NCG140324_COMPLETE FILE - HISTORICAL_20170511

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
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HISTORICAL FILE
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Division of Energy, Mineral and Land Resources
Land Quality Section / Stormwater Permitting Program
National Pollutant Discharge Elimination System (NPDES)
PERMIT OWNER AFFILIATION DESIGNATION FORM
(Individual Legally Responsible for Permit)
FOR AGENCY USE ONLY
Date Received
Year
Month
Day'
if NO CHANGE in company or facility ownership or name has occurred.
If a Name Change and/or Ownership Transfer at the facility has prompted this change, do
NOT use this form. You must fill out the Name -Ownership Change Form and provide all
necessary supporting documentation instead.
1) Enter the permit number for which this change in Legally Responsible Individual ("Owner
Affiliation") applies:
Individual Pennit
N I C I S
2) Facility Information:
Facility name:
Company/Owner Organization:
Facility address:
(or} Certificate of Coverage
N I C I G I I
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N 1 '�w o S 0,es'
31`0w POOR Kielc
Addres.
V
�Tcity State 7_ip
To find the current legally responsible person associated with your permit, go to this website:
bttp:Hporta1.iicdenr.ort,/we6/1r/sw-permit-contacts and run the Permit Contact Summary Report.
3) OLD OWNER AFFILIATION that should be removed:
Previous legally responsible individual:
ry
Q Cr1�1QR1
r
Firs[ tltl
Last
4) NENV OWNER AFFILIATION (Legally responsible
for the permit):
Person legally responsible for this permit:
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First Ml
Last
RECEIVE]
MAY
Title
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Zip
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Fax Number
Pate 1 of 2
SWU-OW NERAFFIL-22May2014

NPDESStormwater Permit OWNER AFFILATION DESIGNATION Form
(if no Facility NamelOvvnership Change)
5) Reason for this change:
A result of: ❑ Employee or management change
❑ Inappropriate or incorrect designation before
Other
If other please explain: �d'y � - � �O(!y �rp �ee QQ��
What does "legally responsible person" mean?
That person is either:
• the responsible corporate officer (for a corporation),-
• this principle executive officer or ranking elected official (for a municipality,
State, Federal, or other public agency);
• the general partner or proprietor (tor a partnership or sole proprietorship);
• or the duly authorized representative, of that person above.
The certification below must be completed and signed by the permit
holder.
PERiMITTEE CERTIFICATION:
r
1 e t attest that this application for this change in Owner Affiliation
(person legally responsible for ih permit) has been reviewed and is accurate and complete to the best of my
knowledge. I understand that if all required parts of this form are not completed, this change may not be
processed.
5 !`7
Signature Date
PLEASE SEND THE COMPLETED FORM TO:
Division of Energy, Mineral and Land Resources
Stormwater Permitting Program
1612 Mail Service Center
Raleigh. North Carolina 27699-1612
For more information or staff contacts, please visit our website:
http:Ilportal.ncdcnr.or.,,,/wcb/ir/stormwater
Pane 2 of 2
SW U-OW N E RAF FI L-22May2614

Mr. Roy L. Etheridge, President
TNT Services Inc.
PO Box 296
Powells Point, NC 27966
Dear Mr.' Etheridge:
Michael F. Easley
Governor
Wiliam G. Ross Jr., Secretary
Department of Environment and Natural Resources
November 8, 2002
Subject: General Permit No. NCG140000
TNT Services Inc.
COC NCG140324
Dare County
Alan W. Klimek, P.E., Director
Division of Water Quality
In accordance with your application for discharge permit received on August 6,.2002, we are forwarding herewithf••T.
the subject certif icatef.of, coverage to discharge under the subject state;-,NPDES general permit. This permit. is issued,1%?-
pursuantito 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 December, 6,,1983.
The stormwater permit. you'are receiving,. NCG140000, does-, not permit ,wasting concrete,- dumping excesses-.
concrete; directly into storm-sewer-outfalls or into waters of the state.- Any facility which either dumps excess concrete;or.. '
-washes..excess,concrete into storm.sewers or watersrof-:the:state will,be-operating iri.direct-violation t_o.both.the..terrins.of _-1,•
this -permit and the North Carolina:General Statutes. 'Such a discharge':shall be'considered an illegal' discharge and'may -'
subject.the owner tolenforcement actions•in accordance with North'. Carolina' General Statutes 143-215.6A'. f.
If any part s;''measLrement frequencies or sampling requirements contained in this permit are unacceptable to
you,,; you .have, the right to request an individual permit by submitting 'an individual permit application- Uniess such
demand is made, this certificate of coverage shall be final and binding.
Please take notice that this certificate of coverage is not transferable except after notice to the Division of Water
Quality. The Division of- Water Quality 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 Quality or permits required by the Division of Land Resources, Coastal Area Management Act or any other
Federal or Local governmental permit that may be required.
If you have any questions concerning this permit, please contact Mr. Mack Wiggins at telephone number 919/733-
5083 ext. 542.
Alan W. Klimek, P.E.
cc: Washington Regional Office
Central Files
Stormwater and General Permits Unit Files
NCDENR
Customer service Division of water Quality 1517 Mail Service Center Raleigh, NC 27699-1617 [phone]
1 800 623-7748

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE No. NCG140324
STORMWATER AND PROCESS WASTEWATER 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,
TNT Services Inc.
:1s hereby'authorized to discharge stormwate.r`and waste%vatdf,frbm mixing drum cleaning, wettirig,'bf ralvmateriafs '`. •+' "<
stockpiles-andlvehicle andequipment'cieaning.from a facility located at` "''
TNT Services Inc.,.
US flighway-15 South
,.,..' 3908.Poor Aidge Road, south of Kitty hawk
Dare County
to receiving waters designated as Kitty Hawk Bay, class SC waters in the Pasquotank River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts 1, I1, 111,
IV, V. and VI of General Permit No. NCGf40000 as attached.
This certificate of coverage shall become effective November 8, 2002.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
a
Signed this day November 8, 2002.
v11111 liLri Nil —
Alan W. Klimek, Y.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

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Copyright (C) 1997, Maplech, Inc

Markers
Name: Discharge Site-NCG140324
Short Name: Dschrg
Coordinates: 0360 03' 28.0" N, 0750 42' 55.5" W
Comment: TNT Services Inc, Subbasin 030155, Pasquotank River Basin, Dare County, Kitty
Hawk Bay, Class SC, Quad C36SW