NCG140417_COMPLETE FILE - HISTORICAL_20160304

STORMWATER DIVISION CODING SHEET
RESCISSIONS.
PERMIT NO.
DOC TYPE
❑COMPLETE FILE -HISTORICAL
DATE OF
RESCISSION
❑ 30I G030N
YYYYMMDD

PAT MCCRORY
c,<rerar
DONAI_D R. VAN DER VAART
.Yecrelary
Energy, Mineral TRACY DAVIS
and Land Resources - ��� � ��� D
FN VIRONME�STAL Ol1ALITY
March 1, 2016 Uireclor
MAR 0 4 2016
Ms. Winnie Jenkins CENTRAL FILES
Concrete Service Company, Inc. DWR SECTION
P.O. Drawer 1867
Fayetteville, NC 28302
Subject: Rescission of NPDES Stormwater Permit
Certificate of Coverage Number NCG140417
Cumberland County
Dear Ms. Jenkins:
On December 15, 2015, the Division of Energy, Mineral and Land Resources received your
request to rescind your coverage under Certificate of Coverage Number NCG140417. In
accordance with your request, Certificate of Coverage Number NCG140417 is rescinded
effective immediately.
Operating a treatment facility, discharging wastewater or discharging specific types of
stormwater to waters of the State without valid coverage under an NPDES permit is against
federal and state laws and could result in fines. If something changes and your facility would
again require stormwater or wastewater discharge permit coverage, you should notify this office
immediately. We will be happy to assist you in assuring the proper permit coverage.
If the facility is in the process of being sold, you will be performing a public service if you would
inform the new or prospective owners of their potential need for NPDES permit coverage.
If you have questions about this matter, please contact us at 919-707-9200, or the Stormwater
staff in our Fayetteville Regional Office [phone],
Sincerely,
E
for Trac �. Davis, PE, PM, Director
Division of Energy, Mineral and Land Resources
cc: Fayetteville Regional Office
Stormwater Permitting Program
Central Files - w/attachments
State of North Carolina I Environmental Quality I Energy, Mineral and Land Resources
1612 Mail Service Center 1 512 North Salisbuty Street I Raleigh, North Carolina 27699-1612
919 107 9220 T

�'� • .
Division of Energy, Mineral & Land Resources
Land Quality Section/stormwater Permitting Program
Q Y g g
NCDENRNational
Pollutant Discharge Elimination System
No-. C,NOL DE�rrr MEN OF
Er+.nwewr+[r+t —D N,ava R�CM
RESCISSION REQUEST FORM
FOR AGENCY USE ONLY
Date Received
Year
Month
Da
Please fill out and return this form if you no longer need to maintain your NPDES stormwater permit.
1) Enter the permit number to which this request applies:
Individual Permit (or) Certificate of Coverage
N C S I I I I N C G l 0 �]
2) Owner/Facility Information: * Final correspondence will be mailed to the address noted below
Owner/Facility Name
Facility Contact
Street Address
City
County
Telephone No.
00I S.
�In
313
State N L
E-mail Address
Fax: 910
ZIP Code
3) Reason for rescission request (This is required information. Attach separate sheet if necessary):
Facilit closed r is closing on rs_ (�D1S All industrial activities have ceased such that no discharges of
stormwater are contaminated by exposure to industrial activities or materials.
❑ Facility sold to
on F__7 . If the facility will continue operations under the new owner it
may be more appropriate to request an ownership change to reissue to permit to the new owner.
AOther:
4) Certification:
I, as an authorized representative, hereby request rescission of coverage under the NPDES Stormwater Permit for the
subject facility. I am familiar with the information contained in this request and to the best of my knowledge and belief
such information true, comple an ccurate.
Signature Date
-- Ms
Print or type name of person signing above Title
Please return this completed rescission request form to: NPDES Permit Coverage Rescission
stormwater Permitting Program RECEIVED
1612 Mail Service Center '"� V
Raleigh, North Carolina 27699-1612 DE�_ 5 2015
1612 Mail Service Center, Raleigh, North Carolina 27699-1612 Q@A1v lij0(W
Phone: [phone] FAX: [phone] Riflr�iY
An Equal Opportunity 1 Affirmative Action Employer Zi
N

FAY BLOCK
CONCRETE SERVICE
D.R. ALLEN & SON, INC. COMPANIES
"Carolina's AGC Pinnacle Award Winner"
WINNIE JENKINS
FIR 1 Safety 1 Environmental Director
P.O. Drawer 18671 130 Builders Blvd. Phone: [phone] Ext. 313
FayettevIdle, NC 28302 Tdll: 1-800.326-9198
Email: [e-mail] Fax: [phone]
i
i
a
i

