NCG050336_COMPLETE FILE - HISTORICAL_20180910

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V Cc, Q�3 3
DOC TYPE
HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ Qc)) p b� �
YYYYMMDD

0
acfi�'ti.SiAT£or�
Fi
ROY COOPER
Governor
MICHAEL S REGAN
Secretary
WILLIAM E (TOBY) VINSON, JR
interim Director
Consolidated Metco Inc
Attention: CeCe Gao
171 Great Oak Drive
Canton, North Carolina 28716
NORTH CAROLINA
Environmental Quality
September 10, 2018
Subject Compliance Evaluation Inspection
Permit NCGOS0336
Buncombe County, North Carolina
Dear Mrs Gao
Enclosed please find a copy of the Compliance Evaluation Inspection Report for the
inspection I conducted at the subject facility on August 29, 2018
The report should be self-explanatory, however, should you have any questions
concerning this report, please do not hesitate to contact me at [phone] or by email
at Isaiah [e-mail]
Enclosure Inspection Report
Sincerely,
Isaiah Reed, CEPSCI, MS4CECI
Environmental Specialist
Land Quality Section
Q5
U.P- 0111R1Tdl dv.iiM
North Carolina Department of Environmental Quality I Division of Energy, Mineral and Land Resources
Asheville Regional Office 12090 U S Highway 70 I Swannanon North Carolina 28778
828 296 4500

• 0
Compliance Inspection Report
Permit NCG050336 Effective 06/01/18
Expiration 05/31/23 Owner
Consolidated Metco Inc
SOC Effective
Expiration Facility
Consolidated Metco, Inc
County Haywood
171 Great Oak Dr
Region Asheville
Canton NC 28716
Contact Person Rick Linville
Title
Phone [phone]
Directions to Facility
System Classifications
Primary ORC
Certification
Phone
Secondary ORC(s)
On -Site Rep rosentative(s)
Related Permits
Inspection Date 08/29/2018 EntryTime
04 0OPM Exit Time
05 0DPM
Primary Inspector Isaiah L Reed
Phone [phone]
Secondary Inspector(s)
Reason for Inspection Routine Inspection Type Compliance Evaluation
Permit Inspection Type ApparellPnntinglPaperlLeather!Rubber Stormwater Discharge COG
Facility Status Compliant Not Compliant
Question Areas
Storm Water
(See attachment summary)
�?aaaES �c��q �Ilc
Con�1 d� dd Md+to ! AG
1

Permit NCGO50336 Owner -Facility Consolidated Metco Inc
Inspection Data 08129/2018 Inspection Type Compliance Evaluabnn Reason for Visit Routine
Inspection Summary
On August 29, 2018 this facility was inspected for compliance I met with CeCe Gao on site During the inspection, the
following items were noted
1) A discharge was noted at one of the stormwater discharge pipes The permitee is directed to identify the source of this
discharge and confirm that there is no non-stormwater discharge coming from any of the outlets on site
2) An empty drum storage area was inspected at the rear of the facility Due to the overall capacity of the drums stared in
this area, the facility is directed to confirm that secondary containment is not needed If it is found that secondary
containment is needed, the facility is directed to immediately begin designing and implementing secondary containment
If you have any questions, please contact this office at 828-296-4614
Page 2

