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HomeMy WebLinkAboutNCG030675_COMPLETE FILE - HISTORICAL_20170221�F� Division of Energy, tNlineral & Land Resources land Quality Section/Stormwater Permitting NCDENRNational Pollutant Dischar<ge Elimination System A PERMIT NAME/OWNERSHIP CHANGE FORM FOR AGENCY LSE ONLY Date Received Year 141onth Day 1. Please enter the pennit number for which the change is requested. NPDES Permit (or) Certificate of Coverage N C S O N T G C7 13 0 1 4 z 11. Permit status prier to requested change. a. Permit issued to (company name): A wexieA,�-) b. Person legally responsible for pen -nit: KeAt $A�keK First &ll Last Fa./nAk, Title /o/ 44V LAME (F G`Ao -J Liar:) Permit Holder Nlailing Address s�f�,spa nJC- 02&'g0 City State Zip ( 3�6 ) 84�o -137Z (33L } Q$7,-G$21. c. Facility name (discharge): Phone 1 Fax 9I v Rle.nv+ovrs[ �,ep4c t- d. Facility address: /Ol A£t! L.A,JF L/6!c n� GA+-S A-V Address Se7Tel�so.J tiL ZB�� e. Facility contact person: City State Zip Ke..4 &V- (334 ) 134e.— i37Z First / M1 / Last Phone 111. Please provide the following for the requested change (revised permit). a. Request for change is a result of: ❑ Change in ownership of the facility ❑ Natne change of the facility or owner If other please explain: �i 4C 4 / Ak3fl )w N di AvA-MC b. Permit issued to (company name): } M Co ftS uQ 1►32 c. Person legally responsible for permit: ZCIFF ggyel- 1L�J �� First N11 �Last �t2E�t. of �io..►u N DEC 13 2017 Title 4,We1Li eAAJ 91At.L_ DENk4A- Nb WALO d. Facility name (discharge): e. Facility address: _ Pennit Holder Mailing Address Je s�a.J aJL Z$Gqo City State Zip ( Sy 11K• c) Re4er 9cLcv. Co A% Phone E-mail Address RE V Re M owsl C10C ia/ AEV L PJ-r Address TQfl�e4soA ^)L Zsb!? City State Zip f. Facility contact person: bae-yeP First MI Last (32.4) 8 `f & So A9 , re -ye r Q cLe V. Coati Phone E-mail Address IV. Permit contact information (if different from the person legally responsible for the permit) Revised Jan. 27, 2014 NPDES PERMIT NAME/OWNERSHIP CHANGE FORM Page 2of2 Permit contact: 41� 1�R41�R- First N11 rLast Title Nlai[in, .Address 7 tom- R ,, P. /Je- 2 E G S City State Zi ( 3?r, ) IPA- Ban ' cam. dgi-,j c2 e,". cow. phone E-mail Address V. Will the permitted facility continue to conduct the same industrial activities conducted prior tot ownership or name change:' [Yes ❑ No (please explain) AJo+ C VI Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITENIS ARE INCONIPLET>E OR NIISSING- ❑ . This completed application is required for both name change and/or ownership change requests. ❑ Legal documentation of the transfer of ownership (such as relevant pages of a contract deed, or a bill of sale) is required for an ownership change request. Articles of incorporation are not sufficient for an ownership change. The certifications below must be completed and signed by both the pen -nit holder prior to the change, and the new applicant in the case of an ownership change request. For a name change request, the signed Applicant's Certification is sufficient. PI?R.-'V1lTTEE CERTIFICATION (Pennit holder prior to ownership change): I, , attest that this application for a name/ownership change has been reviewed and is accurate and complete to the best o o4vledge. I understand that if all required parts of this application are not completed and that if all require orttng infortnation is not included, this application package will be returned as incomnleten Signature Date CERTIFICATION I, , attest that this application for a name/ownership change has been reviewed and is accurate and complete to the best of my knowledge. I understand that if all required parts of this application are not completed and that if all required supporting information is not included, this application package will be returned as incomplete. Signature Date PLEASE SEND TUIE CONIPLETE APPLICATION PACKAGE TO: Division of Energy, Mineral and Land Resources Stormwater Permitting Program 1612 Mail Service Center Raleigh, North Carolina 27699-1612 Revised Jan. 27, 2014 �.` Division of,Energy, Mineral & Lund Resources Land Quality Section/Store water Permitting National Pollutant Discharge Elimination System NC®E® PERMIT NAMEIOWNERSHIP CHANGE FORM FOR AGENCY usE ONLY Date ReCe!ved Year Month Da I. ]']ease enter the p.ennit.nttmber for, which the change is requested_ . NPD.ES Permit (or) Certificate of Coverage N I C I S 10 N C G U 3 O 1 e, 't 11. Permit status LjL(.ir to requested change. a. Pennit issued to (company name): AwaicA,� met .act �%�+ clams b. Person legally responsible for-Tennit: Kea' pakeR First, ill last Title poi Any GA.)6 (GA,-aLT (2a.4r6 LIWS) Yeriiiit. Floldcr hlailing,addi•ess. Sc [rE�t 3p►5 nj Z $ 4 5io city, Stab; Zip Ph2one /1 Fax C. Facility name (discharge): RSV 1lcrwot,ls� rL d. Facility address: /01 AgV LANF [J:e Ass +etc Address 5 �'4 N L zs� City Stale Zip e. Facility contact person: Ke,14 $ P-4ER• (334 ? $41.- 1.372. First / M11Last Phone Please provide (lie fallowing for the requested change (revised permit). a. Request for cliaiige is-6 result of: ❑ Chatige.in ownership of the facility fit❑ Name change of the facility or owner Ifo'iher please xplar.'rt: ��ClCt� � /,t7�,LMAJ� '� f3ytiD 4W0JeJ- AJR»iC b. Permit, issued to (company name): I coif. �p lac Person legally responsible for permit: E::� / First �Ntl M / ]Last �i2F�1f~ CT I'fiW�erT4l7v�%+'�Sr -Title 11,5' ArmniCAIJ .XIA Pennii Holder Mailing Address j 4 Sar] n]L 2964o City slate Zip (Sm }S�Fc.-8o�0 �� c}tzd�� cxey.con. Phone E-mail Address d_ Facility name (discharge): kf ReMObArl e. Facility address: /01 ALfV C.stnl' Address. .3 Q4�rex'-A4 IJL: Zll;b 1'7' City state Zip F. facility contact person: _ bieyeL First Nil Last (. 3 reXer O.