NCG140439_COMPLETE FILE - HISTORICAL_20170417

I
PERMIT NO.
DOC TYPE
DATE OF
RESCISSION
STORMWATER DIVISION CODING SHEET
RESCISSIONS
(VC�IyUy�S
COMPLETE FILE - HISTORICAL
YYYYMMDD

Energy, Mineral &
Land Resources
ENVIRONMENTAL QUALITY
Mr, Christopher M. Ange
The Lane Construction Corporation
2149 Fleming Road
Greensboro, NC 27410
Dear Mr. Ange:
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
TRACY DAVIS
April 11, 2017 V Director
APR .17 2017
CENTRAL FILES
DWR SECTION
Subject: Rescission of NPDES Stormwater Permit
Certificate of Coverage Number NCG 140439
Guilford County
On February 21, 2017, the Division of Energy, Mineral and Land Resources received your
request to rescind your coverage under Certificate of Coverage Number NCG140439. In
accordance with your request, Certificate of Coverage Number NCG140439 is rescinded
effective immediately.
Operating a treatment facility, discharging wastewater or discharging specific types of
stormwater to waters of the State without valid coverage under an NPDES permit is against
federal and state laws and could result in fines. if something changes and your facility would
again require stormwater or wastewater discharge permit coverage, you should notify this office
immediately. We will be happy to assist you in assuring the proper permit coverage.
If the facility is in the process of being sold, you will be performing a public service if you would
inform the new or prospective owners of their potential need for NPDES permit coverage.
If you have questions about this matter, please contact us at 919-707-9200, or the Stormwater
staff in our Winston-Salem Regional Office [phone].
cc: Winston-Salem Regional Office
Stormwater Permitting Program
Central Files - w/attachments
Sincerely,
,for Tracy E. Davis, PE, CPM, Director
Division of Energy, Mineral and Land Resources
Nothing Compares--,-,
State of North Carolina I Environmental Quality I Energy, Mineral and Land Resources
512 N. Salisbury Street 1 1612 Mail Service Center I Raleigh. North Carolina 27699.1612
919 707 9200

• ,
A
Division of Energy, Mineral & Land Resources
Land Quality Section/Stormwater Permitting g Program
NCDENRNational
Pollutant Discharge Elimination System
ENnnor+Mewr .ego Nww..� RewuReu
RESCISSION REQUEST FORM
FOR AGENCY USE ONLY
Date Received
Year
Month
Da
Please fill out and return this form if you no longer need to maintain your NPDES stormwater permit.
1) Enter the permit number to which this request applies:
Individual Permit (or) Certificate of Coverage
C I S N I C I G J114101439
et,eA56 MAML FiNAc Cost 176.,
Ta-. &IA5-rYvpLA GENTC OR,
2) Owner/Facility Information: * Final correspondence will be mailed to the address noted below GHA24o'1r6, rJG X VXI-'
Owner/Facility Name The Lane Construction Corporation
Facility Contact
rj-�eSt-�Y
Street Address
OpQ
City
County
LG�SEp
Telephone No.
Christopher M. Anae
2149 Fleming Rd
Greensboro state NC ZIP Code 27410
Guilford E-mail Address cmangeOlaneconstruct.com
336 406-9060 Fax:
3) Reason for rescission request (This is required information. Attach separate sheet if necessary):
® Facility closed or is closing on 9'/22/16 . All industrial activities have ceased such that no discharges of
Stormwater are contaminated by exposure to industrial activities or materials.
❑ Facility sold to on {^� . If the facility will continue operations under the new owner it
may be more appropriate to request an ownership change to reissue to permit to the new owner.
❑ Other:
4) Certification:
I, as an authorized representative, hereby request rescission of coverage under the NPDES Stormwater Permit for the
subject facility. I am familiar with the information contained in this request and to the best of my knowledge and belief
such information is true, complete nd accurate.
Signature x- Date Christopher M. M. Ange, PE I Senior Job Engineer
Print or type name of person signing above
Title
Please return this completed rescission request form to: NPDES Permit Coverage Rescission
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612RECEIVED
1612 Mail Service Center, Raleigh, North Carolina 27699-1612
Phone: [phone] FAX: [phone]
An Equal Opportunity 1 Affirmative Action Employer
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Alexagder, Laura
From: White, Glen
Sent, Friday, March 10, 2017 9:56 AM
To: Alexander, Laura
Cc: White, Sue
Subject: RE: Rescission Request NCG140439
Follow Up Flag: Follow up
Flag Status: Flagged
Laura
went to 2149 Fleming Road yesterday. The concrete batch plant has been removed and nothing remains onsite. This
permit can be rescinded.
Glen White
Environmental Specialist
NCDENR Winston-Salem Regional Office
Division of Energy, Minerals & Land Resources
450 Hanes Mill Rd — Suite 300
Winston-Salem, NC 27105
[e-mail]
[phone]
From: Alexander, Laura
Sent: Thursday, March 02, 2017 11:09 AM
To: White, Glen <[e-mail]>
Subject: Rescission Request NCG140439
Glen,
Can you take a look at this facility and let me know if okay to rescind?
Thank you,
Laura
From: [e-mail][mailto:[e-mail]]
Sent: Wednesday, March 01, 2017 3:11 PM
To: Alexander, Laura <laura_.alexander(@ncdenr.eov>
Subject: Scanned page
1

