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STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT N0.
IV uc, bQ
DOC TYPE
I� HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ 201v 0 (� �
WYYMMDD
NC�..D.�I tENR
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NWTl WNLEEI T,L,7 OF
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Division of Energy, Mineral and Land Resources
Land Quality Section / Stormwater Permitting Program
National Pollutant Discharge Elimination System (NPDES)
PERMIT OWNER AFFILIATION DESIGNATION FORM
(Individual Legally Responsible for Permit)
FOR AGENCY USE ONLY
Date Received
Year
Ytonth
Da
if NO CHANGE in company or facility ownership or name has occurred.
If a Name Change and/or Ownership Transfer at the facility has prompted this change, do
NOT use this form. You must fill out the Name -Ownership Change Form and provide all
necessary supporting documentation instead.
1) Enter the permit number for which this change in Legally Responsible Individual ("Owner
Affiliation") applies:
Individual Permit
N I C I S
2) Facility Information:
Facility name:
Company/Owner Organization:
Facility address:
(o,) Certificate of Coverage
N I C I G Q Z 1 a 0 3 0
kitJiUttTp�cE Qc.[q�,z
kVAKF_ 57W)C' Co2Po�rro�
6511 ei)tyltrD*LX &VO , —
Address
K k)J16(K�LE , & Z 1-5*5
City State Zip
To find the current legally responsible person associated with your permit, go to this website:
http://portal.ncdenr.org/web/Ir/sw-permit-contacts and run the Permit Contact Summary Report.
3) OLD OWNER AFFILIATION that should be removed:
Previous legally responsible individual: 0A01 D F- LE
first M1 Last
4) NEW OWNER AFFILIATION (Legally responsible for the permit):
Person legally responsible for this permit: 1+&DOX67 D. aaA—rrV j
First Ml Fast
C Eb
Title
RECEIVED
JUL 012014
DENR-LAND QUALITY
STORMWATER PERMITTING
Po BOA 116
Mailing Address
l.3HnjtLC o L 2-j'545
City State `Lip
( 919) Z66 - lIDO 1&,jb1,4&4g lcakeG
Telephone E-mail Address
( q14 ) 2106
l--ax Number
SWU-0WNERAFFIL-22M2y2014 ).
� Rage I of 2
NPDESStormwater Permit OWNER AFFILATION DESIGNATION Form
(if no Facility Name/Ownership Change)
5) Reason for this change:
A result of:
If other please explain:
What does "legally responsible person" mean'?
That person is either:
❑ Employee or management change
Inappropriate or incorrect designation before
❑ Other
• the responsible corporate officer (for a corporation);
• the principle executive officer or ranking elected official (for a municipality,
State, Federal, or other public agency);
• the general partner or proprietor (for a partnership or sole proprietorship);
• or the duly authorized representative of that person above.
The certification below must be completed and signed by the permit
holder.
PERMITTEE CERTIFICATION:
1, , attest that this application for this change in Owner Affiliation
(person legally responsible for the permit) has been reviewed and is accurate and complete to the best of my
knowledge. I understand that if all required parts of this form are not completed, this change may not be
processed.
Signature tc
PLEASE SEND THE COMPLETED FORM TO:
Division of Energy, Mineral and Land Resources
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
For more information or staff contacts, please visit our website:
http://Aortal.nedenr.orpiweb/Ir/stormwater
KA114ftT,0ifL E &4*R L ,
Page 2 of 2
SW U-OWNERAFFIL-22May2014
Division of Energy, Mineral and Land Resources
Land Quality Section / Stormwater Permitting Program
National P011LItanl Discharge Elimination System
PERMIT OWNER AFFILIATION DESIGNATION FORM
(Individual Legally Responsible for Permit)
FOR AGHVCY USEONLY
Dale Rccciwd
Ycar I %lomh
t)u -
if NO CHANGE in company or facility ownership or name has occurred.