+-Y lairs f�libnc 'E-mail Andress 1V. Permit contact information (irdifferent from the person legally responsible for the pennit) Revised Jan. 27, 2014 N I PDES PERMIT MAIVIE/PVVNit-R.59.110 CHANGE. FORM Page 2 of 2, Permit contact' IL MI LaM p4uiiing �ZeyiR: ;04- ciiy 'Siiio "4e_ 4A4. coy%% Phone E-malt Address Will the. permitted U ciliq'contiuue to'.conduct I he. same, i ndus,trial activitksvonducted prior to dI ' :gwnrrship or name chanife? -Yes ❑ No(please explain), 00#0e4-;kk"0 j'i'4. .j-e0'M.2C�:-AJ0+ dhkv,,' VI_ ARE INCOMPLETE OR MISSING- E] , This completed application is requiied for bo(h,nanie change.and/or ownership chanC,ge. El Legal doicuni6ilationof the transfer ofoWfi.&ijj' i P (such as relevant. pages of i'contradt d6dd dr A'bill of sale} is;e0iiired for. in Afti6le§.of itlidbrijohatio-h are. not sufficient,for. an ownership change. .................................................................................................................. The certiricatifl6i'is belcwV rhust.be ddLnpjeted and,sjgned by hoth tk ptirfri . it ho . I&Y pri6f,to the . I c . hange. and I the new,applicani in the ca'se,of an.6wntrship change request, Foi a nanlleichange request, thesighed Applicant's Certiricaiion'i's sufficient. PERMITTEF CERTIFICATION (Pen)iii.holder prior wownership change) -a attest'that this application hrq naine/ownershib change hqs,I?een reviewed and is accurate and ­ , , Attest. "that ­1' ­ ' 11 . I 1. _... I -. I _ . fi.. 4.1 , 1 1. . . - -_ complete to *be t p_ . b,.Vjddge. J understand that ifall rdq�ircd p is app not jcation dre o. t completed acid that if all reqpire­dr*ko:rfihg inf6rmat& is:n6t inli de this a001icati6n package will. lied returned qs.inconiplet� in awall P4 V4Wj C;1':R*_1Ffi7A_fIO' 1, attest 1114t:this application for.a narne/ownership change:'has heen reviewed-and).1,; accurate and .un qrs. and -that il,alllre uired 04rts of this application q pp ication are noll, completed and that ifall,required,supportihg information is:n6t.in'cluded,'this application package will be returned as incomplete. sighfitl#e Date PLEASE SEND THE COMPLETE APPLICATION -PACKAGE TO: Divisjon,olf Energy, M ineral'and Land Resources St6ffnNV. tet Perin it ing rogrqm J 612:.&IiiiI &rvi6e CO(& Raleigh, North Carolina, 27699:" 16 11 Revised Jan. 27',2014-. Energy, Mineral and Land Resources ENVMONMENTAL QUALITY Kent Parker REV Remount Center 101 6wtem-tm I I V REV LAID Jefferson, NC 28640 Dear Mr. Parker: PAT MCCRORY Gnremor DONALD R. VAN DER VAART September 14, 2016 C�e sw - 1016-l« Secri Inry TRACY DAVIS 0rpvcwo Subject: General Permit No. NCG030000 American Emergency Vehicles REV Remount Center COC NCG030675 Ashe County In accordance with your application for a discharge permit received on August 16, 2016, we are forwarding herewith the subject certificate of coverage to discharge under the subject state — NPDES general permit. 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 October 15, 2007 (or as subsequently amended). Please take notice that this certificate of coverage is not transferable except after notice to the Division of Energy, Mineral, and Land Resources. 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 the Division of Energy, Misting, and Land Resources, or permits required by the Division of Water 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 Richard Riddle at telephone number (919) 807-6375. Sincerely, ORIGINAL SIGNED BY MICHEAL F RANDALL for Tracy E. Davis, P.E., CPM, Director Division of Energy, Mineral and Land Resources cc: Winston-Salem Regional Office Central Files Stormwater Permitting Files State of North Carolina I Environmental Quality I Energy, Mineral and Land Resources 1612 Mail Service Cemer 1 512 North Salisbury Street I Raleigh, NC 27699.1612 919 707 9200 T r STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES GENERAL PERMIT NO. NCG030000 CERTIFICATE OF COVERAGE No. NCG030675 STORMWATER 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, American Emergency Vehicles is hereby authorized to discharge stormwater from a facility located at REV Remount Center 101 Gates Lane Jefferson Ashe County to receiving waters designated as Naked Creek, a class C+ water in the New River Basin, in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II, III, and IV of General Permit No. NCG030000 as attached. This certificate of coverage shall become effective September 14, 2016, This Certificate of Coverage shall remain in effect for the duration of the General Permit. Signed this day September 14, 2016. ORIGINAL SIGNED 8Y MICHEAL F RANBA.IJ- for Tracy E. Davis, P.E., Director Division of Energy, Mineral, and Land Resources By the Authority of the Environmental Management Commission Uuj M O ' C- A• REV Remount Center rr _, eft �\,�a,r NCG030675 N W E S Map Scale 1:24, 000 American Emergency Vehicles REV Remount Center Latitude: 360 25' 33.5" N Longitude: -81° 28' 50.6" W County: Rshe Receiving Stream: Naked Creek Stream Class: C+ Index Number: 10-1-32 (New River Basin) Facility Location Riddle, Rick L From: White, Glen Sent: Friday, September 02, 2016 3:12 PM To: Riddle, Rick L Cc: White, Sue; Gantt, Matt Subject: RE: Review of NOI - NCG030675 Rick I went by the site American Emergency site in Ashe Co. yesterday. Ok to permit. Glen White Environmental Specialist NCDENR Winston-Salem Regional Office Division of Energy, Minerals & Land Resources 450 Hanes Mill Rd — Suite 300 Winston-Salem, NC 27105 glen. white@ncdenr.gov (336)776-9660 From: White, Sue Sent: Monday, August 29, 2016 10:42 AM To: Gantt, Matt <matt.gentt@ncdenr.gov>; White, Glen <glen.white@ncdenr.gov> Subject: RE: Review of NOI - NCG030675 Hi Rick We'll get up there asap and let you know the status. Thanks! Sue White, El Assistant Regional Engineer Department of Energy, Minerals and Land Resources 336-776-9661 office sue.white@ncdenr.gov Winston Salem Regional Office 450 W. Hanes Mill Road Winston Salem, NC 27106 t �:-"Nothing Compares --,..- Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed to third parties. From: Gantt, Matt Sent: Monday, August 29, 2016 10:40 AM To: White, Sue <sue.white@ncdenr.gov>; White, Glen <glen.white@ncdenr.gov> Subject: FW: Review of N01 - NCG030675 From: Riddle, Rick L Sent: Monday, August 29, 2016 10:09 AM To: Gantt, Matt <matt. antt ncdenr. ov> Subject: Review of N01 - NCGO30675 Dear Mr. Gantt: Hello and good day again. Please review the attached NOI application and after your review and possible inspection, respond to me with any recommendations for issuance of the permit. 