Permit NCGO50336 Owner -Facility Consolidated Mateo Inc
Inspection Data o812812018 Inspection Typo Compliance Evaluation Reason for Visit Routine
Stormwater Pollution Prevention Plan
Yes No NA NE
Does the site have a Stormwater Pollution Prevention Plan?
0 ❑ ❑ ❑
# Does the Plan include a General Location (USGS) map?
E ❑ ❑ ❑
# Does the Plan include a "Narrative Description of Practices"?
❑ ❑ ❑
# Does the Plan include a detailed site map including outfall locations and drainage areas'
❑ ❑ ❑
# Does the Plan include a list of significant spills occurring during the past 3 years?
E ❑ ❑ ❑
# Has the facility evaluated feasible alternatives to current practices?
E ❑ ❑ ❑
# Does the facility provide all necessary secondary containment?
❑ ■ ❑ ❑
# Does the Plan include a BMP summary?
E ❑ ❑ ❑
# Does the Plan include a Spill Prevention and Response Plan (SPRP)?
■ ❑ ❑ ❑
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
0 ❑ ❑ ❑
# Does the facility provide and document Employee Training?
0 ❑ ❑ ❑
# Does the Plan include a list of Responsible Party(s)?
0 ❑ ❑ ❑
# Is the Plan reviewed and updated annually?
0 ❑ ❑ ❑
# Does the Plan include a Stormwater Facility Inspection Program?
E ❑ ❑ ❑
Has the Stormwater Pollution Prevention Plan been Implemented?
❑ ■ ❑ ❑
Comment See summary for more information
Qualitative Monitorin
Xe3 N9 NA NE
Has the facility conducted its Qualitative Monitoring semi-annually? 0 ❑ ❑ ❑
Comment
Permit and Outfalls
Yea No NA NE
# is a copy of the Permit and the Certificate of Coverage available aline site? ■ ❑ ❑ ❑
# Were all outfalls observed during the inspection E ❑ ❑ ❑
# If the facility has representative outfall status, Is it properly documented by the Division? ❑ ❑ ■ ❑
# Has the facility evaluated all illicit (non stormwater) discharges? 0 ❑ ❑ ❑
Comment
Page 3

•
Compliance Inspection Report
Permit NCG050336 Effective 06/01/18
Expiration 05/31/23 Owner
Consolidated Metco Inc
SOC Effective
Expiration Facility
Consolidated Metco, Inc
County Haywood
171 Great Oak Dr
Region Asheville
Canton NC 28716
Contact Person Rick Linville
Title
Phone [phone]
Directions to Facility
System Classifications
Primary ORC
Certification
Phone
Secondary ORC(s)
On -Site Representative(s)
Related Permits
Inspection Date 08/29/2018 EntryTime
04 0OPM Exit Time
05 0OPM
Primary Inspector Isaiah L Reed
Phone [phone]
Secondary Inspector(s)
Reason for Inspection Routine Inspection Type Compliance Evaluation
Permit Inspection Type Apparel/Pnntong/Paper/LeatherlRubber Stormwater Discharge COC
Facility Status Compliant Not Compliant
Question Areas
Storm Water
(See attachment summary)
Page 1

0 0
permit NCG050338 owner -Facility Consolidated Metco Inc
Inspection Date 011129I2018 Inspection Type Complianre Evaluation Reason for Visit Routine
Inspection Summary
On August 29, 2018 this facility was inspected for compliance I met with CeCe Gao on site During the Inspection, the
following Items were noted
1) A discharge was noted at one of the stormwater discharge pipes The permitee is directed to identify the source of this
discharge and confirm that there is no non-stormwater discharge coming from any of the outlets on site
2) An empty drum storage area was inspected at the rear of the facility Due to the overall capacity of the drums stored in
this area, the facility is directed to confirm that secondary Containment is not needed If it is found that secondary
containment is needed, the facility is directed to Immediately begin designing and Implementing secondary containment
If you have any questions, please contact this office at 828-296-4614
Page 2