Alexander, Laura
From:
Lawyer, Mike
Sent:
Tuesday, January 19, 2016 2:07 PM
To:
Alexander, Laura
Subject:
RE: NCG140417 Rescission Request
Follow Up Flag:
Follow up
Flag Status:
Flagged
Laura,
I was able to conduct a site visit for this one today. Facility has been shut down and all materials removed from the site
as indicated on the form. Please proceed with rescission of permit coverage.
Thanks,
Mike
Michael Lawyer, CPSWQ
Environmental Program Consultant
Division of Energy, Mineral and Land Resources I Land Quality Section
North Carolina Department of Environmental Quality
910 433-3394 office
mike.lawyer(cDncdenr.clov
225 Green Street, Suite 714
Fayetteville, NC 28301
^ Nothing Compares.•,_
Email correspondence to end from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
From: Alexander, Laura
Sent: Thursday, January 14, 2016 9:24 AM
To: Lawyer, Mike <[e-mail]>
Subject: NCG140417 Rescission Request
Mike,
Here is another request. In Cumberland County.
Thank you,
Laura
From: [e-mail][mailto:scanner.942A.arch2ncdenr.gov]
Sent: Thursday, January 14, 2016 9:57 AM

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
CERTIFICATE OF COVERAGE NO. NCGr+14_O� i �] ��'f 0-""i4�SAMPLE COLLECTION YEAR:
FACILITY NAME: uhe0s.� Pam. lC�e 4 c _ip�WJ••c.ES � S_ SAMPLE QUARTER: UJul-Sept ❑Oct -Dec ❑Jan -March ❑April -tune
PERSON COLLECTING SAMPLES: COUNTY:
CERTIFIED LABORATORY: Lab # PHONE NO. ( tc ) tt_(3 U-v ;
Lab # ADD TO LISTSERVE? ❑YES O EMAIL:
LIMIT VIOLATIONS? YES ❑ NO DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout []tither (I- - -
OPTIONAL INFO:
art A: wastewater nnonnonng Kequirements
Date Sam le
P
Type of Wastewater
`f .
pH
Total Suspended
Settleable';"
TPH using
method 1664A
Discharge
Tatal Flow ,.
Outfall No.
Collected_
(VE, RM, MD)
(standard) _
Solids -
5ohds :'
SGT.HkM'
duration
(gallons/day)
(min/dd/yr)
.
(mg/L)
(mIL/ IL)
(mJ l)
(minutes)
_
.�'
6 g3'4
303'S
53
(15.�6.
^Q.►1 efn. y...
I/r IAA 01,1A .-
3 A• �� sc� •- A,c.c
• c
rr In c, Cf'`Ttfl{�i
i
I
1 If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge" here. Please make sure to marls the sample quarter above.- c .
Z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD), Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring,
pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters. _r,
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications:
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

-£ Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to SO% of the Summer 7Q10 Flaw as per 15A
NCAC 028 .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30 DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and
complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing
violations." - /J
rmittee)
Permit Date. 7/1/2010-06/30/2015
(Date)
Last Revised 07/13/11
Page 2 of 2

RECEIVED
PROCESS WASTEWATER -- Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NCG140000
JUL 2 8 2014
CENTRAL FILES
DWO/BOG
CERTIFICATE OF COVERAGE NO. NCGr+14 D� i �] �aa} AMPLE COLLECTION YEAR:,
FACILITY NAME: �Dw�th5�f�v. rc���c� ��tv�.._c.{5 �.[ SAMPLEQUARTER: ❑Jul -Sept ❑Oct -Dec []Jan -March
PERSON COLLECTING SAMPLES: r COUNTY:
CERTIFIED LABORATORY: Lab # PHONE NO. ( tc )
Lab # ADD TO LISTSERVE? DYES NO EMAIL:
LIMIT VIOLATIONS? YES ❑ NO DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout []bther(I,
OPTIONAL'INFO:
'art A: Wastewater Monitoring Requirements
[9pril-June
Hate Sample
:Total 5uspendetl
S6ttl661e
PH elsrng
Discharge
OutfallNo _
x
C61
Type of Wastewater
pH
-
0lyds
5ohds:
method 1664A
"
Duration.
Total Ftow
f
{mm/dd/yr}
(VE' RM MIDI ..
(standa�dj
(mg/L}
(mL/Lj;
SGT H£NI�
- (minutes]
(gallons/clay)
( }
6934
g035,-f
53
_..: _ .
;(15}6
�vta i►t t
AJr�,f .rn1<�
Sr_f.n.cn
9-rcz
1 if wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
Z Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
3If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
° pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
s TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 1 of 2

a Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
7 Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50%of the Summer 7Q10 Flow as per 15A
NCAC 02B .022A. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual Flow
report on a case -by -case basis.
MAIL ORIGINAL. AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW". "NO DISCHARGE"] WITHIN 30 DAYS OF.RECEiPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF F "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUSTSIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and
complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing
~,0 .
(Date)
Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11
Page 2 of 2

