NCG080946_COMPLETE FILE - HISTORICAL_20160229

NUR I H LAHULINA
Department at Environmental Qual

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO
Iv C,,� 6/'D
DOC TYPE
HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ a U / � 0 a C) 9
YYYYMMDD

Central Files APS _ SWP _
2/24/2016
Permit Number NCGO80946✓ Permit Tracking Slip
Program Category RECEIVED Status Project Type
NPDES SW In review New Project
Permit Type FEB 2 p 2016 version Permit Classification
Transportation wNehicle MaintenancelPetroleum Bulk/Oil Water Separator Stormwater COC
Discharge COC CENTRAL FILES
Primary Reviewer DWR SECTION Permit Contact Affiliation
bill duiguid "
Coastal SWRule
Permitted Flow
Facility
Facility Name
Major/Minor
Region
Southland Transportation Company
Minor
Winston Salem
Location Address
County
112 River Rd
Yadkin
Facility Contact Affiliation
Boonville NC 27011
Jason Smith
112 River Rd
Owner
Boonville
NC 27011
Owner Name
Owner Type
Southland Transportation Company
Non Government
Owner Affiliation
Robert J Cummings
PO Box 99
Dates/Events
Boonville
NC 27011
Scheduled
Orig Issue App Received Draft Initiated Issuance
Public Notice Issue
Effective
Expirati% n
2/10/2016
Zit(*
Z�ZS! 4
io/-3/( 17
j
Regulated Activities
Requested /Received Events
Vehicle maintenance
RO staff report received
2122116
RO staff report requested
2/17/16
Outfall 1
Waterbody Name Streamindex Number Current Class Subbasin
Tanyard Creek (Buck Creek) 12 64 C 03 07 02

North Carolina Department of Environmental Quality
Pat McCrory Donald R van der Vaart
Governor Secretary
February 24, 2016
Mr Robert J Cummings
Southland Transportation Company
P 0 Box 99
Boonville, North Carolina 27011
Subject General Permit No NCGO80000
Southland Transportation Company
COC No NCGO80946
Yadkin County
Dear Mr Cummings
In accordance with your revised application for a discharge permit received on February 10,
2016, we are forwarding herewith the subject certificate of coverage (COC) 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 October 15, 2007 (or as subsequently amended)
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
Please take notice that this certificate of coverage is not transferable except after notice to the
Division of Energy, Mineral and Land Resources (Division) The Division 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 or permits required by
the Division of Water Resources, Coastal Area Management Act or any other federal, state or local
governmental permit that may be required
If you have any questions concerning this permit, please contact Bill Diuguid, Stormwater
Program Planner at telephone number [phone]
Sincerely,
ORIGINAL SIGNED 81 �
KEN PICKLE 6
for Tracy E Davis, P E, CPM, Director
Division of Energy, Mineral and
Land Resources
cc Winston-Salem Regional Office
Central Files
Stormwater Permitting Unit Files
Attachments
1601 Mall Service Center Raleigh, North Carolina 276991601
Phone [phone] Internet www ncdenr gov
An Equal opportunity 1 Affirmative Action Employer - Made in part by recycled paper

DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
GENERAL PERMIT NO NCGO80000
CERTIFICATE OF COVERAGE No NCG080946
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute I43-215 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,
Southland Transportation Company
is hereby authorized to discharge stormwater from a facility located at
Southland Transportation Company
112 River Road
Boonville
Yadkin County
to receiving waters designated as an unnamed tributary to Tanyard Creek, a Class C waterbody, Yadkin River Basin,
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II, I11,
IV, V and VI of General Permit No NCG080000, as attached
This Certificate of Coverage shall become effective February 24, 2016
This Certificate of Coverage shall remain m effect for the duration of the General Permit
Signed this day February 24, 2016
ORIGINAL SIGNED 8)
KEN PICKLE
for Tracy E Davis, P E , CPM, Director
Division of Energy, Mineral and Land Resources
By Authonty of the Environmental Management Commission

