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Home My WebLink AboutNCC241248_NOI Application_20240423 Action History (UTC-05:00)Eastern Time(US&Canada) Submit by Anonymous User 4/19/2024 4:28:05 PM (NCG01 NOI Submission) Approve by Brooklyn.Broussard 4/22/2024 6:54:58 AM (Review-NOI 193201 Trinity Wastewater Regionalization Project) • The task was assigned to DEMLR NCG01 NOI Review Team.The due date is:April 24,2024 5:00 PM. The priority is: Medium 4/19/2024 4:28:15 PM • The task was assigned to Brooklyn.Broussard by round robin distribution 4/19/2024 4:28:15 PM Submit by Tev.Holloman 4/23/2024 9:42:14 AM (Payment Verification for NCC241248) P Erin Spencer • The task was assigned to DEMLR NCG01 Payment Team.The due date is:June 3,2024 5:00 PM.The priority is: Medium 4/22/2024 6:55:13 AM • Tev.Holloman assigned the task to Tev.Holloman 4/23/2024 9:41:39 AM applicationConstruction Stormwater: Notice of Intent (NOI) National Pollutant Discharge Elimination System(NPDES) General Permit 1 OOOO:STORMWATER DISCHARGES associated with construction activities N O RTH CAROUNA Environmental Quality A. Project Information Part A. Project Location and Waterbody Information ................................................................................................................................................................................................................................................................................................................................................................................................... Are you submitting an NOI that was rejected before? No Yes 1a.Project Name* Trinity Wastewater Regionalization Project 1b.Specific Lot Numbers This field may be used to list specifc lot numbers. N/A 1c.Parcel ID Number(s)(PIN) List all PINS associated with this project. 6797200253 6797002979 6797018471 6797018555 6797018635 6797018715 6797017892 6797017986 6797027015 6797121972 and 6797029774 6797130196 6797130376 6797130455 and 6797130624 6797130805 and 6797049091 6797047764 6797054250 6787963689 6787967928 6787-02-87-8968 6787-02-88-8004 6787-02-88-7177 and 6787-02-88-7204 6787-02-88-7348 and 6787-02-88-5340 6787-02-88-4572 6787-02-89-3080 6787-02-79-9394 6787-02-79-9555 6787-02-79-8674 6787-02-79-8708 6787-02-79-7952 6788-04-70-6175 6788-04-70-6332 VI VV-V'+-I V-V'+OV 6788-04-70-5640 6788-04-61-9326 6788-04-61-9404 6788-04-61-9534 6788-04-61-8524 6788-04-61-7812 6788-04-62-4409 6788-04-73-0075 6788-04-73-5142 6788-04-73-5186 6788-04-73-6286 6788-04-73-7239 6788-04-73-7396 6788-04-73-8431 6788-04-73-9530 6788-04-73-9585 6788-04-83-0612 6788-04-83-0666 6788-04-83-0802 6788-04-83-2888 6788-02-85-9321 6788-02-96-3684 6788957217 6788959214 6798050341 6798065326 6798161927 6798076131 6798077388 6798172898 6798077904 6798087412 6798099710 6799007957 6799124204 6799125423 6799136342 6799136406 6799136515 6799136611 6799136616 6799136724 6799136826 6797133006 6798050397 6798051426 6798051555 6798051652 6798051791 6798053915 6798062085 6798085083 6799122088 2.County* Randolph 3. Highway or Street Address* Tanner Court Trinity, NC 27370 Street name only is acceptable if no address number assigned yet 4.City or Township* Trinity 5.State* NC 6.Zip Code* 27370 7. Latitude* Enter the latitude in decimal degrees 35.8600 8. Longitude* Enter the longitude in decimal degrees(MUST be negative) -80.0394 If you do not know the latitude and longitude coordinates for this project,you can search the location on this map of North Carolina. Look for the coordinates in the bottom left corner. 9. Date to Begin* 09/02/2024 Estimated Construction Project Start Date 10. Date to End* 09/25/2026 Estimated Construction Project End Date 11.SIC(Primary)* Other(9999) Standard Industrial Classification for Development 12.Acres to be 16.50 disturbed* (including off-site borrow and waste areas) 13.Total site area 16.50 (acres)* 14. Post-construction 0.00 impervious area (Estimated) (acres)* Project Tracking ID NCC-RANDO-2024-Trinity Wastewater Regionalization Project Assigned automatically(not used) Below you must enter waterbody information for surface waters affected by this project. Please consult DWR's Surface Water Classifications Map Viewer to find waterbody name and corresponding index number. Please enter only immediate receiving waterbodies-not waters downstream of those unless the project extends there. You may enter up to 3 waterbodies if needed. 