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HomeMy WebLinkAboutNCG180255_COMPLETE FILE - HISTORICAL_20180612PERMIT NO. DOC TYPE STORMWATER DIVISION CODING SHI NCG PERMITS HISTORICAL FILE MONITORING REPORTS DOC DATE ❑ �,p� � YYYYMMDD ® ROY COOPER Governor Energy, Mineral and Land Resources ENVIRONMENTAL QUALITY June 12, 2018 Ferguson Copeland LLC DBA Chaddock Home Attention: Nikki Cucina 100 Reep Drive Morganton, North Carolina 28655 Subject: Compliance Evaluation Inspection Permit: NCG180255 Burke County, North Carolina Dear Mrs. Cucina: MICHAEL S. REGAN Secretary WILLIAM E. VINSON, JR Interim Director Enclosed please find a copy of the Compliance Evaluation Inspection Report for the inspection I conducted at the subject facility on June 5, 2018. The report should be self-explanatory; however, should you have any questions concerning this report, please do not hesitate to contact me at (828) 296-4500 or by email at Isaiah.reed@ncdenr.gov. Enclosure: Inspection Report Sincere , Isaiah Reed, CEPSCI Environmental Specialist Land Quality Section State of North Carolina I Environmental Quality I Energy, Mineral and Land Resources 2090 US 70 Highway j Swannanoa, NC 28779-821 I 828 296 4500 S Compliance Inspection Report Permit: NCG180255 Effective: 07121117 Expiration: - 08/31/19 Owner; Ferguson Copeland LLC DBA Chaddock Home SOC: Effective: Expiration: Facility: Chaddock Home county: Burke 100 Reep Dr Region: Asheville Morganton NC 28655 Contact Person: James Kennedy Title: Phone: 828-584-0664 Directions to Facility: from westbound i-40 take exit 100, continue across jamestown rd onto reep dr, turn right to continue on reep dr, the facility is located on the right, approximately 600 feet west of the intersection of jamestown rd and reep dr. System Classifications: Primary ORC: Certification: Phone: Secondary ORC(s): On -Site Representative(s): Related Permits: Inspection Date: 06/0512018 Entry Time: 02:00PM Exit Time: 0100PM Primary Inspector_ Isaiah L Reed Phone: 828-296-4614 Secondary Inspector(s): Reason for inspection: Routine Inspection Type: Compliance Evaluation Permit Inspection Type: Furniture and Fixtures Stormwater Discharge COC Facility Status: 0 Compliant ❑ Not Compliant Question Areas: ■ Storm Water (See attachment summary) Page: 1 Permit: NCG180255 Owner- Facility: Ferguson Copeland LLC ❑SA Chaddock Home Inspection hate: 0610512018 Inspection Type : Compliance Evaluation Reason for Visit: Routine Inspection Summary: On June 5, 2018 this facitlity was inspected for compliance. I met with Nikke Cucina, Thomas Parlier, and Richard Creson on site. During the inspection, the following items were noted. 1) General housekeeping around the exterior of the facility should be implemented further. 2) Erosion was occuring at the outfall on the far North perimeter of the site. The outfall areas should be cleaned up and stabilized to allow for better sampling. Wage: 2 • Permit: NGG 180255 Owner - Facility: Ferguson Copeland LLC DBA Chaddock Home Inspection pate: 06/0512018 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? ®❑ 110 # Does the Plan include a General Location (USGS) map? ® ❑ ❑ ❑ # 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? ®❑ ❑ ❑ # Has the facility evaluated feasible alternatives to current practices? ®❑ ❑ ❑ # Does the facility provide all necessary secondary containment? ®❑ ❑ ❑ # 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? ® ❑ ❑ ❑ # Does the facility provide and document Employee Training? ® ❑ ❑ ❑ # Does the Plan include a list of Responsible Party(s)? ®❑ ❑ ❑ # Is the Ptan reviewed and updated annually? ®❑ ❑ ❑ # Does the Plan include a Stormwater Facility Inspection Program? ®❑ ❑. ❑ Has the Stormwater Pollution Prevention Plan been implemented? ® ❑ ❑ ❑ Comment: Qualitative Monitoring Yes No NA NE Has the facility conducted its Qualitative Monitoring semi-annually? ®❑ ❑ ❑ Comment: Permit and Outfalls Yes No NA NE # Is a copy of the Permit and the Certificate of Coverage available at the site? ® ❑ ❑ ❑ # Were all outfails observed during the inspection? N ❑ ❑ ❑ # If the facility has representative outfall status, is it properly documented by the Division? ❑ ❑ ■ ❑ # Has the facility evaluated all illicit (non stormwater) discharges? N ❑ ❑ ❑ Comment: Page: 3 Compliance Inspection Report Permit: NCG180255 Effective: 07/21/17 Expiration: 08/31/19 Owner: Ferguson Copeland LLC DBA Chaddock Home SOC: Effective: Expiration: Facility: Chaddock Home County: Burke 100 Reep Dr Region: Asheville Morganton NC 28655 Contact Person: James Kennedy Title: Phone: 828-584-0664 Directions to Facility: from westbound i-40 take exit 100, continue across jamestown rd onto reep dr, turn right to continue on reep dr, the facility is located on the right, approximately 600 feet west of the intersection of jamestown rd and reep dr. System Classifications: Primary ORC: Certification: Phone: Secondary ORC(s): On -Site Reprose ntative(s): Related Permits: Inspection Date: 06/05/2018 Entry Time: 02:OOPM Exit Time: 03:OOPM Primary Inspector: Isaiah L Reed Phone: 828-296.4614 Secondary Inspector(s): Reason for Inspection: Routine Inspection Type: Compliance Evaluation Permit Inspection Type: Furniture and Fixtures 5tormwater Discharge COC Facility Status'. Compliant ❑ Not Compliant Question Areas: Storm Water {See attachment summary) Page: 1 f� J permit: NCG18€1255 Owner • Facility: Ferguson Copeland LLC DBA Chaddock Home Inspection Date: 06/0512018 Inspection Type: Compliance Evaluation Reason for Visit: Routine Inspection Summary: On June 5, 2018 this facitlity was inspected for compliance. I met with Nikke Cucina, Thomas Parlier, and Richard Creson on site. During the inspection, the following items were noted. 1) General housekeeping around the exterior of the facility should be implemented further. 2) Erosion was occuring at the outfail on the far North perimeter of the site. The outfall areas should be cleaned up and stabilized to allow for better sampling. Page: 2 Permit: NCG180255 Owner - Facility: Ferguson Copeland LLC DBA Chaddock Home Inspection Date: 06/05/2018 Inspection Type : Compliance EvaluatlOn Reason for Visit: Routine Stormwater Pollution Prevention Plan Yes No NA NE Does the site have a Stormwater Pollution Prevention Plan? ■ ❑ ❑ ❑ # 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? ■ ❑ ❑ ❑ # 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? 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? 0 ❑ ❑ ❑ Has the Stormwater Pollution Prevention Plan been implemented? 0 ❑ ❑ ❑ Comment Qualitative Monitoring Yes No NA NE Has the facility conducted its Qualitative Monitoring semi-annually? ■ ❑ ❑ ❑ Comment: Permit and Outfalls Yes No NA NE # Is a copy of the Permit and the Certificate of Coverage available at the site? 0 ❑ ❑ ❑ # Were all outfalls observed during the inspection? 0 ❑ ❑ ❑ # 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 Central Files: APS _ SWP _ 7/20/2017 Permit Number C— NCGI80-255 Permit Tracking Slip Program Category Status Project Type NPDES SW In review New Project Permit Type Version Permit Classification Furniture and Fixtures Stormwater Discharge COC COC Primary Reviewer Permit Contact Affiliation Bethany, Georgoulias Coastal SWRule R..� 4�J Permitted Flow JUL 2 CENTRAL F1LEEi Facility DWR I NI Facility Name Major/Minor Region Chaddock Home Minor Asheville Location Address County 100 Reep Or Burke Facility Contact Affiliation Morganton NC 28655 James Kennedy PO Box 10 Owner Morganton NC 28680 Owner Name Owner Type Ferguson Copeland LLC DBA Chaddock Home Non -Government Owner Affiliation James Kennedy PO Box 10 Dates/Events Morganton NC 28680 Scheduled Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration ` 4/6/2017 �12 f U I7 7)7.i,lul 7 O 31'/ZDO Regulated Activities Requested /Received Events Furniture and fixtures manufacture RO staff report requested 6130117 RO staff report received 7119117 Outfall 001 Waterbody Name Streamindex Number Current Class Subbasin Little Silver Creek 11-34-7-(1) C 03-08-31 yAy Energy. Mineral & Land Resources ENVIRONMENTAL QUALITY July 21, 2017 Mr. James Kennedy Ferguson Copeland, LLC dba Chaddock Home P.O. Box 10 Morganton, NC 28680 Dear Mr. Kennedy: ROY COOPER Governor MICHAEL S. REGAN Secretary TRACY DAVIS Director Subject: General Permit. No. NCG 180000 Chaddock Home COC No. NCG180255 Burke