WQ0020680_Renewal Application_20220131

Non -Discharge Branch Upload/Submittal Form
NORTH CAROLINA
EnWrvnmemfal Qualify
Version 2 - Revised June 23, 2020
Initial Review
Reviewer
Thornburg, Nathaniel D
Is this submittal an application? (Excluding additional information.)*
Yes No
Permit Number (IR) * WQ0020680
Applicant/Permittee Gilkey Lumber Company, Inc.
Applicant/Permittee Address 2250 US 221 N. Hwy Rutherfordton, NC 28139
Is the owner in BIMS? Yes No Is the facility in BIMS? Yes No
Owner Type Organization
Facility Name Gilkey Lumber - Rutherfordton CLRS
County Rutherford
Fee Category Closed -Loop Recycle Fee Amount $0
Is this a complete application?*
Yes No
Signature Authority
Signature Authority Title
Signature Authority Email
Document Type (if non -application)
Email Notifications
Does this need review by the hydrogeologist?* Yes No
Regional Office
CO Reviewer
Admin Reviewer
Complete App Date 01/31/2022
Below list any additional email address that need notification about a new project.
Email Address
Comments to be added to email notfication
Comments for Admin
Comments for RO

Comments for Reviewer
Comments for Applicant

Submittal Form
Project Contact Information
Please provide information on the person to be contacted by NDB Staff regarding electronic submittal, confirmation of receipt, and other correspondence.
Name*
Ben Parton
Email Address*
[e-mail]
Project Information
Application/Document Type *
New (Fee Required)
Modification - Major (Fee Required)
Renewal with Major Modification (Fee
Required)
Annual Report
Additional Information
Other
Phone Number*
828-286-9069
Modification - Minor
Renewal
GW-59, NDMR, NDMLR, NDAR-1,
NDAR-2
Residual Annual Report
Change of Ownership
We no longer accept these monitoring reports through this portal. Please click on the link below and it will take you to the correct form.
https://edocs.deq.nc.gov/Forms/NonDischarge_Monitoring_Report
Permit Type: *
Permit Number: *
Applicant/Permittee *
Wastewater Irrigation
Other Wastewater
Closed -Loop Recycle
Single -Family Residence Wastewater
Irrigation
WQ0020680
Has Current Existing permit number
Gilkey Lumber Company, Inc
Applicant/Permittee Address* 2250 US 221 N. Hwy Rutherfordton, NC 28139
Facility Name*
Gilkey Lumber - Rutherfordton CLRS
Please provide comments/notes on your current submittal below.
Permit No. WQ0020680
Gilkey Lumber-Rutherfordton, NC
Closed -Loop Recycle System
Rutherford County
High -Rate Infiltration
Reclaimed Water
Residuals
Other
Gilkey Lumber has not actively used the Recycle Pond in approximal 20 years. The system
was once used to sprinkle our log inventory, but, at this time we no longer do that. We want to
keep our permit active in case we decided to go back to sprinkling logs in the future. Section
V!-Monitoring Wells, there are non on site. Attachment A, I am including a Google map for the
site map. Attachment B, currently Tim Parton and Mike Parton are the only two names for
signature authority, but including the signature authority form to add my name, Ben Parton.
Attachment E- in 2016, Odom Engineering designed the stormwater ditches away from the
recycle pond to the re -fill pond, included is a drawing of the work they did.
Please let me know if there is any more information you may need,
Ben Parton
Gilkey Lumber Company, Inc.
Office 828-286-9069
Cell 828-288-1314
At this time, paper copies are no longer required. If you have any questions about what is required, please contact Nathaniel Thornburg
at [e-mail].
Please attach all information required or requested for this submittal to be reviewed here.*
(Application Form, Engineering Plans, Specifications, Calculations, Etc.)
image2022-01-31-091150.pdf 1.96MB
Upload only 1 PDF document (less than 250 MB). Multiple documents must be combined into one PDF file unless file is larger
than upload limit.