PROCESS WASTEWATER — Quarterly Discharge Monitoring Report
GENERAL PERMIT No. NC6140000
CERTIFICATE OF COVERAGE NO. NCG14 C%� %_ CI-f 't -SAMPLE COLLECTION YEAR:
FACILITY NAME: u E S.I P.[1� C�,e to ��vduc_ L SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec [RJan-March
PERSON COLLECTING SAMPLES: a Se L L CSCOUNTY: t
CERTIFIED LABORATORY: Lab # PHONE NO. ( lC) Ie ---(3 U 0
I nh it ADD TO LISTSERVE? DYES O EMAIL:
LIMIT VIOLATIONS? YES ❑ NO ❑
Part A: Wastewater Monitoring Requirements
❑April -June
DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout E�bther
OPTIONAL INFO:
Outfall No.
Date Sample
1
Collected
(mm/dd/yr)
Type: of Wastewater
(VE, RM.MD)i
pH
(standard}
Total Suspended
Solids
(mg/L)
-Settleable.
Solids
(mL/L)
TPH using
method 1664A`
SGT-NEAR'
(mg/L).
Discharge
Duration
(minutes)
Total Flow
7
(gallons/day).
-
-
6-93.4
30315
53
L
i�f
lam w�
1.] a
N f}
3
A
s -L.a
A u_
� IF
• t � �" 111
IC. 6.��
JAN
u t
a
r.r link Co
CC
4
IN{14
r%%.A4 fGtfif'_
e
If wastewater systems have not discharged in this quarter — report "No Flow" or "No Discharge" here. Please make sure to mark the sample quarter above.
Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum
Cleanout (MD). Report more than one type if the waste -stream is commingled.
31f an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff
notifies you to continue monitoring.
pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters.
5 TSS limits are 20 mg/L for wastewater discharges to HQW waters, 10 mg/Lfor Trout and PNA waters, and 30 mg/L for all other water classifications.
Permit Date: 7/1/2010-06/30/2015
Last Revised 07/13/11
Page 1 of 2

Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a limit for wastewater,
but instead is subject to benchmarks and provisions of Part IV, Section A, including the Tiered Response Action.
Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 501YGof the Summer 7Q10 Flow as per 15A
NCAC 02B .0224. Permittees who discharge wastewater to HQW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot
obtain a Summer 7Q10 flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow
report on a case -by -case basis.
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE") WITHIN 30_DAYS OF RECEIPT OF SAMPLE (OR
AT END OF MONITORING PERIOD IN CASE OF "NO FLOW") TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[phone]
YOU MUSTSIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and
complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing
violations."
(Sign
Permit Date: 7/1/2010-06/30/2015
(Date)
Last Revised 07/13/11
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE NO. NCG140 `c L —7 .1 AMPLE COLLECTION YEAR:
FACILITY NAME; ��Cr.�C.�c�S c V_ SAMPLING PERIOD: ❑ July -December January -June
r;qPERSON COLLECTING SAMPLES �� COUNTY
CERTIFIED LABORATORY 1C,�c�A-U lab # 11I PHONE NO. (��j `? Le
V r
Lab # ADD TO LISTSERVE? ❑YES ❑ W EMAIL:
OPTIONAL INFO: DISCHARGING TO CLASS: [:]SA ❑HQW ❑PNA ❑Trout [gother�
Part A: Stormwater Monitoring Requirements
Outfall No.
Date Sample
Collected
(mo/dd/yr OR
t
NO FLOW)
PH-.
[Standard
units)
TSS
(fig/L)Monitoring?
Event
Duration...,
(minutes)
Total
c
Rainfall.
(in)
In Tier 2
Monthly
(y/n) .
# of Months in. Tier.
z
2 Sampling
-
-
5-9
100 '
-
—
lti1
'? 1 9
o
a
N
►�',o-
■ .u—W&—j
V L_fl1
UN 3-0 ?nth
nlA101arw-
If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "No DISCHARGE" for each outfall here. Please make sure to mark the sample period above.
2 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2
Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range.
3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HOW, Trout, and PNA waters where they are So mg/I.
For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge.
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 1 of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year.
Outfall '
No.,Collected-
Date Sample
;(mo/dd/yr)1
pH.
(Standard`s
units)
TPH using method.
1664A SGT-HEM
(mg/L)
Total Suspended
Solids
(rng/L)
Event
a Duration
: (miriutes)
'total ,
a
Rainfall
(rn)
New Motor Oil,
-, Usage
(gal/month)
In Tier 2
Monthly
'Monitoring?
r
# of Months'
in Tier 2;` „
z -•
Sampling ,
. 6-9.
15
100
_
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NOZ
HAVE YOU CONTACTED THE REGION? YES NO
REGIONAL OFFICE CONTACT NAME:
Mail Ori.Rinai and one coov of this DMR (including all "No Flow" & "No Discharize" reports) within 30 days of receipt of sample for at end of monitorine period
in case of "No Flow") to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"1 certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsiVeAor gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete
am aware that there aW pen�false information, including the possibility of fines and imp sonment for knowing violations."
(Signature of Per ) -,_ I (Date)
Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11
Page 2 of 2