•
Permit NCG050336 Owner - Facility Consolidated Metco Inc
Inspection Date 08129/2018 Inspection Type Compliance Evaluation
Reason for Visit Routine
Stormwater Pollution Prevention Plan
Yes No NA NE
Does the site have a Stormwater Pollution Prevention Plan?
0
❑ ❑ ❑
# Does the Plan include a General Location (USGS) map?
0
❑ ❑ ❑
# Does the Plan include a "Narrative Description of Practices"?
0
❑ ❑ ❑
# Does the Plan include a detailed site map including outfall locations and drainage areas?
0
❑ ❑ ❑
# Does the Plan include a list of significant spills occurring during the past 3 years?
0
❑ ❑ ❑
# Has the facility evaluated feasible alternatives to current practices?
0
❑ ❑ ❑
# Does the facility provide all necessary secondary containment?
❑
0 ❑ ❑
# Does the Plan include a BMP summary?
❑ ❑ ❑
# Does the Plan include a Spill Prevention and Response Plan (SPRP)?
❑ ❑ ❑
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
N
❑ ❑ ❑
# Does the facility provide and document Employee Training?
❑ ❑ ❑
# Does the Plan include a list of Responsible Party(s)?
❑ ❑ ❑
# Is the Plan reviewed and updated annually?
E
❑ ❑ ❑
# Does the Plan include a Stormwater Facility Inspection Program?
0
❑ ❑ ❑
Has the Stormwater Pollution Prevention Plan been implemented?
❑
0 ❑ ❑
Comment See summary for more information
Qualitative Monitoring Yes No NA_NE
Has the facility conducted its Qualitative Monitoring semi-annually? N ❑ ❑ ❑
Comment
Permit and Outfalls Yes No NA NE
# Is a copy of the Permit and the Certificate of Coverage available at the site? N ❑ ❑ ❑
# Were all outfalls observed during the inspection? ❑ ❑ ❑
# If the facility has representative outfall status, is it properly documented by the Division? ❑ ❑ ❑
# Has the facility evaluated all illicit (non stormwater) discharges? E ❑ ❑ ❑
Comment
Page 3

I �
NC Division of Water Quality
�$ NPDES Stormwater Permit Contacts Summary
NC DX%0 hm tint folio%ins contact information in our Ftrmit Databaw for Your nermst m of 448f20t3
permit Number NCGO50336
Permit Type' &Q0a[aljPdr
FaCillty Name: ConSolidated_Metco. Inc.
Facility Address!; 171 Great Oak br
V
Facility Address!.
City, State A Zip: Canton. tic M716
J
Owner Name: Consolidated Metca In t
Owner Type: Non -Government Owner Type Group: QLaBnuation
Owner Affiliation, R%ck. A L i r.r V I L�c `C TlItle• C +r\ 6 {r 6 R
Address!. c7n. C^'�.".a�; 9 O (N o s cto
Address2- �f
City, Stag & Zip: ' W C.. zl Il 1
Work Phone. Fax 4fiQAKdM • j O �t JZ Z fo - 6 Z 7-
Email Address R�[1t .Ltro��c�k Fj CQnmtc, C0YV%
Contact Name IWA AAWMU Phone FAX EGtail
Ear" 9tc-mot at. 369-829-363G 960-015-6w
9t366.1. tirrr
a,+.►��Liwu�iiF 64{5 [f16� PO f3 Y403 (floilC�O�NC,.�$til 70 Z a+-53�1�9, `jov z76 -3 ZI u_K L,ti.,,+.t�gCof�mrt co»+
facility Contact P.aryon(a) v Lt'{ i{;'t"*'tis-aen �, �'.`•gt1,`�r,f h
Contact Naive Address Phone fAl Al w;
Everett Lynch ehs 171 Great Oak Dr, Canton, NC 2B716 828-454- i000 828.648-6792 elynch@)conmet corn
r04I I I1«vMf�R{7 \. M'r�1aVl���i ' +I iw;ISdr7E�Gi"iT1'.',tis�:S hl�1r!.jT�l�'�l�`A8 },h[."sir. +� jf+ '. 1'. 4a,s".iu"%b°:.Y,Y i' $'Aar r l�'i� `I�
Contort Name IWA Addre Phone rM IMAJ
6uar0*-46ynCb — - .638 4" oe96 & met
-calf"
Flakf�4W�,11E Gt16 90 poOV9,tAomlok,NCZ9111 r7o4jZ26 530 rI64Y4;-Cy2x1
4 Cat+s'ntf CCN^
5/28/2013
Page 136

