NCG020647_COMPLETE FILE - HISTORICAL_20041018

STORMWATER DIVISION CODING SHEET. - -
RESCISSIONS.
PERMIT NO.
NC� OabW
DOC TYPE
COMPLETE FILE -HISTORICAL
DATE OF
RESCISSION
❑ �� l/�� I � I b
YYYYMMDD

0/10/2005 15:d4 9197339612 PAGE 07
pivision of Water Quality ! Water Quality
NCDENR National Pollutant Discharge
1:�lrN fj7CL,Ma DmTrY[M Cf
NcGozoa
NOTICE OF INjE
National Pollutant Discharge Elimination System applice
NCGa20000:
STORMWATER DISCHARGES associated with activities
SIC 14 Mineral Mining industry (except as specifil
The following activities are also included:
• Active or inactive mining operations (locluding borrow p
Mat has coma in contact with, any overburden, raw mat
byproducts or waste products located on the site of suc
• 5tormwater frool vehicle maintenance activities at mink
procass wastewater; and/or mine dewatering
The following activitlea are specifically oxcigded from cl
• Peat mining, coal mining, and metal mining
r� stormweter discharges from mining operations which a
operations, and oil and gas tract'on�o'pera ttop
s
kA ACQj6ase pr
1) Mailing address' of ownerloperator:
Name
Street Address _ rlyw__
city
Telephona No. z--, Ili. �
2) Location of facility producing discharge:
Facility Name `r E&�- __
Facility Contact __
Street Address _ r-2,
City _�- $__
County L--
Telephone No.L
3) Physical Location Information.
Please provide a narrative description of how to get to
distance and dire ion frgm a r adway ' terser en)
IA Gogy of a 00ty reap or USG$ quad shell with faollly! cie&rly IGGal
ination S
ii11 �
t
n for cove U in i
sslfieci 8s OCT 1 8 2004
WATER QHAi.iTY
POIyT SpORGE BRANCH'
p ....
that Ischarge slormwater"cbrttdrriitl�, a .. . r r; }
ial, inte fate praduc%Jl�i]shed rodue7s,-
3perations
operations; overflow from facilities that recycle
arage under this Generai Permit:
intermixed on site With stormweter from asphalt
Standard Industrial Chglilitcotlan Code
or type)
iAl/Cl. •
$take —VC- ZIP Code _'�
Fax:-----
` Addregq to which all parmll correspondence will be wUed
Irk e C_'r)rn tea" ,T.
state [G ZIP Code
T_ Fax: _----_
fgcilitty u&e sheet
the rnap is reprjlfed to be
road
IMa
5WU-217.101701
Page 1 _�f 4

01-l1812005 15:44 5197339612
P46E 08
NCG020000 N.O.I.
4) This NPDES Permit Application applies to which of tht fvllowing :
Now or Proposed Facility p Date a erati�n is to begin
❑ Existing
5) Standard Industrial Classification;
Provide the 4 digit Standard Industrial Classification Code; SlC Code) that describes the primary industrial
n
activity at this facility
SIC Code:
S) Provide a rief arr$tive q9geription of the typos of m lerals mined at this fecllhy: - j -
/ fikOl `f� d 1;5l l
7) Discharge Points:
Number of dischargepolnts (ditches, pipes, chanrls.etc, that convey discharges'from the property):
Stormweter: Mine dewatering:___ f?! ecess Wastewater Overflow_ ; jr_�'6
Please pro ids s rt n native desorotlon pf discharges; '� �1YI0 --11f u- _
i
8) Receiving waters:
What Is the name of the bo y or bodies of water {
discharges end up In? ——�
If the site stormwater discharges to a separate storm s
sewer system (e.g. City of Raleigh municipal storm se,
9). Does this facility have any other NPDES permits?
W No
❑ Yes
If yos, list the permit numbers for all current NPDES p
10) Does this facility have any Non-Dischargo permits
No
❑ Yes
If yes, list the permit. numbers for all current Non-Disel
1.1)- does thla fecllity .employ any boot menagemont pt
❑ No
Ayes
if yes, p se grlcfly Ob.01
em, river, I e, etc.) thal,the facility stormweter
fin ,
_
system, name the operator of the sep&dle storm
;'for this facility,
recycle permits)?
permits for this facility: —�
3'e for stormwater control?
12) Does this facility have a Stormwater Pollution Preve rig oil Plan?
❑ Yes
If yes, when was it implemented?
13) Are vbhtcla Maintenance attivitles occurring at this f4 iiity?
No ❑ Yes
14) Are' mine dawateriag discharges occurring?
�N.O ❑ Yes.
Page 2 of
SW U-217-i M 701 !

