NCG140505_Application_20220307

FOR AGENCY USE ONLY
NCG140 505
Assigned to: ; On
ARO FRO R RRO WARO WIRO WSRO
Division of Energy, Mineral, and Land Resources Land Quality Section
National Pollutant Discharge Elimination System
NCG140000 Notice of Intent
This General Permit covers STORMWATER AND/OR WASTEWATER DISCHARGES associated with activities under
SIC (Standard Industrial Classification) Code 3273 [Ready Mix Concrete] and like activities. 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 (8) below to: NCDEMLR Stormwater Program, 1612 MSC, Raleigh, INC 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 (9) below:
TRI STATE GUNITE OF NEW JERSEY, L.P.
MS. ERIN BAERST
Street address:
City:
State:
Zip Code:
1822 TOWER INDUSTRIAL DRIVE
MONROE
NC
28110
Telephone number:
Email address:
[phone]
[e-mail]
Type of Ownership:
Government
❑County ❑Federal ❑Municipal ❑State
Non -government
El Business (If ownership is business, a copy of NCSOS report must be included with this application)
❑ 1 ndividual
2. Industrial Facility (facility being permitted):
Facility name:
Facility environmental contact:
TRI STATE GUNITE OF NEW JERSEY, L.P (MONROE FACILITY)
MS. ERIN BAERST
Street address:
City:
State:
Zip Code:
1822 TOWER INDUSTRIAL DRIVE
MONROE
NC
28110
Parcel Identification Number (PIN):
County:
09366036
UNION COUNTY
Telephone number:
Email address:
[phone]
[e-mail]
4-digit SIC code:
Facility is:
Date operation is to begin or began:
3273
[]New ❑ Proposed I] Existing
August 2013
Latitude of entrance:
Longitude of entrance:
35.03306
-80.62665
Brief description of the types of industrial activities and products manufactured at this facility:
MANUFACTURING OF CONSTRUCTION CONCRETE MATERIALS (GUNITE)
If the stormwater discharges to a municipal separate storm sewer system (MS4), name the operator of the MS4:
0 N/A
Page 1 of 7

This facility uses:
❑ Phosphorus -containing detergents
❑ Non -Phosphorus -containing detergents
❑ Brighteners
❑ Other Cleaning Agents
❑ Other:
This facility has a closed -loop recycle system that meets design requirements in 15A NCAC 02T. 1000 and hold the facilities
working volume
❑ Yes — stop completion of this NOL Contact DWR Non -Discharge Permitting Program for permitting requirements
3. Consultant (if applicable):
Name of consultant:
Consulting firm:
ROHIT SHETTY, P.E.
GEOLOGICAL RESOURCES, INC.
Street address:
City:
State:
Zip code:
3502 HAYES ROAD
MONROE
NC
28110
Telephone number:
Email address:
[phone]
[e-mail]
4. C utfall(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.
SDO-1
EAST FORK TWELVE MILE CREEK UNKNOWN
❑ This watershed has a TMDL.
Discharge from this outfall is from:
0Stormwater Only ❑ Wastewater Only [3 Wastewater Comingled with Stormwater
7Q10 Flow of receiving waterbody (if discharging Wastewater Only or Wastewater Comingled with Stormwater to waters
classified as HQW, ORW, Tr, WS-I, WS-II, WS-III, SA, or PNA):
Discharge occurs from this outfall:
0Only during a rainfall event
❑ Intermittently (indicate how often)
0 Continuously (indicate flow in CFS)
Latitude of outfall:
Longitude of outfall:
35.03277
-80.62634
Brief description of the industrial activities that drain to this outfall:
STORMWATER RUNOFF FROM PROPERTY DRAINS INTO ON -SITE SEDIMENT POND BEFORE OUTFALLING TO ROADSIDE DITCH.
Do Vehicle Maintenance Activities occur in the drainage are of this outfall? D 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.
Discharge from this outfall is from:
0 Stormwater Only [3 Wastewater Only [3 Wastewater Comingled with Stormwater
7Q10 Flow of receiving waterbody (if discharging Wastewater Only or Wastewater Comingled with Stormwater to waters
classified as HQW, ORW, Tr, WS-I, WS-II, WS-III, SA, or PNA):
Discharge occurs from this outfall:
❑ Only during a rainfall event
❑ Intermittently (indicate how often)
E3 Continuously (indicate flow in CFS)
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 are of this outfall? [3 Yes ❑ No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
Page 2 of 7