,010onta[vo, Sheri A
From: Nimister, Ernie [Ernie Nimister@ConMet com]
Sent: Thursday, ,tune 06, 2013 3 54 PM
To. Georgoulias, Bethany, Montalvo, Sheri A
Cc: Linville, Rick
Subject: RE Stormwater Permit Changes for Consolidated Metco, Inc
Attachments: Permit Contact Change 6-6-2013 pdf
Attached are copies of our NPDES Stormwater Permit Contact Summary, for both our Bryson City and Canton North
Carolina locations, with updates to our contact information effective immediately
If you should have any questions please feel free to contact me or Rick Linville
Thank you
Ernie Nimister
From: Georgoulias, Bethany fmailto:bethan}.aeorgouhas@ncdenr go
Sent, Saturday, June 01, 2013 11:14 AM
To: Nimister, Ernie
Cc: Linville, Rick; Montalvo, Sheri A
Subject: RE: Stormwater Permit Changes for Consolidated Metco, Inc.
Hi Ernie,
Thanks for getting in touch
Attached are:
Permit Owner / Contact Summary Reports for both permits (in one PDF file), and
Name/Ownership Change Form (PDF)
If you need to change the Owner (organization) Information or Owner Affiliation (the section right below the box that
says **Legally Responsible for Permit** and has red text), please fill out the Name/Ownership Change Form for each
permit and submit it to our Unit It can go to the Attention of Sheri Montalvo,
That is the easiest way for us to keep an official record of that Affiliation change request.
If you need to change the other contacts, i.e., Owner Contact Person, Permit Contact Person, and/or Facility Contact
Person, you can either (1) just email the new contact information directly to Sheri, or (2) strike through the information
on the attachments and fax or scan/email them back to us. You could also strike through and make corrections to the
contact summaries, and then attach those to the Name/Ownership form when you send those in (Option 3).
I think you said you were making these changes because you are retiring at the end of the year If there's a date in the
future they should be effective, let us know (especially since we are focusing priority at the moment on renewing the rest
of the NCG05s and correcting errors for permittees that need revised COCs more immediately).
If you have any questions, please just let me or Sheri know.
Best regards,
Bethany
Bethany Georgoulias
Environmental Engineer

NCDENR I DWQ I Stormwater Permitting Unit
-*1617 Mail Service Center, Raleigh, NC 27699-1617
512 N. Salisbury St, Raleigh, NC 27604
Phone: [phone]
Fax: [phone]
NEW Website: http://oortal,ncdlerlr ora/web/wy/ws/su
E marl correspondence to and from this address may be sub)ect to the North Carolina Public Records Law and may to disdosed to thud parties
From: Nimister, Ernie [Ernie. [e-mail]]
Sent: Friday, May 31, 2013 11.28 AM
To: Georgoulias, Bethany
Cc: Linville, Rick
Subject: Stormwater Permit Changes for Consolidated Metco, Inc.
Thank you for returning my call this morning Please send me the information and/or forms to modify ownership
(phone numbers), facility, and permit contact information for the following locations.
Company
Consolidated Metco, Inc,
Consolidated Metco, Inc
Thanks again
Ernie Ntmister, EH5
Consolidated Metco, Inc
Phone [phone]
Cell 503/830-5850
Fax [phone]
Permit Number Location
NCGO50336 Canton, NC
NCGO50249 Bryson City, NC
Privileged and Confidential
The contents of this e-mail and any attachments are confidential It is intended for the named recipient(s) If you have
received this e-mail in error. ;please notify the system manager or the sender immediately and do not disclose the contents
to anyone or make copies