r
Permit Number NCG140439
Central Files: APS _ SWP _
8/28/2015
Permit Tracking Slip
Program Category
Status
Project Type
NPDES SW
Active
New Project
Permit Type
Version
Permit Classification
Ready Mix Concrete StormwaterNVastewater Discharge COC
1.00
COC
Primary Reviewer
Permit Contact
Affiliation
rick.riddle 'r
Coastal SWRule
Permitted Flow
Facility
Facility Name MajorlMinor Region
Greensboro Western Urban Loop -Temporary Concrete Plant Minor Winston-Salem
Location Address County
2149 Fleming Rd Guilford
Facility Contact Affiliation
Greensboro NC 27410 Chad M. Curran
2149 Fleming Rd
Owner Greensboro NC 27410
Owner Name Owner Type
The Lane Construction Corporation Non -Government
Owner Affiliation
Chad M. Curran
2149 Fleming Rd
Dates/Events Greensboro NC 27410
Scheduled
Orig issue App Received Draft Initiated Issuance
Public Notice Issue
Effective Expiration
8/28/2015 7/30/2015
8/28/2015
8/28/2015 6/30/2016
Regulated Activities
Requested /Received Events
Concrete products manufacture
RO staff report received
8/19/15
RO staff report requested
815115
Other agency comments requested
8/25/15
Other agency comments received
8/28/15
Outfall 1
Waterbody Name
Streamindex Number
Current Class
Subbasin
Horsepen Creek
16 11-5 {0.5)
VVS III NSW
03-06-02
I MIVED
AUG 31 2W5
CENTRAL FILES
DWR SECTION

A74
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Chad M. Curran
The Lane Construction Company Corporation
6125 Tyvola Centre Dr.
Charlotte, NC 28217
Dear Mr. Curran:
Donald R, van der Vaart
Secretary
August 28, 2015
Subject: General Permit No. NCG140000
Greensboro Western Loop
Temporary Concrete Plant
COC NCG140439
Guilford County
In accordance with your application for a discharge permit received on July 30, 2015, 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
Energy, Mineral, and Land Resources. The Division may require modification or revocation and
reissuance of the certificate of coverage.
This permit does not affect the legal requirements to obtain other permits which may be required by the
Division of Energy, Mining, and Land Resources, or permits required by the Division of Water
Resources, Coastal Area Management Act, or any other federal or local governmental permit that may be
required.
Division of Energy, Mineral and Land Resources
Energy Section • Geological Survey Section • Land Quality Section
1612 Mail Service Center, Raleigh, North Carolina 27699-1612 • Telephone [phone] FAX: [phone]
512 North Salisbury Street, Raleigh, North Carolina 27604 • Internet: hftp:llportal.ncdenr.org/web/Ir/
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper

Chad, Curran
August 28, 2015
Page 2 of 2
If you have any questions concerning this permit, please contact Richard Riddle at telephone number
[phone].
Sincerely,
IN�
for Tracy E. Davis, P.E., CPM
cc: Winston Salem Regional Office
Central Files
Stormwater Permitting Program Files
Division of Energy, Mineral and Land Resources
1612 Mail Service Center, Raleigh, NC 27699-1612 + Phone: [phone] + Fax: [phone]
Location: 512 N. Salisbury Street, Raleigh, NC 27604 + http:ltportal.ncdenr.org/web/Ir/
An Equal Opportunity/Affirmative Action Employer

