NCG081014_NOI_20220216

FOR AGENCY U E ONLY
NCG081Q_
Assigned to: C>lRsO,✓
ARO FRO MR RRO WARD WIRO WSRO
RECEIVED
FEB 15 2022
Division of Energy, Mineral, and Land Resources Land Quality§@jkJIIMQUALITY
National Pollutant Discharge Elimination System STOWftRRPERMITfING
NCG080000 Notice of Intent
This General Permit covers STORMWATER DISCHARGES associated with activities under the following Standard
Industrial Classifications: SIC 40 [Railroad Transportation], SIC 41 [Local and Suburban Transit and Interurban
Highway Passenger Transportation], SIC 42 [Motor Freight Transportation and Warehousing — except for SIC
4221-4225], SIC 43 [United States Postal Services], SIC 5171 [Petroleum Bulk Stations and Terminals — when total
petroleum site storage capacity is less than 1 million gallons]. The following activities are also included: other
industrial actives where the vehicle maintenance area(s) are the only area requiring permitting; stormwater
discharges from oil water separators and/orfrom secondary containment structures associated with petroleum
storage facilities with less than 1 million gallons of total petroleum site storage capacity. 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:
Union Electric Membership Corporation
David Gross
Street address:
City:
State:
Zip Code:
1525 North Rocky River Road
Monroe
NC
28110
Telephone number:
Email address:
704-221-9645
[e-mail]
Type of Ownership:
Government
13County E3Federal ❑Municipal [3State
Non -government
E] Business (If ownership is business, a copy of NCSOS report
must be included with this application)
❑ Individual
2. Industrial Facility (facility being permitted):
Facility name:
Facility environmental contact:
Monroe Facility
David Gross
Street address:
City:
State:
Zip Code:
1525 North Rocky River Road
Monroe
NC
28110
Parcel Identification Number (PIN):
County:
09342114R
Union
Telephone number:
Email address:
704-221-9645
[e-mail]
4-digit SIC code:
Facility is:
Date operation is to begin or began:
9631
1 M New ® Proposed Il Existing
1940
Latitude of entrance:
Longitude of entrance:
35.01531
-80.60661
Page 1 of 5

Brief description of the types of industrial activities and products manufactured at this facility:
Transformer storage/repair and fleet vehicle maintenance
If the stormwater discharges to a municipal separate storm sewer system (M54), name the operator of the MS4:
❑ N/A
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:
Name of receiving water:
Classification:
❑This water is impaired.
001
Dry Fork
C
❑This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
35.01713
-80.60609
Brief description of the industrial activities that drain to this outfall:
Vehicle maintenance activities, outdoor generator storage, drum storage areas
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? 13 Yes ❑ No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
50.5
3-4 digit identifier:
Name of receiving water:
Classification:
❑ This water is impaired.
002
Dry Fork
C
❑ This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
35.01445
-80.60912
Brief description of the industrial activities that drain to this outfall:
Outdoor generator storage, staging of transformers
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.
003
1 Dry Fork
C
❑ This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
35.01512
-80.60667
Brief description of the industrial activities that drain to this outfall:
Outdoor generator storage
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?
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

5. 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:
O This facility uses best management practices or structural stormwater control measures.
If checked, briefly describe the practices/measures and show on site diagram:
The facility has two stormwater retention ponds to control stormwater drainage.
O 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 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):
O 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
ID 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
O 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 143-215.68 (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 ($10,000).
Under penalty of law, I certify that:
❑ 1 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.
❑ 1 will abide by all conditions of the NCG080000 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 NCG080000 General Permit.
Printed Name of Applicant: Q> v . Ot 6M51
Title: G'rccP—Fres'4e4N-t . Gw> mme-erme, i`o
/o
(Signature of Applicant) (Dat Signed
Mail the entire package to: DEMLR —Stormwater Program -
Department of Environmental Quality Y
1612 Mail Service Center ?,
Raleigh, NC 27699-1612
Page 4 of 5

SOSID: 0153322
Date Filed: 9/18/2014 9:17:00 AM
Elaine R Marshall
North Carolina Secretary of State
STAR Old �40RT2 C.iTfOt INA
DEPARTMENT OF THE SECRETARY OF STATE C2014 238 00082
STATEMENT OF CHANGE OF REGISTER]
OFFICE AND/OR REGISTERED AGENT
Pursuant to §55D-31 of the General Statutes of North Carolina, the undersigned entity submits the following for the purpose of
changing its registered office and/or registered agent fn the State of North Carolina.
The name of the entity is: Ualcn Elecele MembemhlP Corporeucn
Entity Type: ❑Corporation, ❑Foreign Corporatlan, InNoapreSt Corporation, ❑FmeignNoopto& Corporation,
❑Limited Liability Company, QForeiga Limited Liability Compaq ❑Limited Partnetaldp, Doregn Limited Partnership,
❑Limited LiabilityPeriaets*[3ForeigtLimited Liability Partnership
The street address and county of the entity's registered office currently on file is:
Number and Street 1525 Rocky Rhw Road North
City, Stets, Zip Code: Monroe, NC 26110 County. UNon
p0in address etl�. Mamoreniftom4hP 0 addBoa 1irm 27 the Mo5=os a NC 81II-�S3T
The name of the cmrent registered agenda: Tony E. Hearn
NESENEEMW
1. The street address and county of the new registered office ofthe entity is:
(complete this Item only ifthe address of the registered office is being changed)
Number and Street:
City, State, Zip Code:
2. The mailing address IfdUerent from thesireet address of the new registered office is:
(complete this item only ifthe adders of the registered office is being changed)
P. o. Box 5014, Monroe, N. C. 2SiU-5014
3, The name of the now registered agent and the new agent's consent to appointment appears below:
(complete this item only ifthe mmnte of the registered agent is being changed)
Gregory S. Andress
Type or PrintName ofNewAgent • gnattae & Mle
4. The address of the entity's registered office end the address ofthe business office of its registered agent, as changed,
will be identical.
5. This statement will be effective upon filing, unless a date and/or time is specified:
This is the M� day of 27 .2014 UNION ELECTRIC MEMBERSHIP.CORPORATION
Signature
Gregory & Andreae, Ezacu lve Vlce-Presldent a 0anaml Manager
Type orPrhdNmna and Title
Notes: Filing Reis S3A0. Thh domment mudbe medwith tkelleerebryaRState.
• lotted of dgole; here, the am rWdeted agent may der a aparatewdan eonrnt to the appoloimeat, which mud be attached to this Statement.
CORPORATIONS DPVISION P. O. BOX 29622 RALEIOH, NC 2762"622
Revised January 2002 Form BB-06

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UNION POWER FACILITY LOCATION MAP
Sta ntec COOPERATIVE
MONROE, NORTH CAROLINA
FACILITY
oStantec Consulting Services Inc.
3157 Royal Drive Suite 250
Alpharetta GA 30022-2487 Project No. F ure Nc.
Tel. [phone] q 9
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-80.60912
-80.bObb 7
LEGEND CAent/Project THE,
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UNION POWER COOPERATIVE TRANSFORMER LOCATION FACILITY DRAINAGE
Stantec STORMWATER OUTFALL LOCATION MONROE, NORTH CAROLINA DIAGRAM
DRAINAGE BASIN DELINEATION FACILITY
stantec Consulting Services Inc. LOCATION OF SPILL RESPONSE MATERIALS
its] Royal Drive Suite 25D 0 150' 300'
Alpharetta GA 3)=
Project No.
Tel. 4tant c.com 172658282 rg 2 Na.
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