NCG140450_COMPLETE FILE - HISTORICAL_20170208

NORTH CAROLINA .�
Department of Environmental Qua

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STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO
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DOC TYPE
b� HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ QO) 7 0
YYYYMMDD

DRAGADOS USA
Winston —Salem Northern Beltway
June $, 2017
Division of Water Quality
Stormwater Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Re NCG140250
Division of Water Quality Official
The proposed construction of the temporary concrete batch plant site located in Winston-Salem, NC for
the highway project U2579B (Winston-Salem Northern Beltway) has been completed and meets the
specifications and plans submitted with the Notice of intent for this project and all other supporting
documentation The temporary batch plant has been installed and will be producing concrete in
support of the North Carolina Department of Transportation Division of Highways Project U2579B The
batch plant will be fully operational on June 15, 2017
If you have any questions you may contact me at any time
RECEIVED
JUN 15 2017
DENR-LAND QUALITY
STORMWATER PERMITTING
Sincerely,
"�14404�� t���Zvo�
William Scott Gallman, P E
IIIifIII,
Q SEAL {
036767 z
,SCOTI yGQ\\\�.
V�cG �y oys�
336 517 0099 male 775 ROBBINS PERCH TRAIL KERNERSVILLE, NC 27284 336 517 0100 fax

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I
Energy, Mineral &
Land Resources
ENVIRONMENTAL QUALITY
.lose Ignacio Martin Alos
Dragados USA
4600 Marriott Dr, Suite 140
Raleigh, NC 27560
Dear Mr Jose Ignacio Martin Alos
February 08, 2017
OLZ-
ROY COOPE�
Governor
MICHAEL S REGAN
Secretary
TRACY DAVIS
Director
`
NC Department of
Environmental Quality
s
Received
FEB 21 20V
Winston-Salem
. -
Regional Office
h a.
Subject General Permit No NCG140000
Dragados USA
Winston Salem Temp Batch Plant
COC NCG140450
Forsyth County
In accordance with your application for a discharge permit received on January 3, 2017, 'Ae 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 October 15, 2007 (or as subsequently amended)
Please take notice that this certificate of coverage (COC) is not transferable except after notice to the
Division of Energy, Mineral, and Land Resources The Division may require modification or revocation
and reissuance of the certificate of coverage
Please note that NCG I40000 contains effluent limitations for process wastewater discharges (see Part IV,
Section D) Wastewater discharges must meet the requirements of these effluent limitations An
exceedance of any of these limitations is a violation of permit conditions
This permit does not affect the legal requirements to obtain other permits which may be required by the
Division of Energy, Mining, and Land Resources, or permits required by the Division of Water
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 Richard Riddle at telephone number
[phone]
Sincerely,
ORIGINAL SIGNED BY
MICHEAL F RANDAL.L
for Tracy E Davis, P E , CPM
cc Winston Salem Regional Office
Central Files
Stormwater Permitting Program Files
Nothing Compares
55tate of North Carolina I Environmental Quality I Energy Mineral and Land Resources
512 N Salisbury Street 1 l612 Mail Service Center I Raleigh North Carolina 27699 1612
919 707 9200
,r

r
1
STATE OF NORTI I CAROLINA
DEPARTMENT OF ENVIRONMEN FAL QUALITY
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
GENERAL PERMIT NO NCGI40000
CERTIFICATE OF COVERAGE No NCG140450
STORM WATER and WAS FEWA I ER DISCI IARGES
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,
Dragados USA
is hereby authorized to discharge stormwater and process wastewater from a facility located at
Femporary Concrete Batch Plant - Winston Salem
SR 158 & Old Belews Creek Road
Kernersville
Forsyth County
to receiving; waters designated as Lowery Mill Creek, a class WS-I11 water to the Yadkin Pee -
Dee River Basin in accordance with the effluent limitations, monitoring requirements, and other
conditions set forth in Parts I, II, 111, IV, and V of General Permit No NCG 140000 as attached
This certificate of coverage shall become effective February 08 2017
I his Certificate of Coverage shall remain in effect for the duration of the General Permit
Signed this day February 08, 2017
0��IGINAL SIGNET? SY
MICHEAL F RAND -At I_
for Tracy E Davis, P I-, Director
Division of Energy, Mineral, and Land Resources
By the Authonty of the Environmental Management Commission

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1 \ -- ! f—.� /` i _.o�_ _ •i `� +Ili- 9 lr rij
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Dragaclos USA Concrete Batch Plant
t
y l+
fL�i�YX/��.��u�lE3:'���1".1.'liifRlily►1Y3utlA��:, v� �rkrraau�
NCG 140450
N
W E
5
Map Scale 1 24,000
Dragados USA
Winston Salem Concrete Batch Plant
Latitude 360 08' 39" N
Longitude -80" 09' 23" W
County Forsyth
Receiving Stream Lowery Mill Creek
Stream Class WS-III
Index dumber 12-94-12-3-(0 5) (Yadkin Pee Dee Bann)
0
.
14
'III /Y+ I
Facility Location

Central Files APS _ SWP
2/8/2017
Permit Number NCG140450 Permit Tracking Slip
Program Category
Status
Project Type
NPOES SW
In review
New Project
Permit Type
Version
Permit Classification
Ready Mix Concrete StormwaterfWastewater Discharge COC
COC
Primary Reviewer
Permit Contact
Affiliation
rick riddle
RECEIVED
Coastal SWRuls
F EB 0 8 2017
Permitted Flow
CENTRAL FILES
DWR SECTION
Facility
Facility Name
Major/Minor
Region
Temp Concrete Batch Plant Winston Salem
Minor
Winston Salem
Location Address
County
775 Robbins Perch Tri
Forsyth
Facility Contact Affiliation
Kernersville NC 27284
Angel Crespo Alonso
775 Robbins Perch Trl
Owner
Kernersville NC 27284
Owner Name
Owner Type
Dragados USA
Non Government
Owner Affiliation
Angel Crespo Alonso
775 Robbins Perch Tri
DateslEvents
Kernersville NC 27284
Scheduled
Ong Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
1/3/2017
Regulated Activities Requested /Received Events
Ready mixed concrete - stormwater discharges RO staff report received 1117/17
RO staff report requested 1112117
Other agency comments requested 1l12/17
Other agency comments received 217l17
Outfali 1
Waterbody Name Streamindex Number Current Class Subbasin
Lowery Moll Creek 12 94 12 3 (0 5) WS 111 03 07 04