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE No. NCG140439
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,
The Lane Construction Corporation
is hereby authorized to discharge stormwater and process wastewater from a facility located at
Greensboro Western Urban Loop — Temporary Concrete Plant
2149 Fleming Road
Greensboro
Guilford
to receiving waters designated as Horsepen Creek, a class WS-III, NSW 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, and IV of General Permit No. NCG140000 as attached.
This certificate of coverage shall become effective August 28, 2015,
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day August 28, 2015.
M-.
for Tracy E. Davis, P.E., Director
Division of Energy, Mineral, and Land Resources
By the Authority of the Environmental Management Commission

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DENR-LAND OUALITY
STORMWATFR PERMITTING
NPDES Permit
To Discharge Stormwater / Processed
Wasterwater for Ready Mix Concrete Plants
NCG 140000
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General Project Information and
Plant Data
Location Maps
Site Plan
Stormwater Pollution Prevention
Plan
Stormwater Treatment System
Design Calculations &
Specifications
Wastewater Treatment System
Design Calculations & Specification
Appendix

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Division of Energy, Mineral and Land Resources
Land Quality Section
National Pollutant Discharge Elimination Stem
NCG140000 �Q
NOTICE OF INTENT
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National Pollutant Discharge Elimination System application for covIaj9--underGeneral Permit
NCG140000:
STORMWATER AND PROCESS WASTEWATER DISCHARGES associated with activities classified as:
SIC (Standard Industrial Classification) Code: 3273 and like activities
FOR AGENCY USE ONLY
Datc Received
Year Month
Da
Certificate ofCov r >
4
Ch c L I.—'ArJohmf
P n t Ass ed to
Ready Mixed Concrete
This NO] may be an application to discharge process wastewater. NCG140000 contains effluent limitations
for process wastewater discharges. Wastewater discharges must meet the requirements of these
effluent limitations. An exceedance of any of these limitations will result in a violation of the permit
conditions.
For questions, please contact the DEMLR Central Office or Regional Office in your area. (See page 6)
(Please print or type)
1) Mailing address of owner/operator (official address to which all permit correspondence will be
mailed): (Please print or type all entries in this application form.)
Legal Owner Name THE LANE Construction Corporation
(Please attach the most recent Annual Report to the NC Secretary of State showing the current legal name. Alternatively this
permit can be given to an individual.)
Signee's Name (as signed for in question 29 below) Chad M. Curran
Street Address
City
Telephone No.
6125 Tyvola Centre Dr.
Charlotte State NC
704 426 2954
Alternate Contact Name
Alternate Contact Telephone (if different)
2) Location of facility producing discharge:
Facility Name
Facility Contact
Street Address
City
County
Telephone No.
ZIP Code: 28217
[e-mail]
Email (if different)
Greensboro Western Urban Loop — Temporary Concrete Plant
Chad M. Curran
2149 Fleming Road
Greensboro
Guilford
704 426 2954
3) Physical location information:
State NC ZIP Code 27410
Fax: [phone]
Please provide narrative directions to the facility (use street names, state road numbers, and distance and
direction from a roadway intersection). From 140E: Take exit 212B on to Hwy 73, then take Byan Blvd E. exit
onto Fleming Road, take left at bottom of exit ramp. Follow Fleming Road to Highway project site. Plant will
be on left just before crossing over project.
(A copy of a county map or USGS quad sheet with facility clearly located on the map is a required part of this application.)
4) Latitude 36 7' 21.00" Longitude 79 54' 9.81" (deg, min, sec)
5) This NPDES Permit Application applies to the following (check all that apply):
SWU-229-11032011
Page 1 of 7
Last revised 712/14

NCG140000 N.O.I.
X New or Proposed Facility Date operation is to begin 9/15/2015
❑ Existing.Facility Permit # .
.1
0
Page 2 of 7
SWU-229-07122011 Last revised 712114

