NCG160219_COMPLETE FILE - HISTORICAL_20140610

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
e HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
p Jot
YYYYMMDD

Permit Number NCG160219
Central Files: APS — SWP
619I2014
Permit Tracking Slip
Program Category
Status Project Type
r
NPDES SW
In review New Project
Permit Type
Version Permit Classification
Asphalt Paving Mixture Stonnwater Discharge COC
RECEIVED
COC
Primary Reviewer
Permit Contact Affiliation
bill.diuguid
JUG! 10 2014
Coastal SWRule
CENTRAL FILES
DWO]BOG
Permitted Flow
Facility
Facility Name
Major/Minor
Region
Yadkin Valley Paving Inc
Minor
Winston-Salem
Location Address
County
121 Cloverleaf Dr
Forsyth
Facility Contact Affiliation
Winston Salem NC 27103
Patrick Tucker
121 Cloverleaf Dr
Owner
Winston Salem
NC 27103
Owner Name
Owner Type
Yadkin Valley Paving Inc
Non -Government
Owner Affiliation
Patrick Tucker
121 Cloverleaf Dr
Dates/Events
Wnston Salem
NC 27103
Scheduled
Orig Issue App Received Draft Initiated Issuance
Public Notice Issue
Effective
Expiration
5/29/2014
G/, /ir
G�9/jar
9/1 o/...
2. ulated Activities
Requested (Received Events
Asphalt paving mixture production
RO staff report received
616114
RO staff report requested
613114
Outfall 1
Waterbody Name Streamindex Number Current Class Subbasin
Salem Creek (Middle Fork Muddy Creek) 12-94-12-(4) C 03-07-04

AIWAF
NC®ENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
June 9, 2014
Mr. Patrick M. Tucker, Vice President
Yadkin Valley Paving, Inc.
121 Cloverleaf Drive
Winston-Salem, North Carolina 27103
Subject: General Permit No. NCG160000
Yadkin Valley Paving, Inc.
COC No. NCG160219
Forsyth County
Dear Mr. Tucker:
John E. Skvarla, III
Secretary
In accordance with your application for a discharge permit received on May 23, 2014, we are
forwarding herewith the subject certificate of coverage (COC) 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).
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 Energy, Mineral and Land Resources (Division). 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 or permits required by
the Division of Water Resources, Coastal Area Management Act or any other federal, state or local
governmental permit that may be required.
Please note that the attached permit expires on September 30, 2014. Your COC will be
automatically renewed to cover the full 5 year term of the soon to be reissued permit. In the interim
you must abide by the terms of the expiring permit. You can review the proposed general permit
changes once they are posted at: http://portal.ncdenr.org/web/Ir/public-notices.
If you have any questions concerning this permit, please contact Bill Diuguid, Stormwater
Program Planner at telephone number [phone].
Sincerely,
for Tracy E. 4',., CPM
Director, Division of Energy, Mineral
and Land Resources
1612 Mail Service Center, Raleigh, North Carolina 27699-1612
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer — Made in part by recycled paper

Mr. Patrick M. Tucker, Vice President
Yadkin Valley Paving, Inc.
Stormwater Permit NCG160219
June 9, 2014
cc: Winston-Salem Regional Office
Central Files
Stormwater Permitting Unit Files
Attachments

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
GENERAL, PERMIT NO. NCG16000
CERTIFICATE OF COVERAGE No. NCG160219
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,
Yadkin Valley Paving, Inc.
is hereby authorized to discharge stormwater from a facility located at
Yadkin Valley Paving, Inc.
121 Cloverleaf Drive
Winston-Salem
Forsyth County
to receiving waters designated as Unnamed tributary to Salem Creek, a Class C waterbody, to Yadkin River Basin; in
accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts 1, I1, III, IV,
V and VI of General Permit No. NCG 160000, as attached.
This Certificate of Coverage shall become effective June 9, 2014.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day June 9, 2014.
U
for Tracy E. Davis, Director
Division of Energy, Mineral and Land Resources
By Authority of the Environmental Management Commission