L9 i
Energy Mineral &
Land Resources
ENVIRONMENTAL OUALiTY
Jose Ignacio Martin Alos
Dragados USA
4600 Marriott Dr , Suite 140
Raleigh, NC 27560
Dear Mr Jose Ignacio Martin Alos
ROY COOPER
Governor
MICHAEL S REGAN
surowrary
TRACY DAVIS
Director
February 08, 2017
Subject General Permit No NCG140000
Dragados USA
Winston Salem Temp Batch Plant
COC NCG140450
Forsyth County
In accordance with your application for a discharge permit received on January 3, 2017 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 October 15, 2007 (or as subsequently amended)
Please take notice that this certificate of coverage (COC) is not transferable except after notice to the
Division of Energy, Mineral, and Land Resources The Division may require modification or revocation
and reissuance of the certificate of coverage
Please note that NCG 140000 contains effluent limitations for piocess wastewater discharges (see Part IV,
Section D) Wastewater discharges must meet the requirements of these effluent limitations An
exceedance of any of these hinitations is a violation of perina condmons
T his permit does not affect the legal requirements to obtain other permits which may be required by the
Division of Energy, Mining, and Land Resources, or permits required by the Division of Water
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 Richard Riddle at telephone number
[phone]
Sincerely,
for Tracy E Davis, P f- CPM
cc Winston Salem Regional Office
Central Files
Stormwater Permitting Program Files
Nothing Compares,.-
55tate of North Carolina I Environmental Quality I Energy Mineral and land Resources
512 N Salisbury street 1 1612 Mail Service Center I Raleigh North Carolina 27699 1612
919 707 9200

S I A I E OF NOR I I I CAROLINA
DEI'AIZ fMhN F OF ENVIRONMLN I AL QUALITY
DIVISION OI' ENERGY MINERAII AND LAND RESOURCES
GENERAL PERMIT NO NCG140000
CER7 IFICA I E OF COVERAGE No NCG140450
STORMWATER and WAS I EWA I ER DISCI IARGES
NATIONAL POLLU7 ANT DISCHARGE ELIMINA7 ION SYS7 EM
In compliance with the provision of North Carolina General Statutc 143-215 1 other lawiul
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Fedcral Water Pollution Control Act, as amended,
Dragados USA
is hereby authorized to discharge stormwater and process wastewater from a facility located at
1 emporary Concrete Batch Plant - Winston Salem
SR 158 & Old Belews Creek Road
Keinersville
Forsyth County
to receiving waters designated as Lowery Mill Creek, a class WS-1I1 water in the Yadkin Pec-
Dee River Basin, in accordance with the effluent limitations monitoring requirements, and other
conditions sct lorth in Parts 111 111 1V and V of Gencral PermitNo NCG 140000 as attached
I his cei of icate of coverage shall become el fective February 08 2017
I his Certificate of Coverage shall remain in etIect for the duration of the General Permit
Signed this day February 08 2017
for I racy E Davis, 1' E hector
Division of hncigy, Mincral, and Land Resources
By the Authority of the Environmental Management Commission

to
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Fee
V
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•Illy SL �
jDragados USA Concrete Batch Plant
NCG140450
N
W L'
S
Map Scale 124,000
5210111.� ON
Dragados USA
Winston Salem Concrete Batch Plant
Latitude 361 08' 39" N
Longitude -800 09' 23" W
County Forsyth
Receiving Stream Lowery Mill Creek
Stream Class WS-III
Index Number 12-94-12-3-(0 S) (Yadkin Pee Dee Basin)
M.
•F/ r�1:.J
MWWM ,
Facility Location

0
0
ffJ ZACHRY
December 15, 2016
Stomwater Permitting Unit Program
DIVISlon of Energy, Mineral and Land Resources
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Regarding NCG 140000 NO]
RECEIVED
JAN 03 2017
DENR LAND QUALITY
STORIAWATER PERMITTING
We are submitting the attached NOI on behalf of Dragados USA for coverage under NCG140000 for
a concrete batch plant to serve an NCDOT outer loop project in Winston Salem, NC Please contact
the undersigned at 704-778-2855 with any questions
Si cerely, 1:t�-
e�', J
David Sc ster, P E
Regional Concrete Paving Manger
Zachry Construction Corporation
cc Angel Crespo Alonso, Project Manager, Dragados USA
Zachry Construction Corporation
P 0 Box 240130 San Antonio TX 78224 0130 P 210 475 8000 F 210 475 8060 www zachry cam

•
•
40 Division of Energy, Mineral and Land Resources
FA
0- Land Quality Section
NCDENRNational Pollutant Discharge Elimination System
Er1Nwfww[M AvD N.Q1F.4 RL�wC[l
NCG140000
NOTICE OF INTENT
FOR AGENCY USC ONLN
Milt
RCLLMd
) wr
Moth
E)a
ci mttK rtc al Coni.ra �
Cli-ck 9 Amount
Pcrmtt Alstgned to
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG140000
STORMWATER AND PROCESS WASTEWATER DISCHARGES associated with activities classified as
SIC (Standard Industrial Classification) Code 3273 and like activities - Ready Mixed Concrete
This NOI may be an application to discharge process wastewater NCG140000 contains effluent limitations for
process wastewater discharges Wastewater discharges must meet the requirements of these effluent
limitations An exceedence of any of these limitations will result in a violation of the permit conditions
For questions, please contact the DEMLR Central Office or Regional Office in your area (See page 6j
-, (Please print or type)
1) Mailing address of owner/operator official address to which all permit correspondence will be
mailed (Please print or type all entries in this application form)
Legal Owner Name Dragados USA
(Please attach the most recent annual Report to the NC Secretof State showing the current regal name Alternatively this
permit can be given to an individual) � f
Signee s Name (as signed for in question 29 below) Jose Ignacio Martin Alos
Street Address 4600 Marriott Drive, Suite 140
City Raleigh
Telephone No 404-702-1030
Alternate Contact Name
Alternate Contact Telephone (if different)
Location of facility producing discharge
Facility Name
Facility Contact
Street Address
City
County
Telephone No
State ZIP Code 27560
Email fimartinalosb@dragados-usa com
Email (if different)
Temp Concrete Batch Plant - Winston Sale
Crespo Alonso
775 Robbins Perch Trail
Kernersville
State NC ZIP Code 27284
Forsyth
336 782-8994 Fax
3) Physical location information 1�4 r i941 I 43kq
Please provide narrative directions to the facility (use street names, state road numbers, and distance and
�irection from a roadway intersection) SR 158, 1,500 feet north of the SR 158I0Id Belews Creek
Road intersection
(A copy of a county map or USGS quad sheet vmth facility clearly located on the map is a required part of this application)
16 ) Latitude 360 8'39 09"N Longitude 80' 9'23 08"W (deg, min, sec)
5) This NPDES Permit Application applies to the following (check all that apply) .
X New or Proposed Facility Date operation is to begin MARC H 1 2011
❑ Existing Facility
Permit #
SWU 229 11032011
Page 1 of 7
Last revised 7/2/14