3-4 digit identifier:
Name of receiving water:
Classification:
❑ This water is impaired.
❑ This watershed has a TMDL
Discharge from this outfall is from:
❑ Stormwater Only 0 Wastewater Only ❑ Wastewater Comingled with Stormwater
7Q30 Flow of receiving waterbody (if discharging Wastewater Only or Wastewater Comingled with Stormwater to waters
classified as HQW, ORW, Tr, WS-I, WS-ll, WS-III, SA, or PNA):
Discharge occurs from this outfall:
® Only during a rainfall event
E3 Intermittently (indicate how often)
Continuously (Indicate flow in CFS)
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 are of this outfall? [3 Yes 0 No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar ear?
3-4 digit identifier:
Name of receiving water:
Classification:
0 This water is impaired.
This watershed has a TMDL.
Discharge from this outfall is from:
0 Stormwater Only 13 Wastewater Only [3 Wastewater Comingled with Stormwater
7Q10 Flow of receiving waterbody (if discharging Wastewater Only or Wastewater Comingled with Stormwater to waters
classified as HOW, ORW, Tr, WS-1, WS-il, WS-III, SA, or PNA):
Discharge occurs from this outfall:
D Only during a rainfall event
[3 Intermittently (indicate how often)
OContinuously (indicate flow in CFS)
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 are of this outfall? E3 Yes E3 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 NOL
5. Wastewater
Types of Wastewater facility will generate or discharge
Vehicle & equipment cleaning (VE)
O Generate 0 Discharge O sent to WW Treatment system
Wetting of raw material stockpiles (RM)
0 Generate O Discharge O Sent to W W Treatment System
Mixing drum cleaning (MD)
0 Generate 0 Discharge 13 Sent to WV/ Treatment System
Facility will spray -down or actively wet aggregate piles
p Yes
O No
Page 3 of 7

6. Wastewater treatment alternatives
What wastewaters were considered for this alternatives review: 13 VE O RM U MD
Are there existing sewer lines with a one mile radius: 0 Yes E3 No
If Yes:
p The wastewater treatment plant will accept the wastewater. It is feasible to connect. Explain:
OThe wastewater treatment plant will accept the wastewater. It is not feasible to connect. Explain:
© The wastewater treatment plant will not accept the wastewater (attach a letter documenting)
O Surface or subsurface disposal is technologically feasible
Surface or subsurface disposal is not technologically feasible
Explain:
13 Surface or subsurface disposal system is feasible to implement
0 Surface or subsurface disposal system is not feasible to implement
Explain:
What is the feasibility of employing a subsurface or surface discharge as compared to a direct discharge to
surface waters? Explain:
Discharge to surface waters is the most environmentally sound alternative of all reasonably cost-effective
options of the wastewaters being considered:
Yes
0 No —contact DEMLR's Land Application Unit to determine permitting requirements
If this review included all wastewater discharge types, would excluding some types make of the above non -
discharge options feasible?
)3 Yes
E3 No
Other Faciiity Conditions (check all that apply and explain accordingly):
❑ This facility has a DMLR Erosion & Sedimentation Control Permit.
If checked, list the permit numbers for all current E&SC permits for this facility:
❑ This facility has a Division of Waste Management permit.
If checked, list the permit numbers for all current DWM permits for this facility:
❑ 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:
STORMWATER RUNOFF FLOWS INTO AN ON -SITE SEDIMENT POND BEFORE DISCHARGE TO ROADSIDE DITCH
O This facility has a Stormwater Pollution Prevention Plan (SWPPP).
If checked, please list the date the SWPPP was implemented:
SWPPP WILL BE PREPARED AND IMPLEMENTED UPON APPROVAL OF THIS PERMIT.
Page 4 of 7