1111161S."El '
MOR
Ilk
­6114znram_ �
J 1-6
Note: Blue arrows indicate general direction of stormwater flow from the subject site. Ultimate discharge is to Salem Creek, which is a Class 'C" stream and is
listed as an impaired water. The general location of the site is , 36.04763280 W; 80.31907030 N. SDO locations are indicated on Figure 3.
Title: Project: Location: Scale: Date:
Site Location Map Job No.: I" = 1500, 5/2014 GeoSdence &
I VM
Winston Salem West, NC Yadkin Valley Paving, Inc Winston Salem, NC Figure No.: Revision No.: jjechndogy, P.A.
USGS Quadrangles Stormwater Plan' 14.228
Dated 1990 & 1987 Winston Salem, NC 0
I 1 1 Winston-Salem, NC [phone]

�1 'r• Division of Water Quality / Surface Water Protection
NCDENRNational Pollutant Discharge Elimination System
mc� C.%W-ta
NOTICE OF INTENT
FOR AGENCY USE ONLY
Date Received
Ycar
Mnmh
Dac
Cell i f eal e of Covcl a qc
NCG
check!
Amount
r�
I'cunit Assi wd to
U vL
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG160000:
STORMWATER DISCHARGES associated with activities classified as:
Coverage under this general permit is applicable to all owners or operators of stormwater point source discharges
associated with activities classified as establishments primarily engaged in Asphalt Paving Mixtures and Blocks
[standard industrial classification (SIC) 2951].
Rf For questions, please contact the DWO Regional Office for your area. (See page 4)
1
(Please print or type)
1) Mailing address of owner/operator (address to which all permit correspondence will be mailed):
Name Yadkin Valley Paving, Inc.
Owner Contact Patrick Tucker
Street Address 121 Cloverleaf Dr.
City Winston-Salem State NC ZIP Code 27103
Telephone No. 336 765-7900 Fax:
E-mail Address pattucker@yadkinvalleypavin g.com
2) Location of facility producing discharge:
Facility Name Yadkin Valley Paving,Inc.
Facility Contact Patrick Tucker
Street Address 121 Cloverleaf Dr.
City Winston-Salem State NC _ ZIP Code 27103
County Forsyth
Telephone No. 336 765-7900 Fax:
Email [e-mail]
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). 1-40 to Stratford Rd West, 1.4 mi to left on Cloverleaf
DR. Then to end of road
(A copy of a county map or USGS quad sheet with facility clearly located on the map is a required part of this application.)
4) Latitude 36.0476328 Longitude 80.3190703 (degrees, minutes,
seconds) �­����
5) This NPDES Permit Application applies to which of the following : L�
❑ New or Proposed Facility" Date operation is to begin MAY � 3 ZOT�
X Existing 4 0 � - WA—R ALITY
'If this new or proposed facility in one of the 20 coastal counties, you must contac p Op��Hr'ch
Page 1 of 4
SWU-231-030909 Last revised 319109

NCG190000 N.O.l.
Office (see page 4) to determine if a State Stormwater Permit is also needed prior to construction.
6) Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: 2 9 5 1
7) Services and Activites
a) Provide a brief narrative description of the types of industrial activities and products
manufactured at this facility: (Include a site diagram showing the process areas and location of
activities present at this facility.) See attached.
b) Check all services and activities offered or allowed at this facility
at Outdoor stockpiling of materials t Transport of materials by a
t Storage of raw materials conveyor or front-end loader
t Storage of materials in above- t Vehicle and equipment maintenance
ground tanks t Vehicle/Equipment Washing
at Material Loading and Unloading t Vehicle and equipment fueling
8) Discharge points / Receiving waters:
How many discharge points (ditches, pipes, channels, boat ramps, lift wells, 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 tributaries of Salem Creek 03 —a I r 9 4 _ —
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). NA
Receiving water classification (if known): C
9) Does this facility
a) Have an untreated wastewater discharge? X No ❑ Yes
b) Have a treated wastewater discharge? X No ❑ Yes
If yes, list the permit number.
wnh
c) Have a wastewater discharge from a recycle system? X No ❑ Yes
If yes, list the permit number.
d) Have a non -discharge permit? X No ❑ Yes
If yes, list the permit number.
e) Discharge wastewater to a municipal wastewater collection system? ❑ No X Yes
If yes, list the municipality and permit number Winston-Salem NCO037834
Note: Stormwater discharge permit NCG160000 does not authorize the discharge of any wastewater.
If this site discharges wastewater, you must obtain the appropriate wastewater discharge
permit in addition to coverage for stormwater discharges under NCG160000.
10) Does this facility employ any best management practices for stormwater control?
❑ No X Yes (Show any structural BMP's on the site diagram.)
If yes, please briefly describe: See Attached
Page 2 of 4
SWU-234.030909 Last revised 319i09

