NCG060418_Application_20210329

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Situ" e ra
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NOTICE OF INTENT
Division of Energy, Mineral and Land Resources
Land Quality Section
National Pollutant Discharge Elimination System
NCG060000
FOR AGENCY USE ONLY
Date Received
Year
Month
Da
2zl- t
Certificate of Covera e
NICIU10 6o t
Check #
Amount
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Permit Assigned to
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National Pollutant Discharge Elimination System application for coverage under General Permit
NCG060000: RZ rr" � F IV E D
STORMWATER DISCHARGES associated with activities classified as: 14AR 2 D 2021
SIC (Standard Industrial Classification) 20 Food and Kindred Products
SIC 21 Tobacco Products DENIR-LAND QUALITY
SIC 283 Drugs STCRMV`dATER PERMITTING
SIC 284 Soaps, Detergents, & Cleaning Preparations; Perfumes, Cosmetics, & Other Toilet Preparations
SIC 422 Public Warehousing and Storage (except 4226)
For questions, please contact the DEMLR Regional Office for your area. See page 4.
Do Not use this NOI for renewals.
(Please print or type)
1)
Mailing address of owner/operator (address to which all permit correspondence
will be mailed):
Name John Hagfors
Street Address 485 Alisal Road #212
City Solvang State CA
ZIP Code 13463
Telephone No. 805 693-8880 Fax: 801
693-8870
2)
Location of facility producing discharge:
Facility Name Hennessy International Warehouse
Facility Contact John Hagfors
Facility Address INC Highway 87
Facility City Burlington State INC
ZIP Code 27244
Facility County Alamance
Telephone No. 805 701-1324 Fax: 801
693-8870
Email [e-mail]
3)
Physical Location Information:
Please provide a narrative description of how to get to the facility (use street
names, state road numbers, and
distance and direction from a roadway intersection). The property is located 670 feet south of the intersection of NC Highway 87 and
Stoney Creek Church rd, towards Gilliam Church rd.
(A copy of a county map or USGS quad sheet with the facility clearly located must be submitted with this application.)
4) Latitude 36`13'13.48" N Longitude 79' 30'48.71" w (deg, min, sec)
5) This NPDES Permit Application applies to which of the following:
0 New or Proposed Facility Date operation is to begin July 2021
❑ Existing
SW U-221
Page 1 of 4
Last revised 6/24/14

t
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: 4 2 2 2
7) Activities
a) Provide a brief narrative description of the types of industrial activities and products manufactured
at this facility: The facility will be used to store heavy duty drilling equipment.
b) Check all activities occurring at this facility:
❑ use or process meats ❑ use or process animal fats/byproducts
8) Discharge points / Receiving waters:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? 1
What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater
discharges end up in? Haw River
Receiving water classification: WS-V. NWS
Is this a 303(d) listed stream? Yes Has a TMDL been approved for this watershed? Yes
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).
List discharge points (outfalls) that convey discharge from the site (both on -site and off -site) and location
coordinates. Attach additional sheets if necessary, or note that this information is specified on the site plan.
Stormwater Outfall No. I
Latitude (degrees/minutes/seconds): 36° 13' 12.20"
N
Longitude (degrees/minutes/seconds): 79°30'31.28"
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds):
N
Longitude (degrees/minutes/seconds):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds):
N
Longitude (degrees/minutes/seconds):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds):
N
Longitude (degrees/minutes/seconds):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds):
N
Longitude (degrees/minutes/seconds):
W
Stormwater Outfall No. only
Latitude (degrees/minutes/seconds):
N
Longitude (degrees/minutes/seconds):
W
Stormwater Outfall No. only
Latitude (degrees/minutes/seconds):
N
Longitude (degrees/minutes/seconds):
W
Page 2 of 4
SWU-221 Last revised 6124/14

4 1 i
9) Does this facility have any other NPDES permits?
M No
❑ Yes
If yes, list the permit numbers for all current NPDES permits for this facility:
10) Does this facility have any Non -Discharge permits (ex: recycle permit)?
4 No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility: _
11) Does this facility employ any best management practices for stormwater control?
❑ No
11 Yes (Show any structural BMPs on the site diagram.)
If yes, please briefly describe: Sand Filter
12) Does this facility have a Stormwater Pollution Prevention Plan?
IN No
❑ Yes
If yes, when was it implemented?
13) Are vehicle maintenance activities occurring at this facility?
❑ No ❑ Yes
14) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
M No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
❑ No ❑ Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
M No ❑ Yes
d) Is hazardous waste stored in the 100-year flood plain?
ORNo ❑ 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:
Page 3 of 4
SWU-221 Last revised 6/24114

NCG060000 N.O.I.
15) Certification:
North Carolina General Statute 143-215.613 (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).
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.
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.
Title:
ame,of Peopn Sig
of
(Date Signed)
This Notice of Intent must be accompanied by a check or money order for $100.00, made payable
to: NCDEQ. Do not send the check or money order separately.
Page 4 of 4
SWU-221 Last revised 6/24/14

NCG060000 N.O.I.
Final Checklist
This application will be returned as incomplete unless all of the following items have been included:
❑ Check for $100 made payable to NCDEQ. Must be included with this application (not sent separately).
❑ 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,
loaded, and unloaded, (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:
DEMLR - Stormwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Note
The submission of this document does not guarantee coverage under the General 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 ...
[phone]
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........
[phone]
Page 5 of 4
SWU-221 Last revised 6/24/14

