NCG070147_COMPLETE FILE - HISTORICAL_20140314

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO. Iv b J y -7
DOC TYPE -H' HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE ❑ d '� y � J � `l
YYYYMMDD

o t, _
I111-3 n�t-6kd�. -
Dellinger Precast Inc. ✓ Tiq'P&dz r<,er Ac,
8151 Webbs Road
Denver, NC 28037 w �
704-489-0110 / L_ (° `cs� em n
March 14, 2014
NCDENR
Stormvvater & General Permits Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Bradley Bennett
Dellinger Precast applied foi- a second stormwater permit in 2011. We wel-e
planning on moving our present batch plant or erecting a new facility but
have decided against that move at this time. We want to renew both of OL11-
permits. Permit #NCG070147 has the requested information and ices
enclosed. Permit #NCG070198 has only relevant information due to the fact
that we are not in production. A check is enclosed for those fees also. Thant{
you for all your help.

r
AN7
NCDENR
Division of Water Quality / Water Quality Section
National Pollutant Discharge 1linttination System
NCG070000
FOR AGENCY i1SE ONLY
Datc Reeeivett
Year
NIUnth
Du
Cenilicatc of coverue
N '
Check
Aimunt
Permit Assi licd ro
NOTICE OF INTENT
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG070000:
STORMWATER DISCHARGES associated with activities classified as:
SIC 32 Stone, Clay, Glass, and Concrete Products (except as specified below)
SIC' NIA Like activities deemed by DWO to he similar in the process and/or the exposure of raw
materials, products, icy -products, or waste materials
The following activities are specifically excluded from coverage under this General Permit:
SIC 3273 Ready -Mixed Concrete
Standard Industrial Classification Code
(Please print or type)
1) Mailing address of owner/operator (address to which all permit correspondence will be mailed):
Name x t4A pit 9-
Street Address w t-b d
City Del A) r _ State N C
Telephone No. t{ ?'1 - D U i• D Fax: `ice
E-mail Address
2) Location of facility producing discharge:
Facility Name
4Q- _Q_k 1 ; o) \ el
Facility Contact
_CZA" kj
Contact E-mail
Street Address
15 ( Gj b S
�- e�C4S � :Poc .
r
ZIP Code �LrO 3
City [)_e Ny -f-►- State,_ . 1L1 L_ ZIP. Code a So 3 -7
County L` A) Gb ( (i
Telephone No. o y `( eq —d f �O Fax: 'V4 If
3) Physical Location Information:
Please provide a narrative description of slow to get to he facilit (use street names, state road numbers, and
distance an(1~ irection�m�a�roadw Y'nterse i n). _eYJ 0 -t r
1� t s its �ct v� ON
(A copy of a county map or USGS quad sheet with facility clearly located on the map is required to be submitted with this application)
4) Latitude 3 5. 5 1 3 5 `i Longitude - �0 , 9 g 10 3 (degrees, minutes, seconds)
5) This NPDES Permit Application applies to which of the following :
0 New or Proposed Facility Date operation is to begin d � ('
©' Existing
Page 1 of 4 MAR ; S 2013
SWU-222-071408 Last Re ise 7/14/2008
lMR - GYM

NCG070000 N-O-I.
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: 3 a i I
7) Provide a brief narrative description o the types of industrial activities and product manufactured at
this facility: �� Cor�L�e t oY �c2ea.S4- Q�;60ye y c
8) Discharge points 1 Receiving waters:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? i
9) Receiving waters:
What is the name of the body ory bodies of water (creek, stream, river, lake, etc.) that the facility stormwater
discharges end up in? cAV T l I3 CY'e e K
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 NPDES permits?
F No
❑ Yes
If yes, list the permit numbers for all current NPDES permits for this facility:
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
12) Does this facility employ any best management practices for stormwater control?
E] No
9Yes
If yes, please briefly describe: UJ
% ours �4' kk- W R,s h �1 S a
3-�"�-r C�. &f) N C I ­4'+V. &� A -I . -
13) Does this facility have a Stormwater Pollution Prevention Plan?
0 o
Yes
I yes, when was it implemented? A Vj J, t O D
14) Are vehicle maintenance activities occurring at this facility?
!J No. ❑ Yes
15) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
ZNo ❑ Yes
h) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste? -
Page 2 of 4
S W l) -222- 0714 08
Last Revised 7114/2008