01f18/20O5 15:a4 9197339612
i
PAGE 09
NCGO20000 N.0.1.
15) Are discharges of overflows from process wastewater atrttent systems occurring?
X No
❑ Yes
If yes, answer the following questions can the wastewater tT bnont system,
a) Please descfibe the type of process used to treat an r recycle the process wastewater. Givd design
speclfics (I-e. design volume, reWntion One, surface I Via, etc,). Existing treatment todl�es should be
described in detail and design criteria or operational to should be provided (including celbUWlohs) to
efture that the facility can comply with requirements; f the General Permit. fuse ssparate sheet(s)]
NOW Construction of any wastewater traetmant facillbes raqulre submleslon of three (3) seta or plena 'VIM
spacificatbm along with their applicatlon. Doslgn a treatment tadlilies must iuomply with regoMmenie
15A NCAC 2H .013ii, If aanstruction of wastewater er`Itment fecilitlea applies to the dlechdrge or prof e!§@
Wastewalar, Include thrcie seta of plans and spaciri lonti with this application.
b) Dees this facility employ chemical additives to flocou to suspended solids?
❑ No
❑ Yes
If yes, please state the name, manufacturer and the uantity of average daily Usage Of the chemical
additive
c) Does this facility overflow only during rainfall events
❑ No Q Yes
16) Hazardous waste:
a) is this facility a Hazardous Waste Treatment, Storage,
L�No ❑Yes •
1�
b) Is this facility a 5niall Quantily Generator (less than 1
hazardous waste?
X. No Cl Yes
c) Is this facility a Large Quantify Generator (1000 kg, of
hazardous waste?
YNo Q -Yes
d) if you answered yes to questions b. or c., please proms
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:
17) Qertlfleatiow
North Carolina General Statute 143-215.6 b (1) provid g
Any parson who knowingly makes any false slstement, represen c
ptan ar omar document flied Or required to be malntalned un o
Managameni Commisslon implementing t"I Article, or who (alrifi
a'
rocarding or mpnitoriAg devlea nr method required to be operated o
Environmental Management commission Implementing 1hst Articlal51
Page 3 o 4
SWU-217.101701 i
the 10-yr, 24-hr rainfall event?
Disposal Facility?
kg. of hazardous waste'gensrated per li'tonth) q(
more of hazardous waste generated per month) of
the following information:
that.
v er certificatlon In 4iny apollcation, raeerd, report.
Articla 21 or regulations of the Environmental.
Wripere wlit1 or knowingly. rendere InacCUrots shy
rnalntainod under Article 21 or rogulatlans of the
all bo gullty of a mladorneanor punishable by a fine

,0t/18/2005 15:d4 9197339612
PAGE 10
NCG020060 N,Q.S,
not to exceed V0,000, or fay Imprlsonment not to exceed six month; or by both. t10 u.S.C. Sodkm 1001 prgvidlou a
punlahmvnt by a fine of net mere than $10,000 or Imprisonment not ma than 5 yearn, or both, for 9 alrr+ltar Offense.)
hereby requtr5t coyorage-underthe raferencod General Pe mlt. i undofstand that Coverage tender this permit
11
will Constitute the permit requirements for the discharge(s) And is enforceable in the same manner as an
indlvldual permit.
I agree to abide by the following as a part of coverage unda"r this General Permtt,
1. I agree to abide by the approved Mining Permit for t1i s mining activity. (A copy of the valid
mining permit must be attached to this request.
2. 1 agree to not discharge any sanitary wastewater troji this mining activity except under the
provisions of another NPDES permit specifically i,95J d therefore,
3. 1 agree that bulk storage of petroleum products and ther chemicals shall have adequate
protection so as to contain all spills on the site.
1
4- 1 agree that solid wastes will be disposed of in acc t ante with KC. statutes acid rules
governing solid'waste disposal,
5. 1 agree 'that maintenance activities for vehicles and eavy equipment will be performed so as to
not result in contamination of the surface or ground vaters,
I agree to abide by the provisions as listed above and recinj nize that the provisions are to be considered as
enforceable requirements of the General Permit
I certify that I am fhmillar with the information contained in j is application and that to the best of my'knowledge'
and belief such Information is two, complete, and accurate!�
Printed Name o arson igni _P— I Ot
L
Title: --------------- �---------------= ----=---- -_
of R nt t f red
(Signature ppllca t
Notice of Intent must be accompanied by a chock or monq order for $80.00 made payable to: '
NCbENI
Final Checklist
This applidation will'be`returned as incomplete unless all
❑ Check for ` 80 made payable to NCDENR
❑ This completed application and all supporting documen
Q Copy of the valid approved mining permit for the facility
❑ Gopy of mkirity reap or USES quad sheet with location
Mail the entire.pae-kage.to:
Stormwater and Gene'r4H;'ermits Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
the following i:g r,s ;lava &ran Included:
facility dearly marked on map
NkstB
The eubrmiaslon of this document does not guar ntae the Issuance of an I,IIPbES permit.
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