NCG110034_COMPLETE FILE - HISTORICAL_20130312

STORMWATER DIVISION CODING SHEET
NCG -PERMITS
PERMIT NO.
DOC TYPE
Y HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
El aD)3 ` 3 a
YYYYM M D D

70
ICKORY
North Carolina
Life. Well Crafted.
March 12, 2013
Mr. Bradley Bennett, Supervisor
Stormwater and General Permits Unit
Division of Water Quality
NCDENR
1617 Mail Service Center
Raleigh, NC 27699-1617
City of Hickory
Engineering Department
Subject: Notice of Intent for Renewal of COC Number NCG110034
Dear Mr. Bennett:
76 N Center St NE
Hickory, NC 28601
Phone: [phone]
Fax: [phone]
Enclosed are the completed Notice of Intent form, a check in the amount of one hundred dollars,
and a map marked with the location of the Regional Compost Facility.
We hereby request the renewal of Certificate of Coverage Number NCGI 10034, under NPDES
Stormwater General Permit Number NCG 110000,
If you have any questions, please contact at 828-323-7416. or at twatts a,hickorync.gov.
Sincerely;
�4� . •7/
Y
Terr L. Watts
Civil Engineer
Enclosures
C: Chuck Hansen
Kevin Greer

!A a Division of Water Quality / Water Quality Section
NCDENR National Pollutant Discharge Elimination System
Ncmm Clw — Donnr. or
E� u* NANAn RCpOvA *
NCGlI0000
NOTICE OF INTENT RENEWAL FOR COC NUMBER NCGI10034
FOR AGENCY USE ONLY
Dale Received
Year
Month
Day
Certificate ofCovera
e
N
Chock 0
Amount
Pcrmit Assigned to
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG110000:
STORMWATER DISCHARGES associated with activities classified as:
Treatment Works treating domestic sewage or any other sewage sludge or wastewater treatment
device or system, used in the storage, treatment, recycling, and reclamation of municipal or
domestic sewage, with a design flow of 1.0 million gallons per day or more, or required to have an
approved pretreatment program under Title 40 Code of Federal Regulations (CFR) Part 403,
including lands dedicated to the disposal of sewage sludge that is located within the confines of
the facility; and like activities deemed by DWQ to be similar in the process and/or the exposure of
raw materials, products, by-products, or waste materials.
(Please print or type)
1) Mailing address of owner/operator (address to which all permit correspondence will be mailed):
Name CITY OF HICKORY PUBLIC UTILITIES
Street Address i76 NORTH CENTER STREET / PO BOX 398
City HICKORY I State Nd ZIP Code 128603
Telephone No. 828-323-7427 j Fax: [phone]
E-mail Address kgreer(cDhickorync.gov
2) Location of facility producing discharge:
Facility Name !REGIONAL COMPOST FACILITY
Facility Contact EWAYNE CARROLL
Contact E-mail'donald.carroll(a7veoliawaterna.com and kgreerCcD_hickorync.gov
Street Address ;3200 20TH AVENUE SE
City (NEWTON I State Nd ZIP Code 28658
County CATAWBA
Telephone No. 828-465-1401 Fax: [phone]
3) Physical Location Information:
Please provide a narrative description of how to get to the facility (use street names, state road numbers, and
distance and direction from a roadway intersection). I1-40 EXIT 128, SOUTH ON FAIRGROVE CHURCH
ROAD, CROSS US 70, THEN TURN RIGHT ON 20T11 AVENUE SE I D �� 1w 12 Da
(A copy of a county map or USGS quad sheet with facility clearly located on the map is required to be submitted with this a on
4) Latitude '35° 41' 17.739" N I Longitude L al- 15' 55.268" W' (degrees, minutes, seconds) MAR i 5 �013
5) This NPDES Permit Application applies to which of the following
lo, New or Proposed Facility
X Existing
Date operation is to beginI
S W U-226-071408
Page 1 of 4
Last Revised 7/14/2008

