NCG160239_Application_20210527

AFT
M.A
NCDENR
NORTH CA OLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
Division of Energy, Mineral, and Land Resources
Land Quality Section
National Pollutant Discharge Elimination System
NCG160000
FOR AGENCY USE ONLY
Date Received
Year
I Month
I Da
2.02 t
1 Or--
1 VT
Certificate of Coverage
NICIG11 16iPILISM
Check # I
Amount
YWvo
Permit Assigned to
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NOTICE OF INTENT R 6 V I` ED
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG160000 for STORMWATER DISCHARGES associated with activities classified as: MAY 2021
SIC 2951 The manufacture of Asphalt Paving Mixtures and Blocks, DENR-LAND QUALITY
STORMWATER PERMITTING
And, Like activities deemed by DEMLR to be similar in the process, or the exposure of raw
materials, intermediate products, final products, by-products, or waste materials.
(Please print or type)
1)
Mailing address of the owner/operator (address to which official permit correspondence will be mailed):
Name
Southeast Emulsions, Inc.
Owner Contact
Mr. Collin Douglas
Street Address
248 Plemmons Road
City
Duncan State: SC ZIP Code 29334
Telephone No.
478-972-3874 Fax:
E-mail Address
[e-mail]
2) Location of the facility producing the discharge:
Facility Name Southeast Emulsions, Inc. — Denton Terminal
Facility Contact Mr. Joe Harvey
Street Address 18846 NC-8
City Denton State NC
County Davidson
Telephone No. 336-859-0902
Email [e-mail]
3) Physical Location Information:
ZIP Code 27239
Fax:
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).
Transportation facility, which receives, handles, stores and distributes liquid asphalt
(A copy of a county map or USGS quad sheet with facility clearly located on the map is a required part of this application.)
Latitude 35'36'46.7"N Longitude 80°10'37.7"W- (degrees, minutes, seconds)
4) This NPDES Permit Application applies to which of the following :
❑ New or Proposed Facility* Date operation is to begin
X Existing
*If this new or proposed facility is located in one of the 20 coastal counties, please contact the appropriate DEMLR Regional
Office (see page 4) to determine if a State Stormwater Permit is required prior to construction.
Page 1 of 4
SWU-231-030909 Last revised 9/10/14

5) 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
6) Services and Activities
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.) Facility receives in raw materials (liquid asphalt, chemical additives) via
rail and tanker truck. Products are stored within above ground tanks and smaller containers (e.g.
drums/totes). Process includes combining raw materials to make asphalt cement for use in paving operations.
b) Check all activities conducted at this facility.
( X Outdoor stockpiling of materials
( X Storage of raw materials
( X Storage of materials in above-
ground tanks
( X Material Loading and Unloading
7) Discharge points 1 Receiving waters:
Transport of materials by a
conveyor or front-end loader
Vehicle and equipment maintenance
Vehicle or Equipment Washing
Vehicle and equipment fueling
How many discharge points (ditches, pipes, channels, curb and gutter, swales, etc.) convey stormwater from
the property? 3 discharge points. Two pipes and one overflow.
What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater
discharges end up in? Lick Creek and ultimately Yadkin -Pee Dee River
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). N/A
Receiving water classification (if known): WS-1V
8) 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.
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?
If yes, list the municipality and permit number
X No ❑ Yes
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.
9) 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: Closed raw material containers, conveyances directing Stormwater to a
collection basin, loading/unloading operating procedures, spill kits, good house keeping and employee training. _
Page 2 of 4
SWU-234-030909
Last revised 09/10/14

NCG160000 N.O.I.
10) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No XYes
If yes, when was it implemented?
11) Are vehicle/equipment maintenance activities occurring at this facility?
X No ❑ Yes
12) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
XNo ❑ 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:
How is material stored:
Where is material stored:
How many disposal shipments per year:
Name of transport / disposal vendor:_
Vendor address:
13) Certification:
North Carolina General Statute 143-215.6B (1) 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 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
(Environmental Management] 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: Mr. Collin Douglas
Title: _Assistant Safe Director
(Signature of
5 2..1 Z0Z1
(Date Signed)
Page 3 of 4
SWU-234-030909 Last revised 09/10/14

NCG160000 N.O.I.
This 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.
Please do not ask us to "hold" an incomplete application in anticipation of a check under separate cover.
Check for $100 made payable to NCDENR
This completed application signed by the applicant, 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 are
stored, (f) impervious areas, (g) site property lines, (h) vehicle and equipment maintenance, blasting,
painting, and washing areas, and (i) location of activities listed in 7b.
Copy of county map or USGS quad sheet (preferred) with location of facility clearly marked on map
Please mail the entire package to:
Stormwater Permitting Program
Division of Energy, Mineral, and Land Resources
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Please note:
The submission of this document does not guarantee the issuance of NPDES permit coverage.
For questions, please contact the DEMLR Regional Office for your area.
To visit our website please go to http://
portal. ncdenr.or_g/web/Ir/stormwater
DEMLR 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 .........
[phone]
Page 4 of 4
SWU-234-030909 Last revised 09/10/14

• File an Annual Report/Amend an Annual Report • Upload a PDF Filing • Order a Document Online • Add Entity to My Email Notification List • View Filings
Print a Pre -Populated Annual Report form • Print an Amended a Annual Report form
Business Corporation
Legal Name
Southeast Emulsions Inc.
Information
Sosld: 2127463
Status: Current -Active O
Date Formed: 2/8/2021
Citizenship: Foreign
State of Incorporation: SC
Fiscal Month: December
Annual Report Due Date: April 15th
Currentgnnual Report Status:
Registered Agent: Corporation Service Company
Addresses
Mailing
250 Plemmons Road
Duncan, SC 29334
Officers
Stock
Principal Office Reg Office Reg Mailing
250 Plemmons Road 2626 Glenwood Ave Ste 550 2626 Glenwood Ave Ste 550
Duncan, SC 29334 Raleigh, NC 27608 Raleigh, NC 27608

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