If a Name Change and/or Ownership Transfer at the facility has prompted this change, do
NOT use this form. You must fill out the Name -Ownership Change Form and provide all
necessary supporting documentation instead.
l) Enter the permit number for which this change in Legally Responsible Individual ("O-,vner
Affiliation") applies:
Individual Permit
N I C I SI
2) Facility Information:
Facility name:
Company/Owner Organization:
Facility address:
(o) Certificate of Coverage
N I G I G1,012 D O 3 0
k1d1441fTDACC
W/+r-F SMUG COlzPoa�ftrp►J
6,511 6J t(J1trD*cac B L V p.
Address
Kut(2ftf-DAL6E , 1�L ZF-545
City State -Lip
To find tllc current legally responsible person associated Nvith your Hermit, go to this wcbsite:
htt �:II ortal.ncdenr.br ,'~�eb/lr/sw- �rsllit-contacts and ruts the 1'crmit Contact Summary Report.
3) OLD OWNER AFFILIATION that should be removed:
Previous legally -responsible individual: DMJ! p F • LEG
First 11! Lust
4) NEW OWNER AFFILIATION (Legally responsible for the permit):
Person legally responsible for this permit: 1lflit DOPE D. a11.R'I`f71, 1
First ktI Last
CCb
Title
Po 3o l- l 9 o
Mailing Address
h1J iGN--wt,e �) L _ 2- 545
cii}. State zip
{ ql1 } Z66 -11 QD 16r rri(a) WAket-fact ca ti
"T'elephou l -mail Address
( y14) 2b6-11-
FaN Number
Page I of 2
S VV U-O W N E RAF F I L• 22 M a y 2014
NPDESStormwater Permit OWNER AFFILATION DESIGNATION Form
(it' no facility Nanie/Ownership Change)
5) Reason for this change:
A result of:
Ifolher please explain:
What does "legally rc3punsible person" mean?
'>E`lt.lt I�er;:t�i1 is ei,tl�i.°t•:
[� Employee or management change
inappropriate or ineorrect designation before:
[� Other
a the reslionsible corporate officer (for is corporation):
fl e p6nciple executive o('liccr or ranlcim elected offlc.1,11 0'Ot' a nitinicipality;
State. Federal; or other public a-ency)-
s tlac encr.al partner nr Inoprietor (,tor a partnership or sale proprietorship). -
or the duly itulhoril.cd rej)resentative of th�ii person above.
The certification below must be completed and signed by the permit
holder.
1'F;l2M!'I"C'la�.Cl�l�'!'l l~ lCATlQiVs
l"%1ob02 �. �ifZ�T1`on! attest that this application for this change in Owner Affiliation
(person legally resPG)isible for the pQrmit) hits been reviewed rind is accurate and coinplete to the test of my
knowledge. 1 understand that if all required parts of this form are not completed, this change may not he
1�rocag5eti:
A.
Si�r'tittirre �� � to ----
:i.i......... i a ......................
PLEASE SEND TH C COMYLJE11) FOFIM TUt
Division of Energy, Mineral and Land Resources
Si6rmwuter Permitting Program
1612 Mail Service Center
kAleigh; North Carolina 27699-1612
F& More inrormation or .I-aff 6Untacts, please visit our website:
ltttp liort,tl.ncdpnr.ar level /lr/stocit7,k'2 l
K41141r,al-Le- 4k-6
Page 2 of 2
31M13•OWNaRAFFIi:•$2Mny201 a
Michael F. Easley. Governor
o�0� W A Tf R
February 7, 2005
David F Lee
Knightdale Quarry
PO Box 190
Knightdale, NC 27545
William G. Ross Jr„ Seerelary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, Y.L. Director
Division of Water Quality
Subject: NPDES Stormwater Permit Coverage Renewal
Knightdale Quarry
COC Number NCG020030
Wake County
Dear Permittee:
In response to your renewal application for continued coverage under general permit NCG020000 the Division of Water
Quality (DWQ) is forwarding herewith the reissued stormwater general permit. Please review the new permit to familiarize
yourself with the changes in the reissued permit. The general permit authorizes discharges of stormwater and some types of
wastewater. You must meet the provisions of the permit for the types of discharges present at your facility. This permit is
reissued pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement
between the state of North Carolina and the U.S. Environmental Protection Agency, dated December 6, 1983.