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NCDENR
r�rr„ Gw:ww� ❑er�r�neeur ov
Et+vir�rsreKr u.o n�ai fi�[edr+cte
NOTICE OF INTENT
Division of Energy, Mineral and Land Resources
Land Quality Section
National Pollutant Discharge Elimination System
NCGO80000
FOR AGENCY USE ONLY
Date Received
Year
Month
Dav
Cemiicate erCovera e
N I '
h u
AAAt
Permit ASSI ed tO
11,4 vu
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
SIC 40 (Standard Industrial Classification) Railroad Transportationi�
SIC 41 Loca# and Suburban Transit and Interurban Highway Passenger Transportatioy%�
SIC 42 Motor Freight Transportation and Warehousing (except SIC 4221-4225) 14 2016
SIC 43 United States Postal Service S DEAIR-�q�
The following activities are also included
fC'Rrllll;�rzpp 'A17
)VG
• 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
an a case -by -case basis for permitting
For questions, please contact the DEMLR Regional Office for your area See page 4
ff�-EL rp f4 60� q'i (Please print or type)
1) Mailing address of ownerloperator (address to which all correspondence will be mailed)
Name Robert J CummingsT (� �+✓ ��g �ww
W\Ql rStreet Address 7925 US Highway 601 North j'
City Boonville State NC ZIP Code 27011 A�&e, S
Telephone No 336-367-4119 Fax [phone] ktJw !a
Email ricummings(ci��southlandtransportation com le �C
2) Location of facility producing discharge C�7p
Facility Name Southland Transportation Company
Facility Contact Jason Smith
Street Address 112 River Road
City Boonville State NC ZIP Code 27011
County Yadkin
Telephone No 336-367-4116 Fax [phone]
Email Isrnith@southlandtransportation com
Page 1 of 4
SWU 223-071408 Last revised 6124/14

NCGO80000 N O 1
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) In Boonville NC - From US 601 & NC Hwy 67 no east
on 67 for half a Mile and then turn left onto River Road Then ao 1000 feet to 112 River Road on right
(A copy of a county map or USGS quad sheet with facility clearly located must be submitted with this application)
4) Latitude 36 232824 Longitude -80 69908
3 60 13�, ,9 r' 10cPW ` _-5-7r,
5) This NPDES Permit Application applies to which of the following
X New or Proposed Facility Date operation is to begin June 1. 2016
❑ 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 0 0 4 2
7) Provide a brief narrative description of the types of industrial activities and products manufactured at
facility No ManufacturincL_Tr_uck Maintenance Facility including vehicle rehabilitation, mechanical
repairs, lubrication and an a ui ment cleaning operations area
8) Discharge points ! Receiving waters
How many discharge points (ditches, pipes, channels etc ) convey stormwater from the property? 1 One
What is the name of the body or bodies of water (creek, stream, river, lake, etc ) that the facility stormwater
discharges end up in? The area where our stormwater runs Into the creek is over 10,000 LF To Yadkin River
Receiving water classification Water Supply V (WSTV} L�,T To T- rtJ �/ c ier� T %74
Is this a 303(d) listed stream? No Has a TMDL been approved for this waters ed? No 1C'a6z5 03—pPY—pZ
If the site stormwater discharges to a separate storm sewer system, name the oper or of the separate storm
sewer system (e g City of Raleigh municipal storm sewer) Not Applicable GL &-� G
9) Does this facility have any other NPDES permits? ( V LA C' V—' ''Sa �!o'"r'`1- Ili
❑ No
X Yes (Currently Under NPDES # YADKI-2016-002)
If yes, list the permit numbers for all current NPDES permits for this facility
5T9C-, -►% srvD C X iz-GIf
10) Does this facility have any Non -Discharge permits (ex recycle permit)?
X No
❑ 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
X Yes (Show any structural BMPs on the site diagram )
If yes, please briefly describe Southland currently has aN_C_DENR Approved Sediment Basin that all runoff
goes into before leaving the site
12) Does this facility have a Stormwater Pollution Prevention Plan?
X No (However we are initiating a new plan now)
❑ Yes
Page 2 of 4
SWU-223-071408 Last revised 6124114

NCGO80000 N O 1
If yes, when was it implemented?
13) Are vehicle maintenance activities occurring at this facility?
❑ No X Yes
14) Hazardous Waste
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
X No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg of hazardous waste generated per month) of
hazardous waste?
❑ No X Yes
c) Is this facility a Large Quantity Generator (1000 kg or more of hazardous waste generated per month) of
hazardous waste?
X No ❑ Yes
d) Is hazardous waste stored in the 100-year flood plain?
X 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 Note We have our Small Quantity Generator Permit = But don't plan to have to use it
How is material stored NIA
Where is material stored NIA
How many disposal shipments per year 0
Name of transport 1 disposal vendor N/A
Vendor address NIA
15) Certification
North Carolina General Statute 143-215 6B (i) provides that
Any person who knowingly makes any false statement representation or certification in any application record report
plan or other document fled or required to be maintained under this Article or a rule implementing this Article or who
knowingly makes a false statement of a material fad 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 Jason Smith
Title V e-President
(Srgoture of
W & //(,2
(Date Sign d)
Notice of Intent must be accompanied by a check or money order for $100 00 made payable to
Page 3 of 4
SWU 223 071408 Last revised 6/24114

