' CIir1RAC'l'EI✓ lS'I'ICS: Date •� r.� C (first event sampled► Total i'vent Precipitation (inches): or 1)H. you imist implement 'Pier I oi- Tier 2 responses. Date (list each additional event sampled this reporting; period, and rainfall amount! Total Event Precipitation (inches): Mail Original and one copy to: Ivision of Water Quality 1 ti11�DWQ Ccntral Files 1617 Mail Service Center Raleigh. Nbrtllh Carolina 27699-1617 ZS �r SW I-�-2=45-031 30S Pure 1 elf 2 ***** Jennifer Jones 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: (919) 807-6379 Fax: (919) 807-6494 Email: iennifer.ionesPncdenr.gov 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.** Total Tmic Organics sarnliling, is applicable only for those facilities which ped<}rm metal finishing operations, manufacture semiconductoi:c, m,rnuf,tclure electronic crvsurl.s, or manufacture cathode ray tribes. For purposes of this hermit the definition of "folal 'Toxic Organics is Ilia( definition contained in the 17-IIA Effluent Guidelines for (lie facility "object to Itte rcquirerne)t to Samplee (fcir,nicial finishing use the definition as found in 40 CPR 433.1 1; for semiconductor manufacture use the definition as found in 40 C'FR 469.12: for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray uthe manufacture use the definition found in 40 CFR 469.31). Facilities that incorporate a solvent nimiageruent plan into the Stornnvater Pollution Prevention Plan may so certify, and the requirement for TT0 nu)nitoring may be, .vaived. The solvent management plan shall include•a list of the total toxic organic compounds used and the other elements listed in the General hermit. For those facilities electing to employ the TTO monitoring waiver, the dischargersha\ign the following cerlification s(aterncnt: "Based upon my inquiry of the person ornpersons directly responsible for managing amIj)hancr: with thi. permit monitoring rcquirenu:n( for total toxic organics ('I TO), l certify that to the best of my knowledge and.belief', no dumping of concenIra Ied toxic organics into r the s(ormwater or areas which are exposed to rainfall or sior iiw:ilex runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the solvent ;nanagcment plan included in the Stormwa(cr Pollution Preventior flan." Name (I'rint.n\ie), Title (Print title) \ (Signature) . (Date) "I certify, under penalty of law, that this document and all attachments were prepared undei my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on any inquiry of the person or persons who manage the system, or th se,persons directly responsible for gathering the information, the information submitted is, to the best of my knowl&]lge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information including the possibility of fines and imprisonment for knowing violations." o.:3 _iv -t ele�g�- - (Signature of Permiltee) (Date) SWI1_')4S-011 ;OX VN RD Division of Water Quality / Surface Water Protection Section NCDENRNational Pollutant Discharge Elimination System WC - Gaouu. Dtw —C.' or E.1-0--E-T —0 NdWiy RE�CES NCG060000 NOTICE OF INTENT FOR AGENCY USE ONLY Date Received Year Month Day BCD iiisate of CoNeta •e Check fi Amount /00— Pemrit Assi pied to ,V s National Pollutant Discharge Elimination System application for coverage under General Permit NCG060000: STORMWATER DISCHARGES associated with activities classified as: SIC (Standard Industrial Classification) 20 Food and Kindred Products SIC 21 Tobacco Products SIC 283 Drugs SIC 284 Soaps, Detergents, & Cleaning Preparations; Perfumes, Cosmetics, & Other Toilet Preparations SIC 422 Public Warehousing and Storage (except 4226) For questions, please contact the DWO Regional Office for your area. See page 4. (Please print or type) 1) Mailing address of owner/operator (address to which all permit correspondence will be mailed): Name Street Address --- F.0•. Bak 40 City Q G_ 1 State NG ZIP Code Z 64 56 Telephone No. '910 Z 09 • (9952 Fax: L110 2.m- (A) Z- 2) Location of facility producing discha(rrge: /1 r Facility Name �Vwsc OT Facility Contact C-,Iotq Gird [) a s iMc�t a Street Address �j w j I7 -::504F•0- oX 4-0 City — oiz f i t* State NJ G ZIP Code �458 Countyr,'� Telephone No. Fax:~ 1 V Z89` �R1Z Email 3) Physical Location Information: Please provide a narrative description of how to get to the facility (use street name , st to road numb@r5 and distance and direction from a roadway intersection). ley VNOffl t -roan' of Abu I ( On i,� •S. �wr� k I (A copy of a county map or USGS quad sheet with the facility clearly located must be submitted with this application.) 