NCG160244_Application_20220629

RECEIVED
FOR AGENCY USE ONLY
NCG16 b 2 4- L�
Assigned to: 8.. CA A%
ARO FRO MRO 09
WARO WIRO WSRO
DEMLR-Stormwater Program
Division of Energy, Mineral, and Land Resources Land Quality Section
National Pollutant Discharge Elimination System
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 Stormwoter 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:
Carolina Sunrock, LLC
Terry Manis
Street address:
City:
State:
Zip Code:
200 Horizon Drive, Suite 100
Raleigh
NC
27615
Telephone number:
Email address:
919-747-6400
[e-mail]
Type of Ownership:
Government
[3County 171'ederal 13Municipal ©State
Non -government
13 Business (If ownership is business, a copy of NCSOS report must be included with this application)
M Individual
2. Industrial Facility (facility being permitted):
Facility name:
Facility environmental contact:
Carolina Sunrock - Woodsciale Facility
Tracy Davis
Street address:
City:
State:
Zip Code:
5280 Woodsdale Road
Roxboro
NC
27574
Parcel Identification Number (PIN):
County:
A56 22
Person
Telephone number:
Email address:
336-599-4147
[e-mail]
4-digit SIC code:
Facility is:
Date operation is to begin or began:
2951
1 ID New 0 Proposed 0 Existing
January 18, 2008
Latitude of entrance:
Longitude of entrance:
36030'58.60"N
78"57'54.19"W
Brief description of the types of industrial activities and products manufactured at this facility:
The facility produces and distributes ready -mixed concrete and hot mix asphalt products.
If the stormwater discharges to a municipal separate storm sewer system (M54), name the operator of the MS4:
0 N/A
Page 1 of 5

Check all activities conducted at this facility:
El Outdoor Stockpiling of Materials
El Transport of Materials by a Conveyor or Front-end Loader
O Storage of Raw Materials
O Vehicle and Equipment Maintenance
O Storage of Materials in Above -ground Storage Tanks
O Vehicle or Equipment Washing
O Material Loading and Unloading
O Vehicle and Equipment Fueling
3. Consultant (if applicable):
Name of consultant:
Consulting firm:
Jonathan Murphrey
Piedmont Geologic
Street address:
City:
State:
Zip Code:
6003-145 Chapel Hill Road
Raleigh
NC
27607
Telephone number:
Email address:
919-854-9700
[e-mail]
4. Clutfall(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
Castle Creek
C
This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
36'31'22.68"N
78057'50.52"W
Brief description of the industrial activities that drain to this outfall:
Storage/handling/delivery of raw materials (aggregatesJRAP/etc), production of asphalt products, maintenance of associated production equipment
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? El Yes 0 No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
>660 gallons
3-4 digit identifier:
Name of receiving water:
Classification:
❑ This water is impaired.
002
1 Castle Creek
C
❑ This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
36030'52.55"N
78057'23.63"W
Brief description of the industrial activities that drain to this outfall:
Co -mingled stormwater/wastewater from asphalt -production, concrete -production, and mining operations.
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? S Yes E3No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
>660 gallons
3-4 digit identifier:
Name of receiving water:
Classification:
O 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:
Structural BMPs consist of secondary containment for bulk storage of liquids. Non-structural SMPs include SPPP implementation and employee training.
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? O Yes E3No
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 NO1.
Page 2 of 5

5. Other Facility Conditions (check all that apply and explain accordingly):
O This facility has other NPDES permits.
If checked, list the permit numbers for all current NPDES permits:
NCG020722 (active) for adjacent Carolina Sunrock mining operation.
❑ 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:
Structural BMPs consist of secondary containment for bulk storage of liquids. Non-structural BMPs include SPPP implementation and employee training.
El This facility has a Stormwater Pollution Prevention Plan (SWPPP).
If checked, please list the date the SWPPP was implemented:
January 18, 2008
❑ 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
O Copy of most recent Annual Report to the NC Secretary of State
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
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 143-215.6E (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:
El 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 NO1 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.
l7 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.
O I hereby request coverage under the NCG160000 General Permit.
Printed Name of Applicant: Terry Manis
Title: Chief Financial Officer
AL
(Signature ofracka)ge
(Date Signed)
Mail theentito: DEMLR—StormwaterProgram
Department of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
Page 4 of 5