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
February 25, 2005
Mr Craig Ketcham, Plant Manager
Consolidated Metco, Inc
171 Great Oak Drive
Canton, North Carolina 28716
Subject General Permit No NCG050000
Consolidated Metco, Inc
COC No NCGO50336
Haywood County
Dear Mr Ketcham
In accordance with your application for a discharge permit received on February 2, 2004,
we are forwarding herewith the subject certificate of coverage to discharge under the subject
state — NPDES general permit This permit 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 (or as subsequently amended)
Please take notice that this certificate of coverage is not transferable except after notice to
the Division of Water Quality The Division of Water Quality may require modification or
revocation and reissuance of the certificate of coverage
This permit does not affect the legal requirements to obtain other permits which may be
required by the Division of Water Quality or permits required by the Division of Land
Resources, Coastal Area Management Act or any other federal or local governmental permit that
may be required
If you have any questions concerning this permit, please contact Bethany Georgoulias at
telephone number [phone] ext 529
Sincerely,
OtP,]GiNk\L Oi 0-NED D'``
B;ADLEY SENNETT
Alan W Klimek, P E
cc Asheville Regional Office
Central Files
Stormwater Permitting Unit Files
�.One Carolina
turatlty
North Carolina Division of Water Quality IG 17 Marl Service Center Raleigh NC 27699-1617 Phone [phone] Customer Service
Internet h2o enr slate nc us 512 N Salisbury St Raleigh NC 27604 FAX [phone]
An Equal Opportunity/Affirmative Action Employer —50% Recycled110% Post Consumer Paper

iam
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCGO50000
CERTIFICATE OF COVERAGE No. NCGO50336
STORMWATER DISCHARGES
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,
Consolidated Metro, Inc.
is hereby authorized to discharge stormwater from a facility located at
Consolidated Metco, Inc
171 Great Oak Dn ve
Canton
Haywood County
to receiving waters designated as an unnamed tributary to Beaverdam Creek, a class C water in
the French Broad River Basin, in accordance with the effluent limitations, monitoring
requirements, and other conditions set forth in Parts I,11, III, IV, V, and VI of General Permit
No NCGO50000 as attached.
This certificate of coverage shall become effective February 25, 2005.
This Certificate of Coverage shall remain in effect for the duration of the General Permit
Signed this day Febi uary 25, 2005
BRADLEY yBE V�iETT
for Alan W. Klimek, P E , Director
Division of Water Quality
By the Authority of the Environmental Management Commission

LOCATION MAP:
�"iA�*-� x pia `6��r;'e���� r• � '>v � � .4Z; �• - Jfff���ijjfj��'11��n'II
Q • '� �•��
.I x l�ub,� +the ! �� • M4 1 � �� �`[{� � J.M�
yri I • � • ( AAll
Consolidated
Metco Inc.
k�k
y�y�..��3yu •m-
�� � � ��r , t � � rya �i-�• ' `�
f�1 z
'A qlim'ww' W�� ma: YT,
Latitude: 35°33'55" NCGO50336
Longitude:82°50'4" Facility yr' ,ti
County: Haywood, NC Location , �'qv >r
Consolidated Metco >�I ';,.�� `
Stream Class: C Inc.
Receiving Stream. UT to Beaverdam Creek
Sub -basin: 04-03-05 (French Broad River Basin) Ovotth IFTCA LF 1:24,000
•f(w

N
r ,la
NCG050336
Consolidated Metco, Inc.
rev 2/21/05
February 18, 2005
B Georgouhas
Summary
This facility submitted a Notice of Intent to be covered under General Permit NCG050000
(Rubber & Miscellaneous Products) The stormwater discharge drains to a UT to Beaverdam
Creek, a Class C stream in the French Broad River Basin This facility is located in
Haywood County, handled by the Asheville Regional Office
Application review
a) The permit application has been signed and sufficiently completed Yes.
b) The SIC code accurately describes this facility's activities and is covered by this
general permit Yes. SIC: 3089 (Plastics Products). Facility produces molded
plastic parts for the trucking industry Processes include injection molding,
finishing, packaging, and shipping
c) Does this facility have other permits? No.
d) Hazardous Waste Activities? No.
e) Regional Office input requested 2/ 18/2005 (via e-mail to Jim Reid at ARO)
RO Approval received: 2/21/2005 (approval per K Haynes at ARO)
g) Application approved? Yes.