1COC # lFacility ILocation `City/County NCG030675 JAmerican Emergency 1101 AEV Lane !Jefferson/Ashe If you need any more info, please give me a call or email. I would like to request for you to send me your review or recommendation to issue the permit by 9/29/16. 1 appreciate all of your efforts. Thanks and have a great day. Rick Richard L. Riddle, Jr. Stormwater Engineer North Carolina Department Enviromental Quality North Carolina Division Energy Mineral Land Resources 919 807-6375 office rick.riddle a0mcdenr.aov 512 North Salisbury Street 1612 Mail Service Center Raleigh, NC 27699-1612 K�'C- "Nothing Compares. Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed to third parties. 2 A," RCDENR .rn Rpw Mf.Mf wrtl NwTURwL RE90�PCE! Division of Energy, Mineral and Land Resources Lana Quality Section National Pollutant Discharge Elimination System NCG030000 A AGENCY USE 0 Qate deceived aar hlontIi Certirtcaic arCoverp Prgnit A iqn d w National Pollutant Discharge Elimination System application for coverage under General Permit NCG030000: STORMWATER DISCHARGES associated with activities classified as: SIC (Standard Industrial Classification) 335 Rolling, Drawing, and Extruding of Nonferrous Metals SIC 3398 Metal Heat Treating 34 Fabricated Metal Products RECEIVED SIC 35 Industrial and Commercial Machinery SIC 36 Electronic and Other Electrical Equipment a11r, 16 2016 SIC 37 Transportation Equipment SIC 38 Measuring, Analyzing, and Controlling Instruments © PQUALITY STORMWAAND TER PERMI TY ITTING t For questions, please contact the DEMLR Regional Office for your area. See page 4. (Please print or type) 1) Mailing address of owner/operator (address to which all berm it corrQggondence will „be mailed): Name American Emergency Vehicles Street Address 165 American Way City Jefferson State NC ZIP Code 28640 Telephone No. 336 982-2938 Fax: 336 982-9826 2) Location of facility producing discharge: Facility Name REV Remount Center Facility Contact Kent Barker Street Address 101 AEV Lane (Formally 101 Gates Lane) City Jefferson State NC ZIP Code 28640 County Ashe Telephone No. 336 846-1372 Fax: 336 982-9826 Email aary.graybeal(a7aev.com 3) Physical Location Information: Please provide a narrative description of haw to get to the facility (use street names, state road numbers, and distance and direction from a roadway intersection). Travel North on-U.S. Hwy 421 throu_Qh_Vililkes County_ turn right on 16 North. Travel approx..20 miles, then turn left continuing on 16 / 88 for 4 miles. Then right on East Main Street / U.S.221 for 1.3 miles. Turn right on Northwest Drive for .3 miles then right on 101 AEV (A copy of a county map or USGS quad sheet with the facility clearly located must be submitted with this application.) 4) Latitude 36°42'62" Longitude 81°48'02" (deg, min, sec) /* 91, ` tO`73 Page 1 of 4 SWU-218-071408 Last revised 712114 NCG030000 N.O.I. 5) This NPDES Permit Application applies to which of the following: ❑ New or Proposed Facility X Existing 6) Standard Industrial Classification. Date operation is to begin 7115116 Provide the 4-digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial activity at this facility. SIC Code: 3 7 1 3 7) Provide a brief narrative description of the types of industrial activities and products manufactured at this facility: Chassis upgrades and refurbishing _operations for modular type ambulances. This would include interiors s along with paint and body working rocesses to re aidrefinish used modular boxes_ 8) Discharge points ! Receiving waters: How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? 2 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 Naked Creek Receiving water classification: C:+ The + under the New River Basin indicates the following. + This symbol identifies waters that are subject to a special management strategy s ecified in 15A NCAC 2B the Outstanding Resource Waters ORW rule in order to protect downstream waters designated as ORW. ' _ Is this a 303(d) listed stream? No Has a TMDL been approved for this watershed? No 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. n1a 9) Does this facility have any other NPDES permits? X No. ❑ Yes If yes, list the permit numbers for all current NPDES permits for this facility: 10) Does this facility have any Non -Discharge permits (ex: recycle permit)? X No ❑ Yes If yes, list the permit numbers for all current Non -Discharge permits for this facility: 11) Does this facility employ any best management practices for stormwater control? ❑ No X Yes (Show any structural BMPs on the site diagram.) If yes, please briefly describe: BMP_#1 West side parking lot drainage system. BMP #2 Concrete Collection Berm on Northeast side of property. BMP #3 Storm water pit on east side of building and BMP #4 Storm drain on northside. 12) Does this facility have a Stormwater Pollution Prevention Plan? X No ❑ Yes If yes, when was it implemented? SPPP_is in the Developmental_ Stage 13) Are vehicle maintenance activities occurring at this facility? X No ❑ Yes 14) Hazardous Waste: a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? X No ❑ Yes Page 2 of 4 SWU-218-071408 I aer rA%ikPr1 71711A NCG030000 N.O.I, b) Is this facility a Small Quantity Generator (less than 1000 kg, of hazardous waste generated per month) of hazardous waste? ❑ No X Yes c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of hazardous waste? X No ❑ Yes d) Is hazardous waste stored in the 100-year flood plain? X No ❑ Yes If yes, include information to demonstrate protection from flooding. e) If you answered yes to questions b. or c,, please provide the following information: Type(s) of Waste: SiDent Solvent Ra s Paint Thinner Waste Paint,Empty RCRA containers