NCG050453_Application_20211011

Division of Energy, Mineral and Land Resources
Land Quality Section
National Pollutant Discharge Elimination System
Environmental
Quality NCG050000
NOTICE OF INTENT
a� 3
FOR AGENCY USE ONLY
Date Received
Year
Month
Da
002-1
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t t
Certificate of Covera e
NICIG1011F51011
Check #
I Amount
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1 I t�
Permit Assi ed to
C10-01
National Pollutant Discharge Elimination System application for coverage under General Pe
NCGO50000: R t C E i V IELID
STORMWATER DISCHARGES associated with activities classified as:
OCT 112021
SIC 23 Apparel and Other Finished Products Made from Fabrics and Similar Materials DENR-LAND QU/,-Firy
SIC' 265 Paperboard Containers and Boxes ' T°CPiV PVATER PERMIT-TING
SIC" 267 Converted Paper and Paperboard Products
SIC* 27 Printing, Publishing and Allied Industries
SIC* 30 Rubber and Miscellaneous Products (except as specified below)
SIC' 31 Leather and Leather Products (except as specified below)
SIC* 39 Miscellaneous Manufacturing Industries
SIC* N/A 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' 301 Tires and Inner Tubes
SIC* 311 Leather Tanning and Finishing
* Standard Industrial Classification Code
(Please print or type)
1) Mailing address of owner/operator (address to which all permit correspondence will be mailed):
Name
Street Address
City
Telephone No.
E-mail Address
Michael Simmons
1505 13th Street SW
Hickory
828-328-2201
[e-mail]
2) Location of facility producing discharge:
Facility Name
Facility Contact
Contact E-mail
Street Address
City
County
Telephone No.
Hickory Springs Manufacturing Company - PTI
Zenaida Camacho
[e-mail]
1505 13th Street SW
Hickory
Catawba
828 328-2201
3) Physical Location Information:
State NC
Fax:
State NC
Fax:
ZIP Code 28602
ZIP Code 28602
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). From 1-40(E or VV), merge onto US-321N(Exit 123e). Merge onto Us-70 exit(Exit44),
Turn left(W) onto US-70. Turn left(S) onto 13th St. 1505 13th St. SW is on the left.
(A copy of a county map or USGS quad sheet with facility clearly located on the map is required with this application)
4) Latitude 35.710448 Longitude -81.359978
(degrees, minutes, seconds)
SWU-220-071408
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Last Revised 6/24/14

NCG050000 N.O.I.
5) This NPDES Permit Application applies to which of the following :
New or Proposed Facility Date operation is to begin
❑ Existing
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: 3 0 8 3
7) Provide a brief narrative description of the types of industrial activities and products manufactured at
this facility: The Hickory facility manufactures extruded polyethylene foam products, using isobutane as a blowing agent.
8) Discharge points:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? 5
List discharge points (outfalls) that convey discharge from the site (both on -site and off -site) and location
coordinates. Attach additional sheets if necessary, or note that this information is specified on the site plan.
Stormwater Outfall No. 1
Latitude (degrees/minutes/seconds): 35.7118 N
Longitude (degrees/minutes/seconds): -81.3607 W
Stormwater Outfall No. 2
Latitude (degrees/minutes/seconds): 35.7117
N
Longitude (degrees/minutes/seconds): -81.3592
W
Stormwater Outfall No. 3
Latitude (degrees/minutes/seconds): 35.7108
N
Longitude (degrees/minutes/seconds): -81.3585
W
Stormwater Outfall No. 4
Latitude (degrees/minutes/seconds): 35.7101
N
Longitude (degrees/minutes/seconds): -81.3581
W
Stormwater Outfall No. 5
Latitude (degrees/minutes/seconds): 35.7085
N
Longitude (degrees/minutes/seconds): -81.3594
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds):
N
Longitude (degrees/minutes/seconds):
W
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SWU-220-071408 Last Revised 6/24114

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