NCG140000 N 4 1
6) Consultant's application information Please direct technical questions to
Consultant David Schuster
Consulting Firm _Zg�-6rm Con SjrV +1 Or1 Corp
Mailing Address A✓1 0+1 on pC*r V V,►a
City rV10" , s u r i l{
State N G Zip Code
Phone [phone] Fax (__ ]
Email ctaysd Sc,6sjerLZ4chrA orP coLo
(Optional)
Staple Business Card Here
7) Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary
industrial activity at this facility
SIC Code 1611
8) Provide a brief description of the types of industrial activities and products produced at this facility
(Attach a site diagram showing the process areas present at this facility )
-Temporary concrete batch plant for concrete production to serve construction of a connector road between
SR158 and Business 1-40 for SCDOT ' _
Stormwater Discharge, Wastewater Treatment & Discharge and Permitting Information
9) Discharge points I Receiving waters
Number of discharge points (ditches, pipes, channels, etc ) that convey stormwater and/or wastewater from
the property
Stormwater-only a Wastewater -only 0 Wastewater Commingled with Stormwater 2
For new facilities Expected date of commencement of discharge February 2017
What is the name of the body or bodies of water (creek, stream, river, lake, etc ) that the facility stormwater
and/or wastewater discharges end up m?
Receiving water classification(s), if known Lowery Mill Creek and Martin Mill Creek
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)
Will this facility discharge wastewaterto SA (Shellfishing) waters? ❑ Yes X No
Note Discharge of process wastewater to receiving waters classified as WS-II to WS-V or SA must
be approved by the N C Division of Water Resources, Public Water Supply Section It DWR
does not approve, coverage under NCG140000 cannot be granted No new discharges of
process wastewater are permitted in receiving waters classified as WS-I or freshwater ORW
10) Each applicant shall provide the following information (attach additional sheets as necessary)
• Two (2) site plans depicting the facility or site with numbered outtalls which indicate stormwater and
wastewater outfalls The plans shall legibly show at a minimum, (existing or proposed)
o Outline of drainage areas with topographical lines and features
o Stormwater/wastewater treatment structures
o Location of numbered stormwater/wastewater outfalls (corresponding to which drainage areas)
o Runoff conveyance structures
o Areas and acreage where materials are stored
o Impervious area acreages
o Location(s) of streams and/or wetlands the site is draining to, and any applicable buffers
o Site property lines, North Arrow, and bar scale
Page 2 of 7
SWU 229 07122011 Last revised 712114

NCG140000 N O 1
•
•
o If applicable, the 100 year floodplain line
a Acreage of each stormwater and wastewater topographical area
a Each of the facilities' wastewater or stormwater source and discharge structures and each of its
hazardous waste treatment, storage, or disposal facilities
o Site location (insert)
Site plans shall be 24" x 3 6 " in size
• Line drawing and description A line drawing of the water flow through the facility A pictorial
description of the nature and amount of any sources of water and any collection and treatment measures
• A narrative description and identification of each type of process, operation, or production area which
contributes wastewater to the effluent for each outfall, and a description of the treatment the wastewater
receives (or will receive), including the ultimate disposal of any solid or fluid wastes other than by
discharge Processes, operations, or production areas may be described in general terms (e g ash
silo')
11) Does the applicant have any unresolved Notice of Violations (NOVs)?
j X No ❑ Yes
Wastewater
12) What types of wastewater does your facility generate or discharge)
Type of Authorized Wastewater
Generate
Discharge
Sent to WW
Treatment
System
Vehicle and equipment cleaning VE
❑
❑
❑
Wetting of raw material stockpiles RM
X
X
❑
Mixing drum cleaning MD
X
X
❑
Further explanation, if necessary
13) Will your facility spray -down or actively wet aggregate piles9
❑ No X Yes
14) Does the facility use any of the following on sites
❑ Phosphorus containing Detergents
❑ Brighteners ❑ Other Cleaning Agents
❑ Non -Phosphorus -containing Detergents
❑ Other
15) Are wastewater treatment facilities planned in the 100-year flood plain)
X No ❑ Yes
16) Does your facility use or plan to use a recycle system, or recycle components in your treatment system?
❑ Yes X No
If yes, what size storm event is the system designed to hold before overfiowing9 (for example, 10-yr, 24-hr)
year, 24-hr rainfall event
SWU 229 07122011
Page 3 of 7
Last revised 7l2114