NCG110000 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: 1 4952
7) Provide a brief narrative description of the types of industrial activities and products manufactured at
this facility: iThis is a 20 Dry Ton per Day In -Vessel Composting Facility that converts Municipal Wastewater
Bio-solids to beneficial reuse Compost. The facility is equipped with Packed lied Chemical Odor Control
Scrubbers,
8) Discharge points / Receiving waters:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property?;ONE
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?'CLARK 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). iN/A
10) Does this facility have any other NPDES permits?
X 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
�X Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility: W00004563
12) Does this facility employ any best management practices for stormwater control?
No
�X Yes
If yes, please briefly describe: 'Chemical off loading procedures. Frequent inspection of chemicals. Cleaning
and Inspection schedules for any material carry off to storm drains. Preventive maintenance for various
equipment to prevent_ potential discharges. Stormwater from Curing Pad is captured and Pretreated before
discharge to municipal sanitary sewer system in accordance with permit W000045.63. I
13) Does this facility have a stormwater Pollution Prevention Plan?
J❑! No
X Yes
r
If yes, when was it implemented?t June 1, 2004
14) Are vehicle maintenance activities occurring at this facility?
No IX Yes
15) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
k No J❑,Yes
Page 2 of 4
SWU-226-071408 Last Revised 7/14/2008

NCG110000 N.O.I.
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
�X No 10 Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
�X No ❑ Yes
d) 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 / 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 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).
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.
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: Mick W. Berry
Title: I City Manager
(Signature of Applicant) (Date Signed)
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to NCDENR
Page 3 of 4
SWU-226-071408 Last Revised 7/14/2008

NCG110000 N.O.I.
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
k This completed application and all supporting documents
!X 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
Note
The submission of this document does not guarantee the issuance of an NPDES permit.
For questions, please contact the DWQ Central Office or Regional Office for your area.
DWQ Regional Office Contact Information:
Asheville Office.. ....
[phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
[phone]
Washington Office ...(252)
946-6481
Wilmington Office...
[phone]
Winston-Salem ......
[phone]
Central Office .........
[phone]
Page 4 of 4
SVVU-226-071408 Last Revised 7/14/2008

CITY OF HICKORY Hickory's Mission - To deliver high quality services through excellent and ethical coworkers focused on innovation, communication and custemer service. 270855
HICKORY, NC 78601
6975 NCDENR-DWQ 03/07/2013
DATE INVOICE NO. DESCRIPTION AMOUNT
03/06/2013 NCG110034 $*****100.00
TOTAL $*****100.00
DETACH AND RETAIN FOR YOUR RECORDS
.... ..... .......... .............. ..,............ ....
THIS DOCUME NT CONTAINS• . TO LIGHT TO VERIFY WATERMARK
HICKORY This dnt has been -approved isbursemeas required by the Local Government Budget and Fiscal Control Act.
BBc&T 270855
_ CITY OF HICKORY Branch Banking and Trust Company
�� Mvreh Guretina HICKORY, NORTH CAROLINA
HICKORY, NC 28601
Life. "'ell Crafted. 66-1 121531 � ��� C 4
DATE
03/07/2013 $******100.00
ONE HUNDRED AND 00/100 DOLLARS
TO THE NCDENR-DWQ
ORDER 1617 MAIL SERVICE CENTER t/� CITY MANAG
OF RALEIGH NC 27699-1617 /J " .
/v FINANCr OFFFCM
v27085Sum 1:05310b120:00052&

ENDORSE HERE!
X
nor
DO NOT SIGN f WRITE ! STAMP BELOW THIS LINE
FOR FINANCIAL INSTITUTION USAGE ONLY'
n/� The security features fisted below, as well as those
A not listed, exceed industry guldellnos.
s
Security Features! Results of document alteration:
MlcroPrint Endorsement MlcroPrint (Iw) Signature
Lines • Small typo appears as dotted
line when photocopied.
Security Screen Absence or modification of "Original
Document" screen an back of check.
Padlock [con Absence of padlock icon.
0 Padlock design Is a cerlihcotion mark of Check Paymght Systems Association

STATE OF NORTH CAROLINA
VNf['fi. STATES HICKORY QUADRANGLE t
p t OVAITRHO OF [NVIIONY[Nf, HIAIiH
FVfiAARTMENT OF THfi IMERIOR RHO Nw[yRwL RElo4?Cu Hplm W.OIMALIUWiA W. l�
`e OF,OLMICAL SURVEY MEIN[ NORTH CAROLWA iA MIxUT[ AlUTS ITOPOC—MIC) /Y
r �.v wln trot r tarn e�w.m ��W �p�a� IlMITlnOtl
otw,la caa..so wn. n � rm. >atQ ram, r I W r r rwr 7593
w.y.. u..n.w
we sr.anr� rr�ss err
orr.r w.aw�s r wwwr��lonan

