NCG160240_NOI_20211130

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FOR AGENCY USE ONLY
NCG16 0 Z IF o �!J
Assigned to: B. aftdAl
ARO RO MRO RRO WARO WIRO WSRO RECEIVED
Division of Energy, Mineral, and Land Resources Land Quality Sec& 3 0 2021
National Pollutant Discharge Elimination System DENsi W ANDMM�TfNG
NCG160000 Notice of Intent
This General Permit covers STORMWA TER DISCHARGES associated with activities under the following Standard
Industrial Classifications: SIC 2951 [Asphalt Paving Mixtures and Blocks] 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. 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:
Highland Paving Co, LLC
Brian Raynor
Street address:
City:
State:
Zip Code:
2031 Middle Road
Fayetteville
NC
28312
Telephone number:
Email address:
910-824-1238
[e-mail]
Type of Ownership:
Government
❑County ❑Federal ❑Municipal ❑State
Non -government
Il Business (If ownership is business, a copy of NCSOS report must be included with this application)
❑ 1 ndivid ua I
2. Industrial Facility (facility being permitted):
Facility name:
Facility environmental contact:
US 401 Asphalt Plant
Brian Raynor
Street address:
City:
State:
Zip Code:
2520 US 401 N
Lillington
NC
27546
Parcel Identification Number (PIN):
County:
0651-31-5031.000
Harnett
Telephone number:
Email address:
910-824-1238
BRAYNORQHIGHLANDPAVING.COM
4-digit SIC code:
Facility is:
Date operation is to begin or began:
I El New ❑ Proposed ❑ Existing
January 17, 2022
Latitude of entrance:
Longitude of entrance:
35 degrees 26 36.59"
-78 degrees 49' 5.28"
Brief description of the types of industrial activities and products manufactured at this facility:
asphalt production
If the stormwater discharges to a municipal separate storm sewer system (MS4), name the operator of the MS4:
❑ N/A
Page 1 of 5

A
Check all activities conducted at this facility:
❑
Outdoor Stockpiling of Materials
❑ Transport of Materials by a Conveyor or Front-end Loader
❑
Storage of Raw Materials
❑ Vehicle and Equipment Maintenance
El
Storage of Materials in Above -ground Storage Tanks
❑ Vehicle or Equipment Washing
❑
Material Loading and Unloading
❑ Vehicle and Equipment Fueling
3. Consultant (if applicable):
Name of consultant:
Consulting firm:
Scott Brown, PE
4D Site Solutions, Inc
Street address:
City:
State:
Zip Code:
409 Chicago Drive, Suite 112
Fayetteville
NC
28306
Telephone number:
Email address:
910-426-6777
[e-mail]
4. Outfall(s) At least one outfall is required to be eligible for coverage.
3-4 digit identifier:
Name of receiving water:
Classification:
❑This water is impaired.
Neills Creek
18-16-(0.7)
❑ This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
35 degrees 25' 41.83"
-78 degrees 49' 11.95"
Brief description of the industrial activities that drain to this outfall:
runoff from the gravel yard
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.
❑ 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:
Facility qualifies for low density development, storm water retention is not required
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 NOI.
Page 2 of 5

S. Other Facility 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:
❑ This facility uses best management practices or structural stormwater control measures.
If checked, briefly describe the practices/measures and show on site diagram:
Facility qualifies for low density development, storm water retention is not required
❑ 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
rl 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):
p Check for $100 made payable to NCDEQ
❑ Copy of most recent Annual Report to the NC Secretary of State
❑+ This completed application and any supporting documentation
O 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 industrial process 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 143-215.6E (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, 1 certify that:
l 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.
i7 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.
El I will abide by all conditions of the NCG160000 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 hereby request coverage under the NCG160000 General Permit.
Printed Name of Applicant: Brian Raynor
Title: Managing Member
91 - ///A7 /71
(signature oiWppli nt) (Dot Signe )
Mail the entire package to: DEMLR— Stormwater Program
Department of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
Page 4 of 5

Additional Outfails
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 0 No
If yes, how manygallons of new motor oil are used each month when averaged over the calendaryear?
3-4 digit identifier:
Name of receiving water:
Classification:
❑ This water is impaired.
❑ This watershed has 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? 1l Yes I❑ 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 calendaryear?
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?
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? 17 Yes ® No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
Page 5 of 5

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a
LIMITED LIABILITY COMPANY ANNUAL REPORTIOIN17
NAME OF LIMITED LIABILITY COMPANY: Highland Paving Co., LLC
SECRETARY OF STATE ID NUMBER: 0699078 STATE OF FORMATION: NC
REPORT FOR THE CALENDAR YEAR: 2021
SECTION A:
1. NAME OF REGISTERED AGENT: McCauley, John W
2. SIGNATURE OF THE NEW REGISTERED AGENT:
- Filed Annual Report
i99078
A202107101225
12/2021 09:30
SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT
3. REGISTERED AGENT OFFICE STREET ADDRESS & COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS
2031 Middle Road 2031 Middle Road
Eastover, NC 28312 Cumberland County Eastover, NC 28312
SECTION B:
1. DESCRIPTION OF NATURE OF BUSINESS: Highland Paving Co, LLC
2. PRINCIPAL OFFICE PHONE NUMBER: [phone] x_
4. PRINCIPAL OFFICE STREET ADDRESS
2031 Middle Road
NC 28312
3. PRINCIPAL OFFICE EMAIL: Privacy Redaction
5. PRINCIPAL OFFICE MAILING ADDRESS
PO Box 1843
Fayetteville, NC 28302-1843
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: COMPANY OFFICIALS (Enter additional company officials in Section E.)
NAME: John W McCauley NAME: David Brian Raynor NAME:
TITLE: Managing Member TITLE: Managing Member TITLE:
ADDRESS:
ADDRESS:
2054 Middle Road 2204 Bayview Drive
Fayetteville, NC 28312 Fayetteville, NC 28305
ADDRESS:
SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business entity.
John W McCauley 3/12/2021
SIGNATURE
Form must be signed by a Company Official listed under Section C of This form.
John W McCauley Managing Member
Print or Type Name of Company Official Print or Type Tide of Company Official
This Annual Report has been filed electronically.
MAIL TO: Secretary of State, Business Registration Division, Post Office Box 29525. Raleigh, NC 27626-0525