County In accordance with your application for a discharge permit received on April 6, 2017, 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). Please take notice that this certificate of coverage is not transferable except upon approval of the Division of Energy, Mineral, and Land Resources. The Division of Energy, Mineral, and Land Resources 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 Resources, the Coastal Area Management Act, or any other federal or local government permit that may be required. Nothing Compares—,-,- SState of North Carolina Environmental Quality I Energy, Mineral and Land Resources 512 N. Salisbury Street W2 Mail Service Center I Rateigh, Nor1 h Carolina 27699-1612 919 707 g200 If you have any questions concerning this permit, please contact Bethany Georgoulias at telephone number (919) 807-6372 or by email bethany.geor off, uliasna ncdenr.gov. cc: Asheville Regional Office Stormwater Program Files DWR Central Files Sincerely, far Tracy E. vis, P.E., CPM, irector Division of Energy, Mineral, and Land Resources Nothing Compares_ State of North Carolina I Environmental Quality I Energy, Mineral and Land Resources 512 N. Salisbury Street 1 1612 Mail Service Center 1 Raleigh, North Carolina 27699-1612 919 707 9200 STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES GENERAL_PERMIT NO. NCG180000 CERTIFICATE OF COVERAGE No. NCG180255 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, Ferguson Copeland, LLC d/b/a Chaddock Home is hereby authorized to discharge stormwater from a facility located at Chaddock Home 100 Reep Drive Morganton Burke County to receiving waters designated as Little Silver Creek, a class C water in the Catawba River Basin, in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, I1, 1I1, and IV of General Permit No. NCG180000 as attached. This certificate of coverage shall become effective July 21, 2017. This Certificate of Coverage shall remain in effect for the duration of the General Permit. Signed this 211, day of July 9.017 for Director, Division of Energy, Mineral, and Land Resources By the Authority of the Environmental Management Commission Z, < �•\Jj cq- 9 . .. ........ .. ]DIne q, Ic Ac" 3- a vin 1Q1 NCGIS0255 N W E S Map Scale 1:24,000 J A ts aRN" r Kz� S/ Chaddock Home �74 11.241� z� J js U '11 Ferguson Copeland, LLC d/b/a Chaddock Home Latitude: 3511 43' 11" N Longitude: 811 45' 10" W County: Burke Receiving Stream: Little Silver Creek Stream Class: C Index Number: 11-34-7-(1) (Catawba River Basin) VA P Facility Location Energy, Mineral & Land Resources ENWRONMEWAL QUALITY July 21, 2017 Mr. James Kennedy Ferguson Copeland, LLC dba Chaddock Home P.O. Box 10 Morganton, NC 28680 Dear Mr. Kennedy: ROY COOPER Governor MICHAEL S. REGAN Secretary TRACY DAVIS Director Subject: General Permit No. NCG180000 Chaddock Home COC No. NCGIS0255 Burke County In accordance with your application for a discharge permit received on April 6, 2017, 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). Please take notice that this certificate of coverage is not transferable except upon approval of the Division of Energy, Mineral, and Land Resources. The Division of Energy, Mineral, and Land Resources 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 Resources, the Coastal Area Management Act, or any other federal or local government permit that may be required. Nothing Compares—,--- SState of North Carolina I Environmental Quality I Energy, Mineral and Land Resources 512 N. Salisbury Street 1 1612 Mail Service Center I Ralcigh, North Carolina 27b99.1612 919 707 9200 r If you have any questions concerning this permit, please contact Bethany Georgoulias at telephone number (919) 807-6372 or by email bethany.georgouliasPmcdenngov. cc. Asheville Regional Office Stormwater Program Files DWR Central Files Sincerely, ORIGINAL SIGNED BY BETHANY GEORGOULIAS for Tracy E. Davis, P.E., CAM, Director Division of Energy, Mineral, and Land Resources Nothing Compares State 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 ti STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES GENERAL PERMIT NO. NCG180000 CERTIFICATE OF COVERAGE No. NCG180255 