MG1.40000 N.4.1.
6) Consultant's application information:
Consultant:
Consulting Firm:
Mailing Address:
City: _
State:
Phone:( )
Email:
Zip Code. -
Fax: ( )
(Optional)
Staple Business Card Here:
7) Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary
industrial activity at this facility:
SIC Code: 3 2 7 3
8) Provide a brief description of the types of industrial activities and products produced at this facility:
(Attach a site diagram showing the process areas present at this facility.)
Temporary Concrete batch plant to manufacture concrete for the Greensboro Western Urban Loop project.
The operation will include material stockpiles, Bulk water storage„ bulk flyash and cement storage.
Stormwater Discharge, Wastewater Treatment & Discharge and Permitting Information
9) Discharge points 1 Receiving waters: One (2).
Number of discharge points (ditches, pipes, channels, etc.) that convey stormwater and/or wastewater from
the property:
Stormwater-only: _ 1 Wastewater -only: l 1 I Wastewater Commingled with Stormwater.- _00 _
t 7
For new facilities: Expected date of commence ent of discharge: 9/21/15
What is the name of the body or bodies of wa r (creek, stream, river, lake, etc.) that the facility stormwater
and/or wastewater discharges end up in? Ho epen Creek
Receiving water class ification(s), if known. -
If the site stormwater discharges to a sep
sewer system (e.g. City of Raleigh munic
Will this facility discharge wastewater to
ite storm sewer system, name the operator
I storm s
Ilfishing) waters? ❑ Y6s�X No 4 C
t�
storm
Note: Discharge ofprocess wastewater to receiving waters classifi d as WS-ll to WS-V or SA mint
be approved by the N.C. Division of Water Resources, Public ihater-Srrpply Section: If'lJ`WR
does not approve, coverage under NCG140000 cannot be granted. No new discharges of
process wastewater are permitted in receivinq waters classified as WS-1 or freshwater ORW.
10) Each applicant shall provide the following information (attach additional sheets as necessary):
• Two (2) site plans depicting the facility or site with numbered outfalls which indicate stormwater and
wastewater outfalls. The plans shall legibly show, at a minimum, (existing or proposed):
o Outline of drainage areas with topographical lines and features
o Stormwater/wastewater treatment structures
o Location of numbered stormwater/wastewater outfalls (corresponding to which drainage areas)
o Runoff conveyance structures
o Areas and acreage where materials are stored
o Impervious area acreages
o Location(s) of streams and/or wetlands the site is draining to, and any applicable buffers
Page 3 of 7
SWU-229-07122011 Last revised 712114

NCG140000 N.O.I.
o Site property lines, North Arrow, and bar scale
o If applicable, the 100-year floodplain line .
o Acreage of each stormwater and wastewater topographical area
o Each of the facilities' wastewater or stormwater source and discharge structures and each of its
hazardous waste treatment, storage, or disposal facilities
o Site location (insert)
Site plans shall be 24" x 36" in size.
• Line drawing and description: 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.
• A narrative description and identification of each type of process, operation, or production area which
contributes wastewater to the effluent for each outfall, and a description of the treatment the wastewater
receives (or will receive), including the ultimate disposal of any solid or fluid wastes other than by
discharge. Processes, operations, or production areas may be described in general terms (e.g. "ash
silo").
11) Does the applicant have any unresolved Notice of Violations (NOVs)?
X No ❑ Yes
Wastewater:
12) What types of wastewater does your facility generate or discharge?
Type of Authorized Wastewater
Generate
Discharge
Sent to WW
Treatment
System
Vehicle and equipment cleaning VE)
❑
❑
❑
Wetting of raw material stockpiles (RM)
X
X
❑
Mixing drum cleaning (MD)
X
X
❑
Further explanation, if necessary:
13) Will your facility spray -down or actively wet aggregate piles?
❑ No X Yes
14) Does the facility use any of the following on site?
❑ Phosphorus -containing Detergents ❑ Non -Phosphorus -containing Detergents
❑ Brighteners ❑ Other Cleaning Agents ❑ Other:
15) Are wastewater treatment facilities planned in the 100-year flood plain?
X No ❑Yes
16) Does your facility use or plan to use a recycle system, or recycle components in your treatment system?
X Yes ❑ No
If yes, what size storm event is the system designed to hold before overflowing? (for example, 10-yr, 24-hr)
NIA year, 24-hr rainfall event 0
Page 4 of 7
5WU-229-07122011 Last revised 7/2114