The following information is included with your permit package:
• A new Certificate of Coverage
• A copy of General Stormwater Permit NCG020000
+ A copy of a Technical Bulletin for the general permit
• Five copies of Discharge Monitoring Report (DMR) Forms - wastewater and stormwater
• Five copies of Qualitative Monitoring Report Form
Your coverage under this general permit is not transferable except after notice to DWQ. The Division may require modification
or revocation and reissuance of the Certificate of Coverage. This permit does not affect the legal requirements to obtain other
permits which may be required by DENR or relieve the permittee from responsibility for compliance with any other applicable
federal, state, or local law, rule, standard, ordinance, order, judgment, or decree.
If you have any questions regarding this permit package please contact Aisha Lau of the Central Office Stormwater Permitting
Unit at (919) 733-5083, ext.578.
Sin
cerely,
for Alan W. Klimek, P,E.
cc: Central Files
Stormwater & General Permits Unit Files
Raleigh Regional Office
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617
Internet: h2o.enrstate. nc.uslsulstormwater.html 512 N. Salisbury St. Raleigh, NC 27604
NonrhCarohna
,/Vatimil!il
Phone (919) 733-7015 Customer Service
FAX (919) 733-9612 1-877-623-6748
An Equal OpportunilylAffirmative Action Employer — 50% Recycled110% Post Consumer Paper
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG020000
CERTIFICATE OF COVERAGE No. NCG020030
STORMWATER AND PROCESS WASTEWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina 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,
Knightdale Quarry
is hereby authorized to discharge stormwater and to operate treatment systems and discharges associated
with mine dewatering wastewater and process wastewater from a facility located at
Knightdale Quarry
6721 US Hwy 64
Knightdale
Wake County
to receiving waters designated as Beaverdam Creek, a class QNSW stream in the Neuse River Basin in
accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, 11,
III, IV, V, and VI of General Permit No. NCG020000 as attached.
This certificate of coverage shall become effective February 7, 2005.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day February 7, 2005
for Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
L State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
December 17, 1999
DAVID F LEE
WAKE STONE CORP. - KNIGHTDALE QUARRY
PO BOX 190
KNIGHTDALE, NC 27545
Dear Permittee:
1 � •
NCDENR
NORTH CAROLfNA DEPARTMENT OF
ENVIRONMENT ANo NATURAL RESOURCES
Subject: Reissue - NPDES Stormwater Permit
Wake Stone Corp. - Knightdale Quarry
COC Number NCG020030
Wake County
In response to your renewal application for continued coverage under general permit NCG020000. the Division of
Water Quality (DWQ) is forwarding herewith the reissued stormwater general permit. This permit is reissued
pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement
between the state of North Carolina and the U.S. Environmental Protection Agency, dated December 6, 1983.
The following information is included with your permit package:
* . A copy of general stormwater permit NCG020000
* Five copies of the Analytical Monitoring form and five copies of the Qualitative Monitoring form
* A copy of a Technical Bulletin on this permit which outlines permit components and
addresses frequently asked questions
* A Certificate of Coverage for your facility
* DWQ fee schedule
Your coverage under this general permit is not transferable except after notice to DWQ. The Division may require
modification or revocation and reissuance of the Certificate of Coverage. This permit does not affect the legal
requirements to obtain other permits which may be required by DENR or relieve the permittee from responsibility
for compliance with any other applicable federal, state, or local law rule, standard, ordinance, order, judgment, or
decree.
Please note that in 1998 Senate Bill 1366 established changes to the permit fee structure for DWQ permits effective
January L 1999. This change requires that you pay an annual fee to assure continued coverage under this permit.
You will be invoiced for this fee beginning next year. A copy of the current fee schedule is included with this letter.