How is material stored: 55 gallon drums Where is material stored: Satellite Accumulation area, then a Hazardous Waste_ Containment How many disposal shipments per year: Unknown with an estimate of 36 drums per year. Name of transport 1 disposal vendor: Clean Harbors Vendor address: 42 Longwater Drive P.0_ Box 9449 Norwell, MA 02061-9149 15) Certification: North Carolina General Statute 143-215.66 (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 rutemaking 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 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: Gary Graybeal ^ Title: Cojivpliancel,lSQ Manager (Signature e/�--//� (Date Signed) This Notice of Intent must be accompanied by a check or money order for $100.00, made payable to: NCDENR Page 3 of 4 SWU-218.071408 Last revised 712114 NCG030000 N.O.I. Final Checklist This application will be returned as incomplete unless all of the following items have been included: ❑ Check for $100 made payable to NCDENR. ❑ This completed application and all supporting documents. ❑ A site diagram showing, at a minimum, (existing or proposed): (a) outline of drainage areas, (b) stormwater management structures, (c) location of stormwater outfalis corresponding to the drainage areas, (d) runoff conveyance features, (e) areas where materials are stored, (f) impervious areas, (g) site property lines. ❑ Copy of county map or USGS quad sheet with the location of the facility clearly marked on the map. Mail the entire package to: Stormwater Permitting Unit Program Division of Energy, Mineral and Land Resources 1612 Mail Service Center Raleigh, North Carolina 27699-1612 Note The submission of this document does not guarantee coverage under the General Permit. For questions, please contact the DEMLR Regional Office for your area_ DEMLR Regional Office Contact Information: Asheville Office ...... (828) 296-4500 Fayetteville Office ... (910) 433-3300 Mooresville Office ... (704) 663-1699 Raleigh Office........ (919) 791-4200 Washington Office ... (252) 946-6481 Wilmington Office ... (910) 796-7215 Winston-Salem ...... (336) 771-5000 Central Office ......... (919) 807-6300 Page 4 of 4 SWU-218-071408 Last revised 712/14 0 Jefferson Volunteer Fire Department, NC - N36.41804° W8 L48891° Page 1 of 3 Home Yew Maps r n.:f r.1.jj� r-od places Forum Resources 8 Links Welcome to the TopoQuest Map Viewer! Jefferson Volunteer Fire Department. NC is a building located to Ashe County at N36 42498° W81 48216' (NAD83) This is the nearest place in the USGS place names database to the center of the map view below Look below the map view for a list of other places and locations that are visible wrthm this map view If you need to locate a landmark or feature, you can search for its locallon on our Find Places page If ypu need to locate a specific USGS topographic map, try our l' rd Maps page 04M USGS Map Name: Jefferson. NC Map MRC: 36081 D4 Click on map to Map Center N36-41804' W81 48892' Datum: W27 Zoom: 16mf 'xel rk Zoom in • - (x2) - 0" Zoom out I (x2) { + Re -center - • - • -- Map contents Choose Automatically + Overall Coverage 124K coverage ' r tus) 1:24K Topo maps (US) 150K REV Coverage IGanatl:wx 1 ropo - _ maps (Canada) I IOOK Coverage 1-100K Tow ■ �,' maps (US) !_ 1250K r �I• ,'IZ� •'' �r, Coverage ` JuS� r • +e`¢'+ r .... •. 1:250K Topo ��•• 4. ..I n.....s. —pr (L'S) r' ~� ' Satellite 1m - - Coverage r (US) Satellite I ' (US) b- ml ve 1 m per pixel (Sat) 2m per pixel _ — (Sat) ,.., 4m per pixel 8m per pixel a•aa an.n.a r— nxr• i xex lnpograpn¢'^►P mw�p• Places Within This Map View Piece JeMerson V011lnleef Fire Department WKSK-AM 4West Jefferson] Jeflerson_Ele_rnentary chool Asne County Rescue Seuad West Jeurson �r ethporl Jefferson •..s iIWs,.. 2— r Type Coordinates (dick to center) Building N3642498- W81 48216' Tower N36 410681 W81 49649' School N36.42040' W81 47760' Building N36.40736' W81.48239' Populated Place N36 40374' W81 49288` Populated Place N3642651" W01 501771 Populated Place N36.42040" W81 47344' • 16m per pixel 32m per pixel 64m per pixel 128m per pixel 256m per pixel 512m per pixel I km per pixel 2km per pixel Urn per pixel t0km per pixel Mao Size Small%sh (512x512) Medium Rare • (768x768) Grandal (1024x1024) Extra Grandel https:Hwww.topoquest.comlmap.php'?fat=36.41804&ion=-81.48892&datum=nad27&zoom... 8/3/2016 Jefferson Volunteer Fire Department. NC - N36.41804° W'81,48892° ,t , t,Lhh•r: Ail 7 tn•r � � .r•.K',1��1a'i w .. i.,wr_ -„r.. - u School Civil Ctvil Stream Mine Building Civil Summit Stream Summit Church Park Hospital Church Locale Civlf Church Church School Church Stream Populated Place Summit Church Summit Stream Church Church Summit Building Church School Populated Place Stream School Clol Locale Summit Church Church Cemetery Church Cernelery Locale Church Stream Airport Populated Place Church Populated Place Church Church Summit Md. C�r.. „x.C.e --clod—....cr rt.lit.. ixWi. Page 2 of 3 (128ox 12801 Darum • W27 NAD81WGS84 Coordinate formal LITM r Ndod Lod' Wddd olce Nddcrmm m' Wddd'mm m' Nddd'meli Wdi mm' ss, Draw crosshair at Center Refresh Updates Note (SJ31120t6l - Want a =sshair at :he Center coordinates of The map' A number of people have asked. so that option has been added' Note (6126l2003 - Map was are now larger. and an extra4arge (1280x12B0) option has been added as well. Note (W`18120101 - The transition to the new TopoQuest server is now complete ASWe from a glitch that affected the Topoi alternative map asp script much of Monday (W1712010) afternoon and evening• all went prerty srrxaothly, Response time of the TopoQuesl website overall should be much snappier, and addition of more am satellite I serial imagery is back underwayl Note (622010) - Full USGS 1 1O0K and 1250K topographic map coverage of the continental US is now completed and online Plus. I have the new TopoQuesl server under construction with a 9T9 RAID6 disk array to continue adding satelkile/aenal photo coverage. Yay' Note (112172009) - Locations of places