NCG070221_Application_20200204

MCC..-0-7 02-21
NlIZ
FOR AGENCY USE ONLY
Date Received
Year Month Day
Division of Energy, Mineral and Land Resources 'z o2 oLf
Land Quality Section Certificate of Coverage National
1
National Pollutant Discharge Elimination System N heck# Amount Ft20
Environmental 1139 grim)
Quality N/ G070000 Permit
ng r Assigned to 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 DEMLR 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 GenerrPerrEVmit: ,ED
SIC`3273 Ready-Mixed Concrete ll.�� r1
*Standard Industrial Classification Code FEB 0 4 2020
DENR-LAND QUALITY
STORMWATER PERMITTING
(Please print or type)
1) Mailing address of owner/operator(address to which all permit correspondence will be mailed):
Name Alfa Laval,Inc.
Street Address 5400 International Trade Drive
City Richmond State Virginia ZIP Code 23231
Telephone No. 804 236-1243 Fax:
E-mail Address [e-mail]
2) Location of facility producing discharge:
Facility Name Alfa Laval KATHABAR,Inc.
Facility Contact Jonathan Drury
Contact E-mail [e-mail]
Street Address 1301 S.Poplar Street
City Elizabethtown State North Carolina ZIP Code 28337
County Bladen
Telephone No. 910 862-2061 Fax: 910 862-5598
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). From State Route 94 in Elizabethtown,NC,head north on S.Poplar Street
(State Route 242) a rnrox 0.72 miles. Take right at entrance sign. Blda is 0.1 miles on left.
(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 34°38'48" Longitude 78°38'43" (degrees, minutes, seconds)
5) This NPDES Permit Application applies to which of the following :
❑ New or Proposed Facility Date operation is to begin
❑✓ Existing
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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 2 2 9
7) Provide a brief narrative description of the types of industrial activities and products manufactured at
this facility: Alfa Laval KATHABAR manufactures and repairs fiberglass liquid and dry desiccant systems for dehumidification applications.
8) Discharge points/Receiving waters:
How many discharge points (ditches, pipes, channels, etc.)convey stormwater from the property? 2
List discharge points (outfalls)that convey discharge from the site (both on-site and off-site)and location
coordinates. Attach additional sheets if necessary, or note that this information is specified on the site plan.
Stormwater Outfall No. 001
Latitude (degrees/minutes/seconds): 34°36'44" N
Longitude (degrees/minutes/seconds): 78°36'41"
Stormwater Outfall No. 002
Latitude (degrees/minutes/seconds): 34°36'48" N
Longitude (degrees/minutes/seconds): 78°36'39" W
Stormwater Outfall No.
Latitude(degrees/minutes/seconds): N
Longitude (degrees/minutes/seconds): W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds): N
Longitude (degrees/minutes/seconds): W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds): N
Longitude (degrees/minutes/seconds): W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds): N
Longitude (degrees/minutes/seconds): W
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? Unnamed tributary to Browns Creek through Cross Pond to the Cape Fear River
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NCG070000 N.O.I.
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
10) Does this facility have any other NPDES permits?
I 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
I Yes
If yes, please briefly describe: The facility currently implements a Storm Water Pollution Prevention Plan,conducts annual storm water
training of its employees,utilizes covered loading/unloading areas,performs periodic inspections of its manufacturing and material storage areas
for potential pollutants,performs inspections of illicit discharges,practices good housekeeping,and utilizes natural and grassed lined swales to dishcarge storm water.
13) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No
PI Yes
If yes, when was it implemented? October 2015
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?
I No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month)of
hazardous waste?
INo ❑ Yes
c) 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/disposal vendor:
Vendor address:
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NCG070000 N.O.I.
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.
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 of Person Signing: Jonathan Drury
Title: Factory Manager
fl , 1614am
I ► -ture of Applicant, ( o Sned)1
Notice of Intent must be accompanied by a check or money order for$100.00 made payable to NCDEQ
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SWU-222-071408 Last Revised 6/24/14