Re NOI .Qm Consolidated Metco to Canton
Subject: Re N01 from Consolidated Metco in Canton
From: Jim Reid <Jim Reid@ncmatl net>
Date: Mon, 21 Feb 2005 11 13 47 -0500
To: Bethany Georgoulias <bethany georgoulias@ncmail net>
Bethany,
Keith Haynes advises to proceed with issuance of subfect general permit
coverage
Thanks,
Jim Reid
Bethany Georgoulias wrote
Hi, Jim,
We've received an NOI from Consolidated Metco, Inc in Haywood County
for coverage under NCG050000 (Rubber & Masc Products) The facility
manufactures molded plastic parts for the trucking industry Here's the
info
COC #NCG050336
Consolidated Metco, Inc (Haywood Co )
171 Great Oak Drive
Canton, NC 28716
Facility contact Craig Ketcham, Plant Manager
Main activity See above Processes include infection molding,
finishing, packaging, and shipping
Discharge to UT to Beaverdam Creek (Class C) in French Broad Basin
No other permits
This facility began operation in October 2004
Does the Regional Office have any concerns with issuing a COC for this
facility?
Just let me know if you need any additional information Thanks for
your help
Bethany Georgoulias
Environmental Engineer
NC DENR DWQ
Stormwater Permitting Unit
[phone], ext 529
bethany georgoultas@ncmatl net
Jim Reid - Jim Reid@ncmatl net
North Carolina Dept of Environment and Natural Resources
Asheville Regional Office
Division of Water Quality - Water Quality Section
2090 U S 70 Highway
Swannanoa, NC 28778
Tel [phone]
Fax [phone]
Jim Reid <Jim Reid@ncmail net> i
Division of Water Quality - Water Quality Section
NC DENR - Asheville Regional Office
1 of 1 2/21/2005 1 41 PM

7111V
Division of Water Quality 1 Water Quality Section
NCDENRNational Pollutant Discharge Elimination System
Nol C. — ocsr —� or
C—n0—E.T -D Nnnr P[�K%
NCG050000
NOTICE OF INTENT
FOR AGENCY USE ONLY
Date Received
YLar
Month
Da
r'S
a z
n z
Certificate of Covera e
Cr o
Check N
I Amount
3e zzq
tj, cc,
Permit A%sined to
GEo or.
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG050000•
STORMWATER DISCHARGES associated with activities classified as.
SIC 23 Apparel and Other Finished Products Made from Fabrics and Simila Mht&na1sP1 � ; ;
SIC 265 Paperboard Containers and Boxes wTdfira3M, r.
SIC' 267 Converted Paper and Paperboard Products z 0 83J
SIC 27 Printing, Publishing and Allied Industries !!
SIC 30 Rubber and Miscellaneous Products (except as specified below)
SIC* 31 Leather and Leather Products (except as specified below)k9 Elko ;��� ��ia;i
SIC 39 Miscellaneous Manufacturing Industries ~�
The following activities are specifically excluded from coverage under this General Permit
SIC* 301 Tires and Inner Tubes
SIC* 311 Leather Tanning and Finishing
. Standard Industrial Classification Code
(Please print or type)
1) Mailing address of ownerloperator,
Name CotlSc] Lt O P.T C] h'\cTco , �ctic ,
Street Address Roo C-i0x 83201
City _PnaTV P,u 0 State CR ZIP Code q1 z83
Telephone No S03 2L10 - 5--A c13 Fax 503 24u - 5 yq-3
" Address to which all permit correspondence will be mailed
2) Location of facility producing discharge -
Facility Name
Facility Contact
Street Address
City
County
Telephone No
Coa-o GONtF_Ie MC-Vt0 -3 ClC
C}. GZ A tiC-� 1SE t C A ram_, '�A N u N 'E-e
C AtJre V-.� State -1C ZIP Code 2 a rl G,
g29 11A1=1L1- 6000 Fax 82$ yS,L1_-_6D3-?-
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) V-gnrn Aga~ ,�, 4� i -moo wc.- ty , EK \-v 3.3
-rc Yn t RCNX- nNv, �-kA ,
(A copy of a county map or USGS quad sheet with facility clearly located on the map is required to be submitted with this application)
4) This NPDES Permit Application applies to which of the following
❑ New or Proposed Facility Date operation is to begin k i 2[01-k
Page 1 of 3
SWU-220-101701