of interest (from the USGS placari database) within the map area you are viewing are now listed below the map when viewing at Unr/pixel or below You can click the name of the place io go to its description page- or click the coordinates to recenter your map view on that place. Note (fill120O9) - We've started adding Tm/pixel aenal and satellite imagery, starting with Oregon and slowly branching out from there Please he patient, it takes a very long lime to download and process all this imagery as well as huge amounts of disk space' Note ( 7J07r2O09) - We've started adding 1100K and 1250K scale USGS topographic maps. starting with southern Oregon and moving out from there Coverage will be a bit sparse at first while we crank up automated processing of map Iles at these topographic map scales To view 1 10O0< and 1250K scale toi you'll need to manually select them from the sidebar (the Choose •suromaocaiiy selection will not selea these neap scales until we nave more coverage) You can use the coverage map types to see what areas we've already processed and have online Also note that satellite photo coverage sn'I meant to be particularly, useful at this point it's just Iveryl experimental Note (7/3t12000) - We've started adding 15OK scale topographic maps of Canada. starting with British Columbia. The Canadian topographic map coverage is sell a bit experimentaland integration Polo the map viewer still needs a hide wprtt. The map viewer will not yet automatically select the 1 50K scale topographic maps. so if you're drying to view maps in Canada, you may need to manuaity switch to the 1 50K Topo Maps selection in the Map Contents section of the sidebar Note *1512O019) - With the demise of non-subscriji access to r :wu_ , - Inow merged with ' 3 , al, a Subscription servieei, we're scrami to process ail topographic maps lot the US and make them available as qurckty as possible. We now have four Unux PC's crunching map data 24,7 to produce and index map data continuously We should be adding apprommately fifteen 1 degree x 1 degree blocks of map data (approxtnnately 1000 individual 7 5 minute 1, 24000 tope maps) per day We're starting with southern Oregon (because that's where we live') and northern California and branching out from there TopoZone URL Replacement Do you have a Topozone map URL that you want to convert to the TopoQuest equivalent? Simply replace topoxone Corn with topocii corn in the URL. and you II get the equivalent map as what Topozone used to produce I We have more details on using TopoQuest as a Topozone alternative on our :i,", 're ehne,I page hops: ,<ww.topoliquoiom/map.php?lat=36.41804&Ion=-81.48892&datum=nad27&zoom 8/3/2016 - letfterson Volunteer Fire Department, NC - N36,41804' W'81.48892' Page ; of'3 .ynr pm I }pit-_rt!n YI,m ti,cm 411 Rion Re.w—ea https \� ww.topoquest.com/map.php?tat=36.41804&Ion=-8 l .48892&datum=nad27&zoom. 8/3/2016 ` Jefferson Volunteer Fire Department, NC - N36,425281 W'81.480980 Page l of 2 Welcome to the TopoQuest Map Viewer' Jefferson Volunteer Fire Department, NC Is a budding located in Ashe County at N36,42498. Mi 48216• (NAD83). This Is the nearest place in the USGS place names database to the center of the map view below Look below The map view for a list of other places and locations that are visible wlthm this map view. It you need to locate a landmark or feature, you can search for Its location on our .page, tf you need to locate a specific USGS topographic maptry our - � : ! , page. USGS Map Name- Map MRC. 36091 D4 Click on map to. Map Canter N36 42523• MI 48098- Datum- NAD27 Zoom 4mPpixei ¢� Zoom in 'fir 1._� ' •5 ,•\ _ �\ \ `\ \ •. .,. I • .'� • / r i 1 155 1 ^tr r I •- ;-�}<r� �r REV Re -mount Center 731 (k Zoom out (x2) .t. Re -center Map contents Choose ' Automatically Overall Coverage 1:24K Topo maps (US) -...or3;R -araca 1:50K Topo maps (Canadal 1:100K Topo maps (US) 1250K Topo maps (Us) Satellite I •.# �r :`jig �' ' — : , (US) r 'r• t� l .C"kr� M i' .. �� l—�yi . oom level. t� ' f I m per pixel sat) `: —r •� ,F..� �•'_'P• •.9�9 ;`'f -_--, iT�- 2m per pixel (Sall - r \ r 4m per pixel / '�r•�! am per pixel i •' � e, k - �- - -- 16m per pixel a 32m per pixel Places Within This Map View: Place Type ., _ ­ ' iI < � sI I Building leftarsan Fiementary yChggl School Jefferson Populated Place rown of jettersor Civil %W. ^o.ranarn Wod.0 - os'mt— .NK,.d � h. vo . 64m per pixel 128m per pixel 256m per pixel 512m per pixel 1km per pixel 2km per pixel Unn per pixel 10km per pixel Coordinates (dick to center) MaSize. N36 42498' v'a81 482l6 Small'ish N35 42040' N181 47760 {512x512) 1436 42040' YV81 47344' Medium Rare N16,420F,d U481 45968 {768x768) Grande! (102400241 Extra Grande, https://www.topoquest.comlmap.php?lat=36.42528&ion=-81.48098&datum=nad27&zoom... 8/3/2016 I Jztlerson Volunteer Fire Department, NC - N36.42528° W81.48098° Page 2 of 2 112800280) Datum • W27 %AD83NVGS84 Coordinate format UTM Nddd ddd' Wddd ddd° Nddd°mm m' Wddd'mm m' Nddd"mm'ss" Wddd° mm' Ss„ Draw crosshair at center Refresh Updates Note (5/3112016) - Want a krosshair at the center coordinates of the map? A number of people have asked. so that option has been added' Note (612812013) -Map sizes are now larger. and an extra -large (1280x1280) option has been added as well Note (Bit 8/2010) - The transition to the new TopoQuest server is now complete. Aside from a glitch that affected the TopoZone alternative map.asp script much of Monday (811712010) aftemoon and evening, all went pretty smoothly Response lime of the TopoQuest websile overall should be murk snappier. and addition of more 1 m satellite 1 aerial imagery is back underwayt Note (61212010) - Full USGS 1 r100K and 1:250K topographic map coverage of the continental US is now completed and online Plus, I have the new TopoQuest server under construction with a 9TB RAID6 disk array to continue adding satetiitelaenal photo coverage- Yayi Note (712112009) - Locations of places of interest (from the USGS placenames