By checking this box, I acknowledge that I understand the application will not be
accepted for pre -review until the fee (if required) has been received by the Non -
Discharge Branch. Application fees must be submitted by check or money order and
made payable to the North Carolina Department of Environmental Quality (NCDEQ).
I also confirm that the uploaded document is a single PDF with all parts of the
application in correct order (as specified by the application).
Mail payment to:
NCDEQ — Division of Water Resources
Attn: Non -Discharge Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
Signature
Submission Date 1/31/2022

illitcJ VVV�� L laiV[I i, �/6., Jc. "Me, 05` i lit*
2250 US Hwy 221 North • Rutherfordton, North Carolina 28139
Telephone: [phone] - Fax: [phone] "%le
Permit No. WQ0020680
Gilkey Lumber-Rutherfordton, NC
Closed -Loop Recycle System
Rutherford County
Gilkey Lumber has not actively used the Recycle Pond in approximal 20 years. The system was
once used to sprinkle our log inventory, but, at this time we no longer do that. We want to
keep our permit active in case we decided to go back to sprinkling logs in the future. Section
Vl-Monitoring Wells, there are non on site. Attachment A, I am including a Google map for the
site map. Attachment B, currently Tim Parton and Mike Parton are the only two names for
signature authority, but including the signature authority form to add my name, Ben Parton.
Attachment E- in 2016, Odom Engineering designed the stormwater ditches away from the
recycle pond to the re -fill pond, included is a drawing of the work they did.
Please let me know if there is any more information you may need,
Ben Parton
Gilkey Lumber Company, Inc.
Office 828-286-9069
Cell 828-288-1314

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02U —CLOSED-LOOP RECYCLE SYSTEM — RENEWAL
FORM: CLRS-R 02-21
Pursuant to I5A NCAC U2 1' .0 I Il-11io, if the application does not include all required information and the necessary supporting
documentation, the application shall he returned. The application and attachments shall be prepared in accordance with 11 5r1
R('.1( 021 .11I110, 15.1 NC'AC U21:, and Division Policies. For more information, visit the Water Quality Permitting Section's
Non -Discharge Branch ►►ehsite. The Applicant shall submit an electronic copy of the application and attachments uploaded as
a single Portable Document Format (PDF) file to baps://edocs.dect.ne.gov/Forms/NonDischart;e-Branch-Suhmittai-Dorm-Vert,
or entailed to:Nnn-I)ischargc.Itcpnrtsrdnctlenr.gov if Tess than 20 megabytes (MB).
SECTION 1— APPLICANT INFORMATION
Applicant:
( k ) Lt NJ') `e-A J— [I G
Perrnit No.: WQOU
Signature authority:e 'Title:
Phone number; 2.leer
4. Mailin�� address:` `Q� �� 1 {� �] I
City: Tl tay-
5, Contactperson: CfYr1
a-[tq
Primary phone number: {`$a,C} - elect Secondary phone number: {} 5e ect
Email:-f-/1ip?a4 >1400.,0r1
State: Nj Zip:
Email: pcerzfory0 ittrIl
SECTION I1— FACILITY INFORMATION
1. Physical address: .3-cuscvLe c cI _ _ County: �u-(-h Parcel No.:
City: �V� State: NC Zip: -
2. 'Treatment facility coordinates to the sixth decimal degree:
l.atitude:lc ipitpa,L,l.on,itude: -0, go, 64,) j
I . BiIling address:
City:
Method: Select
SECTION III - BILLING INFORMATION
4aoYvtiQ (1
State: Zip:
2. Verify the Applicant does not have any overdue annual fees:
filth, i�;1 u�. en ahout divisions water -resources. titer•-resources-permitti'wo1-epavments
Pursuant to 1 Nt',1(;_[l' 1O1_2()O. permits for renewing facilities shall not be granted if the Applicant or any affiliation has
an unpaid annual Ice.
SECTION IV — OPEN -ATMOSPHERE STRUCTURES
1. 1.ist all open -atmosphere treatment and storage structures associated with the renewing permit. Attach additional sheets if
necessary.
Type
Parcel No.
Volume (gal)
Liner Type
Freeboard (ft)
Latitude
Longitude
Select
1:2,-e+• li
Select
Li
.
a.
- f - qrg, ar`?
Select
R-e i II
Select
3_
.4' 1'
(44
3
-gj . `ii$tq°3S
Select
Select
Select
Select
.
°
- . °
0-
.
FORM: C'i_RS-R 02-21
Page 1 ❑f3