NCG140000 N.O.I.
,_
617) Will your facility build a closed -loop recycle system that meets design requirements in 15A NCAC 02T
6 1 1000 and hold your facilities' working volume'?
❑ Yes X No
•
Will your facility discharge wastewater to surface waters?
❑Yes X No
If the facility's treatment system meets the design requirements of 15A NCACO2T .1000 (including holding
the 25-year, 24-hour storm plus one foot of freeboard), holds the working volume of your site, and does
not discharge wastewater to surface waters, you may not be required .to obtain an NPDES permit for
wastewater discharges. If you believe this is the case, please contact DEMLR's Aquifer Protection Section
Land Application Unit Central Office Supervisor or staff (1636 Mail Service Center, Raleigh, NC 27699-1636)
for more information on obtaining the necessary permits or approvals. If you will discharge wastewater or
stormwater to surface waters, please continue to apply for a permit to discharge associated with ready -mixed
concrete or like operations under NCG140000. For further questions, please contact DEMLR's Stormwater
Permitting Unit Staff
18) A wastewater treatment alternatives review is required by 15A NCAC 2H.0105 (c)(2) for any new or
expanding water pollution control facility's discharge in North Carolina. You may attach additional sheets.
a) What wastewaters were considered for this alternatives review? ❑ VE ❑ RM ❑ MD
b) Connection to a Municipal or Regional Sewer Collection System:
i) Are there existing sewer lines within a one -mile radius? ..................................... X Yes ❑ No
(1) if Yes, will the wastewater treatment plant (WWTP) accept the wastewater? .... ❑ Yes X No
(a) If No, please attach a letter documenting that the WWTP will not accept the wastewater.
(b) If Yes, is it feasible to connect to the WWTP? Why or why not?' No. discharge will
c) Closed -loop Recycle System (must meet design requirements of 15A NCAC 2T .1000):
Are you already proposing a closed -loop recycle system (CLRS)? ❑ Yes X No
(1) If Yes, contact DEMLR's Aquifer Protection Section's Land Application Unit
(2) If No, is this option technologically feasible (possible)? Why or why not?*
(3) If No, is it feasible to build a CLRS on your site? Why or why not?*
Temporary concrete plant will not be on site long enough to consider this option.
(4) What is the feasibility of building a CLRS compared to direct surface water discharge?*
This is not feasible. Please see the guestion 18.i.3.
1 See DWQ's Aquifer Protection Section Land Application Unit's Water Balance Calculation Policy for more information, on DWQ LAU's
website http:ttportal.ncdenr.org/web/walaps/lau/policies for more information.
Page 5 of 7
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NCG140000 N.O.I.
d) Surface or Subsurface Disposal System (e.g., spray irrigation):
i) Is a surface or subsurface disposal technologically feasible (possible)? ..................
Why or Why not?
❑ Yes X No •
ii) Is a surface or subsurface disposal system feasible to implement?* ........................... ❑ Yes X No
Why or Why not?
iii) What is the feasibility of employing a subsurface or surface discharge as compared to a direct
discharge to surface waters?"
e) Direct Discharge to Surface Waters: Is discharge to surface waters the most environmentally sound
alternative of all reasonably cost-effective options of the wastewaters being considered?* ... X Yes ❑ No
i) If No, contact DEMLR's Land Application Unit to determine permitting requirements.
f) If this review included all wastewater discharge types, would excluding some types (e.g. raw
stockpile wetting) make any of the above non -discharge options feasible?..............X Yes ❑ No
*You maybe asked to provide further information to support your answers to these questions after the initial review.
Feasibility should take into account initial and recurring costs.
Stormwater.•
19) Does this facility employ any best management practices for Stormwatercontrol? ❑ No X Yes
If yes, please briefly describe: Retention basins properly sized with diversion ditches.
20) Does this facility have a Stormwater Pollution Prevention Plan? ❑ No X Yes
If yes, when was it implemented? 9/12/15
21) Are vehicle maintenance activities (VMA) occurring or planned at this facility? X No ❑Yes
If yes, does your VMA area discharge into your wastewater treatment device? ❑ No ❑ Yes
Other/Permitting:
22) Does this facility have a Division of Land Resources Erosion & Sedimentation Control (E&SC) Permit?
❑ No X Yes Vecelio and Grogan
If yes, list the permit numbers for all current E&SC permits for this facility:
23) Is your facility subject to Phase II Post -Construction Area? ❑ Yes X No
If yes, who is the permitting authority?
24) Is your facility located in one of the 20 Coastal Counties? ❑ Yes X No
C:
Is your facility adding more than 10,000 ftz of built -upon area or CAMA Major Permit? ❑ Yes X No {�
Page 6 of 7
SWU-229-07122011 Last revised 712114

