NCG210500_Application_20211122

DocuSign Envelope ID: A757Ft98-B36A4FB8-901F-iBDC2B7E3876
SMITH+GARDNER
FM8INEFAB
November 16, 2021
Stormwater Program
Division of Energy, Mineral, and Land Resources
NC Department of Environmental Duality
1612 Mail Service Center
Raleigh, NC 27699-1612
glaaF55
14 N. Boylan Avenue Raleigh NC 27603
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919.828.0577 wwwsmithgardnerinc.cam
RECEIVED
HN 2 2 2021
DENR•LAND QUALITY
STEIRMWATER PERMITTING
RE: Notice of Intent for NCG210000 Certificate of Coverage
Triangle Forest Products (formerCurrin Brothers LC10 Landfill - Permit No.92N-LCI0-1986)
4525 Sunset Lake Road
Apex, North Carolina 27539
Dear Stormwater Engineer:
On behalf of Triangle Forest Products, Smith Gardner, Inc. (S+GI is submitting this Notice of Intent
(NOI) for the NPOES Industrial stormwater program. This is a permitted LCID landfill site that was
recently acquired by Triangle Forest Products. Along with the NOI form, a USGS quadrangle map
showing the site location, a site map, and the 2019-2020 Business Corporation Annual Report are
attached.
Contact information for Triangle Forest Products is as follows:
Ms. Teresa Phillips
E m a i l:tria ng leforestproductsfaya hoo.co m
Phone:[phone]
Thank you for your consideration. If you have any questions, or require further information, please
contact us at (9191 828-0577 or by e-mail below -
Sincerely,
SMITH GARDNER, INC a•`���N CAgU<�',�
s'2�roF�s§ro�.ti2
EDows nea by o0��Signed by. : lQ Sw
YS"y
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CSECC98M7E4AC.. 3369FBA008BBa15 i ep%y4P,,_ . -
Jesse C. Li, E.I. Stacey A. Smith '"4r` r A
Staff Engineer, ext. 170 Senior Engineer, ext. 127 41""446
4essefasmithaardnerinc.com stacevfasmithgardnerinc.com
jcVsas
Att: Site Map
CC: Allen Phillips, Triangle Forest Products
Clayton Horne, Triangle Forest Products
Teresa Phillips, Triangle Forest Products
Mr. Thad Valentine, DEMLR
File
HAPrge ts{Trian91e Forest P,o udt IApev, NClkNPDEATFP NCDE0 Letter 11-1621 NPDESAm

DocuSign Envelope ID: 8ECA153E-0180-48FA-A59D-EFBD22F3BE3A
FOR AGENCY USE ONLY
NCG21 0 5 0 0
Assigned to: 15.,C SL)N
ARO FRO MRO RRO WARO WIRO WSRO
RECEIVED
iJ 12 2021
Division of Energy, Mineral, and Land Resources Land Quality Section, ANJGlUALITY
National Pollutant Discharge Elimination System AERPERMITTING
NCG210000 Notice of Intent
This General Permit covers STORMWATER DISCHARGES associated with activities under the following Standard
Industrial Classifications: SIC 24 [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], SIC 2491 [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 (6) below to: NCDEMLR Stormwater Program,1612 MSC, Raleigh, NC 27699-1612. 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 organizational entity:
Legally responsible person as signed in Item (7) below:
Triangle Forest Products, Inc.
Ms. Teresa Phillips
Street address:
City:
State:
Zip Code:
7151 O'Kelly Chapel Road, suite 278
Cary
IN
27519
Telephone number:
Email address:
919-616-4890
trian leforestproducts ahoo.com
Type of Ownership:
Government
❑County ❑Federal ❑Municipal ❑State
Non -government
OBusiness (If ownership is business, a copy of NCSOS report must be included with this application)
Olndividual
2. Industrial Facility (facility being permitted):
Facility name:
Facility environmental contact:
Triangle Forest Products, Inc.
Ms. Teresa Phillips
Street address:
City:
State:
Zip Code:
4525 Sunset Lake Road
Apex
NC
27539
Parcel Identification Number (PIN):
County:
0750441182
Wake County
Telephone number:
Email address:
919-616-4890
triangleforestproducts yahoo.com
4-digit SIC code:
Facility is:
Date operation is to begin or began:
2499
E3 New 10 Proposed 0 Existing
1986
Latitude of entrance:
Longitude of entrance:
35,40,48 N
78,48,45 W
Brief description of the types of industrial activities and products manufactured at this facility:
LCID landfill and Recycling Facility which recovers woody waste for mulch and lumber
This facility will produce Wood Pellets: ❑Yes ONo
If the stormwater discharges to a municipal separate storm sewer system (MS4), name the operator of the MS4:
O N/A
Page 1 of 5

