NCG210498_Application_20210618

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FOR AGENCY USE ONLY
NCG21___
Assigned to: Aft kxJ
ARO FRO MRO WARO WI 0 WSRO�
Division of Energy, Mineral, and Land Resources Land Quality Section
National Pollutant Discharge Elimination System
NCG210000 Notice of Intent
This General Permit covers STORMWA TER DISCHARGES associated with activities under the following Standard
Industrial Classifications: SIC24 [Timber Products, including Wood Chip Mills -- except as specified below] and like
activities deemed by DEMLR to be similar in the process and/or the exposure of raw materials, products by-
products, or waste materials. The following activities are specifically excluded from coverage under this General
Permit: SIC 2434 [Wood Kitchen Cabinets], SIC2491 [Wood Preserving], and SIC 2411 [Logging]. You can find
information on the DEMLR Stormwater Program at deq.nc.gov/SW.
Directions: Print or type all entries on this application. Send the original, signed application with all required
items listed in Item (b) below to: NCDEMLR alei h, NC 27 The
submission of this application does not guarantee coverage under the General Permit. Prior to coverage under
this General Permit a site inspection will be conducted.
1. Owner/Operator (to whom all permit correspondence will be mailed):
Name of legal organiza tonal entity:
Legally responsible person as signed tn Item (7) below:
Street address: E
Sri �
City:
State-
Zip Code:
Telephone number: Z; 3
Email address:
Type of Ownership:'`
Government
®County ...,E]Federal ®Municipal CIState
Non- overnment
Non
(If ownership is business, a copy of NCSOS report must be included with this application)
®Individual
2. Industrial Facility (facility being permitted):
Facility name: "�L
PS-1 "`� (rro N
ental contact: �3
Facility envirzn"�
NM-"
Street address: W 88('��� n_`
�f}
City: �NJ 6(eb�J
State:
1
co
Parcel Identification Number (PIN):
iI J oX1 04? 1 6V f
County:�C
01) 4
Telephone number: e if J 9 P�_ 53S
Email address:
i�ope
4-digit SIC code:
Facility is:
Date at' n is to begin or began:
® New ® Proposed fisting
3 Z�l
Latitude of entrance:
s . 3C� (a15 i+►+xlK 11
Longitude of entr n :
-1-6.
Brief description of the types of industrial activities and products manufactured at this facility:
�Doce 017 stl�ulta6_�e£C c,'
This facility will produce Wood Pellets: ®Yes ANo
If the stormwater discharges to a municipals-, a storm sewer system (MS4), name the operator of the MS4:
© N/A
Page 1 of 5

3. Consultant (if applicable):
Name of consultant:
Consulting firm:
Street address:
City:
State:
Zip Code:
Telephone number:
Email address:
4. Outfall(s) At least one outfall is required to be eligible for coverage.
3-4 digit identifier:
N me o rece vin wa r
g
am,
Classification-
El This water is impaired.
loo
P,1
C NSW
© This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
-�� 31
Brief description of the industrial activities that drain to this outfall:
,
4�0
'U
Do Vehicle Maintenance Activities occur in the drainage area of this outfall?
® Yes No
if yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
3-4 digit identifier:
Name of receiving water:
Classification:
❑ This water is impaired.
❑ This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
Brief description ofthe industrial activities that drain to this outfall:
Do Vehicle` Maintenance Activities occur in the drainage area of this outfall? El Yes O No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
3-4 digit identifier:
Name of receiving water:
Classification:
❑ This water is impaired.
I] This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
Brief description of the industrial activities that drain to this outfall:
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? ® Yes ® No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
3-4 digit identifier:
Name of receiving water:
Classification:
❑ This water is impaired.
© This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
Brief description of the industrial activities that drain to this outfall:
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? Yes ® No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
All outfalls must be listed and at least one outfall is required. Additional outfalls may be added in the section
"Additional Outfalls" found on the last page of this N01.
Page 2 of 5