❑ This facility is subject to Phase 11 Post -Construction Area
If checked, please list the permitting authority:
❑ This facility is located in one of the 20 Coastal Counties
If checked, please indicate if the facility is adding more than 10,000 ft2 of built -upon area or is a CAMA Major Permit
❑ Will add more than 10,0000 ft of built -upon area
❑ Is a CMA Major Permit
❑ Yes to both
❑ No to both
❑ This facility is discharging wastewater to a stormwater BMP
If checked, please Indicate the permitting authority, and attach letter approval to do so:
❑ This facility has wastewater treatment facilities in the 100-year floodplain
❑ 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
S. 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
O This completed application and any supporting documentation
O A line drawing of the water flow through the facility.
O Copy of county map or USGS quad sheet with the location of the facility clearly marked
❑ Letter documenting that W WFP will not accept wastewater (if applicable)
❑ Approval from permitting authority to discharge wastewater to a stormwater BMP (if applicable)
Page 5 of 7

0 Two (2) 24" x 36" site diagrams showing, at a minimum, existing and proposed:
a) outline of drainage areas
b) Stormwater/wastewater treatment structures
c) Location of numbered stormwater/wastewater outfalis (corresponding to which drainage areas)
d) Delineation of drainage areas to each discharge point
e) Runoff conveyance structures
fl Areas and acreage where materials are stored
g) Impervious area acreages
h) Locations(s) of streams and/or wetlands the site is draining to, and applicable buffers
i) Site property lines, North Arrow, and bar scale
j) If applicable, the 100-year floociplain line
k) Acreage of each stormwater and wastewater topographical area
1) Each of the facilities' wastewater or stormwater source and discharge structures and each of its hazardous waste
treatment, storage, or disposal facilities
m) Notation of the water quality classification of the receiving water that site waters eventually discharge to
❑ A narrative description and identification of the compost manufacturing sequence at the applicant's site, the general
feedstocks, the determination of where the site's final products qualities as "finished compost" as reference in the General
Permit test (NCG240000) and as determined by the DWM permitting process, identification of the stormwater BMPs
employed, and the general nature of the wastewater treatment system utilized to meet process wastewater discharge
limits.
9. 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, I certify that:
0 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.
0 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 1 will abide by all conditions of the NCG140000 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.
0 1 hereby request coverage under the NCG140000 General Permit.
Printed Name of Applicant: ERIN BAERST FOR TRI STATE GUNITE OF NEW JERSEY, L.P.
Title: SAFETY MANAGER
4 "
(Signature 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 6 of 7

Additional Outfalls
3-4 digit identifier:
Name of receiving water:
Classification:
❑ This water is impaired.
❑ This watershed has a TMDL.
Discharge from this outfall is from:
❑ Stormwater Only E3 Wastewater Only E3 Wastewater Comingled with Stormwater
7Q10 Flow of receiving waterbody (if discharging Wastewater Only or Wastewater Comingled with Stormwater to waters
classified as HQW, ORW, Tr, WS-I, WS-II, WS-III, SA, or PNA):
Discharge occurs from this outfall:
E3 Only during a rainfall event
E3 Intermittently (indicate how often)
E3 Continuously (indicate flow in CFS)
Latitude of outfall:
Long tude of outfall:
Brief description of the industrial activities that drain to this outfall:
Do Vehicle Maintenance Activities occur in the drainage are of this outfall? [3 Yes 13 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
Discharge from this outfall is from:
[3 Stormwater Only [3 Wastewater Only E3 Wastewater Comingled with Stormwater
7Q10 Flow of receiving waterbody (if discharging Wastewater Only or Wastewater Comingled with Stormwater to waters
classified as HQW, ORW, Tr, WS-I, WS-11, WS-III, SA, or PNA):
Discharge occurs from this outfall:
E3Only during a rainfall event
13 Intermittently (indicate how often)
[3Continuously (indicate flow in CFS)
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 are of this outfall? 0 Yes D 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
Discharge from this outfall is from:
0 Stormwater Only [3 Wastewater Only 13 Wastewater Comingled with Stormwater
7Q10 Flow of receiving watertady (if discharging Wastewater Only or Wastewater Comingled with Stormwater to waters
classified as HQW, ORW, Tr, WS-I, WS-II, WS-III, SA, or PNA):
Discharge occurs from this outfall:
E3 Only during a rainfall event
I] Intermittently (indicate how often)
Continuously (indicate flow in CFS)
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 are of this outfall? E3 Yes 0 No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
Page 7 of 7