NCG070000 N.OJ.
VNo ❑ Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
V No ❑ Yes
d) If you answered yes to questions b, or c., please provide the following information:
Type(s) of waste:
Wow is material stored:
Where is material stored:
plow many disposal shipments per year:
Name of transport 1 disposal vendor: T
Vendor address:
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 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 falsities, tampers with, or knowingly
renders inaccurate any recording or monitoring device or method required to be operated or maintained under;his Article or rules of the
(Environmental Management) Commission implementing this Article shall be guil;y 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 Nam of Person Signing:r2Ji/�i!t%Of �r
Title: C�G h YVk1R
3-)U--1.3
(Date Signed)
Notice of intent must be accompanied by a check 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:
❑ Check for $100 made payable to NCDENR
❑ This completed application and all supporting documents
❑ Copy of county map or USGS quad sheet with location of facility clearly marked on map
Mail the entire package to:
Stormwater and General Permits Unit '
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Page 3 of 4
SWU-222-071408 last Revised 7/14/2008

KNC®ENR
Division of Water Quality / Water Quality Section
National Pollutant Discharge Elimination System
NCG070000
FOR Ace:NCY USE ONLY
Date Received
ye:u'
I Munth
Day
C'eaitirate of Coverme
N
Chuck 4 Anxnml
Pennit Assikned w
NOTICE OF INTENT
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG070000:
STORMWATER DISCHARGES associated with activities classified as:
SIC 32 Stone, Clay, Glass, and Concrete Products (except as specified below)
SIC' N/A Like activities deemed by DWO to be similar in the process and/or the exposure of raw
materials, products, by-products, or waste materials
The following activities are specifically excluded from coverage under this General Permit:
SIC 3273 Ready -Mixed Concrete
' standard Industrial Classification Code
(Please print or type)
1) Mailing address of owner/operator (address to which all permit corres ondence will be mailed):
Narrle
Street Address
City
Telephone No.
E-mail Address
t , ti 9 -U-
State N C_ ZIP Code 1�1 Va
-- D ti_n Fax: '�� 4? 3-- Fq 2I
2) Location of facility producing discharge:(
Facility Name tt AT Q+ Pl E
Facility Contact Ctr 14 1JQ I� J u q
Contact E-mail
Street Address
City
County
Telephone No.
-,V-A)C, _# tjCG0'10tg9
a
5 3 ( lti - V I (p
{�eu y t Y State A)� - ZIP Code aet7 ?'7
L `vJ two 6 d
-to � Lea-- 0 b1 0 Fax: `G�'F 3'3— g��
3) Physical Location Information:
Please provide a narrative description of how to get to the facility use stleet na es, state road numbers, and
tancoc' 4;•^ i^ from a roadway intersection). L )� ter/ � � j`1 ��rt,, � -e rJ tj J- V
(A copy of a county map or USGS quad sheet with facility clearly located on the map is required to be submitted with this application)
4) Latitude Longitude (degrees, minutes, seconds)
5) This NPDES Permit Application applies to which of the following*
❑ New or Proposed Facility Date operation is to begin
❑ Existing
0
Page 1 of 4
Sw U-222-071408
Last RoVsed 7/14/2008

NCG070000 N.O.I.
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:
7) Provide a brief narrative description of the types of industrial activities and products manufactured at
this facility:
8) Discharge points 1 Receiving waters:
Haw 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?
ff 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 NPDES permits?
No
❑ Yes
If yes, list the permit numbers for all current NPDES permits for this facility:
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
❑ No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
12) Does this facility employ any best management practices for stormwater control?
❑ No
❑ Yes
If yes, please briefly describe:
13) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No
❑ Yes
if yes, when was it implemented?
14) Are vehicle maintenance activities occurring at this facility?
❑ No ❑ Yes
15) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
❑ No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
Page 2 of 4
0
SWU-222-071408
Last Revised 7/14/2008

NCG070000 N.O.I.
❑ No ❑ Yes
0 Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
❑ No ❑ Yes
d) If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste:
How is material stored:
Where is material stored:
How many disposal shipments per year:
Name of transport 1 disposal vendor: _
Vendor address:
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 this Article or a rule implementing this Article, or who knowingly makes a false
statement of a material tact in a rulemaking proceeding or contested case under this Article; or who falsifies, tampers with, or knowingly
renclers 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 len 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 Na�]e of Person Signing: �mN
Title: A �i�16t i r (M t� 1
-4--19 -(3
(Date Signed)
Notice of Intent must be accompanied by a check 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:
❑ Check for $100 made payable to NCDENR
❑ This completed application and all supporting documents
❑ Copy of county map or USGS quad sheet with location of facility clearly marked on map
Mail the entire package to:
Stormwater and General Permits Unit
Division of Water Quality
1617 Maii Service Center
Raleigh, North Carolina 27699-1617
Page 3of4
SWII-222-07 f 408
Last Revised 7/14/2008