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FIGURE Ia Alfa Laval KATHABAR, Inc.
USGS Quad Site Location Map 1301 S. Poplar Street
Source: USGS Quad, Elizabethtown, North Carolina
Elizabethtown South, NC, Date: WES Project No.: 28337
2013 October 2018 18-032
Drawn by: Checked by: Reviewed by: Approved by: Ward Environmental Services
RAW RAW RAW RAW 10077 Amelia Manor Court
Scale: File name: Mechanicsville,Virginia
1:24000 Figure Ia Site Location Map

.#� °P ' i .* Alfa Laval
'' KATHABAR
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FIGURE 2 Alfa Laval KATHABAR, Inc.
Aerial Site Plan 1301 S. Poplar Street
Source: Bing Maps Elizabethtown, North Carolina
Date: WES Project No.: 28337
October 2018 18-032
Drawn by: Checked by: Reviewed by: Approved by: Ward Environmental Services
RAW RAW RAW RAW 10077 Amelia Manor Court
Scale: File name: Mechanicsville,Virginia
No Scale Figure 1b Site Plan

NCG070000 N.O.I.
Final Checklist
This application will be returned as incomplete unless all of the following items have been included:
Gd/ Check for$100 made payable to NCDEQ
This completed application and all supporting documents
Y Copy of county map or USGS quad sheet with location of facility clearly marked on map
Mail the entire package to:
DEMLR - Stormwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Note
The submission of this document does not guarantee the issuance of an NPDES permit.
For questions, please contact the DEMLR Central Office or Regional Office for your area.
DEMLR Regional Office Contact Information:
mo—
Asheville Office [phone]
Fayetteville Office [phone] ,`y, ` t�� ', r :111F1 h
Mooresville Office [phone] ►� '�'4` � ��;�
Raleigh Office [phone] -- `
.. s Ile N 44":41° 4
Washington Office ...[phone] �,
Wilmington Office ... [phone] ,'
c} ,
FayIles
Winston-Salem [phone] S.f
Central Office [phone] �.'
/`Wi1, ngton
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SWU-222-071408 Last Revised 6/24/14

North Carolina Secretary of State Search Results Page 1 of 1
•File an Annual Report/Amend an Annual Report•Upload a PDF Filing•Order a Document Online•Add Entity to My Email Notification List•View
Filings• Print a Pre-Populated Annual Report form•Print an Amended a Annual Report form
Business Corporation
Legal Name
Alfa Laval Inc.
Information
Sosld: 0654633
Status: Current-Active
Annual Report Status: Current
Citizenship: Foreign
Date Formed: 12/3/2002
Fiscal Month: December
State of Incorporation:
NJ
Registered Agent:CT Corporation System
Addresses
Reg Office Reg Mailing Mailing Principal Office
160 Mine Lake Ct Ste 200 160 Mine Lake Ct Ste 200 5400 International Trade Drive 5400 International Trade Drive
Raleigh, NC 27615-6417 Raleigh, NC 27615-6417 Richmond, VA 23231 Richmond, VA 23231
Officers
Secretary Vice President Vice President Treasurer
William J. Connolly William J. Connolly Ross Glendinning Joseph M. Lawrence
5400 International Trade Drive 5400 International Trade Drive 5400 International Trade Drive 5400 International Trade Drive
Richmond VA 23231 Richmond VA 23231 Richmond VA 23231 Richmond VA 23231
Vice President Assistant Secretary Assistant Treasurer Vice President
Joseph M. Lawrence John Lund Robert T. Madison , Jr. Victor Mazza
5400 International Trade Drive 5400 International Trade Drive 5400 International Trade Drive 955 Mearns Road
Richmond VA 23231 Richmond VA 23231 Richmond VA 23231 Warminster PA 18974
Vice President Assistant Treasurer Chief Executive Officer President
John Piazza Anil Rohani-Shukla Jo Vanhoren Jo Vanhoren
5400 International Trade Drive 5400 International Trade Drive 5400 International Trade Drive 5400 International Trade Drive
Richmond VA 23231 Richmond VA 23231 Richmond VA 23231 Richmond VA 23231
Stock
https://www.sosnc.gov/online_services/search/Business_Registration_Results 2/5/2020