SECTION V — RELATED PERMITS
I. List all wastewater permits (i.e., sewer. collection system. NPDES, residuals) that have interactions with the renewing permit. •
Attach additional sheets if necessary.
Permit Type
Permit No.
Relationship Type
Select
l~ C G 2! o 6 0 0
53rvt m wr4.�e-r Select
Select
Select
Select
Select
SECTION VI — MONITORING WELLS
«1'On nO►walul' lot niinrin i' ll'Ciis a snrI IIv[1 ulT1i 1f4F rPn['u+rnu nnnnir AEfnrh aririit ieniI cr�n
Well Name
Parcel No.
Status
Gradient
or_ .... , ...........
Location
Latitude
Longitude
Select
Select
Select
0
- . °
Select
Select
Select
°
-
Select
Select
Select
°
- . °
Select
Select
Select
°
- . °
Select
Select
Select
°
- . 0
Select
Select
Select
°
- °
ATTACHMENT A — SITE MAP
Was the facility originally permitted or had a nutjnr modification issued after September I, 2006?
❑ Yes - Pursuant to 15A NCAC 02;I .0I05(11), submit a site map pursuant to the requirements in I5A NCAC 021.1 ,0201(di. These
requirements are:
❑ A scaled map unite site with topographic contour intervals not exceeding 10 feet or 25 percent of fatal site reliefand showing
all facility -related structures and fences within 500 feet oldie treatment, storage, and recycle areas.
❑ Delineation of the compliance and review boundaries per 15A NCAC 021, .0107 and .0108.
❑ Setbacks as required by 15A NCAC' 021..1 .0701.
❑ Site property boundaries within 500 feet of all treatment, storage, and recycle sites.
❑ No Skip Attachment A.
ATTACHMENT B—SIGNATURE AUTHORITY DELEGATION
Does the signature authority in Section I, Item 3 meet the requirements pursuant to I5A NCAC 02 1' .0106(b)?
❑ Yes - Skip Attachment 13.
❑ No - Submit a Icner pursuant to 15A NCAC 021.0I 06{,j authorizing the signature authority to sign.
ATTACHMENT C-- EASEMENT, ENCROACHMENT, AND LEASE AGREEMENTS
Does the Pernnittce own all of the land associated with the treatment, storage, and recycle system'?
[✓J Yes -- Skip Attachment C.
❑ No Pursuant to 1; 1 \t'.•1t' 021..0i Ic1cr, provide a copy of all easements, lease agreements. and encroachment agreements
allowing the Penn ittee to operate and maintain the treatment. storage. and recycle system on property not owned by the Permittee.
ATTACHMENT D — AFFILIATIONS
Are the Permittee's affiliations of record con.ect." Check affiliations.
Er Yes - Skip Attachment D.
❑ No -- Provide the corrected affiliations and their contact information.
FORM: ('1.RS-R 02-21
Page 2 of 3