NCG190000 N.O.I.
11) Does this facility have a Stormwater Pollution Prevention Plan?
X No ❑ Yes (�
If yes, when was it implemented? P2 �� C�Q cX
12) Are vehicle/equipment maintenance activities occurring at this facility?
❑ No X Yes
13) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
X No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
X No ❑ 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:
Flow is material stored:
Where is material stored:
How many disposal shipments per year:
Name of transport / disposal vendor:_
Vendor address:
14) Certification:
North Carolina General Statute 143-215.6 e(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 rulemaking proceeding or contested case under this Article; or who falsities, 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
[Environmental Management] Commission implementing this Article shalt be guilty of a Class 2 misdemeanor which may include a fine
not to exceed ten thousand dollars (S10,000).
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 iss� — true, complete, and accurate.
�_ l-
Printed Name of Person Signin ! ATH ,!,,`'�
Title: J . Pr ->''IQ ai
q--
(Signature of Applicant)
S ai 201 ``
(Date Signed)
Page 3 of 4
SWU-234-030909 Last revised 3/9109

NCG190000 N.O.I.
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to:
NCDENR
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 which drainage areas), (d) runoff conveyance structures, (e) areas where materials
and/or boats are stored, (f) impervious areas, (g) site property lines, (h) boat maintenance, blasting, painting
and washing areas, and (i) location of services and activities listed in 7b.
❑ Copy of county map or USGS quad sheet (preferred) with location of facility clearly marked on map
Mail the entire package to:
Stormwater Permitting Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Note
The submission of this document does not guarantee the issuance of an NPDES permit.
For questions, please contact the DWO Regional Office for your area.
DWQ Regional Office Contact Information:
Asheville Office ......
[phone]
Fayetteville Office
... [phone]
Mooresville Office
... [phone]
Raleigh Office ........
[phone]
Washington Office
...[phone]
Wilmington Office
... [phone]
Winston-Salem ......
[phone]
Central Office .........(919)
807-6300
Page 4 of 4
S W U-234-030909
Last revised 319/09

Hai r ti A; N i t vxGl 51 s {``n�y�y�+11�rr
A�},(rRiWO
Ap
Iv-
�tI XKIOF
`,�-•<;y,.5t5y'Y,"X k it C d i ,� �` `r�ti'°` •,- ,.�, a.t f t4i
ty. a+ rr"W4's'"Ir�S4 'a?i• Y w ,�" F F a' � � 1'' �v
r
r'r.,+'
gn
it ti
®1
{ I' Vehicle Fueli g
- A y �9 �ii� S d• �` `t MtS' r �1' F'
� °
:n
• � .. 4,Y � y - is yr '� " •wf �, r- r _. �,
' ,'ti:
�
o
7"y�
.j�� r,kRecycli
L" AS a
t l- r'r?�y y{ �•� I 3 �1. yE:�tt: d y�1p 1'ik
a. '`+'fki��i,l� r�' ' � ,i •Y