S. Other Facility Conditions (check all that apply and explain accordin&):
❑ This facility has other NPDES permits.
If checked, list the permit numbers for all current NPDES permits:
❑ This facility has Non -Discharge permits (e.g. recycle permit).
If checked, list the permit numbers for all current Non -Discharge permits:
<This facility uses best management practices or structural stormwater control measures.
ked, briefly describe the practices/measures and show on site diagram:'.
ke oSe iUi i
❑ This facility has a Stormwater Pollution Prevention Plan (SWPPP).
If checked, please list the date the SWPPP was implemented:
❑ This facility stores hazardous waste in the 100-year floodplain.
If checked, describe how the area is protected from flooding:
❑ This facility is a (mark all that apply)
❑ Hazardous Waste Generation Facility
❑ Hazardous Waste Treatment Facility
❑ Hazardous Waste Storage Facility
❑ Hazardous Waste Disposal Facility .
If checked,
indicate:
Kilograms of waste generated each month:
Type(s) of waste:
How material is stored:
Where material is stored:
Number of waste shipments per year: `
Name of transport/disposal vendor:
Transport/disposal vendor EPA I D:
Vendor address:
❑ This facility is located on a Brownfield or Superfund site
If checked, briefly describe the site conditions
6. Required Items (Application will be returned unless all of the following items have been included):
❑ Check for $100 made payable to NCDEQ
❑ Copy of most recent Annual Report to the NC Secretary of State (if applicable)
© This completed application and any supporting documentation
❑ A site diagram showing, at a minimum, existing and proposed:
a) outline of drainage areas
b) surface waters
c) stormwater management structures
d) location of stormwater outfalls corresponding to the drainage areas
e) runoff conveyance features
f) areas where materials are stored
g) impervious areas
h) site property lines
❑ Copy of county map or USGS quad sheet with the location of the facility clearly marked
Page 3 of 5

7. Applicant Certification:
North Carolina General Statute 143-215.6B (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 ... shall be guilty of a Class 2 misdemeanor which may include a fine not
to exceed ten thousand dollars ($10,000).
Under penalty of law, I certify that:
❑ I am the person responsible for the permitted industrial activity, for satisfying the requirements of this permit, and for any
civil or criminal penalties incurred due to violations of this permit.
❑ The information submitted in this NOI is, to the best of my knowledge and belief, true, accurate, and complete based on
my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the
information.
❑ I will abide by all conditions of the NCG210000 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.
❑ 1 hereby request coverage under the NCG210000 General Permit.
Printed Name of Applicant:
Title: P�� ' De�'
f.
{ ' e of Applicant) (Date Signed)
Mail the entire.package to: DEMLR —Stormwater Program
Department of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
Page 4 of 5

BL.ncicw000
FROM: Ryan Conrad
DATE: Monday, June 7, 2021
SUBJECT: NOTICE OF VIOLATION (NOV-2021-PC-0262) West Farms Wood Products
Johnston County delivered 6/1/2021
This March, an inspector from the Raleigh Regional Office of the Division of Energy, Mineral, and Land
Resources (DEM LR), conducted a compliance inspection for the West Farm Wood Products facility
located at 1683 Barefoot Road, Newton Grove in Johnston County, North Carolina.
As a result of the inspection, we were asked to apply for NCG210000. Please see attached completed
NOI and $100 application check. This was our first notice to apply for NCG210000.
From our 2019 application for the Permit to Operate:
Stormwater is naturally diverted from the facility work area due to the slope of the site and runs
off into forested riparian buffers. There is presently no pooling of water at the site. Stormwater
best management practices are utilized to prevent soil and other pollutants from accessing
surface waters and to prevent excessive on -site erosion. Silt fences are presently in place to
prevent silt from leaving the site.
We will continue to utilize best practices to prevent erosion.
Please call me directly with questions.
9
Ryan Conrad
ryan@?bwoodsolutions.com
812-327-4934
699 East Dillman Road Bloomington, IN 47401 [phone]

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