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Home My WebLink AboutNCG080982_Application_20191023nrc&- 016 o a 67, Division of Energy, Mineral and Land Resources K,-I� Land Quality Section National Pollutant Discharge Elimination System Environmental NCG080000 Quality NOTICE OF INTENT FOR AGENCY USE ONLY Date Received Year Month Da ( (D 2 Certificate of Coverage NCG08019 16T Check # Amount 0, Permit As si ned to S• i G lauh0l National Pollutant Discharge Elimination System application for coverage under General Permit NCG080000: STORMWATER DISCHARGES from Vehicle Maintenance Areas (including vehicle rehabilitation, mechanical repairs, painting, fueling, lubrication, and equipment cleaning operations areas)associated with activities classified as: RECEIVED SIC 40 (Standard Industrial Classification) Railroad Transportation OCT 2 3 2019 SIC 41 Local and Suburban Transit and Interurban Highway Passenger Transportation SIC 42 Motor Freight Transportation and Warehousing (except SIC 4221-4225) DENR-LAND QUALITY SIC 43 United States Postal Service STORMWATER PERMITTING The following activities are also included: • Other industrial activities where the vehicle maintenance area(s) is the only area requiring permitting • Petroleum Bulk Stations and Terminals (SIC 5171) with total petroleum site storage capacity of less than 1 million gallons • Stormwater discharges from oil water separators and/or from secondary containment structures associated with petroleum storage facilities with less than 1 million gallons of total petroleum site storage capacity. • Discharges associated with vehicle maintenance operations at activities, which are otherwise designated on a case -by -case basis for permitting. `, ( For questions, please contact the DEMLR Regional Office for your area. See page 4. (Please print or type) 1) Mailing address of owner/operator (address to which all correspondence will be mailed): Name $,,,ry,cNaCAf—C t'Ji� Cor!!:eun,l Street Address Po ao A l26 City VAJ-0ry State N C ZIP Code agb(33 Telephone No. 9 32Z - Lo-77 Fax: IL9 322 •-7362- 2) Location of facility producing discharge: Facility Name R..,tiaa -" c.r 0A Facility Contact Street Address City County Telephone No. Email (,ei- fc a`y \,(..AD'.0 3Z4 (t+sa16r-4L Sir tjw Le.woic State M G ZIP Code 996o3 Cold u►� �( 7ty 321 - 43-)I Fax: 30M�QbanetiA0.lnG.la9\l, ZOM Page 1 of 4 SWU-223-071408 Last revised 6/24/14 NCG080000 N.O.I. 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). ti&ad nor Ur' ills `e;l' OAD ,Mo., Si NW , aAe-r b.3 M• US ca lt.ft (A copy of a county map or USGS quad sheet with facility clearly located must be submitted with this application) 4) Latitude 3S , `i 34a Longitude — Tk • 5`1 .13 (deg, min, sec) 5) This NPDES Permit Application applies to which of the following: ❑ New or Proposed Facility Date operation is to begin V Existing 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: I Mc be, 7) Provide a brief narrative d scription of the types of industrial activities and products manufactured at facility: i3�(k =3 5'kc-S 8) Discharge points / Receiving waters: How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? oZ — 3 What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater discharges end up in?e-'c- Receiving water classification: Is this a 303(d) listed stream? ? Has a TMDL been approved for this watershed? ? 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. Latitude (degrees/minutes/seconds): N 7 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. Latitude (degrees/minutes/seconds): N Longitude (degrees/minutes/seconds): W Page 2 of 4 SWU-223-071408 Last revised 6/24/14 NCG080000 N.O.I. Stormwater Outfall No. Latitude (degrees/minutes/seconds): N 7 Longitude (degrees/minutes/seconds): W ` Stormwater Outfall No. _7 Latitude (degrees/minutes/seconds): N Longitude (degrees/minutes/seconds): W 9) Does this facility have any other NPDES permits? 7 ❑ 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)? ❑ No r ❑ 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 ❑ Yes (Show any structural BMPs on the site diagram.) If yes, please briefly describe: 12) Does this facility have a Stormwater Pollution Prevention Plan? ❑ No ❑ Yes If yes, when was it implemented? 13) Are vehicle maintenance activities occurring at this facility? G/No ❑ Yes 14) Hazardous Waste: a) Is t is facility a Hazardous Waste Treatment, Storage, or Disposal Facility? Is ❑ Yes b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of h ardous waste? 7No ❑ Yes c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of h ardous waste? YNo ❑ Yes d) Is hazardous waste stored in the 100-year flood plain? ❑ No ❑ 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: Page 3 of 4 SWU-223-071408 Last revised 6/24/14 NCG080000 N.O.I. Name of transport / disposal vendor: Vendor address: 15) Certification: North Carolina General Statute 143-215.6E (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. Printed Name of Person Signing: ZAC A!' `3�,, n� Uc-v%,tr Title: 't" , I M.,:-%Q W21/C mt (Date Signed) Notice of Intent must be accompanied by a check or money order for $100.00 made payable to: NCDEQ Page 4 of 4 SWU-223-071408 Last revised 6/24/14 NCG080000 N.O.I. Final Checklist This application will be returned as incomplete unless all of the following items have been included: V Check for $100 made payable to NCDEQ ❑ 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, (f) impervious areas, (g) site property lines. Copy of county map or USGS quad sheet with location of facility clearly marked on 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 NPDES General Permit. For questions, please contact the DEMLR Regional Office for your area. DEMLR Regional Office Contact Information: Asheville Office ...... (828) 296-4500 Fayetteville Office ... (910) 433-3300 Mooresville Office ... (704) 663-1699 Raleigh Office ........ (919) 791-4200 Washington Office ...(252) 946-6481 Wilmington Office ... (910) 796-7215 Winston-Salem ...... (336) 771-5000 Central Office .........(919) 807-6300 Page 5 of 4 SWU-223-071408 Last revised 6/24/14 Caldwell County r t - i! M 10 t• ,,aa Ail r � r Y • � ..1f �� Ir y w f ` w� This map is NOT of land survey quality and is hC- , .: is for such usa 1 1.556 0 0.0125 0025 O.00 Mi 0 0.02 0.04 Q0O tm 10/25/2019 North Carolina Secretary of State Search Results • File an Annual Report/Amend an Annual Report • Upload a PDF Filing • Order a Document Online • Add Entity to My Email Notification List • View Filings • Print a Pre -Populated Annual Report form • Print an Amended a Annual Report form Business Corporation Legal Name Bumgarner Oil Company, Inc. Information Sosld: 0018670 Status: Current -Active Annual Report Status: Current Citizenship: Domestic Date Formed: 7/17/1967 Fiscal Month: September Registered Agent: Bumgarner, Glenn a Addresses Principal Office 2004 Highland Ave N.E. Hickory, NC 28601-4336 Officers Vice President DAVID S BUMGARNER PO Box 126 Hickory NC 28603 Stock Class: COMMON Shares: 100000 Par Value 1 Reg Office 2004 Highland Ave N.E. Hickory, NC 28601-4336 President GLENN A BUMGARNER PO Box 126 Hickory NC 28603 Mailing P O Box 126 Hickory, NC 28603-0126 Secretary Janette Bumgarner PO Box126 Hickory NC 28603 Reg Mailing PO BOX 126 Hickory, NC 28603-0126 https://www.sosnc.gov/online_services/search/Business_ Registration_ Results 1/1