NCG120100_COMPLETE FILE - HISTORICAL_20171027

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V
DOC7YPE
6� HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ d'0/ 7 � � a 7
YYYYMMDD

Division of Energy, Mineral, and Land Resources
~• Land Quality Section / Stormwater Program
National Pollutant Discharge Elimination System (NPDES)
Energy. Mineral & PERMIT OWNER AFFILIATION DESIGNATION FORM
Land Resources
ENVIROMMENTAL QUALITY (Individual Legally Responsible for Permit)
Use this form if there has been:
FOR AGENCY USE ONLY
Dale Received
Year
Sonth
Da
NO CHANGE in facility ownership or facility name, but the individual
who is legally responsible for the permit has changed.
If the name of the facility has changed, or if the ownership of the facility has changed,
do NOT use this form. Instead, you must fill out a Name -Ownership Change Form
and submit the completed form with all required documentation.
What does "legally responsible individual" mean?
The person is either: OCT 2 % 2011
• the responsible corporate officer (for a corporation);
• the principle executive officer or ranking elected official (for a municipality?, -Mate,, federahor other public
agency); STORMWATER PLkj,, l i 1,i ;
• the general partner or proprietor (for a partnership or sole proprietorship):
• or, the duly authorized representative of one of the above.
I) Enter the Permit number for which this change in Legally Responsible Individual ("Owner Affiliation")
applies:
Individual Permit
N I C I S
2) Facility Information:
Facility name:
Company/Owner Organization:
Facility address:
(a) Certificate of Coverage
N I C I G I I LPjo 1 10 10
O�crrn.� vav�
`l
Q Address �j
S/✓%Y.r e r / /rrt h, C, •.� U 7
City State Zip
To find the current legally responsible person associated with your permit, go to this website:
http://deg,.nc.gov/about/divisions/eiierev-mineral_laiid_resources/energy, inineral-land-permits/storinwater-program
and run the Permit Contact Summary Report.
3) OLD OWNER AFFILIATION that should be removed:
Previous legally responsible individual: //,efx r`.
F st MI Last
4) NEW OWNER AFFILIATION (legally responsible for the permit):
0 1
Person legally responsible for this permit: ,t1 r I e_P%N C A
First MI Last
Page I of 2
SWU•OWNF,RAFFIIr23March2017

r
NPDES Stormwater Permit OWNER AFFILATION DESIGNATION Form
(if no Facility Name/Ownership Change)
Dllmle-' %, /" " /-)
/1' 0 -1 o'I'itle
hl Mailing Address
City state Zip
Telephone E-mail Address
Fax Number
5) Reason for this change:
A result of: ET -'Employee or management change
❑ Inappropriate or incorrect designation before
❑ Other
If other please explain:
The certification below must be completed and signed by the permit holder.
PER ITTEE CERTIFICATION:I, /r/�I �+-� /` J , attest that this application for this change in Owner Affiliation
(person legally responsible for the permit) has been reviewed and is accurate and complete to the best of my
knowledge. 1 understand that if all required parts of this form are not completed, this change may not be
pro essed.
Signature Date
PLEASE SEND THE COMPLETED FORM TO:
Division of Energy, Mineral, and Land Resources
Stormwater Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
For more information or staff contacts, please call [phone] or visit the website at:
http://deq.nc.gov/about/divisions/energ-y-mineral-land-resources/storinwater
Page 2 of 2
5 WU-OWNERAFF11 23NIar2017

t
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Energy, Mineral, and Land Resources
Land Quality Section
Tracy E. Davis, PE, CPM
Director
October 9, 2013
Mr. Henry "Buddy" Norris
Avery County C & D Landfill
P. 0. Box 640
Newland, NC 28657
Pat McCrory, Governor
John E. Skvarla, III, Secretary
Subject: General Permit No. NCG120000
Avery County C & D Landfill
COC NCG120100
Avery County
Dear Mr. Norris:
In accordance with your application for a discharge permit received on
September 12, 2013, 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 is not transferable except
after notice to the Division of Energy Mineral & Land Resources (DEMLR). If the
property changes ownership or the facility is closed DEMLR may require
modification, revocation or reissuance of the certificate of coverage.
This permit does not affect the legal requirements to obtain other permits
which may be required by DEMLR or any other federal, state, or local governmental
authority.
If you have any questions concerning this permit, please contact Larry Wade
at telephone number [phone].
SincerelyPt�
/`-"
for Tracy E. Davis, P.E. CPM
cc: Asheville Regional Office
Central Files
Stormwater Permitting Unit Files
1612 Mail Service Center, Raleigh, North Carolina 27699-1612 • Telephone [phone] FAX•. 919-733-2876
512 North Salisbury Street, Raleigh, North Carolina 276041 Internet: htt2�//portal.ncdenr.org/web/Irliand:gqarty
An Equal Opportunity 1 Affirmative Action Employer 150% Recycled 110% Post Consumer Paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
GENERAL PERMIT NO. NCG120000
CERTIFICATE OF COVERAGE No. NCG120100
STORMWATFR 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,
Mr. Henry "Buddy" Norris
is hereby authorized to discharge stormwater from a facility located at
Avery County C & D Landfill
2175 Brushy Creek Rd.
Spruce Pine
Avery County
to receiving waters designated as Brushy Creek, a class C,Tr water in the French Broad
River Basin, in accordance with the effluent limitations, monitoring requirements, and
other conditions set forth in Parts I, II,111, IV, V, and VI of General Permit No. NCG120000 as
attached.
This certificate of coverage shall become effective October 9, 2013.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day October 9, 2013.
for Tracy E. Davis, P.E., Director
Division of Energy, Mineral, and Land Resources
By the Authority of the Environmental Management Commission