database) within the map area you are viewing are now listed below the map when viewing at 64mlpixel or below, You can click the name of the place to go to its desenption page, or click the coordinates to recenter your map view on Mat place_ Note 461112009) - We've started adding lmlpixel aerial and satellite imagery, starting with Oregon and slowly branching out from there. Please be patient, it takes a very long time to download and process all this imagery. as well as huge amounts of disk spacel Note (3/07/2009) - We've started adding 1 100K and 1250K scale USGS topographic maps, starting with southern Oregon and moving out from there. Coverage will be a bit sparse at first while we crank up automated processing of map tiles at these topographic map scales_ To view 1:100K and 1250K scale topos, you'll need to manually select them from the sidebar (the Choose Automatically selection will not select these map scales until we have more coverage). You can use the coverage map types to see what areas we've already processed and have online- Also note that satellite photo coverage isn't meant to be particularty useful at this point, it's just (very) experimental. Note 4713112008) - We've started adding I.50K scale topographic maps of Canada, starting with British Columbia. The Canadian topographic map coverage is still a bit experimental. and integration into the map viewer still needs a little work. The map viewer will not yet automatically select the 1.50K scale topographic maps, so if you're trying to view maps in Canada, you may need to manually switch to the f 50K Topo Maps selection in the Map Contents section of the sidebar Note 1411512008) - With the demise of non -subscription access to TopoZone (now merged with Trails com, a subscription service), we're scrambling to process all topographic maps for the US and make them available as quickly as possible. We now have four Linux PC's crunching map data 207 to produce and index map data continuously. We should be adding approximately fifteen 1 degree x 1 degree blocks of map data (approximately 1000 individual 7.5 minute 124000 lopo maps) per day. We're starting with southern Oregon (because that's where we livel) and northern Caldomia and branching out from there. TopoZone URL Replacement Do you have a Topozone map URL that you want to convert to the TopoQuest equivalent? Simply replace topozone.eom with topoquesl.com in the URL, and you'll get the equivalent map as what Topozone used to produce! We have more details on using TopoQuest as a Topozone alternative on our Topozone Reolacement page. Convrighi tf') 201:)A-2016 R)ve Nremr ...411 Nights Resenvd https://www.topoquest.comlmap.php?lat=36.42528&lon=-81.48098&datum=nad27&zoom... 8/3/2016 NCG030000 N.O.I. Final Checklist This application will be returned as incomplete unless all of the following items have been included. 2", Check for $100 made payable to NCOENR, L7 This completed application and all supporting documents. A site diagram showing, at a minimum, (existing or proposed): (a) outline of drainage areas, (b) stormwater management structures, (c) location of stormwater outfalls corresponding to the drainage areas, (d) runoff conveyance features, (e) areas where materials are stored, (f) impervious areas, (g) site property lines. Copy of county map or USGS quad sheet with the location of the facility clearly marked on the map. Mail the entire package to: Stormwater Permitting Unit Program Division of Energy, Mineral and Land Resources 1612 Mail Service Center Raleigh, North Carolina 27699-1612 Note The submission of this document does not guarantee coverage under the General Permit. For questions, please contact the AEMLR Regional Office for your area. DEMLR Regional Office Contact Information: Asheville Office ...... (828) 296-4500 Fayetteville Office ... (910) 433-3300 Mooresville Office ... (704) 663-1699 Raleigh Office ........ (919) 791-4200 Washington Office ... (252) 946-6481 Wilmington Office.. (910) 796-7215 Winston-Salem ...... (336) 771-5000 Central Office .........(919) 807-6300 Page 4 of 4 SWU-218-071408 Last revised V2114 American Emergency Vehicles CHECK NO 0 0 3 3 `4 9 3 7 PAYABLES ACCOUNT JP Morgan Chase { 165 American way Columbus, Ohio ..� 56-1544/441 DATE: Jefferson, NC 28640 - PH. {3361 982-9824 AMOUNT, { PAYONE-HUNDREDAND.001100`•'•r.w.................................................... ...•...$ 100.00 T O. GNATURES'REOUIRED>•,:i'i PAY -TO THE ORDER OF I IN'E 5,000.00':; NCDENR DI:VISION,:,OF, ENERGY, MINERAL&LAND RES 1612MAIL 'SERVICE CENTER tgENsir` AUTHOR NATURE- ATTIC:. STORMWATER BILLING zy-T i RALE IGH NC` 2 7 6 9 9 - 1612 AUTHORIZED.5IGNATURE rt ' I -fR fA 70,yF, FutaDW DWGSee 2016 ! _"ic_I Ve-s—i o . h' ii:p: /%4:ww- au1LcdWQ. C4:T,. f �' M OTC riot /�nv'W. �O W�.CO i -c, re0-S e' z:— vrU*'_'cm, t:--e ncGte will be re111oved. I i� MAJNTENANCE VACU-PORM STORAGE 70K4a m.0 —W Room LEM CONF 1 ELEC TFsr ROOM OFFICE VAN LExAN { VAN HARNESS E E Pam'' a em oc 0� fl_ E. I F ,E'tl ceEa=1k8j;= �6B€C3m�®mom ---------- --_-_-- - --I-I--------J — — — — — — ( WALK ) (WALY. )— — — — — . - • ; r — I I BREAK - Moo LEXA><' I I -- �� I 4e.45 I I i ROOM 02 MOO:{ARNEM I 1 I OCf PAINT PREP I I I CABINET SHOP I BRENN': V Bowe I ' n- ROOM p I I BOOT, �w LT -----------1— V �wux) � GRAPHIC: � I , �-' - CONF, r'i00M INSTAUAMN ENGIPURISAI�£ --- I "• II I I - 50 K 40 DETAIL AREA FENCE _ I I I •-- I5 6CK74 f { CUSTOMER r ! P'w7s sroq',c� 50-48 DELIVERY AREA I I I� LIVER�AREA OEI I - I RECEONJG PARTS ROOM / / Si /L- C i r r/ 4 L t r r• PAVED AREA �'A'' 4c . i �i - I .® T PyT t[a.� cmKsaKo { .m OCs ma 4OOW- E I BOOTF MY=. SICP NA BUF CSTOWA O'.EN E SL IF �aPU.I Pp, BE'.S PREP 1 18.9 I� y PAR'S NNW ODOL ca^ IJ 23,4 sco Ewe, i' LLB p r = - Pacrcc:,rx..aToaoraf m.w ----� PAINT Pam,ti WT H1, = - J L_ c SHOP STORAGE - o ec� REMOUNT mBO ] iPKn SHOP P,WI' BooTrL B00" rmm.z J.J 1,1 FOW�1F K9..EI a U" m I I O:Fµ VV 7.0, �� ° L--- r niFJ6iAL 000M. L�,f1 I Por B7OTH V ----J L SAC KKn BLFE PUT BCCTM I L m.e n..a urarscuPP I Pars BOOTH w T-A z� MENS LADIES OFFICE OFFICE PARTS SALTS I CC irNrY�-'�-fi /. 