NCC201233_NOI Application_20200401

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 3/25/2020 1:16:06 PM (NCG01 NOI Submission)
Approve by Clark, Paul 3/26/2020 9:51:48 AM (Review- Construction NOI 23570)
• Georgoulias, Bethany reassigned the task to Clark, Paul 3/26/2020 9:14 AM
• The task was assigned to McCoy, Suzanne by round robin distribution 3/25/2020 1:16 PM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: March 27, 2020 5:00
PM 3/25/2020 1:16 PM
Submit by McCoy, Suzanne 4/1/2020 8:28:39 AM (Payment Verification for NCC201233)
* Chandra N Woods
• McCoy, Suzanne assigned the task to McCoy, Suzanne 4/1/2020 8:28 AM
• The task was assigned to DEMLR NCG01 Payment Team. The due date is: May 7, 2020 5:00 PM
3/26/2020 9:51 AM

d� #
NORTH CAROLINA
Ernvlronmental qualily
A. Project Information
Part A.
Project Location and Waterbody Inforrration
la. Project Name * Blue Ridge Paper Products, Inc. dba Evergreen Packaging - Cell
6E Construction
1 b. Specific Lot This field rray be used to list specffc lot nunbers.
Numbers
2. County* Haywood
3. Highway or Street 1155 Incinerator Road
Address * Street narre only is acceptable if no address nun ber assigned yet
4. City or Township* Clyde
5. State * NC
6. Zip Code* 28721
7. Latitude* Enter the latitude in decinal degrees
35.5496
8. Longitude* Enter the longitude in decir al degrees (MJST be negative)
-82.8747
If you do not know the latitude and longitude coordinates for this project, you can search the location on this map of
North Carolina. Look for the coordinates in the bottom left corner.
9. Date to Begin*
03/30/2020
Estinated Construction Project Start Date
10. Date to End*
09/07/2020
Estir ated Construction Project End late
11. SIC (Primary)*
Industrial (1541)
Standard Industrial aasslfication for Ceveloprrent
12. Acres to be
10.70
disturbed*
(including off -site borrow and waste areas)
13. Total site area 244.30
(acres) *
14. Post- 0.00
construction (Estimated)
impervious area
(acres) *

NCC Project NCC-HAYWO-2020-Blue Ridge Paper Products, Inc. dba Evergreen
Tracking ID Packaging - Cell 6E Construction
Assigned automatically
Below you must enter waterbody information for surface waters affected by this project. Please consult
DWR's Surface Water Classifications Map Viewer to find waterbody name and corresponding index number. Please
enter only immediate receiving waterbodies - not waters downstream of those unless the project extends there. You
may enter up to 3 waterbodies if needed.
15a. Receiving Pigeon River
Wate rbody* Wre of waterbody into which stormwater runoff will discharge
15b. Waterbody 5-(7)
Index No.* NCWaterbody Index Number
Stormwater rJ No
discharges will flow r- Yes
to additional
wate rs *
16a. Is this project r Yes
subject to the NC r No, not subject to NC SPCA
Sediment Pollution
Control Act?*

B. Permittee Information
Part B. ^
F2rnittee Inforrration - Legally Fbsponsible Entity and Individual
Important: The person who signs the NOI Certification Form and signs the Certification in Section E of this application
form should be the same person as listed in THIS SECTION, or an authorized responsible individual within the same
organization. That person must be a responsible corporate officer who owns or operates the construction activity, such
as a president, secretary, treasurer, or vice president, or a manager that is authorized in accordance with Part IV,
Section B, Item (6) of the NCG010000 General Permit. For more information on signatory requirements, see Part
IV, Section B, Item (6) of that permit.
1. Organization Blue Ridge Paper Products, Inc., dba Evergreen Packaging
Name * If pernittee is an individual (i.e., organization does not apply), enter first and last nave in this field.
2. First Name* Wallace
If Corporation, enter Fbgistered Agent First Barre
3. Last Name* McDonald
If Corporation, enter Faegistered Agent Last %rre
3b. Title General Manager
4. Permitee E-mail [e-mail]
Address *
5. Permittee 828-646-2841
Telephone No.*
6. Permittee Mailing Street Address
Address* 175 Main St.
Address Line 2
city
Canton
Fostal / Zip Code
28716
Check box if the r Yes
street address the
same as mailing
address
State / Frovince / Faegion
NC
Country
us
7. Permittee Street
Street Address
Address*
1155 Incinerator Rd
Address Line 2
C7ty
State / Ffovince / Fbgion
Clyde
NC
Fbstal / Zip Code
Country
28721
us
8. Type of
Non -Government
Ownership*

