NCG510399_Permit issuance_20060929

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Linda Blalock
NC Division of Waste Management
1637 Mail Service Center
Raleigh, NC 27699-1637
Dear Permittee:
Michael F. Easley
Governor
William G. Ross, Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E., Director
Division of Water Quality
September 29, 2006
Subject: General Permit NCG510000
Certificate of Coverage NCG510399
Isaac's Tire & Service Center site
Watauga County
The Division received your request for renewal of the subject Certificate of Coverage (CoC) on March
17, 2006. The revised General Permit was signed on September 20th, 2006 and takes effect October 1, 2006.
Accordingly, we are forwarding the attached CoC to discharge under NCG510000. This CoC 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 May 9, 1994.
A copy of the renewed General Permit is enclosed, as well as an updated Technical Bulletin. The
Technical Bulletin summarizes the changes from the previous version of NCG510000. If any parts,
measurement frequencies or sampling requirements contained in this permit are unacceptable to you, you
have the right to request an individual permit by submitting an individual permit application. Unless such
demand is made, this Certificate of Coverage shall be final and binding.
The CoC is not transferable except after notice to the Division. You must notify the Division if you
sell or otherwise transfer ownership of the permitted facility. The Division may require modification or
reissuance of the CoC.
If your facility ceases discharge of wastewater before the expiration date of this permit, contact the
Regional Office listed below. Once discharge from your facility has ceased, this permit may be rescinded.
This permit does not affect the legal requirements to obtain other permits which may be required by the
Division of Water Quality, the Division of Land Resources, Coastal Area Management Act or any other
Federal or Local government. If you have any questions concerning this permit, please contact Charles
Weaver at the telephone number or e-mail address listed below.
Sincerely,
fo. Alan W. Klimek
cc: Central Files
Winston-Salem Regional Office — Surface Water Protection
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 919 733-5083, extension 511 (fax) 919 733.0719
An Equal Opportunity Affirmative Action Employer e-mail: [e-mail]

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NCG510000
CERTIFICATE OF COVERAGE NCG510399
TO DISCHARGE PETROLEUM CONTAMINATED GROUNDWATER AND SIMILAR WASTEWATERS
UNDERTHE
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,
NC Division of Waste Management
is hereby authorized to operate a groundwater remediation system for petroleum -contaminated groundwater
or similar waste streams that will discharge treated wastewater from the
Isaac's Tire & Service Center site
Watauga County
to receiving waters designated as an unnamed tributary to Sharp Creek, a class C stream in
subbasin 40201 of the Watauga River Basin.
All discharges shall be in accordance with the effluent limitations, monitoring requirements, and
other conditions set forth in Parts I, II, III and IV of General Permit NCG510000 as attached.
This certificate of coverage shall become effective October 1, 2006.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day, September 29, 2006.
for Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

MAR. AT 06 (THU) 16:46 DENR DOVUST SECTION
TEL [phone] P.003/006
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► /V GSiL��l`l%� NC pENR 1 DWQ / Water Quality Section
�� National Pollutant Discharge Elimination System
NCDENR
NCG510000
Cn,41�, Jp NMK PYgNCY
RENEWAL application for coverage under General Permit NCG510000
[remodlation projects treating petroloura-contaminated groundwater]
(Please print or type) 1
1) Mailing address of site Owner: C
CompaayName: kcDeNR- FtJerXA Tr✓S(� J c-1d &.x4CA
Company Contact:
Street Address:
City:
Telephone No,;
e-mail addreee:
Leda (�lF (cc�
2) Location of remediation site producing discharge:
Facility Name: T sa a c s 1, � e.
Facility Contact:
Street Address:
City:
County:
Telephone No.:
e-m ail address:
e
v
State:
Fax: -
e/
ZIP Code: 1 -7 /m 9 9
State: Ne- ZIP Code:
Fax: —
9) System operator / Coneultaut ID [if different from Owner]:
Company Name:
Company Contact:
Street Address: AL OAS 0 /1 U
City: State: ZIP Code:
County:
Telephone No.: Fax:
e-mail address:
4) Site ranking & ID:
GW incident ti: 3 S 2 (o
Site Ranking (A - E):_
Date of moat recent site ranking: ZOOS -
Date of most recent discharge: 2006,
Additional data required:
a) A site map clearly showing the path of the remediation system effluent from the site to its
discharge point.
b) If this application is being submitted by a consulting engineer (or ongineoring firm), include
documentation from the current permittee showing that the perennial submitting the
application has been designated an Authorized Representative.
Page 1 of 2
�� AN5

MAR. --09' 06 (THU) 16 46 DENR DWM/UST SECTION TEL [phone] P. 004/006
NCG510000 renewal appllcatlon
CERTIFICATION:
I certify that I am familiar with the information contained in this application and
that to the beet of my knowledge and belief such information is true, complete, and
accurate.
Printed Name of Person Signing: L-102 4 t— • P, LA L-OC L
Title: E&)UI-RnN/ut=K)Ti�L
of Applicant)
3A /G A
( (ate Signed)
North Carolina General Statute 148-216.6 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 punishnble by a fine not to exceed $10,000, 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 $10,000 or imprisonment not more than 5 years, or both, for a similar offense.)
IIWORWODWODWOBWOBWODWOI)WOflWOIIWOnWOUWO
Mail THIS COMPLETED FORM to:
Mr. Charles H. Weaver, Jr.
NC DENR / DWQ / NPDES
1617 Mail Service Center
Raleigh, North Carolina 27699-1017
YlSflilllflR6 MlnICIMlflRfMlnRlllllllCf 11lIIILf 11lnRllllflRf
For electronic copies of this form or the NCG510000 Fact Sheet, send a request to:
[e-mail]
Page 2 of 2

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