If you have any questions regarding this permit package please contact Tony Evans of the Central Office Stormwater
and General Permits Unit at (919) 733-5083, ext. 584
Sincerely,
for Kerr T. Stevens
Director, Division of Water Quality
cc: Central Files
Raleigh Regional Office
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone 919-733-5083 FAX 919-733-9919
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG020000
CERTIFICATE OF COVERAGE No. NCG020030
STORMWATER AND PROCESS WASTEWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina 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,
WAKE STONE CORP.
is hereby authorized to discharge stormwater and to operate or continue operation of treatment systems and
discharges associated with mine dewatering and process wastewater from a facility located at
WAKE STONE CORP. - KNIGHTDALE QUARRY
NORTH US 64 SMITHFIELD ROAD
KNIGHTDALE
WAKE COUNTY
to receiving waters designated as Beaverdam Creek in the Neuse River Basin in accordance with the effluent
limitations, monitoring requirements, and other conditions set forth in Pans 1, 11, II1, IV, V, and VI of General
Permit No. NCG020000 as attached.
This certificate of coverage shall become effective December 17, 1999.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day December 17, 1999.
for Kerr T. Stevens, Director
Division of Water Quality
By Authority of the Environmental Management Commission
A
COMPLIANCE
Permit No, N CC-M2Z?�3LN'ew 1 Modification Renewal
Discharging code: Actives_ Special*INewly issued �—
Active, but not discharging (on Hold
SIC Code: 427T_Wastewater code(s): M T U:
Basin Code: Major, 03Minor: 04 Sub -minor: O-Z
Latitude: 36 6 'Zi Longitudes la� 3 O 00
Type Ownership_ PV-- I Minor: ,I Major;
*No monitoring required
or
State of North Carolina
Department of Environment, Health and Natural Resources
Division of Environmental Management
512 North Salisbury Street • Raleigh, North Carolina 27604
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
April 30, 1993
David F. Lee
Wake Stone Corporation
P O Box 190
Knightdale, NC 27545
A. Preston Howard, Jr., P. E.
Director
Subject: General Permit No. NCG020000
Wake Stone Corporation-Knightdale Quarry
COC NCG020030
Wake County
Dear Mr. Lee:
In accordance with your application for discharge permit received on September 29, 1992, we are
forwarding herewith the subject certificate of coverage to discharge under the subject state - NPDES general
permit. Issuance of this certificate of coverage supercedes the individual NPDES permit No. NCO003646.
This permit is issued pursuant to the requirements of North Carolina General Statute 143-215 .1 and the
Memorandum of Agreement between North Carolina and the US Environmental Protection agency dated
December 6, 1983,
If any parts, measurement frequencies or sampling requirements contained in this 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, this 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
of Environmental Management. The Divsion of Environmental Management may require modification or
revocation and reissuance of the certificate of coverage.
This permit does not affect the legal requirements to obtain other permits which may be required by the
Division of Environmental Management or permits required by the Division of Land Resources, Coastal Area
Management Act or any other Federal or Local governmental permit that may be required.
If you have any questions concerning this permit, please contact Mr. Steve Ulmer at telephone number 919f733-
5083.
cc
Sincerely,
Original Signed By
Coleen H. Sullins
A. Preston Howard, Jr., P. E.
Raleigh Regional Office
Pollution Prevention Pays
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone 919-733-7015
An Equal Opportunity Affirmative Action Employer
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
ROOM M W 01MMEMM9111HO-14IIII
I I _�: _ aI ► I II I
STORMW ATER, MINE DEW ATERING, AND/OR OVERFLOW FROM
PROCESS WATER RECYCLE SYSTEMS DISCHARGES
In compliance with the provision of North Carolina General Statute 143-215.I, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
Wake Stone Corporation
is hereby authorized to construct and operate or continue operation of a treatment system for mine dewatering and/or
recycle systems process wastewater overflow with the discharges of treated wastewater and/or construct and discharge
stormwater from a facility located at
Wake Stone Corporation - Knightdale Quarry
US Hwy 64
Knightdale
Wake County
to receiving waters designated as Beaverdam Creek in the Neuse River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I,1I, III
and IV of General Permit No. NCG020000 as attached.
This Certificate of Coverage shall become effective April 30, 1993.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day April 30, 1993.
Original Signed By
Coleen H. Sullins
A. Preston Howard, Jr., P.E., Director
Division of Environmental Management
By Authority of the Environmental Management Commission
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