NCC191333_NOI Application_20190813

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 8/12/2019 11:46:58 AM (NCG01 NOI Submission)
Approve by Clark, Paul 8/12/2019 12:40:23 PM (Review- Construction NOI 14719)
• The task was assigned to Clark, Paul by round robin distribution 8/12/2019 11:47 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: August 14, 2019 5:00
PM 8/12/2019 11:47 AM
Submit by Lucas, Annette 8/13/2019 10:09:05 AM (Payment Verification for NCC191333)
• Lucas, Annette assigned the task to Lucas, Annette 8/13/2019 10:08 AM
• The task was assigned to DEMLR NCG01 Payment Team. The due date is: August 26, 2019 5:00 PM
8/12/2019 12:40 PM

1 r-G) ff T:M'G)M F1Ii f_TiI a 10141
NORTH CAROLINA
Ernvlronmentol qualily
A. Project Information
Part A.
Project Location and Waterbody Inforrration
1. Project Name * Carolina Connector Intermodal Rail Terminal
2. County* Edgecombe
3. Highway or Street 5770 Old Battleboro Road
Address * Street name only is acceptable if no address nurrber assigned yet
4. City or Township * Rocky Mount
5. State * NC
6. Zip Code* 27809
7. Latitude * Enter the latitude in decirral degrees
36.0275
8. Longitude * Enter the longitude in decirral degrees (WISTbe negative)
-77.7517
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*
08/14/2019
Estimated Construction Project Start Date
10. Date to End*
01 /01 /2021
Estimated Construction Project End Date
11. SIC (Primary)*
Industrial (1541)
Standard Industrial aassification for Development
12. Acres to be
235.00
disturbed*
(including off -site borrow and waste areas)
13. Total site area
400.00
(acres)*
14. Post-
32.30
construction
(Estimated)
impervious area
(acres) *
NCC Project
NCC-EDGEC-2019-Carolina Connector Intermodal Rail Terminal
Tracking ID
Assigned autorratically

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. You may
enter up to 3 waterbodies.
15a. Receiving Unnamed Tributary of Beech Branch
Waterbody * Nacre of waterbody into which stormuater runoff will discharge
15b. Waterbody 28-75-(2)
Index No. * NCWaterbody Index Nanber
Stormwater r No
discharges will flow rj Yes
to additional
wate rs *
15c. Additional Unnamed Tributary of Compass Creek
Receiving Waterbody narre
Waterbody
15d. Waterbody 28-72
Index No. NCWaterbody Index Ninber
15e. Additional Waterbody nave
Receiving
Waterbody
15f. Waterbody NCWaterbody Index Nunter
Index No.
16a. Is this project r Yes
subject to the NC f No, not subject to NC SPCA
Sediment Pollution
Control Act?*

B. Permittee Information
Part B.
Perrrittee Information - Legally Responsible Entity and Individual
.....................................................................................................................................................................
h
Important: The person who signs the NOI Certification Form and signs the Certification in Section E of this application
form should 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. Organization CSX Transportation, Inc
Name *
2. First Name* Richard
ff Corporation, enter Registered Agent First l\brre
3. Last Name * Hisrich
ff Corporation, enter Registered Agent Last Barre
3b. Title Director Terminal Development
4. Permitee E-mail [e-mail]
Address*
5. Permittee 904-633-1427
Telephone No.*
6. Permittee Mailing Street Address
Address* 500 Water Street, S/C J350
Address Line 2
City State / Province / Region
Jacksonville FL
Rastal / Zip Code Country
32202 us
Check box if the r% Yes
street address the
same as mailing
address
7. Permittee Street Street Address
Address* 500 Water Street
Address Line 2
City
State / Province / Region
Jacksonville
FL
Pastal / Zip Code
Country
32202
us

C. Site Contact Information
Part C.
Roiect Site Contact Information
1. Type of Non -Government
Ownership*
2. Primary Site Brandon
Contact - First
Name *
3. Primary Site Knapp
Contact - Last
Name *
4. Title Director of Construction - Public Projects
5. Site Contact E- [e-mail]
mail Address*
6. Site Contact 904-652-5690
Telephone No.*
7.Organization CSX Transportation
Name
8. Site Contact Street Address
Mailing Address* 500 Water Street S/C J350
Address Line 2
aty
Jacksonville
Fbstal / Zip Code
32202
State / Province / Region
FL
Country
us

D. E&SC Plan
Part D.
Erosion & Sediment Control (E&SC) Ran Approval Information
.......................................................................................................................................................................................................................................
1. Date E&SC Plan 08/12/2019
Approved *
2. E&SC Plan Project EDGEC-2020-002
Number/ID* Assigned by agency or local program
3. E&SC Plan f• State DEQ Office
Approved by r Local Program
4. State DEQ Office * Raleigh (RRO)
Documentation of E&SC Plan approval and the signed Notice of Intent (NOI) Certification Form is required for a
complete application.
5. E&SC Plan EDGEC-2020-002 LOA 20190812.pdf 55.21 KB
Approval Mast be FDF format
letter/documentation
6. NOI Certification Carolina Connection Intermodal Rail Terminal
Form NOI.pdf 643.77KB
Mist be FDFforrrat
This is an Express f• No
Review Project* r Yes

E. Certification
North Carolina General Statute 143-215.613 (1) provides that:
Anyperson who knowinglymakes any false statement, representation, or certification in anyapplication, record, report, plan, or other
documentfiled or required to be maintained under this Article or a rule implementing this Article; or who knowinglymakes 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 deice or method required to be operated or maintained under this Article or rules of the
Commission implementing this Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine not to exceed ten thousand
dollars ($10,000).
Under penalty of law, I certify that:
rJ 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.
* rJ 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.
* I7 I will abide by all conditions of the NCG010000 General Permit and the
approved Erosion and Sediment Control Plan.
* rJ 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:* r The Responsible Person named on this Notice of Intent
r Authorized Responsible Person*
Important: The person who signs this Certification above and signs the NOI Certification Form should be the same
person (or authorized responsible person within the same organization) as listed in Section B (Permittee Information)
of this form. *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 * Richard Hisrich
Title Director Terminal Development
Organization CSX Transportation, Inc.
Date * 08/12/2019

F. Tracking and COC Info
NOI Tracking No. 14719
NC Reference No. NCG01-2019-1333
Uses 'count number variable (incremrented by SP)
Certificate of NCC191333
Coverage (COC) Uses 'count _nunber'variable (increrrented bySP)
No. *
Count Number 1333
Sequential nunber for subrrittal that is incremented by Stored Procedure
COC Year 2019
Year of date reviewed (used to assign YY digits after "NGC' in OOCno.)