NCG,120100
Map Scale 124, 000
Henry "Buddy" Norris
Avery County C & D Landfill
Latitude: 350 57' 31.7" N
Longitude: - 811 58' 15.3" W
County: Avery
Receiving Stream: Brushy Creek
Stream Class: C,Tr
Sub -basin: 04-03-05 (French Broad River Basin)
F4 k
Facility Location

Wade, Larry
From: Stepp, Jonathan
Sent: Tuesday, October 01, 2013 12:10 PM
To: Wade, Larry
Subject: RE: NCG120100 Avery County C & D Landfill
HI Larry,
My recommendation is to proceed with permitting. I will schedule an inspection after they are covered. Solid waste just
inspected the site and it is in good standing. Please let me know if I can be of further assistance.
Sincerely,
Jonathan
Jonathan Stepp — [e-mail]
North Carolina Dept. of Environment and Natural Resources
Asheville Regional Office
Division of Energy, Mineral, and Land Resources - Land Quality Section
2090 U.S. 70 Highway
Swannanoa, NC 28778
Tel: [phone]
Fax: [phone]
Notice: E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and
therefore may be disclosed to third parties.
From: Wade, Larry
Sent: Friday, September 27, 2013 2:05 PM
To: Stepp, Jonathan
Subject: NCG120100 Avery County C & D Landfill
Hello Jonathan,
Please find attached the NOI for the subject project for your review. If you have any concerns for prior to the issuance
of this NCG12000 permit please let me know. If a response is not received within 30 days of this request, J will proceed
to issue the permit pending approval from the central office.
If you have any questions or require additional information, please let me know.
Thanks,
Larry W. Wade PE Telephone: [phone]
Fax: [phone]
Stormwater Permitting Program
North Carolina Department of Environment & Natural Resources
Division of Energy Mineral and Land Resources

1612 Mail Service
942S
Physical Address - 512 N. Salisbury St. Room
Raleigh, NC 27699-1612
Raleigh, NC 27604
is a government E-mail address****************************
*********E-mails sent and received from this address can be disclosed to third parties************

r
SMITH--RARHNER �.
ENGINEERS — - ---
September 10, 2013
NCDENR
Division of Energy, Mineral and Land Resources
Attention: Stormwater Permitting Program
1617 Mail Service Center
Raleigh, NC 27699-1617
*Mss IR WE
14 N. Boylan Avenue. Raleigh NC 27503 919.028.3577 mvw.sm1hgardnerinc.com
RE: Avery County C&D Landfill, Spruce Pine, NC
N01: General Permit #NCG120000 (Landfills)
Dear Sir/Madam:
Smith Gardner, Inc. (S+G) is pleased to submit this Notice of Intent (N01) package for the Avery County
C&D Landfill facility located in Avery County, NC. The site operates under NC Solid Waste Permit No.
06-03. As such, we are submitting an N01 for coverage under the General Permit #NCG120000
(Landfills). Please find the attached N01 package for coverage under this permit.
If you have any questions, or require further information, please contact me at (9191 828-0577 ext. 224
or by email at donfdsmithgardnerinc.com.
Sincerely,
Sh..�.. , .......�.. ...,.
Dc
Pr
CC: File
Attachment
HAProjeclOAvery County INCRNPDESSNONAveryC&D_Nfl1_Sep1 2013.docs

