NCG030729_Application_20220606

• RECEIVED
FOR AGENCY USE ONLY !UN Oh 1022
NCG03 0 -129
Assigned to: lii DEMLRStor
ARO FRO MRO RRO WARO WIRO WSRO rnwaterProgram
Division of Energy, Mineral, and Land Resources Land Quality Section
National Pollutant Discharge Elimination System
NCG030000 Notice of Intent
This General Permit covers STORMWATER DISCHARGES associated with activities under the following Standard
Industrial Classifications: SIC335 [Rolling, Drawing, and Extruding of Nonferrous Metals], SIC3398 [Metal Heat
Treating], SIC34 [Fabricated Metal Products], SIC35 (Industrial and Commercial Machinery], SIC36 [Electronic
and Other Electrical Equipment], SIC 37[Transportation Equipment], and SIC38 (Measuring, Analyzing, and
Controlling Instruments]. You can find information on the DEMLR Stormwater Program at deq.nc.gov/5W.
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:
PowerSecure Manufacturing Inc.
Scotty Moates
Street address:
City:
State:
Zip Code:
4068 Stirrup Creek Drive
Durham
NC
27703
Telephone number:
Email address:
205-639-2838
[e-mail]
Type of Ownership:
Government
®County 13Federal E3Municipal E3State
Non -government
0 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:
PowerSecure Manufacturing Inc. - PowerFab
Scott Linthacum
Street address:
City:
State:
Zip Code:
1410 Coltrane Mill Road
Randleman
NC
27317
Parcel Identification Number (PIN):
County:
7748775452
Randolph
Telephone number:
Email address:
919-630-2271
scott.linthacum owersecure.com
4-digit SIC code:
1
Facility is:
Date operation is to begin or began:
1
362
® New 13 Proposed M Existing
5/12/2017
Latitude of entrance:
Longitude of entrance:
35.91093630499328
-79.85060293131792
Brief description of the types of industrial activities and products manufactured at this facility:
Fabrication and assembly of diesel electric generators and fuel storage tanks for the generator systems.
If the stormwater discharges to a municipal separate storm sewer system (MS4), name the operator of the MS4:
❑ N/A
Page 1 of 5

3. Consultant (if aoolicable):
Name of consultant:
Consulting firm:
Chris Bagley
S nterra Corporation
Street address:
City:
State:
Zip Code:
511 Keisler Drive, Suite 102
Ca
NC
27518
Telephone number:
Email address:
919.858.9898
[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.
001
Deep River/Randleman Lake
WS-IV;CA:'
❑ This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
35.91058917232003
-79.85100688915875
Brief description of the industrial activities that drain to this outfall:
Fabrication/testing of deisel engines, material transport
3-4 digit identifier:
Name of receiving water:
Classification:
❑ This water is impaired.
002
Deep River/Randleman Lake
WS-IV;CA:'
❑ This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
35.91189974310577,
-79.8526073773636
Brief description of the industrial activities that drain to this outfall:
Raw and waste material storage, material transport
3-4 digit identifier:
Name of receiving water:
Classification:
is 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:
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:
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:
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 N01.
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:
0 This facility uses best management practices or structural stormwater control measures.
If checked, briefly describe the practices/measures and show on site diagram:
Energy dissipation structures in ditches, earthen berms, grass lining and silt fencing.
❑ This facility has a Stormwater Pollution Prevention Plan (SWPPP).
If checked, please list the date the SWPPP was implemented:
currently under development
❑ 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)
O 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:
<1000
Waste paint and solvents
How material is stored:
Where material is stored:
Sealed drums
Indoors in containment structure with adequate secondary containment
Number of waste shipments per year:
Name of transport/disposal vendor:
6-9
SouMem Logistic¢ Emmmmentel mmnsporler) / DART, A Clean Ea Company (Desig,uiee Faaty)
Transport/disposal vendor EPA ID:
Vendor address:
NCR000163832(Transporter)/NCD121700777(Designated Facility)
1 n+o r.5t� NCrwn�iI.,. � t4 clunw rx zazrs ioezgmuar�l
❑ 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
O Copy of most recent Annual Report to the NC Secretary of State (if applicable)
O 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
El 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 fled 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:
❑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.
❑O The information submitted in this NO] 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.
❑O I will abide by all conditions of the NCG030000 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 NCG030000 General Permit.
Printed Name of Applicant: spotty Moates
Title: Environmental Permitting & Compliance Manager
a/ / 5/31/22
(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 4 of 5