North Carolina Department of Environmental Quality
Pat McCrory Donald R van der Vaart
Govemor Secretary
February 24, 2016
Mr Robert J Cummings
Southland Transportation Company
P 0 Box 99
Boonville, North Carolina 27011
Subject General Permit No NCG080000
Southland Transportation Company
COC No NCGO80946
Yadkin County
Dear Mr Cummings
In accordance with your revised application for a discharge permit received on February 10,
2016, we are forwarding herewith the subject certificate of coverage (COC) to discharge under the
subject state - NPDES general permit This permit is issued pursuant to the requirements of North
Carolina General Statute 143-2151 and the Memorandum of Agreement between North Carolina and
the US Environmental Protection Agency dated October 15, 2007 (or as subsequently amended)
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
Please take notice that this certificate of coverage is not transferable except after notice to the
Division of Energy, Mineral and Land Resources (Division) The Division 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 or permits required by
the Division of Water Resources, Coastal Area Management Act or any other federal, state or local
governmental permit that may be required
If you have any questions concerning this permit, please contact Bill Diuguid, Stormwater
Program Planner at telephone number [phone]
Sincerely,
ORIGINAL SIONFED 61
Plr'KI E
for Tracy E Davis, P E , CPM, Director
Division of Energy, Mineral and
Land Resources
cc Winston-Salem Regional Office
Central Files
Stormwater Permitting Unit Files
Attachments
1601 Mad Service Center Raleigh North Carolina 27699 1601
Phone [phone] \ Internet www ncdenr gov
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STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DNISION OF ENERGY, MINERAL AND LAND RESOURCES
GENERAL PERMIT NO NCG080000
CERTIFICATE OF COVERAGE No NCG080946
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,
Southland Transportation Company
is hereby authorized to discharge stormwater from a facility located at
Southland Transportation Company
112 River Road
Boonville
Yadkin County
to receiving waters designated as an unnamed tributary to Tanyard Creek, a Class C waterbody, Yadkin River Basin,
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II, III,
IV, V and VI of General Permit No NCG080000, as attached
This Certificate of Coverage shall become effective February 24, 2016
This Certificate of Coverage shall remain in effect for the duration of the General Permit
Signed this day February 24, 2016
ORIGINAL SIGNED W
KEN PICKI F
for Tracy E Davis, P E , CPM, Director
Division of Energy, Mmeral and Land Resources
By Authority of the Environmental Management Commission

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AI Division of Energy, Mineral and Land Resources
Land Quality Section
National Pollutant Discharge Elimination System
NCDENR
�� �� °�v� °� NCGos0000
NRirna�esa�sic rze'
NOTICE OF INTENT
FOR AGENCY USC ONLY
Date Received
Year Month
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National Pollutant Discharge Elimination System application for coverage under General Permit
NCGO80000
STORMWATER DISCHARGES from Vehicle Maintenance Areas (including vehicle rehabilitation,
mechanical repairs, painting, fueling, lubrication, and equipment cleaning operations areas) associated
with activities classified as
SIC 40 (Standard Industrial Classification) Railroad Transportation -11 i11"
SIC 41 Local and Suburban Transit and Interurban Highway Passenger TransportatioxcD W Q
SIC 42 Motor Freight Transportation and Warehousing (except SIC 4221.4225) 10 2016
SIC 43 United States Postal Service �� [�
The following activities are also included
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• 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
*'JI F For questions, please contact the DEMLR Regional Office for your area See page 4
M 61L ro PO 40x qq (Please print or type)
1) Mailing address of owner/operator {address to which all correspondence will be mailed]
Name Robert J Cummins (1 �� 7��G N�i FACE.—`q
W,(a&J'Street Address 7925_US_Highway 601_ North }-
City Boonville State NC ZIP Code 27011 l��- Es s
Telephone No 336-367-4119 Fax [phone] Lt/
Email Bcummings@southlandtransportation com 19 CrtJ V1 r AJC
2) Location of facility producing discharge 617D l l
Facility Name Southland Transportation Company
Facility Contact Jason Smith
Street Address 112 River Road
City Boonville State NC ZIP Code 27011
County Yadkin
Telephone No 336-367-4116 Fax [phone]
Email Lsmitlh@southlandtransaortation com
Page 1 of 4
5WU 223-C71408
Last revised 6/24l14