2120113
3200 20th Avenue southeast, NevAon, NC - Google Maps
Address 3200 20th Ave SE
Newton, NC 28658
City of Hickory
Regional Compost Facility
t'�` � �\ •� _ T ^ash Si 5ti'� =-
1 7:Ls Qrrinta Inn h�
ij wuiteS HrCkpry
Pld
St `I
70-�Conover,8AVV
lay
risl�Parittf �--';h 7aatiAve5E.' j f f
! l
maps.google.conYmaps?t=q&source=s q&hl=en&geocode=&q=3200+20th+Avenue+Southeast,+Newton,+NC&aq=1&oq=320D+20th&slI=35.790091,-81.3067... 1/1

City of Hickory
-TI RY Engineering Department
--�,C'e_, f' 76 N Center St NE
Hickory, NC 28601
1 North Carolina y Phone: [phone]
Life. Well Crafted. Fax: [phone]
March 12, 2013
Mr. Bradley Bennett, Supervisor
Stormwater and General Permits Unit
Division of Water Quality
NCDENR
1617 Mail Service Center
Raleigh, NC 27699-1617
Subject: Notice of Intent for Renewal of COC Number NCGI10037
Dear Mr. Bennett:
Enclosed are the completed Notice of Intent form, a check in the amount of one hundred dollars,
and a map marked with the location of the Henry Fork Wastewater Treatment Plant.
We hereby request the renewal of Certificate of Coverage Number NCG 110037, under NPDES
Stormwater General Permit Number NCGI 10000.
If you have any questions, please contact at 828-323-7416, or at twattsnhickorync.gov.
Sincerely,
qTry . Watts
Civil Engineer
Enclosures
C: Chuck Hansen
Kevin Greer

TINWA
Division of Water Quality / Water Quality Section
NCDENR National Pollutant Discharge Elimination System
mu« C�— 6[ri1tTKMT ew
E—wow.o —o N. P.5ourt s
NCGI 10000
NOTICE OF INTENT RENEWAL FOR COC NUMBER NCG110037
FOR AGENCY USE ONLY
Date Received
Year
Month
Da
Certificate of Covera e
NOG
Check h,
Amount
Permit Assigned to
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG110000:
STORMWATER DISCHARGES associated with activities classified as:
Treatment Works treating domestic sewage or any other sewage sludge or wastewater treatment
device or system, used in the storage, treatment, recycling, and reclamation of municipal or
domestic sewage, with a design flow of 1.0 million gallons per day or more, or required to have an
approved pretreatment program under Title 40 Code of Federal Regulations (CFR) Part 403,
including lands dedicated to the disposal of sewage sludge that is located within the confines of
the facility; and like activities deemed by DWO to be similar in the process and/or the exposure of
raw materials, products, by-products, or waste materials.
(Please print or type)
1) Mailing address of ownerloperator (address to which all permit correspondence will be mailed):
Name 'CITY OF HICKORY PUBLIC UTILITIES
Street Address 176 NORTH CENTER STREET / PO BOX 398
City `HICKORY State, NC _ I ZIP Code � 28603
Telephone No. 828-323-7427 Fax: '828-322-1405
E-mail Address kgreer{a)hickorync.gov
2) Location of facility producing discharge:
Facility Name IHENRY FORK WASTEWATER TREATMENT PLANT
Facility Contact kEVIN GREER, PE
Contact E-mail kgreerghickorync.gov
Street Address 4014 RIVER ROAD
City
County
Telephone No.
HICKORY _
CATAW BA
828-323-7427
3) Physical Location Information:
State NC ZIP Code
I Fax: �828-322-1405
Please provide a narrative description of how to get to the facility (use street names, state road numbers, and
distance and direction from a roadway intersection). 1I=40 EXIT 123, SOUTH ON US 321 TO RIVER ROAD
EXIT, EAST ON RIVER ROAD TO PLANT ENTRANCE
(A copy of a county map or USGS quad sheet with facility clearly located on the map is required to be submitted with
4) Latitude f350 40' 29.577" N I Longitude L 81° 19' 8.361" W (degrees, minutes, seconds
5) This NPDES Permit Application applies to which of the following :
❑; New or Proposed Facility Date operation is to begin
X Existing
Do
FIJAIR1 5 2013
l,. D _ NVR - WATER t lu4trY
Page 1 of 4
SWU-226-071408 Last Revised 7/14/2008