ATTACHMENT E — COMPLIANCE SCHEDULES
Does the existing permit include any Compliance Schedules? (See Section I oftlte most recently issued permit)
Er Yes - Submit documentation that the compliance schedules have been met.
❑ No -- Skip Attachment 1i.
ATTACHMENT F — CIVIL PENALTIES AND OUTSTANDING VIOLATIONS
Does the Permittce have any existing civil penalties or outstanding violations?
❑ Yes (civil penalties) - Submit payment for the civil penalty, or proof of remission request.
Nos (violations) -- Submit a copy ofyour response to the Notice of Violation.
-- Skip Attachment F.
ATTACHMENT G — INDUSTRIAL WASTEWATER
Does the closed -hoop recycle system treat and/or store industrial wastewater?
❑ Yes — Proceed to the next question.
No -- Skip Attachment G.
Has the nature o('the industrial wastewater changed since the last permit issuance (i.e., changes in industrial process, introduction of
new materials or chemicals. etc.)?
❑ Yes - Provide a chemical analysis of the wastewater pursuant to the requirements in 15A NCAC 021.1 .0201(g). Provide an
overview ofthe manufacturing process; an inventory of all chemical and biological materials used in the manufacturing process;
and an overview attic: cleaning and treatment methodology.
Er No Provide an ov erview of the manufacturing process; an inventory of all chemical and biological materials used in the
manufacturing process: and an overview of the cleaning and treatment methodology.
ATTACHMENT H — SETBACK WAIVERS
Does the existing permit include setback waivers?
❑ Yes • Pursuant to I5A NCAC 02U .0701(t), provide setbacks waivers that have been written, notarized, signed by all parties
involved, and recorded with the county Register of Deeds. Waivers involving the compliance boundary shall be in accordance
Nith 15ANtAC_021_:0107_
,►o -- Skip Attachment l i.
APPLICANT'S CERTIFICATION
I. Ugh Par }cv4
attest that this application
(Signature authority's name as noted in Section 1, Item 3)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of this
application package are not completed, and that if all required supporting information and attachrnents are not included. this
application package will be returned as incomplete. 1 further certify pursuant to 15A NCAC 02T .0120(b), that the applicant, or any
parent, subsidiary. or other affiliate of the applicant has: not been convicted of environmental crimes under; not previously abandoned
a wastewater treatment facility without properly closing the facility: not paid a civil penalty; not been compliant with any compliance
schedule in a permit, settlement agreement, or order; not paid an annual fee.
Note: The Applicant's Certification shall be signed pursuant to 15A NCAC 02•1• .0106(b1. An alterniate person may be delegated as
the signing official ifa letter is provided pursuant to I5A NCAC (121 .0106(c). Pursuant to § 143-215.6A and § 143-215.6B, any
person who knowingly makes any false statement. representation, or certification in any application package shall be guilty of a Class
2 misdemeanor, which may include a fine not to exceed S10,000 as well as civil penalties up to $25.000 per violation. e
Signature:
Date: t [2 $ I Qa
THE COMPLETED APPLICATION AND ATTACHMENTS SHALL BE SUBMITTED AS A SINGLE PDF FILE VIA:
Email:
Non-l)ischa r2e.Renorts(a)ncdenr.go►
Laserfiche Upload:
https: does.del.nc.2ov/Forms/NonDischar2e-Branch-
Su bin ittaI-Form-Vert
FORM: CLRS-R 02-21
Page 3 of 3

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Permit No. W00020680
Gilkey Lumber-Rutherfordton, NC
Closed -Loop Recycle System
Rutherford County
Gilkey Lumber has not actively used the Recycle Pond in approximal 20 years. The system was
once used to sprinkle our log inventory, but, at this time we no longer do that. We want to
keep our permit active in case we decided t❑ go back to sprinkling logs in the future. Section
V!-Monitoring Wells, there are non ❑n site. Attachment A, I am including a Google map for the
site map. Attachment B, currently Tim Parton and Mike Parton are the only two names for
signature authority, but including the signature authority form to add my name, Ben Parton.
Attachment E- in 2016, ❑dom Engineering designed the stormwater ditches away from the
recycle pond to the re -fill pond, included is a drawing of the work they did.
Please let me know if there is anymore information you may need,
Ben Parton
Gilkey Lumber Company, Inc.
Office 828-286-9069
Cell 828-288-1314

ROY COOPER
Govo rw:
MICHAEL 5. REGAN
.Sec'relury
S. DANIEL SMITH
►hreani
Division of Water Resources
Non -Discharge Branch
1617 Mail Service Center
Raleigh. North Carolina 27699-1617
NORTH CAROLINA
Environmental Quality
January 27. 2022
Subject: Permit No. WQOO
Signature Authority Designation
FACILITY
SELECT System
COUNTY County
To Whom It May Concern:
As an appropriate signing official fnr L idmpc( c r pc r Inc_ (cilyllail,► or
1►.vtnt'.'x ► ame) as deskmated by 15A NCAC 2T .0106. l hereby delegate authority to sign and certify all
permit applications. reports or other permit related documents to the following staff for the following
permit i\ pes (sever. spray- land application) and/or permit numbers:
Position
Person
Permit Type
Currently in
or Permit
Position
Number
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Prey1CAc.r•}
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If you have any questions. please contact Inc at the following:
Perntittee/Applicant naive (please print): D'e r+ C.ar�cn
Title: Cxc.fr1 e[c.\ \c.nq r2mr
Complete mailing address: a a Sn vs a at N. l-I w•{
Cii\ : -CoraforN State: r(c Zip: a q l
Telephone number: (Fa't ) a$G- 90CDct Facsimile number: ( Sat ) . 8-- .3 t
signitture
GRE
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 11617 Mail Service Center I Raleigh. North Carolina 27699-1617
919.707.9000

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