NCG080000 N O 1
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)_ In Boonville NC - From US 601 & NC Hwy 67go east
on 67 for half a Mile and then turn left onto River Road Then go 1000 feet to 112 River Road on right
(A copy of a county map or USGS quad sheet with facility clearly located must be submitted with this appkcation)
4) Latitude 36 232824 Longitude -80 69908
5) This NPDES Permit Application applies to which of the following
X New or Proposed Facility Date operation is to begin June 1, 2016
❑ 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 0042
7) Provide a brief narrative description of the types of industrial activities and products manufactured at
facility No Manufacturing -- Truck Maintenance Facility including vehicle rehabilitation, mechanical
repairs, lubrication, and an equipment cleaning operations area
8) Discharge points ! Receiving waters
How many discharge points (ditches, pipes, channels, etc ) convey stormwater from the property? 1 LOne
What is the name of the body or bodies of water (creek, stream, river, take, etc ) that the facility stormwater
discharges end up in? The area where our stormwater runs into the creek is over 10,000 t-F To Yadkin River_
Receiving water classification Water Supply V (WS-V) jt7- To '7—k rr
Is this a 303(d) listed stream? No Has a TMDL been approved for this wats ed? NO S(A153 03-Or7—bz
If the site stormwater discharges to a separate storm sewer system, name the oper or of the separate storm
sewer system (e g City of Raleigh municipal storm sewer) Not Applicable CL & —5- .0
9) Does this facility have any other NPDES permits?
(15 u cV--
❑ No
X Yes (Currently Under NPDES # YADKI-2016-002)
If yes, list the permit numbers for ali current NPDES permits for this facility
10) Does this facility have any Non -Discharge permits (ex recycle permit)?
5 "-A-+-t stvp 6 X IZ—Gif
X No
❑ 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
X Yes (Snow any structural BMPs on the site diagram )
If yes please briefly describe Southland currently has a NCDENR Approved Sediment Basin that all runoff
goes into before leaven the site T
12) Does this facility have a Stormwater Pollution Prevention Plan9
X No (However we are initiating a new plan now)
❑ Yes
Page 2 of 4
SWU-223-071408 Last revised 6124114

NCGO80000 N 4 {
If yes, when was it implemented?
13) Are vehicle maintenance activities occurring at this facility?
❑ No X Yes
14) Hazardous Waste
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
X No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg of hazardous waste generated per month) of
hazardous waste?
❑ No X Yes
c) Is this facility a Large Quantity Generator (1000 kg or more of hazardous waste generated per month) of
hazardous waste?
X No ❑ Yes
d) Is hazardous waste stored in the 100-year flood plain?
X 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 Note We have our Small Quantity Generator Permit — But don't plan to. have to use it
How is material stored NIA
Where is material stored NIA
How many disposal shipments per year 0
Name of transport 1 disposal vendor NIA
Vendor address NIA
15) Certification
North Carolina General Statute 143-215 6B (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 rulemakmg proceeding or contested case under this Article or
who falsifies tampers with or knowingly renders inaccurate any recording or monitonng 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 discharges) and is enforceable in the same manner as an
individual permit
l certify that 1 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 Jason Smith
)2 & //62
(Date Sign d)
Notice of Intent must be accompanied by a check or money order for $100 00 made payable to
Page 3 of 4
SWU 223 071408 Last revised 6124114