DocuSign Envelope lD. 8ECA153E-0180-48FA-A59D-EFBD22F3BE3A
3. Consultant (if applicable):
Name of consultant:
Consulting firm:
Street address:
City:
State:
Zip Code:
Telephone number:
Email address:
4. Outfall(5) At least one outfall is required to be eligible for coverage.
3-4 digit identifier:
Name of receiving water:
Classification:
❑ This water is impaired.
001
Middle Creek
C;NSW
❑ This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
35,41,05 N
78,49,05 W
Brief description of the industrial activities that drain to this outfall:
LCID screening and processing area
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? ❑ Yes El 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.
002
Middle Creek
C;NSW
❑ This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
35,41,02 N
78,49,18 W
Brief description of the industrial activities that drain to this outfall:
LCID landfill
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? ❑ Yes 0 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.
003
Middle Creek
C;NSW
❑ This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
35,41,09 N
78,49,22 W
Brief description of the industrial activities that drain to this outfall:
LCID landfill
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? 13 Yes [3 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 NO].
Page 2 of 5

IDocuSign Envelope ID: 8ECA153E-0180-48FA-A59D-EFBD22F3BE3A
5. Other Facilitv Conditions (check all that apply and explain accordingly):
❑ 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:
L7 This facility uses best management practices or structural stormwater control measures.
If checked, briefly describe the practices/measures and show on site diagram:
Sedimentation Basins
❑ This facility has Stormwater Pollution Prevention Plan (SWPPP).
If checked, please list the date the SWPPP was implemented:
❑ This facility stores hazardous waste in the 100-yearfloodplain.
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 ID:
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):
17
Check for $100 made payable to NCDEQ
O
Copy of most recent Annual Report to the NC Secretary of State (if applicable)
O This completed application and any supporting documentation
0
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
I7 Copy of county map or USGS quad sheet with the location of the facility clearly marked
Page 3 of 5

DocuSign Envelope ID: 8ECA153E.0180-48FA-A59D-EFBD22F3BE3A
7. Applicant Certification:
North Carolina General Statute 143-215.68 (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 (510,000).
Under penalty of law, I certify that:
O 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.
171 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.
0 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.
El I hereby request coverage under the NCG210000 General Permit.
Printed Name of Applicant:
Teresa Phillips
Title: corporate secretary
�Docu8gnW by -
(Signature
PG.iU.a�s
sreneeesese:as_.
(Signature of Applicant)
Mail the entire package to:
11/17/2021
(Date Signed)
DEMLR— Stormwater Program
Department of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
Page 4 of S

IDocuSign Envelope ID. 8ECA153E-018048FA-A59D-EFBD22F3BE3A
Additional Outfalls
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? 0 Yes 0 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? 0 Yes 0 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? Dyes 0 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? 0 Yes 0 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? 0 Yes 0 No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
Page 5 of 5

BUSINESS CORPORATION ANNUAL REPORT
�w� „p
10-20V
NAME OF BUSINESS CORPORATION: Triangle Forest Products, Inc.
SECRETARY OF STATE ID NUMBER: 0289844 STATE OF FORMATION: NC
REPORT FOR THE FISCAL YEAR END: 6/30/2020
SECTION A:
- Filed Annual Report
202107609738
712021 04:30
❑X Changes
1. NAME OF REGISTERED AGENT: PHILLIPS, ALLEN R -
2. SIGNATURE OF THE NEW REGISTERED AGENT:
SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT
3. REGISTERED AGENT OFFICE STREET ADDRESS & COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS
4525 Sunset Lake Rd.
Apex, NC 27539 Wake County
SECTION B: PRINCIPAL OFFICE INFORMATION
7151 O'Kelly Chapel Rd, Suite 278
Carv. NC 27519
1. DESCRIPTION OF NATURE OF BUSINESS: Triangle Forest Products Inc.
2. PRINCIPAL OFFICE PHONE NUMBER: [phone] x_ 3. PRINCIPAL OFFICE EMAIL: Privacy Redaction
4. PRINCIPAL OFFICE STREET ADDRESS
4525 Sunset Lake Rd.
Apex, NC 27539
5. PRINCIPAL OFFICE MAILING ADDRESS
7151 O'KellyChapel Rd.
NC 27519
6. Select one of the following if applicable. (Optional see instructions)
❑ The company is a veteran -owned small business
❑ The company is a service -disabled veteran -owned small business
SECTION C: OFFICERS (Enter additional officers in Section E.)
NAME: Teresa E. Phillips NAME: Allen R. Phillips NAME:
TITLE: Secretary TITLE: President
ADDRESS:
1282 Hanks Chapel Road
Pittsboro, NC 27312
ADDRESS:
1282 Hanks Chapel Rd
Pittsboro, NC 27312
TITLE:
ADDRESS:
SECTION D: CERTIFICATION OF ANNUAL REPORT, Section D must be completed in its entirety by a person/business
entilyeresa E. Phillips 3/17/2021
SIGNATURE
Form must be signed by an officer listed under Section C of this form.
DATE
Teresa E. Phillips Secretary
Print or Type Name of Officer Print or Type Title of Officer
This Annual Report has been filed electronicaUy.
MAIL TO: Secretary of Stale, Business Registration Division, Post Office Box 29525, Raleigh, NC 27626-0525

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