NCG140000 N O 1
17) Will your facility build a closed -loop recycle system that meets design requirements in 15A NCAC 02T
1000 and hold your facilities' working volume'?
❑ Yes X No
Will your facility discharge wastewater to surface waters
X Yes ❑ No
If the facility's treatment system meets the design requirements of 15A NCACO2T 1000 (including
holding the 25-year, 24-hour storm plus one foot of freeboard), holds the working volume of your site,
and does not discharge wastewater to surface waters, you may not be required to obtain an NPDES
permit for wastewater discharges If you believe this is the case, please contact OEMLR's Aquifer
Protection Section Land Application Unit Central Office Supervisor or staff (1636 Mail Service Center,
Raleigh, NC 27699-1636) for more Information on obtaining the necessary permits or approvals If you will
discharge wastewater or stormwater to surface waters, please continue to apply for a permit to discharge
associated with ready -mixed concrete or like operations under NCG 140000 For further questions, please
contact DEMLRs Stormwater Permitting Unit Staff
1
18) A wastewater treatment alternatives review is required by 15A NCAC 2H 0105 (c)(2) for any new or
expanding water pollution control facility's discharge in North Carolina You may attach additional sheets
a) What wastewaters were considered for this alternatives review? ❑ VE ❑ RM X MD
b) Connection to a Municipal or Regional Sewer Collection System
i) Are there existing sewer lines within a one -mile radius? X Yes ❑ No
. (1) If Yes, will the wastewater treatment plant (WWTP) accept the wastewater? ❑ Yes IX No
(a) If No please attach a letter documenting that the WWTP will not accept the wastewater
(b) If Yes is it feasible to connect to the WWTP? Why or why not?"
c) Closed -loop Recycle System (must meet design requirements of 15A NCAC 2T 1000)
Are you already proposing a closed -loop recycle system (CLRS)? ❑ Yes
(1) If Yes, contact DEMLR s Aquifer Protection Sections Land Application Unit
(2) If No, is this option technologically feasible (possible)? Why or why not?`
End product specification restrict reuse of wastewater
(3) If No, is it feasible to build a CLRS on your site? Why or why not?"
Small volumes of wastewater produced render Infeasible closed loop recycling
systems
X No
(4) What is the feasibility of building a CLRS compared to direct surface water discharge?`
Small volumes of wastewater and the temporary nature of the facility render
infeasible closed loop recycling systems
d) Surface or Subsurface Disposal System (e g , spray irrigation)
0 l) Is a surface or subsurface disposal technologically feasible (possible)? ❑ Yes X No
1 See DWQ s Aquifer Protection Section Land Application Unit s Water Balance Calculation Policy for more information on DWQ LAU s
website httD / ortal ncdenr org/welo/wg/aps/lau/policies for more information
Page 4 of 7
SWU 229 07122011 Last revised 7/2/14

NCG 140000 N G f
Why or Why not? Small volumes of washout water and the temporary nature of the facility render
infeasible surface or subsurface systems
ii) Is a surface or subsurface disposal system feasible to implement?* ❑ Yes IX No
Why or Why not? Small volumes of washout water render infeasible surface and subsurface systems
iii) What is the feasibility of employing a subsurface or surface discharge as compared to a direct
discharge to surface waters?*
Small volumes of washout water and the temporary nature of the facility render
infeasible surface or subsurface systems
e) Direct Discharge to Surface Waters Is discharge to surface waters the most environmentally sound
alternative of all reasonably cost-effective options of the wastewaters being considered?* X Yes ❑ No
t) If No contact DEMLR's Land Application Unit to determine permitting requirements
f) If this review included all wastewater discharge types, would excluding some types (e g law
stockpile wetting) make any of the above non -discharge options feasible? ❑ Yes X No
" You maybe asked to provide further information to support your answers to these questions after the initial review
Feasibility should take into account initial and recurring costs
Stormwater
19) Does this facility employ any best management practices for Stormwater control? ❑ No X Yes
If yes, please briefly describe _Refer to attached Process Description
20) Does this facility have a Stormwater Pollution Prevention Plan? ❑ No X Yes
If yes, when was it implemented? Will be implemented upon receipt of notification of permit coverage and _
pnor to commencement of operations _
21) Are vehicle maintenance activities (VMA) occurring or planned at this facility? ❑ No 1X 'es
If yes, does your VMA area discharge into your wastewater treatment device? ❑ No ❑ Yes
Other/Permitnnn
22) Does this facility have a Division of Land Resources Erosion & Sedimentation Control (E&SC) Permit9
X NX) ❑ Yes
If yes, list the permit numbers for all current E&SC permits for this facility
23) Is your facility subject to Phase II Post -Construction Area? ❑ Yes
If yes, who is the permitting authority?
IX No
24) Is your facility located in one of the 20 Coastal Counties? ❑ Yes X No
Is your facility adding more than 10,000 fe of built upon area or CAMA Major Permit? ❑ Yes X No
(1) The concrete batch plant will be contained entirely in the project footprint for the U 2579B project in Forsyth County This
E&SC permit for the U 2579B project was approved by the NCDOT Roadside Environmental as part of NCDOT s Delegated
Erosion Control Program, not the Division of Land Resources Any changes required by the addition of the concrete batch
plant will be reviewed by the NCDOT Resident Engineers office and NCDOT Roadside Environmental
Page 5 of 7
SWU 229 07122011 Last revised 712/14

NCG140000 N O 1
25) Is your facility discharging wastewater (treated or untreated) such as water from wetting of aggregate piles,
is drum rinse -out, or vehicle and equipment cleaning to a stormwater BMP9 ❑ No IX Yes
If yes, please attach your approval from the permitting authority to do so
26) Does this facility have any other NPDES permits > 1X No ❑ Yes
If yes, list the permit numbers for all current NPDES permits for this facility
27) Does this facility have any Non -Discharge permits (ex recycle permits)) X No ❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility
28) 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?
X No ❑ Yes
c) Is this facility a Large Quantity Generator (1000 kg or more of hazardous waste generated per month) of
hazardous waste?
d)
•
X No ❑ Yes
Type(s) of waste Not a Generator of hazardous waste
How is material stored
Where is material stored
How many disposal shipments per year
Name of transport 1 disposal vendor
Vendor address
Final Checklist
This application will be returned as incomplete unless all of the following items have been included
X Check for $100 made payable to NCDENR
WI
X This completed application and all supporting documentation See Question 10
❑ If an Erosion & Sedimentation Control (E&SC) Plan is required from Division of Land Resources (DLR)
or local designee documentation verifying applicant has developed and submitted that Plan to the
governing agency (required per 15A NCAC 02H 0138)
" ,� f IX Two (2) site plans depicting the site plan with numbered outfalls which indicate stormwater and wastewater
l outfalls See Question 10
IX A county map or USGS quad sheet with location of facility clearly marked
29) Signatory Requirements (per 40 CFR 122 22)
Ail applications reports or information submitted to the Director shall be signed and certified
a All notices of intent to be covered under this General Permit shall be signed as follows
(1) For a corporation by a responsible corporate officer For the purpose of this permit a responsible corporate officer means (a) a president
secretary treasurer or vice president of the corporation in charge of a pnncipal business function or any other person who performs similar
policy or decision making functions for the corporation or (b) the manager of one or more manufacturing production or operating facilities
is employing more than 250 persons or having gross annual sales or expenditures exceeding 25 million (in second quarter 1980 dollars) 4
authority to sign documents has been assigned or delegated to the manager in accordance with corporate procedures
(2) For a partnership or sole proprietorship by a gene4 partner or the proprietor respectively or
(3) For a municipality state federal or other public agency by either a principal executive officer or ranking elected official
Page 6 of 7
SWU 229 07122011 Last revised 712114