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, Ferguson Copeland, LLC d/b/a Chaddock Home is hereby authorized to discharge stormwater from a facility located at Chaddock Home 100 Reep Drive Morganton Burke County to receiving waters designated as Little Silver Creek, a class C water in the Catawba River Basin, in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, I1, III, and IV of General Permit No. NCG180000 as attached. This certificate of coverage shall become effective July 21, 2017. This Certificate of Coverage shall remain in effect for the duration of the General Permit. Signed this 215t day of July 2017. SIGNED BY for Tracy E. Davis, P.E., CPM Director, Division of Energy, Mineral, and Land Resources By the Authority of the Environmental Management Commission LOCATION MAP: NCG180255 W E S M,3P SOIL- 1:24,000 Ferguson Copeland, LLC d/b/a Chaddock Home Latitude: 350 43' 11" N Longitude: 810 45'10" W County: Burke Receiving Stream. Little Silver Creek Stream Cass: C Index Number: 11-34-7-(1) (Catawba River Basin) Facility Location Georgoulias, Bethany From: Conway, Jean Sent: Wednesday, July 19, 2017 2:30 PM To: Georgoulias, Bethany Cc: Aiken, Stan E Subject: RE: NOI from Chaddock Home for NCG18 Bethany, Hope you are doing well. i did a site visit to this site and do not have any concerns for issuing this permit. They have a very clean site with much of their outside products under cover and they have a good SWPPP. I have not put in an inspection yet but will if we now counting NOI inspections in RIMS. Thanks, Jean From: Aiken, Stan E Sent: Friday, June 30, 2017 12:02 PM To: Conway, Jean <jean.conway@ncdenr.gov>; Riddle, Shawna <shawna.riddle@ncdenr.gov> Subject: FW: NOI from Chaddock Home for NCG18 Please take a look at the site and let me know your comments. Thank you for your help in this matter. Thank You, Stanley E Aiken Regional Engineer Land Quality Section North Carolina Department of Environmental Quality 828 296-4500 main 828 296-4610 office stan.aiken((Dncdenr.gov 2090 US70 Highway Swannanoa, NC 28778-8211 %'Nothing Compares Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed to thud parties. From: Georgoulias, Bethany Sent: Friday, June 30, 2017 12:00 PM To: Aiken, Stan E <stan.aiken@ncdenr.gov> Subject: NOI from Chaddock Home for NCG18 Sta n, We received the attached NOI for coverage under NCG180000 for the Chaddock Home facility in Morganton, Burke County. The site manufactures wood household furniture and discharges stormwater to Little Silver Creek, a class C water in the Catawba River Basin. Does the ARO have any objections to issuing a COC to this facility? Thanks, Bethany 13ethany Georgoulias 13nviroil mentaI 1 ngineer Stornlwater Program, Division of Lnergy, Mineral, and Land Resources N.C. Department. of Environmental Quality 919 807 6372 office bethany.eor�,oulias(7ncdenr.go_v 1612 Mail Service Center, Raleigh, NC 27699-1612 (mailing) 512 N. Salisbury Street, Raleigh, NC 27604 (location) Website: http://deg.ne.Lyov/about/divisions/energy-mineral-land-resources/stonnwater Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed to third parties. Permit Number NCG180255 Program Category NPDES SW Permit Type Furniture and Fixtures Stormwater Discharge COC Primary Reviewer Bethany.Georgoulias Coastal SWRule Permitted Flow Facility Facility Name Chaddock Hone Location Address 100 Reep Or Morganton NC 28655 Owner Owner Name Ferguson Copeland LLC DBA Chaddock Home Dates/Events Central Files: APS _ SWP 7/20/2017 Permit Tracking Slip Status Project Type in review New Project Version Permit Classification COC Permit Contact Aff illation Major/Minor Region Minor Asheville County Burke Facility Contact Affiliation James Kennedy PO Box 10 Morganton NC 28680 Owner Type Non -Government Owner Affiliation James Kennedy PO Box 10 Morganton NC 28680 Scheduled Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration 4/6/2017 W211U 17 ^! f 2,il All D{'33/,Zo I9 Regulated Activities Requested !Received Events ! Furniture and fixtures manufacture RO staff report requested 6/30/17 RO staff report received 7/19/17 Outfall 001 Waterbody Name Streamindex Number Current Class Subbasin Little