NCG110000 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: 14952
7) Provide a brief narrative description of the types of industrial activities and products manufactured at
this facility: Municipal Wastewater Treatment Facility
8) Discharge points 1 Receiving waters:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? One
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? HenryFork River in the Catawba River Basin !
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). �N/A I I
10) Does this facility have any other NPDES permits?
❑! No
X Yes
If yes, list the permit numbers for all current NPDES permits for this facility: �NC0040797
11) 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:
12) Does this facility employ any best management practices for stormwater control?
X No
JDi Yes
If yes, please briefly describe:
13) Does this facility have a Stormwater Pollution Prevention Plan?
❑i N o
X Yes
If yes, when was it implemented?, June 1, 2004
14) Are vehicle maintenance activities occurring at this facility?
X No �❑i Yes
15) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
3X No �0 Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
!X No ❑j Yes
Page 2 of 4
SWU-226-071408 Last Revised 7/14/2008

NCGlIO000 N.O.I.
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
X; No I ❑l 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 / 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 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).
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.
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: I Mick W. Ber[y
Title: ICity Manager
(Signature of Applicant)
ZZ /'31
(Date Signed)
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to NCDENR
Page 3 of 4
SWU-226-071408 Last Revised 711412008

NCG110000 N.O.I.
Final Checklist
This application will be returned as incomplete unless all of the following items have been included:
EX Check for $100 made payable to NCDENR
�X This completed application and all supporting documents
!X 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
Note
The submission of this document does not guarantee the issuance of an NPDES permit.
For questions, please contact the DWQ Central Office or Regional Office for your area.
DWQ Regional 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 4 of 4
SWU-226-071408 Last Revised 7/14/2008

CITY OF HICKORY Hickory's Mission - To deliver high quality services through excellent and ethical coworkers focused on innovation, communication and customer service. 270857
HICKORY. NC 28601
6975 NCDENR-DWQ 03/07/2013
DATE
INVOICE NO.
DESCRIPTION
ANTOUNT
03/06/2013
NCGI10037
$*****100.00
TOTAL
$*****100.00
DETACII AND RETAIN FOR YOUR RECORDS
............... .............. .. ........................
I��� This disbursement has been approved as required by the Loca! Government Budge:
North
,1• CITY OF HICKORY
HICKORY, NORTH CAROLINA
Carolina �
Life. Well Crafted.
DATE
03/07/2013
ONE HUNDRED AND 00/100 DOLLARS
TO THE NCDENR - DWO
ORDER 1617 MAIL SERVICE CENTER
OF RALEIGH NC 27699-1617
BB&T 270857
Branch Banking and Trust Company
HICKORY, NC 28601
66-1 121531 x;.. • z 0
1
$******100.00
A�> W'�) -
�CITY MAtJAGE; A&0—
R"NU
OFFICER

ENDORSE HERE:
X W
wP
DO NOT SIGN / WRITE 1 STAMP BELOW THIS LINE
FOR FINANCIAL INSTITUTION USAGE ONLY'
The securi!y features listed below, as well as those
Y not
listed, exceed industry guidelines.
a
Security Features:
Results of document alteration:
MlcroPrini
• Endorsement MicroPrint (hp) Signature
Lines - Small type appears as dotted
line when photocopied.
Security Screen
• Absence or modification of "Original
Document" screen an back of check.
Padlock [can
• Absence of Padlock icon.
0 Pkdlock design is a
certification mark of Check Payment Systems Assoctaffon

del UNffET! $TAT65 STATE OF NORTH CAROL[NA HCC<.OiT QUAORANGLC ff
RTMENT OF THE WTMOR OVA7T HIH7 OC INvj&ON10EN7, HCAITH IIORIH CReOIUTA{AYAWiA CCC ♦�I
E AND NATV CAL R[SOUICC!
�wN ��r^•••,�--•-•—�-- in`w.�we.oi.0 �wwca�w.m iNlwni, rv�
�r4 � w np'�1 uy�r �wwd a 1lC�Ifli�4N
wr ww�� ww M mYurx IWnE�•~� Ywr+��R��ar
tlrfW xw�aYr wn rr nroasmww� n �r�n �rrrlfgr Rwr� 1993
•!a!r yawn ti+r11116 w��n�aam+rW
p11'nw IInn11 wAM M �I rR YYJ �w�
f IwY1� N� pia a wsy ww� u W i