�S. e.+,f�- •' F��^�.<� ,� `v'M} - - ,af =� Fi �c� e �' S - - 'a 4 - $ :`3
S1 0
y4
-
t tom: �e,.• zus'enVW
r-
+{
�wa _ Pik A .r/sl"gib �r sf1 q y,.} p }.-b �t,,'y��.ttF�.. -`n _,• �' \r "� ''• L, 4
S+r.r„jrstF
Wi ,y, -9 :ST'r'r 2[ .:.lr err- ✓ t� �' ` i'. ,�' 4r f iS,i 3i
t,t�, W��yA
4 � �Kv k� � - } - �' '� x'4 w ,♦ w+� � ! •..5 �.- BLS o- -h ♦ .p .1t � r,...
•�z �j�\�F ry �' � f�� Y,'. �y� �_g� r ••y'� T r� t-,�i�e . `,§ i1" '�J� 7 ._ q.� '( f N''� { -4 �h 5�?
FI Cr L J,c ,� '�•a-r r,�q� � i � ,� �. - i Ci � ..
�� k r�`-w �`x��` u ,� J �Is�� � Reba � � 5 r'4 � r � 1,..• ,r ^ 7>�S }'i n - b
'AS'�' �•`�,Fd^1 N .1� 'i' in r • '1� �r r � �_� r `t�' -, 3 _; • ry'
t�j r. y r4 d t
r ;`fame ♦ L.. • � � .�-,� �, - { { � ,*'L•t - r
y.
'Spy 'a}+.r M,• - J iYa >' r! �� _ t t }R y`.
:�. �'9, t ,'f`r,n.�, �,. §" J °., r; rx Y � • � ..SFj :rt fyl . �•4+�r`'g
k— 6SM1 bps c� �• � .,r",
4Y^ s✓ t' ,51 �dPa ��,s .$`ell
` rIL Y>,. s• a9
1NaastQil ASTs-i Al
A s
yt��.� p:s{ F >4 _ � �m�,�ey� ���e;�� r ,s�.�ar7ir y �' }1 r ,tM 1 f \� :`•
yl1r�lry! �- •.�,a�.`��„r-VSi dT `�r�y t +. 1Y' ``
Jjr?
prz 4 r a
� f L 'To�� J v+ L .7 I .,fl 4 J M ,,y G. ' •`h
y 'SDO 0'2
' 1�v � t 1F rr JY''"�*' �'�i'S� � �'�', ����r. +! r ; '.A� � 4 e'��x`' z�y�n .'`a � t fit: a� } s �, �,: - •':. .
�' 11
h ri',��,btly..k 7 r lv-ry�F� .3.�+€s ' ' -d.�• s(t .� 11`s �, •-� ,� f. � iA�ys!.��">'� t, e
+1' 1�+t}� 4 f F 14 C �.Y �Y ,7 •'H�1 �.lt �4Yu k]ilr �."�"L� ! `/'`r 1 1 elf •GI
t �., �'j� . � 1 �F, f`2'�t i ac•hr� s �i ` w_ . r,�q�,' ��sM � y a; � r �'� � } n }� rw•' 4 ' y . ,
� k r� ; ,r3 + robs � � �r - r" � ,. ' .. `'"�, r ''4s•,�,C c � � •dd,� � - 'C +ter. �
F„ ! i ry-� - ,,., �* r '� ^ _ .ern y �'i .a ,.ecM•i� a ` r q s ! t a r�
„�.
a��' °�7 �, r�'�sy,T � jet �F f � � � i t. _ a• � t .-- - - - r � u is �`. ti M n [} ('! 1 r
rli #p ...RrFsm f r sl'
F4. f ��. '-'; Pd-'t+' �,i '.r, •se r , C tr fc Y' -,' w'' ' , trr"s,
5M y `f y >-' - y 'rt r rM i' s ,.4` r ,� "S f i '✓ F.
41r�S ,, h H �y�,s u r : '� i. ,��.•F �' -,. �F �� .; � �.. r -4
.:x.4"'f'. �: Y.+`z4.'=i'.e ..°:.� •rr-: X'�+SL• .'r,°-'1 .. i09rf tN �rr`*a. .a .:.rur'tr -•e .`ti",1.arr«f...r;. �:�:l a..,.K�... ...,.,1 .a... ..