Silver Creek 11.34.7-(1) C 03-08-31 19 harthickman SMARTER ENVIRONMENTAL SOLUTIONS Via 2"d Day FedEx April 4, 2017 NC DEQ — Stormwater Permitting Program Division of Energy, Mineral, and Land Resources 1612 Mail Service Center Raleigh, NC 27699-1612 Re: Notice of Intent for NCG 180000 Chaddock Home 100 Reep Drive Morganton, NC 28655 I-I&H .lob No. BDP-009 Dear Sir/Madam: Please find the attached Notice of Intent for coverage under Stormwater General Permit NCG 180000 for the above -site. If you have any questions, please feel free to contact me at 704.887.4620. Sincerely, Hurt & Hickman, PC ZVX44-to Matt Braniblett, PE Principal Enclosures Cc: Mr. Don Nielsen, BDP (via email) Mr. James Kennedy, Chaddock (via email) Ms. Anna Buckley. 1700 LLC (via email) RECEIVED APR 0 6 2017 DENR-L AND QUALITY STORMWATER PERMITTING 2923 South Tryon Street, Suite 100 3334 Hillsborough Street Charlotte, NC 28203 Raleigh, NC 27607 www.harthickman.corn 704.586.0007 main 919.847.4241 main WADivision of Energy, Mineral, and Land Resources 4 s Land Quality Section NCDENRNational Pollutant Discharge Elimination System rw.rror✓r .r ..vN4+mu rtr.�e..Kra ,\CG1.80 0 0 0 NOTICE OF INTENT National Pollutant Discharge Elimination System application for coverage under General Permit NCG180000: REMVED STORMWATER DISCHARGES associated with activities classified as: AN in 5 2017 SIC' 25 Furniture and Fixtures, and SIC 2434 Wood Kitchen Cabinets, And, Like activities deemed by DEMLR to be similar in the process, or the a A,ALITY materials, products, by-products, or waste materials. A MiiTING ' Standard Industrial Classification Code (Please print or type) 1) Mailing address of owner/operator (address to which official permit correspondence will be mailed): Name Ferguson Copeland, LLC dba Chaddock Home Street Address P.O. Box 10 City Morganton State NC ZIP Code 28680 Telephone No. 828 584-0664 Fax: E-mail address jkennedy@chaddockhome.com 2) Location of facility producing discharge: Facility Name Chaddock Home Facility Contact .lames Kennedy Street Address 100 Reep (give City Morganton State "c ZIP Code 28655 County Burke Telephone No. 828 584-0664 Fax: 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 frorn a roadway intersection). Fromwestbound I-Q, take exit 100. Condnueacross Jamestown Road onto Reep Drive. Turn right to continue on Reep Drive. The facility is located on the right, approximately 600 feet west of the intersection of Jamestown Road and Reep Drive. (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) F 4) Latitude 35' 43' 11" Longitude -81° 45' 10" (degrees, minutes, seconds) ��. �� 3 �� 5) This NPDES Permit Application applies to which of the following : � ! / ❑ New or Proposed Facility Date operation is to begin El 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: 2 5 1 1 7) Provide a brief narrative description of the types of Industrial activities and products manufactured at this faCility: The Chaddock facility manufactures wood household fumlture. Page 1 of 4 SWU-233.82814 Last revised 8/28/14 NCG180000 N.O.I. 8) Discharge points 1 Receiving waters: How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? 9) Receiving waters: What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater discharges end up in? Life Silver 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). 10) Does this facility have any other water quality permits? p No ❑ Yes If yes, list the permit numbers for all current water quality permits for this facility: 11) Does this facility have any Non -Discharge permits (ex: recycle permits)? I] No ❑ Yes If yes, list the permit numbers for all current Non -Discharge permits for this facility: 12) Does this facility employ any best management practices for stormwater control? ❑ No 0 Yes It yes, please briefly describe: The facility employs pollution prevention practices, which include spill prevention practices, Including maintaining a covered, diked storage area for hazardous wastes, using covered containers for sawdust collected at the site, and minimizing outdoor storage of materials. 