HomeMy WebLinkAboutNCS000567_Renewal Application_20210504Permit Coverage
Renewal Application Form
National Pollutant Discharge Elimination System NP Permit Number
Envrronmenta(
NC
Stormwater Individual Permit NCS 0005s7
unlit)
Please provide your permit number in box in the upper right hand corner, complete the information in the space provided
below and return the completed renewal form along with the required supplemental information to the address indicated,
Owner Information
* Address to which permit correspondence will be mailed RECEIVED
Owner / Organization Name:
ECOFLO, ino.
Owner Contact:
Stuart Stapleton
Mailing Address:
2750 Patterson Street Greensboro, N.C. 27407 P �f3� 1' 0 4 2021
2750 Patterson Street Greensboro, N.C. 27407
Phone Number:
(336) 617-2733 DENR-LAND QUALITY
Fax Number:
STORMWATER PERMITTING
E-mail address:
sstapleton@ecotlo.com
Facility Information
Facility Name:
ECOFLO, Inc.
Facility Physical Address:
2750 Patterson Street Greensboro, N.C. 27407
Facility Contact:
Preston Black
Mailing Address:
2750 Patterson Street Greensboro, N.C. 27407
Phone Number:
(336)617-2714
Fax Number:
E-mail address:
pblack@ecoflo.com
Permit Information
Permit Contact:
Preston Black
Mailing Address:
2750 Patterson Street Greensboro, N.C. 27407
Phone Number:
(336) 617-2714
Fax Number:
E-mail address:
pblack@ecoflo.com
Discharge Information
Receiving Stream:
South Buffalo Creek
Stream Class:
wS-v
Basin:
Cape Fear River Basin
Sub -Basin:
Number of Outfalls:
3
Facility/Activity Changes
Please describe below any changes to your facility or activities since issuance of your permit. Attached a
separate sheet if necessary.
No facility changes have been made.
CERTIFICATION
I certify that I am familiar with the information contained in the application and that to the best of my knowledge and belief
such information is 7Z�
rate.
Signature ' Date 4i27/2021
Preston Black EHS Coordinator
Print or type name of person signing above
Please return this completed application form
and requested supplemental information to:
Title
DEMLR - Stormwater Program
Dept, of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
SUPPLEMENTAL INFORMATION REQUIRED FOR RENEWAL OF INDIVIDUAL
NPDES STORMWATER PERMIT
Two copies of each of the following shall accompany this submittal in order for the application
to be considered complete:
(Do not submit the site Stormwater Pollution Prevention Plan)
Initials
PB 1. A current Site Map from the Stormwater Pollution Prevention Plan. The location of
industrial activities (including storage of materials, disposal areas, process areas and
loading and unloading areas), drainage structures, drainage areas for each outfall,
building locations and impervious surfaces should be clearly noted.
P B 2. A summary of Analytical Monitoring results during the term of the existing permit
(if your permit required analytical sampling). Do not submit individual lab reports.
The summary can consist of a table including such items as outfall number,
parameters sampled, lab results, date sampled, and storm event data.
P B 3. A summary of the Visual Monitoring results. Do not submit individual monitoring
reports. The summary can consist of a table including such items as outfall number,
parameters surveyed, observations, and date monitoring conducted.
P B 4. A summary of the Best Management Practices utilized at the permitted facility.
Summary should consist of a short narrative description of each BMP's in place at
the facility. If the implementation of any BMP's is planned, please include
information on these BMP's.
N/A 5. A short narrative describing any significant changes in industrial activities at the
permitted facility. Significant changes could include the addition or deletion of
work processes, changes in material handling practices, changes in material storage
practices, and/or changes in the raw materials used by the facility.
P B 6. Certification of the development and implementation of a Stormwater Pollution
Prevention Plan for the permitted facility (Sign and return attached form).
If the final year analytical monitoring of the existing permit term has not been completed
prior to filing the renewal submittal, then the last years monitoring results should be submitted
within 30 days of receipt of the laboratory reports. (i.e. do not withhold renewal submittal
waiting on lab results)
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APPENDIX D
STORMWATER
SITE PLOT PLAN
POLLUTION*A=w
PREVENTION PLAN
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STORMWATER
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9 3
Best Management Practices
Risk Identification and Summary of Potential Pollution Sources
The major areas of concern identified at the facility that may pose significant risk as potential
storm water pollutant sources include all areas discussed above.
MEASURES AND CONTROLS
This section is designed to identify the currently acknowledged and appropriate "Best
Management Practices" (BMPs) for minimizing storm water pollution. The measurements and
controls listed are adequate to minimize storm water pollution.
Source Area Control
To the maximum extent practicable, and to the extent it is cost effective, the use of source area
control best management practices designed to prevent storm water from becoming
contaminated will be used.
Good Housekeeping
The facility will follow good housekeeping procedures to reduce the possibility of accidental
spills and to minimize safety hazards to facility personnel. These procedures include training,
inspections for situations that could lead to a release, procedures for reporting and cleaning
spills and preventive maintenance.
Preventive Maintenance
Preventive Maintenance involves the regular inspection, testing, and cleaning of facility
equipment and operational systems. These inspections will help to uncover conditions that
might lead to a release of materials. Thus, allowing for maintenance to prevent such a release.
Daily, inspection activities contribute to the facilities continued operations.
Best Management Practices
Risk Identification and Summary of Potential Pollution Sources
The major areas of concern identified at the facility that may pose significant risk as potential
storm water pollutant sources include all areas discussed above.
MEASURES AND CONTROLS
This section is designed to identify the currently acknowledged and appropriate "Best
Management Practices" (BMPs) for minimizing storm water pollution. The measurements and
controls listed are adequate to minimize storm water pollution.
Source Area Control
To the maximum extent practicable, and to the extent it is cost effective, the use of source area
control best management practices designed to prevent storm water from becoming
contaminated will be used.
Good Housekeeping
The facility will follow good housekeeping procedures to reduce the possibility of accidental
spills and to minimize safety hazards to facility personnel. These procedures include training,
inspections for situations that could lead to a release, procedures for reporting and cleaning
spills and preventive maintenance.
Preventive Maintenance
Preventive Maintenance involves the regular inspection, testing, and cleaning of facility
equipment and operational systems. These inspections will help to uncover conditions that
might lead to a release of materials. Thus, allowing for maintenance to prevent such a release.
Daily, inspection activities contribute to the facilities continued operations.
STORMWATER POLLUTION PREVENTION PLAN
DEVELOPMENT AND IMPLEMENTATION
CERTIFICATION
North Carolina Division of Energy, Mineral, and Land Resources — Stormwater Program
Facility Name: ECCFLO, Inc.
Permit Number: NCS000567
Location Address: 2750 Patterson Street Greensboro, N.C. 27407
County: Guilford
"I certify, under penalty of law, that the Stormwater Pollution Prevention Plan (SPPP) document and all
attachments were developed and implemented under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gather and evaluate the information required by the SPPP.
Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information gathered is, to the best of my knowledge and belief, true,
accurate and complete."
And
"I certify that the SPPP has been developed, signed and retained at the named facility location, and the SPPP
has been fully implemented at this facility location in accordance with the terms and conditions of the
stormwater discharge permit."
And
"I am aware that there are significant penalties for falsifying information, including the possibility of fines and
imprisonment for knowing violations."
Sign (according to permit signatory requirements) and return this Certification. DO NOT
SEND STORMWATER POLLUTION PREVENTION PLAN WITH THIS CERTIFICATION.
Signature
Preston Black
Print or type name of person signing above
Date 4/27/2021
EHS Coordinator
Title
SPPP Certification 10/13