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HomeMy WebLinkAboutNCG520109_Regional Office Historical File 20200527 EMERGENCY NOTIFICATION INFORMATION NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF WATER OUALITY-LABORATORY SECTION 4405 REEDY CREEK ROAD RALEIGH,NC 27607-6445 TEL.#(919)733-3908 FAX#(919)733-6241 (This confidential information will be kept in a sealed envelope in your personnel file and with your supervisor. It will only be used in �1ip`n the event of a real emergency.) Update this form if the information changes. NAME: U\�ll�l.I� Al V"e SOAAV\AkyS DATE: : "-I3-05 (First) (Middle Name) �� (Last) �� 11tt HOME: 12�50 � �iu..StAS A_;YU1,XWnQ. A�Y4I),Q9, n 111 N oZ�'51�- l�5/1 ADDRESS (Street Number and Name) (City) (State) (Zip) (County) AGE_a'&—DATE OF BIRTH ;a-q- 9Ra RACE aew6EX F MARITAL STATUS j SOCIAL SECURITY#:_ /a a4-�I ,,--1�- �IZ HOME PHONE: 2 9 I`�-3 70- 9I0C4 MEDICAL PROVIDER: i.=J KeA IDENTIFICATION#: PRIMARY PHYSICIAN: �Ih TELEPHONE Ia4ES /\ PERSONS TO CONTACT IN CASE OF EMERGENCY f NAME: �OIAr> I alo-iiok lho RELATIONSHIP: �L HOME 5a aS Abovle- ADDRESS: (Street Number and Name) p (City) (State) (Zip) EMPLOYER: VastU C &LZL kA t�, HOME PHONE: q Iq- -n O- -I IOU WORK PHONE: '1 I q - 1 (D -a I Op 5 r (Area Code) (Number) (Area Code) (Number) NAME: ^^ I \,, W 5 RELATIONSHIP:_1 l /��0� //-� HOME: 6d�� T + k'h Dim `P;IQuI L6- V A 9'; 3)0 ADDRESS (Street Number -and �Name) (City) (State) (Zip) EMPLOYER: r LCX �^1 alzt la / HOME PHONE: 0-3 d-4' WORK PHONE: 6�/� Ul '0439 (Area Code) (Number) (Area Code) (Number) SPECIAL MEDICAL INFORMATION Do you wear contact lenses? Yes `� No Are you an organ donor? Yes Do you currently have any medical condition or allergy that should be made aware to others? Yes ✓ No If so,p1EsG rl �,Q�lj)r` explain the procedures to follow in case of emergency: ememotl07/05 i '.i I� 'I 'j I� n n STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY DIVISION OF WATER RESOURCES GENERAL PERMIT NCG520000 CERTIFICATE OF COVERAGE NCG5201.09 DISCHARGE OF IN-STREAM SAND MINING WASTEWATER, ASSOCIATED STORMWATER AND SIMILAR DISCHARGES UNDER THE NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM In compliance with the provision of North Carohna 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, LBM Industries, Inc. _ is hereby authorized to discharge instream mining wastewater from the following facility: Solesbee Mine Wide Horizon Rd Franklin Macon County to receiving waters designated as the Little Tennessee River, a class C stream in subbasin 04-04- 01 of the Little Tennessee River Basin. All discharges shall be in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, If, III and IV hereof. This certificate of coverage shall become effective June 22, 2016. This Certificate of Coverage shall remain in effect for the duration of the General Permit. Signed this day June 22, 2016 C for S. Zimmerman, P.G. Director, Division of Water Resources By Authority of the Environmental Management Commission e°;r: r.lL PAT MCCRORY DONALD R. VAN DER VAART Wafer Resoi�nres S. JAY ZIMMERMAN ENVIItoXM6N rfil.LiePLI I Y pirry[ur June 22, 2016 Mr. William L McNeely, III LBIVJ Industries, Inc. P.O. Box 40 - Sapphire, NC 28774-0040 - Subject: Renewal of coverage/General Permit NCG520000 Solesbee Mine Certificate of Coverage NCG520109 Macon County - Dear Permittee: The Division hereby renews Certificate of Coverage(CoC) NCG520109 to discharge under General Permit NCG520000. This CoC is issued pursuant to the requirements of North Carolina General Statue 143-215.1 and the Memorandum of Agreement between North Carolina and the US Environmental Protection agency dated October 15, 2007 for as subsequently amended]. If any parts, measurement frequencies or sampling requirements contained in this General Permit are unacceptable to you,you have the right to request an individual permit by submitting an individual permit application. Unless such demand is made, the 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. The Division may require modification or revocation and reissuance of the certificate of coverage. Contact the Asheville Regional Office prior to any sale or transfer of the permitted facility. Regional Office staff will assist you in documenting the transfer of this CoC. This permit does not affect the legal requirements to obtain any other Federal, State, or Local governmental permit that may be required. If you have any questions concerning the requirements of the General Permit, please contact John Hennessy [919 807-6307 or john.hennessy@ncdenr.gov]. er ly, f.2 or S.Jay Zimmerman, P. Director,Division of Water Resources o Ism tw mr ere eurcas '. cc: Asheville Regional Office NPDES file Jun 3 0 2011 State of North Carolinas Environmental Quality I Water R sour�srp�C�����r q�nione�pnerntlone 1617 Mail Service Center I Raleigh,NC 27699-1617 9198076300 919-807-6389FAX https://deq.ne.gDv/about/divisims/water-resources/water-r mrceapevnits/wastewater-bmch/npdes-wasteweer-permits