BK017036PG01293
WAKE COUNTY. HC 41
CHARLES P. GILLIAM
REGISTER OF DEEDS
PRESENTED & RECORDED ON
02102/2016 1.1:49:12
BOOK9017039 PAGE:01293 - 01294
ASSUMED BUSINESS NAME CERTIFICATE{NCGS §66-71.51
Please print legibly.
1. The assumed business name is:
The Sunrock Group
(You may Include no more than five (5) assumed business names on this form.)
2. The real name of the person or entity engaging in business under the assumed business name is:
(Corporations, LLCs, limited partnerships must provide the exact name registered with the NC Secretary of StaWs office and
the SOSID number assigned at the time of formation. Go to,www.sosnc.gov/br/seamh to lookup your information.)
3. The nature/type of the business is: Mininq and manufacturing of aqqreqate, concrete and asphalt
4. The street address of the principal place of business is: (PO Boxes are not acceptable)
200 Horizon Drive, Suite 100, Raleigh, NC 27615
S. The mailing address, if different from the street address, is:
6. The counties where the assumed business name will be used to engage in business are:
5 All 100 North Carolina counties
This certificate is signed by the owner/legal representative of the person or entity named above,
this 29M day of Auary 2018
Signature:
Printed/Typed Name: Grew W. Bowler
Title: CFO & VP I Authorized Aqent
(See instructions forwho must sign for various business entity types.)
Assumed Business Name Certificate 10.03.17

BKO17036PGO1294
� I��IIII��Y�IO
DOOK:817836 PAGE:01293 - 01294
W-AlUl
COUNTY
NORTH CAROLINA
Please retain yellow trailer page
It is part of the recorded document and must be submitted with the original for re-
recording.
Charles P. Gilliam
Register of Deeds
Wake County Justice Center
300 South Salisbury Street, Suite 1700
Raleigh, NC 27601
❑ New Time Stamp
❑ Additional Document Fee
This Customer Group
# of Excessive Entities
# of Time Stamps Needed
•❑ $25 Non -Standard Fee
❑ Additional Reference Fee
This Document
d —# of Pages
Ps P�
4

Q
, 7`
34
= Site Location — I
_ r
PIEDMONT 0 1,000 2,000 3,000 4,000ft FIGURE 1
SITE LOCATION MAP
GEOLOGIC Carolina Suarock
Data Source: USGS US Topo 7.5-min map for Woodsdale Facility
SMART EARTH SOLUTIONS Cluster Sotinp , VA2016. 5280 Woodsdale Rd, Roxboro, NC 27574

11SUNROCK
CAROLINA SUNROCK LLC
CERTIFIED MAIL No. 7020 3160 0000 2173 7294
Return Receipt Requested
June 21.2022
Stormwater Program
NCDEQ - Division of Energy, Mineral and Land Resources
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
RE: Application for Coverage under NPDES General Industrial Permit NCG160000
Carolina Sunrock — Woodsdale Facility
5280 Woodsdale Road, Roxboro, North Carolina
Two Whom It May Concern:
Tracy E. Davis, PE
Director of Environmental Compliance
200 Horizon Drive, Suite 100
Raleigh, NC 27615
RECEIVED
rJkMLR-Stormwater Program
Enclosed is a Notice of Intent (N01) application, with supporting information, for coverage under NPDES General Industrial
Permit NCG160000 for the Carolina Sunrock facility referenced above. This is an existing facility that produces hot -mix
asphalt and ready -mixed concrete products. Sunrock is pursuing this permit in response to a recent change in NCDEQ
policy by which each industrial activity associated with a site now requires coverage under the appropriate NPDES General
Permit corresponding to each activity. The previous policy implemented by DEMLR allowed for asphalt- and concrete -
production operations at a site (when both are present) to be covered under a single NPDES General Permit (NCG140000).
Also enclosed is a $100.00 check to cover the application -processing fee. Please feel to contact me if you have any
questions or need additional information pertaining to our application for this facility.
Sincerely,
C lina Sunrock, LLC
y E. avis, PE
Dire t of Environmental Compliance
Attachments
tdavQthesunrockgroup.com
Office Phone: [phone]
Fax: [phone]