s
NCG140000 N O 1
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 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 knowngly renders inaccurate
any recording or monitoring device or method required to be operated or maintained under this Article or rules of the [Environmental
Management] Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a Tine not to exceed ten
thousand dollars ($10 000)
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 Jose Ignacio Martin Alos
Title
(Signature of Applicant) r \� (Date Signed)
Notice of Intent must be accompanied by-6
Mad the entire package to
Stormwater Permitting Unit Program
Division of Energy Mineral and land Resources
1612 Mail Service Center
Raleigh North Carolina 27699-1612
or money order for $100 00 made payable to NCDENR
Note
The submission of this document does not guarantee the issuance of an NPDES permit
For questions, please contact the DEMLR Regional Office for your area
DEMLR Regional Office Contact Information
Asheville Office
[phone]
Fayetteville Office
[phone]
Mooresville Office
[phone]
Raleigh Office
[phone]
Washington Office
[phone]
Wilmtngton Office
[phone]
Winston-Salem
[phone]
Central Office
[phone]
Page 7 of 7
SWU 229 07122011 Fast revised 712114

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Storm and Process Water Management
Stormwater
The 5 8 acre site will be graded into two drainage areas, one containing the plant operations, the other
containing the stock piles The entire site will drain into a perimeter Swale that will encompass the site
The perimeter swale will be lined with silt fence and contain check dams to provide initial treatment
5tormwater collected by the swale will discharge into one of the two settling basins for secondary
treatment The basins will discharge through additional check dams for final treatment prior to
discharge into the NCOOT roadway drainage system
Process water
Process water will be generated at three sources 1) the mixer drum, 2) truck concrete washout and 3)
the stock piles The small volumes of washout generated by cleaning the mixer will be collected in the
bucket of a front end loader and deposited in the truck concrete iYashout pit The truck concrete
washout pit will be constructed of concrete and consist of three bays with weirs to clarify the washout
The first bay will accept truck and mixer drum washout and discharge over a weir into the second bay
which will provide primary clarification and discharge over a weir to the third bay for tertiary treatment
Depending on need, flocculent may be used in the third bay to facilitate settling of fines Upon final
clarification, pH will be treated in the third bay to within discharge limits using a CO2 pump injection
system if required The treated water will be piped to the settling basin located on the site's southeast
corner for discharge
40

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BATCH PLANT PROPOSED AREAS
TOTAL AREA = 5 853 acres
MATERIAL STORAGE AREA = 1 029 acre
IMPERVIOUSAREA =0571acres �""UNL
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PERCENT IMPERVIOUS AREA ,\
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DNpE oY� paNw,,,nv� I r WINSTON SALEM NORTHERN BELTWAY &2016 llSIrEFLAN
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Winston Salem r Forsyth County
0 /bo
IIItili
untyytoes
Sewer r Solid Waste Disposal
Utilities
Administration
W Scott Gallman, P E
Project Engineer-Dosion Contiol
Cat)orWinuonSalcni
Diagados-USA
r a Box 2511
775 Robbins Pei ch TI atl
Winston Salem N( 27102
CnyLt.k3it(3367278000)
Kenietsvtllc NC 27284
Fax [phone]
!r !Y![i!r!j'nflY! erg
December 12, 2016
Dear Mr Gallman
The City/County Utilities (CCU) of Winston-Salem and Forsyth County
has received your request for permission to tie Into the sewer systern for
the purpose of discharging wastewater genet ated at the Northern Beltway
highway project in the Kernetsville/Walker town aica This discharge
would be waste generated by a temporary concrete batch plant In an
email, you Indicated that most of the wastewater would be stoirnwater
witli some grit It appeats that most of the girt would be removed through
vegetated swales and a settling basin this treatment should produce
iclatively clean storinwatei Unfortunately, the Sewer Use Ordinance of
the City of Winston-Salem (Article IV, Section 46, A Genetal
Prohibitions) specifically piohtbits the discharge of stormwatei into the
sanitary sewet system
Unfoitunately, the CCU is unable to giant your request for a sanitaty
sewei tie -on
(hank you foi your support and coopetation of the Industtial Waste
Contiol Piogiam of the CCU If you have any futther questions of
concerns, please feel flee to contact me at 336 397 7619 of by email at
inonicah@cityofws oig
Srnccr ly,
i t
Monica W Hayes
Industrial Waste Contiol Supeivisoi
n
City Caunnh T[tt ne Alba) urn N. uu 11 Nude Nhyr r I, i r Inn N--bent Hurd ❑ m r Il A I rmt N nl \Yard Dan M- Saud i H nI It hcts t„ (I k \\ ra \\aid
John larutn 4+nrh\\art 101 hl iclninch Nnrihncac\\un1 Dcminl Mnmg 1ma7 Fjrr Hui Jamn'isl lnr 1, Stuthcatr\l ini OiyMmagn Icc 17 (rmn
G= ForMhCaungCommlu3onentDA,idR irl)icrChauman Don Martin Vice Chair Ted Kaplan Richard\ 11nvdlrWa&rMarshall ClomD Whisenhunt Fxretic\Vsherspoon
Call 311 or 336 727 8000 Lowity \iamger L%.&y War. Jr
Clt 11nk Cit t7IW$Or cdtylCauntylluhtjrCammiaJomllaiitNcdI Ouirn t Randall lutd \uishatr\\cdgCurt. Jr IlamldI Day lurn(n11tn 11-IdIt, Ifolmi lhurr.lup
y Y 9 NO S M C dI Ch... I ukn Jim Ruffin Ilunafd R Sr our