2120113
4104 River Road, Hickory, NG - Google Maps
Goggle
Address 4104 River Rd
Hickory, NC 28602
City of Hickory
Henry Fork Wastewater Treatment Plant
maps.google.conYmaps?f=q&source=s q&hl=en&geocode=&q=4104+River+Road,+Hickory,+NC&aq=&sII=35.669604,-81.321573&sspn=0.010494,0.01929&... 111

HIQKORY
Life. Well Crafted.
March 12, 2013
Mr. Bradley Bennett, Supervisor
Stormwater and General Permits Unit
Division of Water Quality
NCDENR
1617 Mail Service Center
Raleigh, NC 27699-1617
City of Hickory
Engineering Department
Subject: Notice of Intent for Renewal of COC Number NCG110038
Dear Mr. Bennett:
76 N Center St NE
Hickory, NC 28601
Phone: [phone]
Fax. [phone]
Enclosed are the completed Notice of Intent form, a check in the amount of one hundred dollars,
and a map marked with the location of the Northeast Wastewater Treatment Plant.
We hereby request the renewal of Certificate of Coverage Number NCG110038, under NPDES
StormwTater General Permit Number NCG 110000.
If you have any questions, please contact at 828-323-7416, or at twattsnhickorync.gov.
Sincerely,
Terr`v�atts
Y
Civil Engineer
Enclosures
C: Chuck Hansen
Kevin Greer

FOR AGL'NCY USEd ONLY
I Year I Month I Dav I
NCDENR
E�OM�+4/T �rlp Nd1A� �!IX/�CtO
NOTICE OF INTENT
Division of Water Quality 1 Water Quality Section
National Pollutant Discharge Elimination System
NCG 110000
RENEWAL FOR COC NUMBER NCG110038
Permit
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG110000:
STORMWATER DISCHARGES associated with activities classified as:
Treatment Works treating domestic sewage or any other sewage sludge or wastewater treatment
device or system, used in the storage, treatment, recycling, and reclamation of municipal or
domestic sewage, with a design flow of 1.0 million gallons per day or more, or required to have an
approved pretreatment program under Title 40 Code of Federal Regulations (CFR) Part 403,
including lands dedicated to the disposal of sewage sludge that is located within the confines of
the facility; and like activities deemed by DWQ to be similar in the process and/or the exposure of
raw materials, products, by-products, or waste materials.
(Please print or type)
1) Mailing address of ownerloperator (address to which all permit correspondence will be mailed):
Name I CITY OF HICKORY PUBLIC UTILITIES(
Street Address 176 NORTH CENTER STREET 1 PO BOX 398
City (HICKORY State NC ZIP Code128603
Telephone No. 1828-323-7427 Fax: '828-322-1405
E-mail Address kgreer(cDhickorync.gov
2) Location of facility producing discharge:
Facility Name
Facility Contact
Contact E-mail
Street Address
City
County
Telephone No.
(NORTHEAST W
:HICKORY
CATAW BA _
828-323-7427
3) Physical Location Information:
R MILL R
State NC ZIP Code'286011
Fax. '828-322-1405
Please provide a narrative description of how to get to the facility (use street names, state road numbers, and
distance and direction from a roadway intersection).11-40 EXIT 125, NORTH ON LR BLVD, LEFT ON IT AVE
SE RIGHT ON NC 127 RIGHT ON CLONINGER MILL ROAD I
(A copy of a county map or USGS quad sheet with facility clearly located on the map is required to be submitted with this
4) Latitude�35° 47' 19.142" NI Longitudes 81° 18' 28.491" W (degrees, minutes, seconds)
5) This NPDES Permit Application applies to which of the following :
1❑, New or Proposed Facility
X Existing
Date operation is to begin
19. U
MAR 15 201i
D NR - WP,iE UALITY
4 T _
Page 1 of 4
SWU-226-071408 Last Revised 7/14/2008