r
Muguid, BIII
From Diuguid, Bill
Sent Monday, February 22, 2016 817 AM
To White, Glen
Subject RE NCG080946 Southland Transportation Company Booneville Yadkin County NOI Feb
102016
Ok, thanks, will issue then
Bill D
From White, Glen
Sent Monday, February 22, 2016 8 14 AM
To Diuguid, Bill <bill diuguid@ncdenr gov>
Cc Gantt, Matt <matt gantt@ncdenr gov>, White, Sue <sue white@ncdenr gov>, Latham, Tim
<tim latham@ncdenr gov>
Subject RE NCG080946 Southland Transportation Company Booneville Yadkin County NO1 Feb 10 2016
MI
Tim Latham and I visited the site at 112 River ]toad together with the owner and the grading contractor They have a
permit at another site but this will be a new facility at a different location We asked the owner to submit the NOI to
have this facility covered before it opens We recommend issuing the permit
_,
Glen White
Environmenial Specialist
NCDENR Winston-Salem Rebional Office
Division of Energy, Minerals & Land Resources
450 Ham% Mill lid -- Suite 300
Wmtiton-Salem NC 27105
glen while@ncdenr gov
[phone]
From Gantt, Matt
Sent Thursday, February 18, 2016 7 02 PM
To White, Glen <glen white@ncdenr gov>, White, Sue <sue white@ncdenr gov>
Subject EW NCG080946 Southland Transportation Company Booneville Yadkin County NOI Feb 10 2016
Can ya'll handle this?
Thanksi
From Muguid, Bill
Sent Wednesday, February 17, 20161148 AM
To Gantt, Matt <matt antt ncdenr Rov>
Subject NCG080946 Southland Transportation Company Booneville Yadkin County NO1 Feb 10 2016
Matt Gantt, Winston-Salem Regional Office
Please review the attached NOI application with the objective of responding to me with a recommendation to issue the
permit I recognize that you may not visit each new permittee during this NOI review, but it affords you the opportunity

4
to log the permit into your regional database and add the facility to a future monitoring and compliance visit
schedule Therefore, your recommendation now to issue the permit serves as your acknowledgement that (1) the
facility is located in your region, (2) that there are no current complaints outstanding about the facility that have not
been dealt with, and (3) that the facility may ultimately be inspected by the regional staff I've also attached a scanned
copy of the NO1 and a location map for your review
COC # Facility Location Gty/County
NCG080946 Southland Transportation Company 112 River Road Booneville/Yadkin County
if you need any more info, give me a call If you could send me a recommendation to issue the permit by 03/17/2016,
I'd appreciate it, so I can issue their COC I cannot issue the permit until the respective regional office reviews and
comments back to me with a recommendation to issue the permit
Thanks
Bill
Bill Diuguid
Stormwater Permitting Program
Land Quality Section
Division of Energy, Mineral and Land Resources I NCDEQ
1612 Mail Service Center (Mail)
512 N Salisbury St, Raleigh, NC 27604 1 91h Floor (Location & Parcels)
Raleigh North Carolina 27699-1612
Phone [phone] Fax [phone]
Website http//t)ortainedenrorg/web/wq/ws/su
N;t A
Nothing Compares,,,-,
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties

NCG080000 N O 1
NCDENR
Final Checklist
This application will be returned as incomplete unless all of the following items have been included
❑ Check for $100 made payable to NCDENR
❑ 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
Stormwater Permitting Unit Program
Division of Energy, Mineral and Land Resources
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) 296-450C
Fayetteville Office
[phone]
Mooresville Office
[phone]
Raleigh Office
[phone]
Washington Office
[phone]
Wilmington Office
[phone]
Winston-Salem
[phone]
Central Office
[phone]
Page 4 of 4
SWU-223-071408 Last revised 6124114

CEi2TIFIC'A'TE OF PL AN APPROVAL,�
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the posting of this certi ica e, ce�rtffies that an-er�osid and' -sell entatl®n c®n ®1 plan
ias been approved for this pebjecf,by the North.'Caroli'iiDeprtment of Environment
ind Natural Resources in- accordance with Forth Carolina General -Statute 113A,- -57'(4
ind 113A - 54 (d) ,(4) and Nortlf.Cgrolina Adriiinis' trAtiye Code, Title 1.5A-, Chapter
&B.0007 (c)o This certifichte�MuW he posted at `hi� primary entrance -of the job site-
_ ,.
,jefore construction begins -anti until -establishment 'of,�efinan`ent groudc®�� as
required by North Carollna Adlnstrat�ive,C®de�++''�'ile:lrSA 'Chapter 4'D.0027 } '
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Date of Plan Approval
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DIVISION OF BLAND RESOURCES
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SOUTHLAND TRANSPORTATION CO
PHONE [phone]
PO BOX 99
BOONVILLE NC 27011
*ONE HUNDRED AND XX 1 100 DOLLARS
PAY NCDENR
TO THE 1612 MAIL SERVICE CENTER
ORDER OF RALEIGH,c-y-
NC�699-161
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Oft CAPITAL BANK 096252
capitalbank us com
VOl?,pfTjMDAYS
CHECK 096252
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DATE AMOUNT
2/8/2016 *www*wwww***100 00*
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AUTHORIZED SIGNATURE HP