15a.Receiving Waterbody* Little Uwharrie River Name of waterbody into which stormwater runoff will discharge 15b.Waterbody Index No.* 13-2-1 NC Waterbody Index Number Stormwater discharges will flow to additional waters* No Yes 15c.Additional Receiving Waterbody North Hamby Creek; Waterbody name 15d.Waterbody Index No. 12-119-7-4-1 INC Waterbody Index Number 15e.Additional Receiving Waterbody Hunts Fork Waterbody name 15f.Waterbody Index No. 12-119-7-3 INC Waterbody Index Number 16a.Is this project subject to the NC Sediment Pollution Control Act?* Yes No, not subject to NC SPCA 17. Is this project funded with ARPA(American Rescue Plan Act)grant funds? No Yes This question was added to the eNOI on 1/26/2023 and will not be answered in applications submitted prior to that date. 18.ARPA Project Number Project number assigned by Division of Water Infrastructure(e.g.,SRP-D-ARP-0090) ARP-W-ARP-0064 CONFIRMED ARPA Project Number REVIEWER:Confirm DWI Assigned ARPA Project No.(Revise if necessary) SRP-W-ARP-0064 19. Letter of Intent to Fund(LOIF)ARPA Project Please upload the Letter of Intent to Fund provided by the N.C.Division of Water Infrastructure(DWI)for this project that references the assigned ARPA Project number. Tri nity_W_ARP_0064_LOI F_220321.pdf 796.96KB Must be PDF format B. Permittee Information Part B. Permittee Information-Legally Responsible Entity and Individual ...................................................................................................................................................................... Important:The person who signs the NOI Certification Form and signs the Certification in Section E of this application form must be the same person as listed in THIS SECTION,or an authorized responsible individual within the same organization. That person must be a responsible corporate officer who owns or operates the construction activity,such as a president,secretary,treasurer,or vice president,or a manager that is authorized in accordance with Part IV,Section B, Item(6)of the NCG010000 General Permit. For more information on signatory requirements,see Part IV,Section B, Item(6)of that permit. 1. Permittee* Legally Responsible Entity City of Trinity If permittee is an individual,enter first and last name in this field.Otherwise,enter organization/business name. Note: If the permittee is a business,the business must be registered with the INC Secretary of State.You can verify the registration here. Permittee must be the same entity that is responsible for the land-disturbing activity as listed on the NC SPCA Financial Responsibility/Ownership(FRO)Form. 2. First Name* Stevie If Corporation,enter Registered Agent First Name 3. Last Name* Cox If Corporation,enter Registered Agent Last Name 3b.Title City Manager 4. Permitee E-mail Address* CityManager@trinity-nc.gov 5. Permittee Telephone No.* (336)431-2841 6. Permittee Mailing Address* Street Address P.O. Box 50 Address Line 2 City State/Province/Region Trinity North Carolina Postal/Zip Code Country 27370 United States Check box if the street address the same as mailing address Yes 7. Permittee Street Address* Street Address 5978 NC-62 Address Line 2 City State/Province/Region Trinity NC Postal/Zip Code Country 27370-7757 US B.Type of Ownership* Ownership is only individual if an individual is named in B.1.above. Government-Municipal C. Site Contact Information Part C. Project Site Contact Information ................................................................................................................................................................................................................................................................................................................................................................................................ 1. Primary Site Contact-First Name* Clark 2. Primary Site Contact-Last Name* Maness 3.Title Engineer 4.Site Contact E-mail Address* cmaness@withersravenel.com 5.Site Contact Telephone No.