NCG 110000 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: 1 4952
7) Provide a brief narrative description of the types of industrial activities and products manufactured at
this facility: Municipal Wastewater Treatment FacilitV
8) Discharge points 1 Receiving waters:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? FIVE I
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?FALLING 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). NIA
10) Does this facility have any other NPDES permits?
❑, No
X Yes
If yes, list the permit numbers for all current NPDES permits for this facility: INC0020401
11) 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:
12) Does this facility employ any best management practices for stormwater control?
X No
❑� Yes
It yes, please briefly describe:
13) Does this facility have a Stormwater Pollution Prevention Plan?
i
❑l No
X Yes
If yes, when was it implemented?; June 1, 2004
14) Are vehicle maintenance activities occurring at this facility?
X No - I❑r Yes
15) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
�X No I❑' 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
Page 2 of 4
SWU-226-071408 Last Revised 7/14/2008

NCG110000 N.O.I.
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
?X No ID'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
How many disposal shipments per year:
Name of transport/ 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 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),
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.
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: Mick W. Berry
Title: i City Manager
(Signature of
z Z)3
(Date Signed)
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to NCDENR
Page 3 of 4
SWU-226-071408 Last Revised 7/14/2008

NCG110000 N.O.I.
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
IX, This completed application and all supporting documents
!X; 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
Note
The submission of this document does not guarantee the issuance of an NPDES permit.
For questions, please contact the DWQ Central Office or Regional Office for your area.
DWQ Regional 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 4 of 4
SWU-226-071408 Last Revised 7/14/2008

CITY OF HICKORY Hickory's Mission - To deliver high quality services through excellent and ethical coworkers focused on innovation, communication and customer service. 270856
HICKORY, NC 28601
6975 NCDENR-DWQ 03/07/2013
DATE
INVOICE NO.
DESCRIPTION
MOUNT
03/06/2013
NCG110038
$*****100.00
TOTAL
$*****100.00
DETACI-I AND RETAIN FOR FOUR RECORDS
_UPOR
This di5bur5ement has been approved as required dy .he I-ccal Government BI
�,�_ CITY OF HICKORY
HICKORY, NORTH CAROLINA
Norttr Garallna -
Life. Well Crafted.
DATE
03/07/2013
ONE HUNDRED AND 00/100 DOLLARS
TO THE NCDENR-DWQ
OR
DER
1617 MAIL SERVICE CENTER
OF
RALEIGH NC 27699-1617
and Fiscal Control Act.
BB&T 270856
Branch Banking and TFUSl Company
HICKORY, NC 28601
66-1 121531 „ M
$******100.00
i/ w'�)" ' /1
�c,ITYMANAGER
R,/ W.
Amo-
FINANCE OFFICEit
'in 2 708 S GO i:D S 3 L0 L& 2 b1o000 S 2 b 3 S 300 6I-ol

ENDORSE HERE:
X
I
DO NOT SIGN I WRITE t STAMP BELOW THIS LINE
FOR FINANCIAL INSTITUTION USAGE ONLY'
The security features listed below, as well as those
4 not listed, exceed Industry guidelines.
Security Features: Results of document alteration:
MicroPrint Endorsement MicroPrini (LP) Signature
Lines - Small type appears as dotted
line when photocopied.
Security Screen Absence or modification of "Original
Document' screen on hack of check.
Padlock Icon Absence of padlock icon.
a Padlock design is a certification mark of Ctreck Payment Systems Association

A

2r,,&13
310 Cloninger Mill Road Northeast, Hi6Dry, NC - Google Maps
Address 310 Cloninger Mill Rd NE City of Hickory
Gologle Hickory, NC 28601 Northeast Wastewater Treatment Plant
.o
?' yt27
w 41
'c
! �l
�. ,
m Kt� r
qtP
tT '�
1
,2y 1L
r+
kJ.
f, 4
�ly`,` `tJl�, �V •,5
.AAN "A
�
3(Elh:+4i`e`nUe rl=. .- '1�' ,! ��• • A7cy ,�.yJ�S'�• `°
--:�OtnSt,FlEti1 •fix. �\ r/�1 � -. { �_._.�;
35in'Alve
J= p
i r N:, h _ ± pAan'rlsi f21�f11 f;nnnln�
maps,google.corrUmaps?f=q&source=s q&h1=en&geocode=&q=310+Cloning er+Mill+Road+Northeast,+Hickory,+NC&aq=O&oq=310+cloninger&sl1=35.690... 1/1