1V " 1J 1 32- Lon g' etude W -Mo(deg, 4} Latitude �i 57 _ min, sec} ��:�: •�'' `: -, 5) This NPDES Permit Application applies to which of the following: �Z rI ❑ New or Proposed Facility Date operation is to begin Existing Page 1 of 4 SWU-221-071408 Last revised 7/44/08 oi- NCG060000 N.O.I. 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: 2 0 1 7) Provide a brief narrative description of the types of industrial activities and products manufactured at this facility: C"kIc q" _l3vN41� s ! AL'% 8) Discharge points 1 Receiving waters: Flow many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? Z- What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater discharges end up in? _ e Vtw- DLwvt RY9Mc'�' Receiving water classification:_ w Is this a 303(d) listed stream? _ Has a TMDL been approved for this watershed? 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). N/A 9) Does this facility have any other NPDES permits? ❑ No Ef Yes If yes, list the permit numbers for all current NPDES permits for this facility: NC&1500 coo wa�m 10) Does this facility have any Non -Discharge permits (ex: recycle permit)? ❑ No Yes If yes, list the permit numbers for all current Non -Discharge permits for this facility: _WQOOU2005 11) Does this facility employ any beast management practices for stormwater control? U No ❑ Yes (Show any structural BMPs on the site diagram.) If yes, please briefly describe: 12) Does this facility have a Stormwater Pollution Prevention Plan? X No ❑ Yes E If yes, when was it implemented? _ 13) Are vehicle maintenance activities occurring at this facility? I ❑ No X Yes 14) Hazardous Waste: i 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 li of hazardous waste generated per month) of hazardous waste? b( No ❑ Yes Page 2 of 4 SWU-221-071408 Last revised 7/14/08 F � NCG060000 N.O.l. c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of hazardous waste? la No ❑ Yes d) is hazardous waste stored in the 100-year flood plain? ,KNo ❑ Yes If yes, include information to demonstrate protection from flooding. e) 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: 15) 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, or who knowingly,makes a false statement of a material fact in a rulemaking proceeding or contested case under this Article; or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the 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). 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 certify that I am familiar with the information contained in this application and that to the best of my knowledge and befef such i orm/ition is true, complete, and accurate. Printed Nam of P r JSiiit'g: 0 ujay Title: � 1/ ) �itJMs Y�OVYI� old - - - Applicant) 9-I-Zo/y (Date Signed) This Notice of Intent must be accompanied by a check or money order for $100.00, made payable to: NCDENR Page 3 of 4 SWU-221-071408 Last revised 7114108 NCG060000 N.O.I. Final Checklist This application will be returned as incomplete unless all of the following items have been included: X Check for $100 made payable to NCDENR. This completed application and all supporting documents. A site diagram showing, at a minimum, (existing or proposed): (a) outline of drainage areas, (b) stormwater management structures, (c) location of stormwater outfalls corresponding to the drainage areas, (d) runoff conveyance features, (e) areas where materials are stored, (f) impervious areas, (g) site property lines. ❑ Copy of county map or USGS quad sheet with the location of the facility clearly marked on the map. Mail the entire package to: Stormwater Permitting Unit Division of Water Quality 1617 Mail Service Center Raleigh, North Carolina 27699-1617 i Note E The submission of this document does not guarantee coverage under the General Permit. . f For questions, please contact the DWO Regional Office for your area. DWO Regional Office Contact Information: Asheville Office ...... (828) 296-4500 Fayetteville Office •.. (910) 433-3300 Mooresville Office ... (704) 663-1699 Raleigh Office ........ (919) 791-4200 Washington Office ...(252) 946-6481 Wilmington Office ... (910) 796-7215 Winston-Salem ...... (336) 771-5000 Central Office .........(919) 807-6300 Page 4 of 4 SWU-221-071408 Last revised 7/14/08 q, O O 5 Y l,. I 000 rc 00 ' off /* 11 1V I •a° .-. -- - - _.-- - 1J Aa�� Opp ' IGHIGKEN 71210GES51NIG PL-AI�T SITE r o 1+OUSF- OF CAE FOP-D FARMS , I tJG . �zosE HILL NG r-,-GALE : I" I y . HOUSE OF - HOUSE OF RAEFORD FARMS, INC. Bank of America wa4ace, N.C. 66-19 18 5 2 8 5' ROSE HILL,. N.C.N28458 FO ® P.O. 530 NC . 1-800-POULTRY PATE 911/10 I NET AMOUNT one hundred and xx 1 100 **********100.00 Pay NCDENR DIVISION OF WATER QUALITY To the 1617 MAIL SERVICE CENTER AUTHOR{ EDSIGNATURE order of RALEIGH, NC 27699-1617 AUTHORIZED SIGNATURE