NCG510431_Renewal (Application)_20201116

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Governor ( 4'
MICHAEL S.REGAN ^P.
Secretory t.
S. DANIEL SMITH NORTH CAROLINA
Director Environmental Quality
November 16, 2020
Davie County
Attn: Robin West, Interim County Manager
123 S Main St
Mocksville, NC 27028
Subject: Permit Renewal
Application No. NCG510431
Law Enforcement Center
Davie County
Dear Applicant:
The Water Quality Permitting Section acknowledges the November 11, 2020 receipt of your permit renewal application
and supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW
permitting branch. Per G.S. 150E-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https://deq.nc.gov/permits-regulations/permit-guidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
Sincerely,
—"Cittl
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
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LETTER OF TRANSMITTAL
S&ME, Inc.
8646 W. Market St. Suite 105 RECEIVED
Greensboro, NC 27409 NOV 1 1 2020
336.288.7180 phone
336.288.8980 fax NCDEQ/DWRINPDES
To: NC DENR-DWR Date: November 5, 2020
Water Quality Permitting Section Job No. 1584-98-109A
1617 Mail Service Center Davie Law Enforcement
Raleigh, NC 27699-1617 Center
Attn: Mr. Charles Weaver
We Are Sending You: ® Attached ❑ Under separate cover via the
following items:
❑ Shop drawings ❑ Contract ❑ Plans ❑ Samples ❑ Specifications
❑ Copy of letter ❑ Report
Copies Date No Description
p p
10/30/2020
2 1 NPDES Permit Renewal Application, (1) Original + (1) copy
These Are Transmitted As Checked Below:
❑ For approval ® For your use
❑ As requested ® For Review
❑ For Bids Due: I / ❑ Prints Returned After Loan To Us
Remarks: The original renewal application signed by Robin West, the Interim County
Manager is attached. If you have any questions, please contact Ed
Henriques at 336.312.3330 or at [e-mail]
Thank you
Signed: Edmund Henriques

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Resources
Pat McCrory Thomas A. Reeder John E. Skvarla, III
Governor Director Secretary
NOTICE OF RENEWAL INTENT
[Required by 15A NCAC 02H.0127(d)]; [term definition see 15A NCAC 02H.0103(19)]
Application for renewal of existing coverage under General Permit NCG510000
Existing Certificate of Coverage (CoC): NCG510
(Please print or type)
1) Mailing address of site Owner: (address to which all correspondence should be mailed)RECEIVED
Company Name Davie County NOV 1 1 2020
Company Contact Robin West,Interim County Manager NCDEQIDWR/NPDES
Street Address 123 S. Main Street
City Mocksville State NC ZIP 27028
Telephone# [phone] Fax# [phone]
Cell/Mobile# Email [e-mail]
2) Location of remediation site producing discharge:
Facility Contact Davie County Law Enforcement Center; Robin West
Street Address 140 S. Main Street
City Mocksville State NC ZIP 27028-
County Davie
Telephone# [phone] Fax# [phone]
3) System operator/Consultant ID: (if different from Owner)
Company Name S&ME,Inc.,(Edmund Q.B. Henriques,P.G.)
Street Address 8646 W.Market Street, Suite 105
City Greensboro State NC ZIP 27409-
County Guilford
Telephone# [phone] Fax# [phone]
Email [e-mail]
Page 1 of 2 Revised 9/1/13

NCG510000 Renewal Application
4) Site ranking& ID: GW incident#: 14691
Site Ranking(if available): NCDEQ UST Section - Intermediate 165D
Date of most recent discharge: 10/31/20
Additional Application Requirements:
The following information must be included in duplicate [original+ 1 copy]with this application or
it will be returned as incomplete.
➢ Site map: Clearly showing the path of the remediation system effluent from the site to
its discharge point
➢ Authorization for representatives. If this application will be submitted by a consulting
engineer(or engineering firm), include documentation from the Permittee showing that
the consultant submitting the application has been designated an Authorized
Representative of the applicant.
CERTIFICATION
I 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: Robin West
Title: Interim County Manager
l Q/30/2020
Click here to enter a date.
(Signature of Applicant) (Date Signed)
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 Article 21 or regulations of the Environmental Management Commission implementing that Article, or who
falsifies,tampers with or knowingly renders inaccurate any recording or monitoring device or method required to be operated or maintained under
Article 21 or regulations of the Environmental Management Commission implementing that Article,shall be guilty of a misdemeanor punishable by a
fine not to exceed$25,000,or by imprisonment not to exceed six months,or by both.(18 U.S.C.Section 1001 provides a punishment by a fine of not
more than$25,000 or imprisonment not more than 5 years,or both,for a similar offense.)
♦ ♦ ♦ ♦ ♦
This Notice of Renewal Intent does NOT require a separate fee.
The permitted facility already pays an annual fee for coverage under NCG510000.
♦ ♦ ♦ ♦ ♦
Mail this application and one copy of the entire package to:
NC DENR/DWR/Water Quality Permitting Section
1617 Mail Service Center
Raleigh,North Carolina 27699-1617
Attn: Charles Weaver
Page 2 of 2 Revised 9/1/13

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