if NCGO50000 N.O.I.
5, Existing
5) Standard Industrial Classification
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code _3_ d 8'L_
6) Provide a brief narrative description of the types of industrial activities and products manufactured at
this facility Roouwof R �il[r x StQuS
P62t7tt �S�c, SwaCtu.i7G ScaCFrr�nttirnb�O�i��C � �'11.)�51`111.�Cr--� QQ, g 6 .� rite\�Pll�r
7) Discharge points 1 Receiving waters
How many discharge points (ditches, pipes, channels, etc ) convey stormwater from the property? Z_
What is the name of the body or bodies of water (creek, stream, river, lake, etc ) that the facility stormwater
discharges end up in?
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)
8) Does this facility have any other NPDES permits?
1% No
❑ Yes
If yes, list the permit numbers for all current NPDES permits for this facility
9) Does this facility have any Non -Discharge permits (ex recycle permits)?
No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility
10) Does this facility employ any best management practices for stormwater control?
❑ No
is Yes
If yes, please briefly describe ��` mA��F�c_�,�a:�U Nt7 szuiZ�,c��
C P t N Q
11) Does this facility have a Stormwater Pollution Prevention Plan?
N No
❑ Yes
If yes, when was it implemented? MN
12) Are vehicle maintenance activities occurring at this facility?
0 No ❑ Yes
13) Hazardous Waste
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
% No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg of hazardous waste generated per month) of
hazardous waste?
-%No ❑ Yes
Page 2of3
5WU-220-101701

e NCG050000 N.O.I.
c) is this facility a Large Quantity Generator (1000 kg or more of hazardous waste generated per month) of
hazardous waste?
M No ❑ Yes
d) 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
Name of transport 1 disposal vendor _
Vendor address
14) Certification
North Carolina General Statute 143-215 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 punishable 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 )
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 V\ . Ni \ M i s-x C 2
Title t`Slo c . [� F Ewe v . cz u %'� e'kc--t'l.I_P` C.QM2�Jy :, Gs. j& SAFE-t u
of Applicant)
r f8 2vo5
(Date Signed)
Notice of Intent must be accompanied by a check or money order for $80 00 made payable to
NCDENR
Final Checklist
This application will be returned as incomplete unless all of the following items have been included
t& Check for $80 made payable to NCDENR
K This completed application and all supporting documents
02 Copy of county map or USGS quad sheet with location of facility clearly marked on map
Mail the entire package to
Stormwater and General Permits Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Page 3 of 3
SWU-220-101701

NCG050000 N.O.I.
Note
The submission of this document does not guarantee the issuance of an NPDES permit
Page 4 of 3
SWU-220-101701

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FIGURE 2 PROPERTY DETAIL MAP PROJECT NO 154904 1 DRAWN BY GB
DATE 5/24/2004 JAPPROVED BY JHG BENSINGER & GARRISON
Industrial Property REVISION DATE NA IFILE Canton Phase I ENVIRONMENTAL. INC
171 Great Oak Drtve BLUEFIEL© ENGINEERING, P C
Canton, Haywood County, North Carolina SCALE NA

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)ATE:
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RES
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SCALE:
As Shown
OURCE:
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TopoAuads
ISGS Topos:
Conton, NC
NOTES:
CURE 1: SITE LOCATION MAP 171 Great Oak Drive
Industrial Property Canton, Haywood Co., North Carolina 28716

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