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L clergy, Min rr a!
and t and Resources
ENVIRONMENTAL QUALITY
January 12, 2017
Memot andum
To Regional Water Supply Supervisor, DWR Public. Water Supply Section
From Richard Riddle, Jr, DEMLR Stormwater Pet mitting Program
Subject Review of the discharge location fol. the following
Dragados USA
ROW near SR158 (See application)
Kernersville, NC 27284
Forsyth County
NCG140450
ROY (00PF'R
i rlllilr
W II. LIAM G R055, JR
4 fin S'rr Inn
TRACY l DAMS
Reported receiving water Lowery Mill Creek & Martin Mill Creek (WS-III)
Please indicate youi agency's position on the facility listed above Attached is the staff report or other
application infot mation for this facility We cannot issue the permit without your concurrence Please
return this foi m at your earliest convenience
RESPONSE
Q--�Thls agency has reviewed the draft permit and determined that the, proposed dischaige will not be
sufficiently close to ally existing or known pioposed public watei supply intalce so as to create an
advei se. effect on water quality We concur with the issuance of this perimit, provided the facility
is operated and maintained properly, the stated effluent limits are met prior to discharge, and the
discharge does not contiavene the designated water quality standards
❑ Concurs with issuance of the above permit, provided the following conditions arc met
❑ Opposes the, issuance, of the above, permit, based on reasons staled below (of attached)
Signed , Date 1
Y� 7Era�,:Ll 1-3 9 y►- F
cc Stonnwater Petinitting Pi ogratTiFiles (919oG. i,t9,.-*.Tek � LsPP�``ff
Attachment j iti^S-PA) -5 ALEM, RECTIoN/krr
Stale of Nurth Corohnn I Lnvitunmcntal Quuluy I Lnerfy Muicml and Lnnd Resw%cs
1612 Mad 51; VILL e,a,gtcr 1 512 Nrntih Sabsbury Sorel I Rak igh NC 27699 1612
919 707 9200 T

NCDENR
NO— Cw ccrrrrrr o-
EMM .rM —0 Nr — A +
NOTICE OF INTENT
Division of Energy, Mineral and Land Resources
Land Quality Section
National Pollutant Discharge Elimination System
NCG140000
FOR AGENCY USE ONLY
Date Recemed
Year
Month
Da
Cendicate of Coveta c
Chick #
Amount
Pemut Asst ed to
3 If
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG140000
STORMWATER AND PROCESS WASTEWATER DISCHARGES associated with activities classified as
SIC (Standard Industrial Classification) Code 3273 and like activities - Ready Mixed Concrete
This NOI may be an application to discharge process wastewater NCG140000 contains effluent limitations for
process wastewater discharges Wastewater discharges must meet the requirements of these effluent
limitations An exceedence of any of these limitations will result in a violation of the permit conditions
For questions, please contact the DEMLR Central Office or Regional Office in your area (See page S)
(Please print or type)
1) Mailing address of owner/operator (official address to which all permit correspondence will be
mailed) (Please print or type all entries in this application form )
Legal Owner Name Dragados USA
t (Please attach the most recent Annual Report to the NC Secretary of state showing the current legal name Alternatively this
i permit can be given to an individual)
Signee s Name (as signed for in question 29 below) .lose Ignacio Martin Alos
Street Address 4600 Marriott Drive, Suite 140
City Raleigh State ZIP Code 27560
Telephone No 404-702-1030 Email immartinalosb@dragados-usa corn
Alternate Contact Name Email (if different)
Alternate Contact Telephone (if different)
i� Location of facility producing discharge
Facility Name
Facility Contact
Street Address
City
County
Telephone No
Temp Concrete Batch Plant - Winston Salem
Angel Crespo Alonso QC ES _
775 Robbins Perch Trail -
Kernersville
336-782 8994
3) Physical location information O iL , 19410 `
I
Please provide narrative directions to the facility (use street names, state road numbers, and distance and
/direction from a roadway intersection) SR 158, 1,500 feet north of the SR 158/Old Belews Creek
F Road intersection
State NC ZIP Code 27284
Fax � r
(A copy of a county map or USGS quad sheet vwth facility clearly located on the map is a required part of this application)
V4Latitude 360 8'39 09"N Longitude 80' 9r23 08"W (deg, min, sec)
5) This NPDES Permit Application applies to the following (check all that apply)
-� IX New or Proposed Facility Date operation is to begin MARC H 4 2017
❑ Existing Facility
Permit #
Page 1 of 7
SWU 229 11 D32011 Last revised 712114

NCG140000 N O 1
6) Consultant's application information Please direct technical questions to
Consultant David Schuster
Consulting Firm _ Zac kru Con OrVt+i orl Corp
Mailing Address 9O
city Morr�Suii){ y
State im G Zip Code
Phone [phone] _ _ Fax (�
Email el atoid ,c6isiere-x4ehr�eorp. co&I
(Optional)
Staple Business Card Here
7) Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary
industrial activity at this facility
SIC Code 1611
8) Provide a brief description of the types of industrial activities and products produced at this facility
(Attach a site diagram showing the process areas present at this facility)
-Temporary concrete batch plant for concrete production to serve construction of a connector road between
SR158 and Business 1-40 for SCOOT _
Stormwater Discharge, Wastewater Treatment & Discharge and Permitting Information
9) Discharge points / Receiving waters
Number of discharge points (ditches, pipes, channels, etc ) that convey stormwater and/or wastewater from
the property
Stormwater-only a Wastewater only 0 Wastewater Commingled with Stormwater 2
For new facilities Expected date of commencement of discharge February 2017
What is the name of the body or bodies of water (creek, stream, river, lake, etc ) that the facility stormwater
and/or wastewater discharges end up in?
Receiving water classification(s), it known
Lowery Mill Creek and Martin Mill Creek
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)
Will this facility discharge wastewater to SA (Shellfishing) waters? ❑ Yes X No
Note Discharge of process wastewater to receiving waters classified as WS-II to WS-V or SA must
be approved by the N C Division of Water Resources, Public Water Supply Section If QWR
does not approve, coverage under NCG140000 cannot be granted No new discharges of
process wastewater are permitted in receiving waters classified as WS-I or freshwater ORW
10) Each applicant shall provide the following Information (attach additional sheets as necessary)
• Two (2) site plans depicting the facility or site with numbered outfalls which indicate stormwater and
wastewater outfalls The plans shall legibly show at a minimum, (existing or proposed)
o Outline of drainage areas with topographical lines and features
o Stormwater/wastewater treatment structures
a Location of numbered stormwater/wastewater cutfalls (corresponding to which drainage areas)
o Runoff conveyance structures
o Areas and acreage where materials are stared
o Impervious area acreages
o Location(s) of streams and/or wetlands the site is draining to, and any applicable buffers
o Site property lines, North Arrow, and bar scale
Page 2 of 7
SWU 229 07122011
Last revised 712/14