MG1.40000 N.O.I.
25) Is your facility discharging wastewater (treated or untreated) such as water from wetting of aggregate piles,
• drum rinse -out, or vehicle and equipment cleaning to a stormwater BMP? ❑ No X Yes
If yes, please attach your approval from the permitting authority to do so.
26) Does this facility have any other NPDES permits? X No ❑ Yes
If yes, list the permit numbers for all current NPDES permits for this facility:
27) Does this facility have any Non -Discharge permits (ex: recycle permits)? X No ❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
28) hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
X No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg, of hazardous waste generated per month) of
hazardous waste?
XNo El Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
X No ❑ Yes
d) 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:
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.
I X This completed application and all supporting documentation. See Question 10.
K1al X If an Erosion & Sedimentation Control (EBSC) Plan is required from Division of Land Resources (DLR)
or local designee: documentation verifying applicant has developed and submitted that Plan to the
governing agency (required per 15A NCAC 02H .0138).
1Pt X Two (2) site plans depicting the site plan with numbered outfalls which indicate stormwater and wastewater
�� outfalls. See Question 10.
X A county map or USGS quad sheet with location of facility clearly marked.
29) 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 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.
Page 7 of 7
SWU-229-07122011 Last revised 712/14

NCG140000 N.O.I.
Certification: North Carolina General Statute 143-215.6 B(i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan, or other document
filed or required to be maintained under this Article or a rule implementing this Article; or 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 (Environmental 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).
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.
certify that I am familiar with the information contained in this application and that to the best of my knowledge
and belief such information is true, complete, and accurate.
Printed Name of Person Signing: ( _ Xl Q CA M . L. U V FC1 rl . F. C.
Title: b l5Ti2 lGr MAAAk26R
G,
(Signature of Applicant) (Date Signed)
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to: NCDENR
Mail the entire package to:
Stormwater Permitting Unit Program
Division of Energy, Mineral and Land Resources
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Note
The submission of this document does not guarantee the issuance of an NPDES permit.
For questions, please contact the DEMLR Regional Office for your area.
DEMLR Regional Office Contact Information:
Asheville Office ...... [phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
[phone]
Washington Office ...(252)
946-6481
Wilmington Office_
[phone]
Winston-Salem ......
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SWU-229-07122011 Last revised 712l14

PIMA
ROENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Danny Cecile
Appalachian Materials, LLC
P.O. Box 2692
Boone, NC 28607
Dear Mr. Cecile:
Donald R. van der Vaart
Secretary
August 28, 2015
Subject: General Permit No. NCG160000
Glendale Springs Plant
COC NCG160220
Ashe County
At the request of the engineer, Derek Goddard with Blue Ridge Engineering Company, we are changing
the COC to reflect the name of the company instead of the owners' name. Please find the corrected COC
and replace the previous one with this copy.
Thank you and if you have any questions concerning this permit, please contact Richard Riddle at
telephone number [phone].
Sincerely,
6_,J P-z'4e,
for Tracy E. Davis, P.E., CPM
cc: Winston-Salem Regional Office
Central Files
Stormwater Permitting Program Files
Division of Energy, Mineral and Land Resources
Energy Section • Geological Survey Section • Land Quality Section
1612 Mail Service Center, Raleigh, North Carolina 27699-1612 • Telephone [phone] FAX: [phone]
512 North Salisbury Street, Raleigh, North Carolina 27604 • Internet: hftp://portal.ncdenr.org/web/Ir/
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
GENERAL PERMIT NO. NCG160000
CERTIFICATE OF COVERAGE No. NCG160220
STORMWATER 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,
Appalachian Materials, LLC
is hereby authorized to discharge stormwater from a facility located at
Glendale Springs Plant
1073 Glendale School Road
Glendale Springs
Ashe County
to receiving waters designated as South Fork New River, a class WS-IV, HQW water in the New
River Basin, in accordance with the effluent limitations, monitoring requirements, and other
conditions set forth in Parts 1, II, III, and IV of General Permit No. NCG160000 as attached.
This certificate of coverage shall become effective August 25, 2015,
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day August 25, 2015.
for Tracy E. Davis, P.E., Director
Division of Energy, Mineral, and Land Resources
By the Authority of the Environmental Management Commission