13) Does this facility have a Stormwater Pollution Prevention Plan? ❑ No El Yes If yes, when was it implemented? ApH12017 14) Are vehicle maintenance activities occurring at this facility? Q No ❑ Yes 15) Hazardous Waste: a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? 0 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 c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of hazardous waste? 0 No ❑ Yes Page 2 of 4 SWU-233-82814 Last revised 8/28/14 NCG180000 N.O.I. d) If you answered yes to questions b. or c., please provide the following information: Types) of waste: Ignitable waste and spent non -halogenated solvents (D001, F003, F005) How is material Stored: Hazardous waste materials are stored in sealed 55-gallon drums Where i5 material stored: .Hazardous waste materials are stow in a mvgroa, ii&Aa arum storage area iooalu l along We eastern site DOunoary, P OO& of the ails bulldog, How many disposal shipments per year: 12 Name of transport 1 disposal vendor: clean Earth Vendor address: 402 Webster chapel Road f R(- 3S9b5' 16) 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 tine not to exceed $10,000, or by imprisonment not to exceed six months, or by both. (1a 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: J(5(me s 1KPJnYiejV Title: r Y, 3 (Signature Appficanf) (Date Signed) Notice of Intent must be accompanied by a c eck or money order for $100.00 made payable to: NCDENR. Final Checklist This application will be returned as incomplete unless all of the following items have been included. Please do not ask us to hold an incomplete application in anticipation of a check under separate cover. Z Check for $100 made payable to NCDENR [ This completed application, signed by the owner/operator, and all supporting documents Copy of county map or USGS quad sheet with the location of the facility clearly marked on the map Mail the entire package to: Stormwater Permitting Program Division of Energy, Mineral, and Land Resources 1612 Mail Service Center Raleigh, North Carolina 27699-1612 Please note: The submission of this document does not uarantee the issuance of an NPDES permit. Page 3 of 4 5WU-233.82814 Last revised 8/28/14 NCGI80000 N.O.I. For questions, please contact the DEMLR Central Office or Regional Office for your area. To visit our website, go to http://portal.ncdenr.org/web//rlstormwater DEMLR Regional_ Office Contact Information: Asheville Office ...... (828) 296-4500 Fayetteville Office ... (910) 433-3300 Mooresville Office ... (704) 663-1699 Raleigh Office ........ (919) 791-4200 Washington Office ...(252) 946-6481 Wilmington Office ... (910) 796-7215 Winston-Salem ...... (336) 771-5000 Central Office .........(919) 707-9220 Page 4 of 4 5W U-233-82814 Last revised 8/28/14 TO SURFACE "` V . T - - i 3 RAN FORM . f S �fi5 wARM�� ' . \ ,;+• ti' � _ i � OLITFALL TO SURFACE NSFORMEPS r • I' STORMWATER DRAINAGE CHANNEL is / HAZARDOUS WAS TORAGE EMPTY DRUM STD E k. � , � • � "fi: ' • � � Tyr s. �$' .Y �` • • ��r • OU t OF SERVICc a r 1 - � ..�i1 ,y r \ �w �f r • 0i0%L AS DUST COtLEC Ir' f BAGH4d5 en Alpine~� a t.�st�,-_ i .• Calvi n ---- �� SITE 5ti'06f. �r� a i 40 f� r. APPROXIMATE N 0 2000 4000 SITE LOCATION MAP CHADDOCKHOME SCALE IN FEET 100 REEP DRIVE MORGANTON, NORTH CAROLINA GLEN ALPINE, NC 1994 10 2923 S Tryon Street, Suite 100 hart 01• hickman Charlotte. MC28203 U.S G.S. QUADRANGLE MAP w 704 586 0007(p) 704.5860373(o 7.5 MINUTE SERIES (TOPOGRAPHIC) DATE: 1-24-17 REVISION NO 0 JOB NO: BDP-009 FIGURE NO 1 HART & HICKMAN PC 42565 Re, Pay To NC DENR - Stormwater Permitting Program Invoice No. Invoice Date Invoice Amount Amount Due 04032017 04/03/2017 100.00 100.00 'y1Cr15��0 2-.5� Check Total: $100.00 04/03/2017 Discount Apply Balance 0.00 100.00 0.00 RECEIVED DENR-LAND QUALITY STORMWATER PERMITTING hart `-hickmanWellsfargo'Bank, N-A. A Professional Corporation - "66.21/53D ? 2923 S. Tryon Street, Suite 100 Charlotte;; NC 28203-5449 DATE One,Hundred' and 00/100PDolla`s 42 66 51 cnrrs�srar I/ AMOUNT, F 4/3/2017 f $100:f?0 PAY TOTHE . ' - NC DENR,-`St&mn eater Permitting Program , ORDER''. 'Attn: Division of Energy; Mineral; and'Land-Resources r 8 3%U.�. x ('I 1612 Mail SenriceiCeriter ��• •�. 'Raleigh, NC 27699-1612 f 1 r•. // ,� t AUTHORIZED SIGNATURE 11 11804 2