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:
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:
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:
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:
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:
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:
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:
Page 5 of 5

r :t E '.
.� � BUSINESS CORPORATION ANNUAL REPORT
1..
NAME OF BUSINESS CORPORATION: POwer.S'ecure Manufacturing, Inc.
SECRETARY OF STATE ID NUMBER: 0873676 STATE OF FORMATION: DE
REPORT FOR THE FISCAL YEAR END: 12/31/2021
SECTION A: REGISTERED AGENTS INFORMATION
1. NAME OF REGISTERED AGENT: Corporation Service Company
2. SIGNATURE OF THE NEW REGISTERED AGENT:
E - Filed Annual Report
0873676
CA202210901520
4/1912022 10:15
QX Changes
SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENI
3. REGISTERED AGENT OFFICE STREET ADDRESS & COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS
2626 Glenwood Avenue, Suite 550
2626 Glenwood Avenue, Suite 550
Raleigh, NC 27608 Wake County Raleigh, NC 27608
SECTION B: PRINCIPAL OFFICE INFORMATION
1. DESCRIPTION OF NATURE OF BUSINESS: Manufacturing
2. PRINCIPAL OFFICE PHONE NUMBER: (321 ) 422-2718 3. PRINCIPAL OFFICE EMAIL: Privacy Redaction
4. PRINCIPAL OFFICE STREET ADDRESS
4068 Stirrup Creek Drive
Durham, NC 27703
5. PRINCIPAL OFFICE MAILING ADDRESS
4068 Stirrup Creek Drive
Durham, NC27703
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: John L Pemberton NAME: Dat Tran
TITLE: Secretary TITLE: President
ADDRESS:
ADDRESS:
NAME: CATHY E STEVENS
TITLE: Treasurer
ADDRESS:
241 Ralph McGill Boulevard 4068 Stirrup Creek Drive 4068 Stirrup Creek Drive
Atlanta, GA 30308 Durham, NC 27703 dURHAM, NC 27703
SECTION D: CERTIFICATION OF ANNUAL REPORT Section D must be completed in its entirety by a person/business
end,
L Pemberton 4/19/2022
SIGNATURE DATE
Form must be signed by an officer listed under Section C of this form.
John L Pemberton
Secretary
Print or Type Name of Officer Print or Type Tile of Officer
This Annual Report has been filed electronically.
MAIL TO: Secretary of State, Business Registration Division, Post Office Box 29525. Raleigh, NC 27626-0525
■

,
r PowerSecure
May 31, 2022
NCDEMLR Stormwater Program
1612 MSC
Raleigh, NC 27699-1612
RE: NCG030000 Notice of Intent— PowerFab, Inc.
Dear Sir or Madam:
4068 Stirrup Creek Dr
Durham, NC 27703
Tel: [phone]
Email: [e-mail]
PowerSecure, Inc. (PowerSecure) would like to submit the enclosed Stormwater Permit Application for
our facility, PowerFab Inc, located at 1410 Coltrane Mill Road, Randleman, NC.
Please feel free to contact me at [phone] or [e-mail] if you have any
questions or require additional information.
Sincerely,
Q x�
Scotty Moates
Environmental Permitting and Compliance Manager
PowerSecure, Inc.