4-L 5u1L;}f1,,IC �%fJfNE i�'Te' �OLLcCTGiti G' i�LL N�lrtrr A,iCr<r/�5 �7�G C�' e` � %�f+ `�� �� �kC �%K /1 %/�L- rw` /n'1 i!7 �:ZLL t• �i2,/�,° �; �.G 6�k A-55 c !? 4',I-' 4 61' i u_/E Lcly;njb f%.�= •Grr! v�'� 1I�1�r7uG=t7 em /1 � r • • 14 ! /1--�.___ � I •P• � � �}� 'art �" � "� _ � / REV Re -mount Center - 1 ,:� __tea _ ti �� �► fet�`�- I • zy Wk tj lop ;•� - D spO a , 1 . • �6�7 f; $iu ,f • � �i 4� +Test � 'L`1 �' , , �" = �" r , • � /,�J//' E '!/!!i1y��!Hfl1r rS IV it i. �J,` y {/jam.-..J / - - `• ti I • '..�4 . .. .JTµ J if y-, (`� �i V1i \ •• 1 1 .., �� r_ _.- . k .\ � .� .. ! - _i=` 1,. l'�_ '�`4...-- ,fir•-- �;Y.,•�.��1` .:�. ���t`` %� �' ---- - _, �+ `� � •_� � .'i-� � �--^� �\ _ � mil. Stream Information: •• �J "4 " REV Re -mount Center enter From source :o South Fork Clem ( _ ;anuar,, :997 . " r• �� �.�._:y*� •. ; ...�..�_ . - f. l A. • � � � ' ' r;µlate. 1 \ • • 1 • , • - • �. _ .. � ` • ' •` ii �_ .!� • •• \ - ♦ • '\ �_ti � J _ � • ,� � • � ten.. ia'�:n •-fie ►� - �rl ~�., . - .� �'q�� `;.a��� �=• Central Files: APS _ SWP 9/1412016 Permit Number NCG030675 Permit Tracking Slip Program Category Status Project Type NPDES SW In review New Project Permit Type RECEIVED Version Permit Classification Metal Fabrication Stormwater Discharge COC COC �y SEP 14 ZU16 Primary Reviewer Permit Contact Affiliation rick riddle CENTRAL FIEFS Coastal SWRule DWR SECTION Permitted Flow Facility Facility Name Major/Minor Region REV Remount Center Minor Winston-Salem Location Address County 101 Aev Ln Ashe Formally 101 Gates Ln Facility Contact Affiliation Jefferson NC 28640 Kent Barker 101 Aev Lane Formally 101 Gales Ln Owner Jefferson NC 28640 Owner Name Owner Type American Emergency Vehicles Non-Govemment Owner Affiliation Kent Barker 101 Aev Lane Formally 101 Gates Ln Dates/Events Jefferson NC 28640 Scheduled Ong Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration 8/16/2016 Regulated Activities Requested /Received Events Metal products manufacture RO staff report received 912116 RO staff report requested 8/29/16 Outfall 1 Waterbody Name Streamindex Number Current Class 5ubbasin Naked Creek 10-1-32 C:+ 05-07-01 Energy, Mineral and Land Resources ENV}RONMFNTAL QUALITY Kent Parker REV Remount Center 101 Gates Lane Jefferson, NC 28640 Dear Mr. Parker: PAT MCCRORY rantm�u DONALD R. VAN DF..R VAART September 14,2016 TRACY DAVIS Subject: General Permit No. NCG030000 American Emergency Vehicles REV Remount Center COC NCGO30675 Ashe County In accordance with your application for a discharge permit received on August 16, 2016, we are forwarding herewith the subject certificate of coverage to discharge under the subject state -- NPDES general permit. 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 October 15, 2007 (or as subsequently amended). Please take notice that this certificate of coverage is not transferable except after notice to the Division of Energy, Mineral, and Land Resources. 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 the Division of Energy, Mining, and Land Resources, or permits required by the Division of Water 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 Richard Riddle at telephone number (919) 807-6375. Sincerely, for Tracy . Davis, P.E., CPM, Director Division of Energy. Mineral and Land Resources cc: Winston-Salem Regional Office Central Files Stormwater Permitting Files State of North Carolina I Environmental Quality I Energy, Mineral and Land Resources 1612 Mail Serme Center ! 512 North saWmry street I Raleigh, NC 27699-1612 919 707 9200 T STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES GENERAL PERMIT NO. NCGO30000 CERTIFICATE OF COVERAGE No. NCG030675 STORMWATER 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, American Emergency Vehicles is hereby authorized to discharge stormwater from a facility located at REV Remount Center 101 Gates Lane Jefferson Ashe County to receiving waters designated as Naked Creek, a class C+ water in the New River Basin, in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts 1, I1, 111, and IV of General Permit No. NCG030000 as attached. This certificate of coverage shall become effective September 14, 2016. This Certificate of Coverage shall remain in effect for the duration of the General Permit. Signed this day September 14, 2016. for Tracy E. Davis, P.E., Director Division of Energy, Mineral, and Land Resources By the Authority of the Environmental Management Commission • ''�� 4 a REV Remount Center"' NCG030675 American Emergency Vehicles REV Remount Center Latitude: 360 25' 33.5" N Longitude: -810 28' 50.6" W County: Ashe 5 Receiving Stream: Naked Creek Stream Class: C+ Map Scale 1:24,000 Index Number: 10-1-32 (New River Basin) Facility Location NCDENR EN IRp...n[ - NtlLRIL RLSO nC[S Division of Ener,fir, Mineral and Land Resources Land Quality Section iational Pollutant Discharge Elimination System NCG030000 FOR AriENCY USE ONLY Dille Received � .Year hlonlh Day Certi icaae of Covertke F to National Pollutant Discharge Elimination System application for coverage under General Permit NCG030000: STORMWATER DISCHARGES associated with activities classified as: SIC (Standard Industrial Classification) 335 Rolling, Drawing, and Extruding of Nonferrous Metals SIC 3398 Metal Heat Treating RECEIVED SIC 34 Fabricated Metal Products SIC 35 Industrial and Commercial Machinery SIC 36 Electronic and Other Electrical Equipment A IS 16 2016 s SIC 37 Transportation Equipment SIC 38 Measuring, Analyzing, and Controlling Instruments DENRQUALITY STORMWATER7ER PERMITTING l For questions, please contact the DEMLR Regional Office for your area. See page 4. (Please print or type) 1) Mailing address of ownerfoperator (address to which all permit corres jQndence will be mailed): Name American Emergency Vehicles Street Address 165 American Way _ T City Jefferson State NC ZIP Code 28640 Telephone No. 336 982-2938 Fax: 336 982-9826 2) Location of facility producing discharge: Facility Name REV Remount Center Facility Contact Kent Barker Street Address 101 AEV Lane (Formally 101 Gates Lane) City Jefferson State NC ZIP Cade 28640 County Ashe Telephone No. 336 846-1372 Fax: 336 982-9826 Email a ra beat aev.com 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). Travel North on U.S. Hwy 421 through Wilkes County, turn riaht on 16 North. Travel aoorox..20 miles. then turn left continuina on 16 / 88 for 4 miles. Then riaht on East Main Street I U.S.221 for 1.3 miles. Turn right on Northwest Drive for .3 miles then riclht on 101 AEV Lane, (A Copy of a county map or USGS quad sheet with the facility clearly located must be submitted with this application.) W)Tlas" - gr'�'so.