Division of Water Quality / Surface Water Protection
Section
National Pollutant Discharge Elimination System
- M—m,
'ti}�1�cs�6�QAE2' �fil��
NCG120000
FOR AGFNCY USE ONLY
Date Received
Year
Month
I Da
Certificate of Coverage
Check #
Amount
P Rrtit Assigned to
VV ad e
NOTICE OF INTENT
National Pollutant Discharge Elimination System application for coverage under Gener " ''}''', ,
NCG120000: ' :
STORMWATER DISCHARGES associated with activities classified as: i u� If
.
Landfills that are permitted by the North Carolina Division of Waste Management un er the i
provisions and requirements of North Carolina General Statute 130A — 294. 15 WNK 4vf,Tgi� rUtiLiYY
! W lands S St,r:nvar2• Branch !
The following activities are specifically excluded from coverage under this General Permit:
• Stormwater discharges from open dumps, hazardous waste disposal sites, or discharge of waste (including
leachate) to the waters of the state.
For questions, please contact the DWO Regional Office for your area. See page 4.
(Please print or type)
1) Mailing address of owner/operator (address to which all permit correspondence will be mailedi:
Name
Street Address
City
Telephone No.
Mr. Henry "Buddy" Norris
P 0 Box 640
Newland
[phone]
2) Location of facility producing discharge:
Facility Name
Facility Contact
Street Address
City
County
Telephone No.
Email -
Avery County C&D LAndfill
State NC ZIP Code 28657
Fax: [phone]
Mr. Henry "Buddy" Norris
2175 Brushy Creek Road
Spruce Pine State NC ZIP Code 28777
Avery
[phone] Fax: [phone]
[e-mail]
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).
The site entrance is on Brushy Creek Road, approximately 2.2 miles east of the Brushy Creek Road and HYW 19E intersection.
(A copy of a county map or USGS quad sheet with facility clearly located must be submitted with this application.)
t 4) Latitude 35deg 57-31,743 N Longitude 81deg 58115.314 W (deg, min, sec)
5) This NPDES Permit Application applies to which of the following:
❑ New or Proposed Facility
® Existing
Date operation is to begin
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NCG120000 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: 4 9 5 3
7) Provide a brief narrative description of the types of industrial activities and products manufactured at
this facility:
Site activities include the operation of a permitted CLD Landfill, as well as, the
operation of a permitted waste Transfer Station.
8) Discharge points i Receiving waters:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? 3
What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater
discharges end up in? Brushy Creek
Receiving water classification: C, Tr
Is this a 303(d) listed stream? Na Has a TMDL been approved for this watershed? No
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).
9) Does this facility have any other NPDES permits?
© No
❑ Yes
If yes, list the permit numbers for all current NPDES permits for this facility:
10) Does this facility have any Non -Discharge permits (ex: recycle permit)?
© No
The site has an NC solid waste permit, No. 06-03.
❑ Yes
if yes, list the permit numbers for all current Non -Discharge permits for this facility:
11) Does this facility employ any best management practices for stormwater control?
❑ No
® Yes (Show structural BMPs on the site diagram.)
If yes, please briefly describe:
The Site utilizes sediment bas'.na, rock check dams, diversin berms,
and stormwater convevance channels.
12) Does this facility have a Stormwater Pollution Prevention Plan?
® No
❑ Yes The site has a DWM approved' Erosion and Sediment Control Plan as required.
If yes, when was it implemented?
13) Are vehicle maintenance activities occurring at this facility?
® No El Yes
14) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
x❑ No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
® No ❑ Yes
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NCG120000-N.O.i.
c) Is this facility a Large Quantity Generator (1000 kg. or more of Hazardous waste generated per month) of
hazardous waste?
® No ❑ Yes
d) is hazardous waste stored in the 100-year Hood plain?
® No ❑ Yes if yes, Include information to demonstrate protection from flooding.
e) If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste:
How is material stored:
Where Is material stored;
How many disposal shipments per year:
Name of transport 1 disposal vendor: _
Vendor address:
15) Certification:
North Carolina General Statute 143-215.613(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 Commission implementing this Article shall he guilty of a Class
2 misdemeanor which may include a fine not to exceed ten thousand dollars ($1 %000),
I hereby request coverage under the referenced General Permit. 1 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 o ' cc&Is Per on Sign€n : #v-,n r C orir 5 it
- -
Title: /�,• -�c - - - - -_
OT1
/0 /,T
(bate Signed)
Notice of Intent mast be accompanied by a check or money order for $100.00 made payable to:
NCDENR
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NCG120000 N.O.I.
Final Checklist
This application will be returned as incomplete unless all of the following items have been included:
❑ Check for $100 made payable to NCDENR
❑ This completed application and all supporting documents
❑ A site diagram showing, at a minimum, (existing or proposed):
(a) outline of drainage areas, (b) stormwater management structures, (c) location of stormwater outfalls
corresponding to the drainage areas, (d) runoff conveyance features, (e) areas where materials are stored,
(f) impervious areas, (g) site property lines.
❑ Copy of county map or USGS quad sheet with location of facility clearly marked on map
Mail the entire package to:
Stormwater Permitting Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Note
The submission of this document does not guarantee coverage under the NPDES General Permit.
For questions, please contact the DWQ 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 .........(919)
807-6300
Page 4 of 4
SWU-227-071408 Last revised 7/14/08