NCG140000 N O 1
M
V
o If applicable, the 100-year floodpla[n lime
a Acreage of each stormwater and wastewater topographical area
o Each of the facilities wastewater or stormwater source and discharge structures and each of its
hazardous waste treatment, storage, or disposal facilities
o Site location (insert)
Site plans shall be 24" x 36" In size
• Line drawing and description Aline drawing of the water flow through the facility A pictorial
description of the nature and amount of any sources of water and any collection and treatment measures
• A narrative description and identification of each type of process, operation, or production area which
contributes wastewater to the effluent for each outfall, and a description of the treatment the wastewater
receives (or will receive), including the ultimate disposal of any solid or fluid wastes other than by
discharge Processes, operations, or production areas may be described in general terms (e g "ash
silo")
11) Does the applicant have any unresolved Notice of Violations (NOVs)?
I X No ❑ Yes
Wastewater
12) What types of wastewater does your facility generate or discharge)
"type of Authorized Wastewater
Generate
ak Discharge
Sent to UVW '
Treatnment
* r
System,
Vehicle and a ui ment cleaning VE
Cl
❑
Cl
Wetting of raw material stockpiles RM
X
i
X
❑
Mixing drum cleaning MD
X
X
❑
Further explanation, if necessary
13) Will your facility spray -down or actively wet aggregate piles'
❑ No X Yes
14) Does the facility use any of the following on site9
❑ Phosphorus -containing Detergents
❑ Brighteners ❑ Other Cleaning Agents
❑ Non Phosphorus containing Detergents
❑ Other
15) Are wastewater treatment facilities planned in the 100-year flood plain's
X No ❑ Yes
16) Does your facility use or plan to use a recycle system, or recycle components in your treatment system?
❑ Yes X No
If yes, what size storm event is the system designed to hold before overflowing? (for example, I0-yr, 24-hr)
year, 24-hr rainfall event
5W U 229 07122011
Page 3 of 7
Last revised 7/2/14

N CG 140000 N O 1
17) Will your facility build a closed -loop recycle system that meets design requirements in 15A NCAC 02T
1000 and hold your facilities' working volume'?
❑ Yes X No
Will your facility discharge wastewater to surface waters
X Yes ❑ No
If the facility's treatment system meets the design requirements of 15A NCACO2T 1000 (including
holding the 25-year, 24-hour storm plus one foot of freeboard), holds the working volume of your site,
and does not discharge wastewater to surface waters, you may not be required to obtain an NPDES
permit for wastewater discharges if you believe this is the case, please contact DEMLR's Aquifer
Protection Section Land Application Unit Central Office Supervisor or staff (1636 Mari Service Center,
Raleigh, NC 27699-1636) for more information on obtaining the necessary permits or approvals if you will
discharge wastewater or slormwater to surface waters, please continue to apply for a permit to discharge
associated with ready -mixed concrete or like operations under NCG140000 For further questions, please
contact DEMLR's Stormwater Permitting Unit Staff
18) A wastewater treatment alternatives review is required by 15A NCAC 2H 0105 (c)(2) for any new or
expanding water pollution control facility s discharge in North Carolina You may attach additional sheets
a) What wastewaters were considered for this alternatives review? © VE ❑ RM X MD
b) Connection to a Municipal or Regional Sewer Collection System
i) Are there existing sewer lines within a one -mile radius? X Yes El No
(1) If Yes, will the wastewater treatment plant (WWTP) accept the wastewater? ❑ Yes IX No
1 (a) If No, please attach a letter documenting that the WWTP will not accept the wastewater
(b) If Yes, is it feasible to connect to the WWTP? Why or why not?'
c) Closed -loop Recycle System (must meet design requirements of 15A NCAC 2T 1000)
i) Are you already proposing a closed -loop recycle system (CLRS)? ❑ Yes X No
(1) If Yes, contact DEMLR's Aquifer Protection Section s Land Application Unit
(2) If No, is this option technologically feasible (possible)? Why or why not?*
End product specification restrict reuse of wastewater
(3) 1f No, is it feasible to build a CLRS on your site? Why or why not?*
Small volumes of wastewater produced render infeasible closed loop recycling
systems
(4) What is the feasibility of building a CLRS compared to direct surface water discharge?*
Small volumes of wastewater and the temporary nature of the facility render
infeasible closed loop recycling systems
d) Surface or Subsurface Disposal System (e g , spray irrigation)
Ui) Is a surface or subsurface disposal technologically feasible (possible)? ❑ Yes X No
1 See DWQ s Aquifer Protection Section Land Application Unit s Water Balance Calculation Policy for more information on DWO LAU s
website hito I/portal ncdenr orolweblw /c{/a sAaulpolices for more information
Page 4 of 7
SWU 229 07122011 Last revised 712114

NCG140000 N O 1
Why or Why not? Small volumes of washout water and the temporary nature of the facility render
Infeasible surface or subsurface systems
ii) Is a surface or subsurface disposal system feasible to implamenr?* ❑ Yes IX No
Why or Why not? Small volumes of washout water render infeasible surface and subsurface systems
What is the feasibility of employing a subsurface or surface discharge as compared to a direct
discharge to surface waters?'
Small volumes of washout water and the temporary nature of the facility render
infeasible surface or subsurface systems
e) Direct Discharge to Surface Waters Is discharge to surface waters the most environmentally sound
alternative of all reasonably cost-effective options of the wastewaters being considered?' X Yes ❑ No
ij if No, contact DEMLR's Land Application Unit to determine permifng requirements
f) If this review included all wastewater discharge types, would excluding some types (e g �aw
stockpile wetting) Mane any of the above non -discharge options feasible? ❑ Yes X No
" You may be asked to provide further information to support your answers to these questions after the initial review
Feasibility should take into account initial and recumng costs
Stormwater
19) Does this facility employ any best management practices for Stormwater controll ❑ No X Yes
If yes, please briefly describe _Refer to attached Process Description
20) Does this facility have a Stormwater Pollution Prevention Plans ❑ No X Yes
If yes, when was it implemented? Will be implemented upon receipt of notification of permit coverage and
prior to commencement of operations _
21) Are vehicle maintenance activities (VMA) occurring or planned at this facility? ❑ No IX 'es
If yes, does your VMA area discharge into your wastewater treatment device? ❑ No ❑ Yes
Other/Permlttin
22) Does this facility have a Division of Land Resources Erosion & Sedimentation Control (E&SC) Permit?
X NoM ❑ Yes
If yes, list the permit numbers for all current E&SC permits for this facility
23) Is your facility subject to Phase II Post -Construction Area? ❑ Yes IX No
If yes, who is the permitting authority?
24) Is your facility located In one of the 20 Coastal Counties? ❑ Yes X No
Is your facility adding more than 10,000 fe of built -upon area or CAMA Major Permit? ❑ Yes X No
(1) The concrete batch plant will be contained entirely in the project footprint for the U-2579B project in Forsyth County This
E&SC permit for the U 2579B project was approved by the NCDOT Roadside Environmental as part of NCDOT s Delegated
Erosion Control Program not the Division of Land Resources Any changes required by the addition of the concrete batch
plant will be reviewed by the NCDOT Resident Engineers office and NCDOT Roadside Environmental
Page 5 of 7
SWU 229 07122011 Last revised 712114