C. Site Contact Information
Part C.
^
Roject Site Contact Inforrration
.......................................................................................................................................................................................................................................................................................................................................................................................
1. Primary Site
Nick
Contact - First
Name *
2. Primary Site
Batton
Contact - Last
Name *
3. Title
Environmental Manager - Waste and Water
4. Site Contact E-
[e-mail]
mail Address*
5. Site Contact
828-424-0101
Telephone No.*
6. Organization
Evergreen Packaging
Name
7. Site Contact
Street Address
Mailing Address*
175 Main Street
Address Line 2
City State / Rovince / Region
Canton NC
Fbstal / Zip Code Country
28716 US
8. Consultant Name
(Optional)
Kevin Connolly
First and Last narre
9. Consultant E-mail
[e-mail]
This person will be copied on all correspondence.
10. Consultant
207-329-9489
Telephone No.

D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 03/20/2020
Approved *
2. E&SC Plan Project 032320
Number/ID * Assigned by agency or local program
3. E&SC Plan f State DEQ Office
Approved by* r Local Program
4. Local Program* Haywood County
Documentation of E&SC Plan approval and the signed Notice of Intent (NOI) Certification Form is required for a
complete application. For linear projects, please also upload a site map showing the overall extent of the project or
include the beginning point and end point coordinates in the "Notes" box below.
5. E&SC Plan Land Disturbing Permit County.pdf 177.39KB
Approval letter or Mast beRDFformat
Grading Permit
Site Map (Optional) Helpful for linear project review
Mast be R7Fform3t
Notes (Optional) Frovide any additional information that night help the reviewer better understand how uploaded documents support
the application. Include additional w aterbodies for linear projects if necessary.
6. NOI Certification NCG01 NOI Certification From.pdf 163.86KB
Form Mast be FDFfon-rat
This is an Express F No
Review Project* r Yes

E. Certification
North Carolina General Statute 143-215.66 (1) provides that:
Any person who knowingly makes anyfalse 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 Artcle; 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 Artcle shall be guilty ofa Class 2 misdemeanor which may include a fine not to exceed ten thousand
dollars ($10,000).
Under penalty of law, I certify that:
17 I am the person responsible for the construction activities of this project, for
satisfying the requirements of this permit, and for any civil or criminal penalties
incurred due to violations of this permit.
rJ The information submitted in this NOI is, to the best of my knowledge and belief,
true, accurate, and complete based on my inquiry of the person or persons who
manage the system, or those persons directly responsible for gathering the
information.
* 17 I will abide by all conditions of the NCG010000 General Permit and the
approved Erosion and Sediment Control Plan.
* rJ If the Erosion and Sediment Control Plan approved by the delegated program is
not compliant with Part II (Stormwater Pollution Prevention Plan) of the
NCG010000 General Permit. I will nonetheless ensure that all conditions of Part
II of the permit are met on the project at all times.
* 17 I hereby request coverage under the NCG010000 General Permit and
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.
Specify if you are:* r The Responsible Person named on this Notice of Intent
f Authorized Responsible Person*
Important: The person who electronically signs this Certification above must be the same person who signs the NOI
Certification Form. If that person is signing on behalf of the Permittee, that individual must be an authorized responsible
person within the same organization as the Permittee. *An authorized individual is a responsible corporate officer who
owns or operates the construction activity, such as a president, secretary, treasurer, or vice president, or a manager
that is authorized in accordance with Part IV, Section B, Item (6) of the NCG010000 General Permit. For more
information on signatory requirements, see Part IV, Section B, Item (6) of that permit.
Signature
j�%lLflaZr7� �/fr���vlraZlllr
Type Name* Wallace McDonald
Title General Manager
Organization Evergreen Packaging
Date * 03/25/2020

F. Tracking and COC Info
NOI Tracking No. 23570
NC Reference No. NCG01-2020-1233
Uses 'count number' variable (incremrented by SP)
Certificate of NCC201233
Coverage (COC) Uses 'count number' variable (incremented by SP)
No.*
Count Number 1233
Sequential number for submittal that is incremented by Stored Frocedure
COC Year 2020
Year of date reviewed (used to assign YY digits after "NOC' in COCno.)