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FIGURE 2
TOPOGRAPHIC MAP
RANDOLPH COUNTY
POWERSECURE, INC. - RANDLEMAN CAMPUS
synTerra (POWERFAB)
RANDLEMAN, NORTH CAROLINA
PLEASANT GARDEN QUADRANGLE
148 RIVER STREET. SUITE 220
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NOTES:
1. GOOGLE EARTH IMAGE DATED
SEPTEMBER 2020.
2. LIDAR CONTOURS OBTAINED FROM
NC SPATIAL DATA DOWNLOAD
https://sdd.nc.gov/Requests.aspx
g 3. 2 FOOT CONTOUR INTERVAL
npPRGxInIgTE LOCATION OF 4. PROPERTY BOUNDARY OBTAINED
EXISTINGTRENCHDRAIN. ~"' FROM CLIENT AND LOCATION IS
i 4
APPROXIMATE.
I
LEGEND
EXISTING MAJOR CONTOURS
---- EXISTING MINOR CONTOURS
SILT FENCE
PROPERTY LINE
EXISTING PIPE
PROPOSED PIPE
'94+ ❑ PROPOSED STRUCTURE
PROPOSED RIPRAP CHANNEL
• / V LE 1
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2t CONCRETE JUNE .}
BOX PROVIDED BY GVNER ]T
B 2022 MUM FORSILENTRENEW LOUCM LL CNIF
BU
A 2Vt2 65UED FOR COFMREVIEW CM CID BUG
EXISTINGAND AI ORNN LACEMUG DR V UA E TO TR O PRWIOE ACE!
ANO AHNIOON IN PLACE OFPINAGE TO TR4PEZOIOAL ORCX ORNflEv. W1E L£$C0.1F(IQY RY dY. AP,
EXISTING 6-CORRUGATED PIPE.
PWGgNp ABANDON IN PLACE.
APPROXIMATE LOCATION OF
EXISTING TRENCH DRAIN
APPROXIMATE LOCATpN ,S
OF FUTURE CONNECTION
TO EXISTWG STRUCTURE
BY OTHERS
T# CONCRETEJUNCTION 14p WRECT FLOW TOTPAPEZCIDAL ORGH
ROX PROVDED BY OXNE
2 WIDE a6'TPLLFARTXEN SERM TO 2 EXISTING 6' CORRUGATED PIPES.
OWECTFLOW TO TMPE2q OITOP PLUG AND ABANDON IN PLACE
360 LF OF tYADS Mt2 Wi PIPE. FULL
5 OEFTH STONE. MINIMUM OF I'OF COVER �\ /�^� :TH LF OF +rhos N-+zm PIPE, FULL CO2 CO3 sy Tena
DEPTH SITUPOF1, AGE
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CD2 CO3 2YT+Y CONCRETE JUNCTON
BOX PROVIDED BY OWNER
su rcDSLER DR e102
5 x3U LF OF tY—H-02 WL PIPE FULL CARY, NORTH CAROLINA 27518
DEPTH STONE, MINIMUM OF 1' OF COVER WM Nn95893B8
WOSEO35LLLF YM5SEES 8
CO2 CO3 rRAPELOIv.L CHwnEL Dlawn BY: J. OND oAre Os/o3/202i
1 S'wIDE BOTTOM WIotH 3 cnEcnEo eY: LiRAnuL IMre 05/m/2022
Z DEEP WITX TH:tV SIDE SLOPES PROTECTMANAGER: M. FUNCHUM
:::y "' LINE WnH FILTER FABPoCgND
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DIMENSIONGA,, TOTOP OF RIP ROW SILT FENCE
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PROPoSEO SINGLE
ROW SILT FENCE 335 LFOFiTAI)5 N-t2NT PRE. FULL �E RANDLEMAN FACILITY
C)02 C)03 DEPTH STDNE, MINIMUM OF I'OF COVER p 4 5
PUALE NOWT 310.03 ENO SECTION WITH STORMWATER OUTFALL IMPROVEMENTS
ouREr PRorscnaN AreoTH ENDS of CO2 CO3 CO2 CO3 CO2 CO3
APPROXIFMTE PRE.
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Ewsnxc SHED ENLARGED SITE PLAN
REsiORE TRAIL NEPD To
ORIGtN4 LONGIT DRAWING SHEET REVISION
CO2 201 B
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TEMPORARY SILT FENCE
1. GOOGLE EARTH IMAGE DATED
SEPTEMBER 2020.
2. LIDAR CONTOURS OBTAINED FROM
NC SPATIAL DATA DOWNLOAD
https:/Isdd.nc.gov/RequesM.aspx
.�i'� m `....• ....<..,....— 3. 2 FOOT CONTOUR INTERVAL
4. PROPERTY BOUNDARY OBTAINED
FROM CLIENTAND LOCATION IS
a-•- .._....'-... •, ,�� APPROXIMATE.
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RIPRAP CHANNEL
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(per AASHTO)
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PowerSecure
1410 COLTRANE MILL RD
RANDLEMAN, NORTN CAROLINA
RANDLEMAN FACILITY
STORM ATER OUTFA-L IMPROVEMENTS
CONSTRUCTION NOTES AND DETAILS
DRAWING SHEET REV151011
CO3 3OF3 B