NCG140000 N O 1
25) Is your facility discharging wastewater (treated or untreated) such as water from wetting of aggregate piles,
r1 drum rinse -out, or vehicle and equipment cleaning to a stormwater BMPI ❑ No IX Yes
If yes, please attach your approval from the permitting authority to do so
26) Does this facility have any other NPDES permits9 IX No ❑ Yes
If yes, list the permit numbers for all current NPDES permits for this facility
27) Does this facility have any Non -Discharge permits (ex recycle permits)' X No ❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility
28) 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?
X No ❑ Yes
c) Is this facility a Large Quantity Generator (1000 kg or more of hazardous waste generated per month) of
hazardous waste?
d)
X No ❑ Yes
Type(s) of waste Not a Generator of hazardous waste
How Is material stored
Where is material stored
How many disposal shipments per year
Name of transport / disposal vendor
Vendor address
Final Checklist
This application will be returned as incomplete unless all of the following items have been included
X Check for $100 made payable to NCDENR
X This completed application and all supporting documentation See Question 10
❑ It an Erosion & Sedimentation Control (E&SC) Plan is required from Division of Land Resources (DLR)
or local designee documentation verifying applicant has developed and submitted that Plan to the
governing agency (required per 15A NCAC 02H 0138)
=i IX Two (2) site plans depicting the site plan with numbered outfalls which indicate stormwater and wastewater
1 — outfalls See Question 10
IX A county map or USGS quad sheet with location of facility clearly marked
29) Signatory Requirements (per 40 CFR 122 22)
All applications reports or information submitted to the Director shall be signed and certified
a All notices of intent to be covered under this General Permit shall be signed as follows
(1) For a corporation by a responsible corporate officer For the purpose of this permit a responsible corporate officer means (a) a president
secretary treasurer or vice president of the corporation in charge of a principal business function or any other person who performs similar
policy or decision making functions for the corporation or (b) the manager of one or more manufacturing production or operating facilities
employing more than 250 persons or having gross annual sales or expenditures exceeding 25 million (in second quarter 1980 dollars) if
authority to sign documents has been assigned or delegated to the manager +n accordance with corporate procedures
(2) For a partnership or sole proprietorship by a general partner or the proprietor respectively or
(3) For a municipality state federal or other public agency by either a principal executive officer or ranking elected official
Page 6 of 7
5wU 229 07122011 Last revised 712114

V
NCG140000 N O 1
Certification North Carolina General Statute 143-215 6 B(i) provides that
Arty person who knowingly makes any false statement representation or cerlification in any apptication 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 [Environmental
Management] 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)
1 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 Signin
Title s ki , t .0 a V
(Signature of Applicant j
Notice of Intent must be accompanied byre
Mail the entire package to
Stormwater Permitting Unit Program
Division of Energy, Mineral and Land Resources
1612 Mall Service Center
Raleigh North Carolina 27699-1612
Ignacio Martin Alos
It i(, it,
(Date Signed)
5--money order for $100 00 made payable to NCDItNR
Note
The submission of this document does not guarantee the issuance of an NPDES permit
For questions, please contact the DEMLR Regional Office for your area
DEMLR Re tonal Office Contact Information
Asheville Office
[phone]
Fayetteville Office
[phone]
Mooresville Office
[phone]
Raleigh Office
[phone]
Washington Office
[phone]
Wilmington Office
[phone]
Winston-Salem
[phone]
Central Office
[phone]
Page 7 of 7
5WU 22"7122011 Last revised 7i2114

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Site Location
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n Storm and Process Water Management
Stormwater
The 5 8 acre site will be graded into two drainage areas, one containing the plant operations, the other
containing the stock piles The entire site will drain into a perimeter swale that will encompass the site
The perimeter swale will be lined with silt fence and contain check dams to provide initial treatment
Stormwater collected by the swale will discharge into one of the two settling basins for secondary
treatment The basins will discharge through additional check dams for final treatment prior to
discharge into the NCDOT roadway drainage system
Process water
Process water will be generated at three sources 1) the mixer drum, 2) truck concrete washout and 3)
the stock piles The small volumes of washout generated by cleaning the mixer will be collected in the
bucket of a front end loader and deposited in the truck concrete washout pit The truck concrete
washout pit will be constructed of concrete and consist of three bays with weirs to clarify the washout
The first bay will accept truck and mixer drum washout and discharge over a weir into the second bay
which will provide primary clarification and discharge over a weir to the third bay for tertiary treatment
Depending on need, flocculent maybe used in the third bay to facilitate settling of fines Upon final
clarification, pH will be treated in the third bay to within discharge limits using a CO2 pump injection
system if required The treated water will be piped to the settling basin located on the site's southeast
corner for discharge
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TOTAL AREA = 5 853 acres
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MATERIAL STORAGE AREA = i Q29 acre�,
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,0 This check Gears through Posltfve Pay
.,r, Zactiry Constructaon`Corporatian "'�- '"� _ '' " " ` f; Date 12 20I16 ` _-314401
` P 0 Box 33240 - ` ' 641278
;, r�r t y 4 "q
San Antonia TX 78248+ Bank of America
o w � - �- - -
+ tF i" i Atlanta oeKatbCounty Georgia , 611 L
ZACHRY 210 s�1 2�ao
ONE HUNDRED AND 001100 ' �� �i p� ; ; Y T . ; ; n*H , ^
Pay Dollars ,
100 ao
VOID AFTER 180 DAYS? +� `
Y The -` NC Dept of Environmental Quality
Order Div of Energy Mineral4& Land Resource�q,HST�y
_ 1612 Mail Service Center �a
t , NC 27699-1612� 4/
Of
Raleigh�
jri'� �4 Authorized $ignatufe5 tN,`