APPENDIX B
SITE PLAN - SEPTEMBER 5, 2018
(FROM PREVIOUS CONSULTANT)

Geological Resources, Inc.
February 25, 2022 RECEIVED
DEMLR— StormwaterProgram tiAt% 03 7p),
North Carolina Department of Environmental Quality DENR-LAND QUALITY
1612 Mail Service Center STORMWATER PERMITTING
Raleigh, North Carolina 27699-1612
Re: General NPDES Permit Application
Tri State Gunite of New Jersey, L.P. — Monroe, NC Facility (SIC Code 3273)
1822 Tower Industrial Drive, Monroe, Union County, North Carolina
GRI Project No. 5969
Permit No. NCG140000
Catawba River Sub -Basin (East Fork Twelve Mile Creek Watershed)
Dear Sir or Madam:
On behalf of Tri State Gunite of New Jersey, L.P., Geological Resources, Inc. (GRI) presents the General NPDES
permit application (NCG140000) for the above referenced facility. As required by the permit guidelines, a
check (No. 35944) dated 02/08/2022 for $100 towards the permit application fee is included with this
application. In addition to the completed application, supporting documents include a copy of the USGS
Topographic Map showing the location of the facility, a Site Map, a Site Plan with Surface Flow and a Site
Vicinity Map (Figures 1 through 4). The existing retention pond and storm water outfall (SDO-1) are shown on
Figure 3 (Site Plan with Surface Flow). In accordance with permit requirements, the Storm Water Pollution
Prevention Plan (SWPPP) will be developed upon approval of the permit and will include best management
practices for storm water control.
A completed Notice of Intent application form is included as Appendix A. A copy of the site survey that shows
the existing retention pond and storm water outfall is included as Appendix B.
If you should have questions or if additional information is required, please do not hesitate to contact me at (704)
698-1221 or at [phone].
Sincerely,
Geological Resources, Inc.
c�'^'""j
Rohit Shetty, P. E.P. E.
Vice President
attachment
cc: Erin Baerst, Tri State Gunite of New Jersey, L.P.
3502 Hayes Road a Monroe, North Carolina 28110
113 West Firetower Road, Suite G a Winterville, North Carolina 28590
Phone [phone] a [phone] a Fax [phone]

FIGURES
Figure 1: Site Location Map (USGS Topo)
Figure 2: Site Map
Figure 3: Site Plan with Surface Flow
Figure 4: Site Vicinity Map

500 M
9 2000 FT
Date: 02/11/2022 Location: 35.0332680 N-80.626428' W

LEGEND
SUBJECT PROPERTY BOUNDARY LINE
RF
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IRS
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R/W
RIGHT—OF—WAY
SF
SQUARE FEET
PC
PLAT CABINET
DB
DEED BOOK
PG
PAGE
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FRONT SETBACK
RY
REAR YARD
SY
SIDE YARD
IPF
IRON PIPE FOUND
CID
COMPUTED POINT
CMP
CORRUGATED METAL PIPE
CHAINLINK FENCE
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■
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SITE MAP
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TO State Gunite of NJ, L.P. (Monroe) 1522 Tower Industrial Drive
GRI Project No. 5969 Monroe, North Carolina
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LEGEND
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RY
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SITE PLAN AND SURFACE FLOW
0 40 60 160 1822 Tower Industrial Drive
Tri State of NJ, (Monroe) Monroe, North Carolina
( IN FEET) GRI Project No. 59 5989 Union County
Geo%g, Resources, Inc. 1 Inch = 80 ft Date: 02/19/20221 Drawn by. DTH I Figure: 3

LEGEND
Roads_070620
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Ponds
Subject Property
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County NC Parcels
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Xq:* J� FIGURE 4: SITE VICINITY MAP
TRI STATE GUNITE OF NEW JERSEY, L.P.
1822 TOWER INDUSTRIAL DRIVE
•r+�; y �J , , MONROE, UNION COUNTY
NORTH CAROLINA
NPDES PERMIT NO. NCG140000
yr" 0 `:
�� �: GRI N0. 5969
PREPARED BY:
A
' ' Y GEOLOGICAL RESOURCES INC.
ry w l ;c FEBRUARY 24, 2022
+c• a' e •' w a. 1 // Webgiwl Nezour<es. Inc.