* 919-469-3340 6.Organization Name WithersRavenel 7.Site Contact Mailing Address* Street Address 115 Mackenan Drive Address Line 2 City State/Province/Region Cary NC Postal/Zip Code Country 27511-7903 us 8.Consultant Name (Optional) First and Last name 9.Consultant E-mail This person will be copied on all correspondence. 10.Consultant Telephone No. 11. Billing E-mail (For Annual Fee correspondence) cmaness@withersravenel.com Default is legally responsible person e-mail 12. Billing Telephone (For Annual Fee correspondence) 919-535-5213 Default is legally responsible person telephone D. E&SC Plan Part D. Erosion&Sediment Control(E&SC)Plan Approval Information ...................................................................................................................................................................... 1. Date E&SC Plan 12/19/2023 Approved* 2. E&SC Plan Project RANDO-2023-001 Number/ID* Assigned by agency or local program 3. E&SC Plan State DEQ Office Approved by* Local Program 4.State DEQ Office* Winston-Salem(WSRO) Documentation of E&SC Plan approval and the signed Notice of Intent(NOI)Certification Form is required for a complete application. Please also upload a site map showing the overall extent of the project(for linear projects,can include the beginning point and end point coordinates in the"Notes"box below). 5. E&SC Plan 00 03 00j-NCDEMLR Permit.pdf 1.39MB Approval letter or Must be PDF format Grading Permit 6.Signed FRO Financial Responsibility/Ownership Form Signed FRO Form.pdf 4.12MB Must be PDF format 7.Site Location Map Must be PDF format(limit 20 MB) Trinity LS FM_Routing Map_8.5x11 USGS.pdf 600.38KB Please do not upload entire set of E&SC plans. 8. Notes(Optional) Provide any additional information that might help the reviewer better understand how uploaded documents support the application.Include additional waterbodies if necessary. 9. NOI Certification Signed NOI.pdf 406.75KB Form Must be PDF format This is an Express No Review Project* Yes E. Certification North Carolina General Statute 143-215.613(1)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). Under penalty of law, I certify that: * I am the person responsible for the construction activities of this project,for satisfying the requirements of this permit,and for any civil or criminal penalties incurred due to violations of this permit. * The information submitted in this NOI is,to the best of my knowledge and belief,true, accurate,and complete based on my inquiry of the person or persons who manage the system,or those persons directly responsible for gathering the information. * I will abide by all conditions of the NCG010000 General Permit and the approved Erosion and Sediment Control Plan. * I hereby request coverage under the NCG010000 General Permit and 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. Specify if you are:* The Legally Responsible Person named on this Notice of Intent Authorized Responsible Person'(signing on behalf of Legally Responsible Person named in Part B) Important:The person who electronically signs this Certification above must be the same person who signs the NOI Certification Form. If that person is signing on behalf of the Permittee,that individual must be an authorized responsible person within the same organization as the Permittee. 'An authorized individual is a responsible corporate officer who owns or operates the construction activity,such as a president,secretary,treasurer,or vice president,or a manager that is authorized in accordance with Part IV, Section B, Item(6)of the NCG010000 General Permit. For more information on signatory requirements,see Part IV,Section B, Item(6)of that permit. Signature Type Name* Stevie Cox Title City Manager Organization Legally Responsible Entity City of Trinity Date* 04/19/2024 F. Tracking and COC Info NOI Tracking No. 193201 NC Reference No. NCG01-2024-1248 Indicates NCG01 or NCG25.Uses NOI number until approved,then uses NUMBER incremented by SP(passed from workflow if eNOI approved) Certificate of NCC241248 Coverage(COC)No.* Uses NOI number until approved,then uses NUMBER incremented by SP(formatted and passed from workflow if eNOI approved) Initial Invoice No. NCC241248-2024 Invoice Due Date 5/22/2024 Initial Fee $ 120.00 Fee increased to$120,effective October 3,2023 Invoice Status OPEN