��, 4) Latitude 362424&2'- Longitude 9+14V,82" (deg, min, sec) -Fl. �C073 Page 1 of 4 SWU-218-071408 Last revised 712114 NCG030000 N.O.I. 5) This NPDES Permit Application applies to which of the following: ❑ New or Proposed Facility X Existing 6) Standard Industrial Classification: Date operation is to begin 7115/16 Provide the 4-digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial activity at this facility. SIC Code: 3 7 1 3 7) Provide a brief narrative description of the types of industrial activities and products manufactured at this facility: Chassis upgrades and refurbishinc operations for modular type ambulances, This would include interiors s along with paint and body working processes to repair/refinish used modular boxes. 8) Discharge points 1 Receiving waters: How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? 2 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 Naked Creek" _ Receiving water classification: _C:+ The + under the New River Basrn indicates the following: + This-svmboi identifies waters that are subiect to a special management strategy specified In 15A N_CAC 2B the Outstanding Resource Waters (oRW) rule, in order to protect downstream waters designated as ORW. Is this a 303(d) listed stream? No Has a TMDL been approved for this watershed? No 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). nla 9) Does this facility have any other NPDES permits? X No ❑ Yes If yes, list the permit numbers for all current NPDES permits for this facility: 10) Does this facility have any Non -Discharge permits (ex: recycle permit)? X No ❑ Yes If yes, list the permit numbers for all current Non -Discharge permits for this facility: 11) Does this facility employ any best management practices for stormwater control? ❑ No X Yes (Show any structural BMPs on the site diagram.) If yes, please briefly describe: BMP#1 West side parking lot drainage system. BMP #2 Concrete Collection Berm on Northeast side of property. BMP #3 Storm water pit on east side of building and BMP #4 Storm drain on northside. 12) Does this facility have a Stormwater Pollution Prevention Plan? X No ❑ Yes if yes, when was it implemented? SPPP is in the Developmental Stage 13) Are vehicle maintenance activities occurring at this facility? X No ❑ Yes 14) Hazardous Waste: a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? X No ❑ Yes Page 2 of 4 SWU-218-071408 Last revised 71204 NCG030000 N.O.I. b) is this facility a Small Quantity Generator (less than 1000 kg_ of hazardous waste generated per month) of hazardous waste? ❑ No X Yes c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of hazardous waste? X No ❑ Yes d) Is hazardous waste stored in the 100-year flood plain? X No ❑ Yes If yes, include information to demonstrate protection from flooding. e) If you answered yes to questions b, or c., please provide the following information: Type(s) of Waste: Spent Solvent Ra-gs.Pain_t Thinner,Waste Paint.Empty RCRA containers How is material stared: 55 -gallon drums Where is material stored: Satellite Accumuiation area, then a Hazardous Waste Containment How many disposal shipments per year: Unknown with an estimate of 36 drums per year. Name of transport 1 disposal vendor: Clean Harbors Vendor address: 42 Lon-gwater Drive P.O. Box 9449 Norwell, MA 02061-9149 15) Certification: North Carolina General Statute 143-215.68 (i) provides that: Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan, or other document riled 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 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). 1 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: GaN Graybeal Title: Compliance- JSO Manaqer (Signature e/'�-//4 (Date Signed) This Notice of Intent must be accompanied by a check or money order for $100.00, made payable to: NCDENR Page 3 of 4 SWU-218-071408 Last revised 712114 NCGO30000 N.O.I. Final! Checklist This application will be returned as incomplete unless all of the following items have been included: ❑ Check for $100 made payable to NCDENR, ❑ This completed application and all supporting documents. ❑ A site diagram showing, at a minimum, (existing or proposed): (a) outline of drainage areas, (b) stormwater management structures, (c) location of stormwater outfalls corresponding to the drainage areas, (d) runoff conveyance features, (e) areas where materials are stored, (f) impervious areas, (g) site property lines, ❑ Copy of county map or USGS quad sheet with the location of the facility clearly marked on the map. Mail the entire package to: Stormwater Permitting Unit Program Division of Energy, Mineral and Land Resources 1612 Mail Service Center Raleigh, North Carolina 27699-1612 Note The submission of this document does not guarantee coverage under the General Permit. For questions, please contact the DEMLR Regional Office for your area, DEMLR Regional Office Contact Information: Asheville Office ...... (828) 296-4500 Fayetteville Office ... (910) 433-3300 Mooresville Office ... (704) 663-1699 Raleigh Office ........ (919) 791-4200 Washington Office ... (252) 946-6481 Wilmington Office_ (910) 796-7215 Winston-Salem ...... (336) 771-5000 Central Office ......... (919) 807-6300 Page 4 of 4 SWU•218-071408 Last revised 712114