2/3/2021 tv_browse.pl (7456X8911)
SITE COORDINATES
LATITUDE: 36013'13.48"N
LONGITUDE: 79030'48.71"W
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BK 3917 PG 0985
FILED ELECTRONICALLY
ALAMANCE COUNTY NC
HUGH WEBSTER
This instrument prepared by: Taylor Law Office, P.C.,
a licensed North Carolina attorney,
Delinquent taxes, if any, to be paid by the
closing attorney to the County Tax Collector
upon disbursement of closing proceeds.
Excise Tax: $70.00
Tax Map No.
Mail after recording to: Grantee
NORTH CAROLINA
GENERAL WARRANTY DEED
FILED Sep 19, 2019
AT 11:34:49 AM
BOOK 03917
START PAGE 0985
END PAGE 0989
INSTRUMENT # 15333
EXCISE TAX $`I0.00
Recording Time, Book and Page
Parcel Identifier No. 111083
This instrument was prepared by: Evans J. Haile, a licensed North Carolina Attorney of Taylor Law Office, P.C.,
without benefit of title examination. Delinquent taxes if any, to be paid by the closing attorney to the county tax
collector upon disbursement of closing proceeds.
THIS DEED made this day ofby and between
GRANTORS
Betty Carolyn Gilliam Little (AKA Carolyn Gilliam Little), widow
AND
Judith Little Collins, individually, and husband Larry Joseph Collins,
AND
Hal Douglas Little, Individually, and wife, Melissa Jean Cline Little
GRANTEE
Hennessy International, Inc., A California Corporation
PO Box 1983
Buellton, CA 93427
The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns,
and shall include singular, plural, masculine, feminine or neuter as required by context.
WHEREAS, Glenn H. Little, Decedent, died and the Last Will and Testament of Decedent has been duly probated
and is recorded in the Office of the Clerk of Superior Court of Alamance County, North Carolina, Estate File
Number 18E 283; and
submitted electronically by "Taylor Law office, P.C."
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Alamance county Register of Deeds.

BK 3917 PG 0987
IN WITNESS WHEREOF, the Grantor has hereunto set his hand and seal, or if corporate, has caused
this instrument to be signed in its corporate name by its duly authorized officer(s), the day and year
first above written.
C4,4e j, /�,�,t Gip..«. �`" Qom+ (SEAL)
Betty Carolyn Gilliam Little (AKA Carolyn Gilliam
Little), widow
NORTH CAROLINA A(4. 011 ce COUNTY
I, certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or
she voluntarily signed the foregoing document for the purpose stated therein and in the capacity indicated: Betty
Carolyn Gilliam Little, AKA Carolyn Gilliam Little Grantor(s). Witness my hand and official stamp or seal, this the
' Z3 day of ek
My Commission Expires:
Notary Publi
Print Notary Name: C CA"s ctl
EYANS J. HAILE
Notary Public
North Carolina
Johnston County

BK 3917 PG 0989
IN WITNESS WHEREOF, the Grantor has hereunto set his hand and seal, or if corporate, has caused
this instrument to be signed in its corporate name by its duly authorized officer(s), the day and year
first above written.
(SEAL)
al o glee Little
(SEAL)
Melissa Jean Clt a Little, Spouse
NORTH CAROLINA COUNTY
1, certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or
she voluntarily signed the foregoing document for the purpose stated therein and in the capacity indicated: Hal
Douglas Little and Melissa Jean Cline Little, Grantor(s). Witness my hand and official stamp or seal, this the
30 day of Zc,II.
My Commission Expires: �o_trc_4/�22
Notary Public
Print Notary Name: 4qnclteo J_ Jr^os k
ANDREW J. JUOSKA
Notary Public . North Carolina
Forsyth County
My Commission Expires October 9. 2022

Green Mountain Engineering, PLLC Civil Engineering Consultants
C% 1= 11
To: Mike Meloy
Address: Dept. of environmental Quality 1612 Mail service center, Raleigh, NC 27699-1612
From: Nicholas W. Scheopner, E.I.
Date: 2021-03-23
Re: Hennessy International, INC Warehouse NCGO60000
Messages RECEIVED
Mike,
MAR 2 5 2021
DENR-LAND QUALITY
STORMWATER PERMITTING
Please find the following attached items for the Hennessy International Warehouse project.
• A signed NCG060000
• The deed for the property.
• A set of plans
• A cheque for the review fee of $100
Please let us know if you require additional information. You can reach me via email
nick(a,greenmountainengineers.com or by telephone [phone]) at your convenience.
Best Regards,
Nicholas W. Scheopner, E.I.
Green Mountain Engineering, PLLC
7A Wendy Court - Greensboro, NC 27409 - [phone]
Page 1 of 1

Green Mountain Engineering, PLLC Civil Engineering Consultants
To: Mike Meloy
Address: Dept. of environmental Quality 1612 Mail service center, Raleigh, NC 27699-1612
From: Nicholas W. Scheopner, E.I.
Date: 2021-03-26 RECEIVED
Re: Hennessy International, INC Warehouse NCG060000 MARMO-mi
MessagesUEN- G ALITY
g STQRMWATER PERMITTING
Mike,
Please find the following attached items for the Hennessy International Warehouse project.
• A cheque for the review fee of $100 that was intended to be submitted with the permit
and plans that were submitted 3/25/21
Please let us know if you require additional information. You can reach me via email
nickkgreenmountainengineers.com or by telephone [phone]) at your convenience.
Best Regards,
Nicholas W. Scheopner, E.I.
Green Mountain Engineering, PLLC
7A Wendy Court - Greensboro, NC 27409 - [phone]
Page 1 of 1