NCG081034_Application_20221213

FOR AGENCY USE ONLY
RECEIVED
NCG08 1 _03_1t DEC 1 3 ZOZ2
Assigned to: , COOL4
ARO FRO MRO e5 WARO WIRO WSRO
Program
Division of Energy, Mineral, and Land Resources Land Quality Section
National Pollutant Discharge Elimination System
NCGO80000 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], SIC42 [Motor Freight Transportation and Warehousing —except for51C
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 areas] 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, 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. _,3 '-
1. Owner/ODerator (to whom all permit correspondence will be mailed):
Name of legal organizational entity:
Legally ible per
on as signed in Item (7) below:
T.R. Vernal Paving, Inc.
�respon
lyh v
Street address:
City:
State:
Zip Code:
6221 Mt. Herman Road -'
Raleigh
NC
27617
Telephone number:
Email,address:
919-868-5455
[e-mail]
Type of Ownership:
Government
[3County 13Federal ©Municipal ©State
Non -government
0Business (If ownership is business, a copy of NCSOS report must be included with this application)
E3Individual
2. Industrial Facility (facility being permitted):
Facility name:
Facility environmental contact:
T.R. Vernal Paving, Inc.
Kim Vernal
Street address:
City:
State:
Zip Code:
6221 Mt. Herman Road
Raleigh
NC
27617
Parcel Identification Number (PIN):
County:
0768974782
Wake
Telephone number:
Email address:
919-868-5455
[e-mail]
4-digit SIC code:
Facility is:
Date operation is to begin or began:
4214 uMr like adivitles of 1611
®New OProposed El Existing
2001
Latitude of entrance:
Longitude of entrance:
35054'49.53"N
I 78"45'58.25"W
Page i of 5

Brief description of the types of industrial activities and products manufactured at this facility:
Maintenance, repair, and washdown on mobile paving equipment and commercial vehicles.
If the stormwater discharges to a municipal separate storm sewer system (MS4), name the operator of the MS4:
i7 N/A
3. Consultant (if applicable):
Name of consultant:
Consulting firm:
Paul Spangenberg
Boyer Enterprises East, LLC
Street address:
City:
State:
Zip Code:
127 Red Hill Church Road
Dunn
NC
28334
Telephone number:
Email address:
919-624-0630
[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 1
Sycamore Creek
B; NSW
1 ❑ This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
35 54' 50.07 N
78 45' 54.26" W
Brief description of the industrial activities that drain to this outfall:
Maintenance, repair, and washdown on mobile paving equipment and commercial vehicles.
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? 0 Yes ❑ No
If yes, how many gallons of new motor oil.are used eaclrmonth`when average if oiVer the calenda`ryear�x "t;
300
3-4 digit identifier:
Name'of receiving wate
Classification
t ❑ This water,is rmparred,-
"
❑ This wete5shgd Osla TMDL.
Latitude of outfall:
Lon rtuiie of outfall-
a —
- t —
Brief description of the industrial activities that drain to
..,._
Do Vehicle Mai rftenanc"e'Activities occur in tN6'drain5ge area'df this outfall?
El 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? © 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 NOL
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:
El This facility uses best management practices or structural stormwater control measures.
If checked, briefly describe the practices/measures and show on site diagram:
Oil/Water separator, spill response measures & equipment, secondary containment on all ASTs
O This facility has a stormwater Pollution Prevention Plan (SWPPP).
If checked, please list the date the SWPPP was implemented:
12/1/2022
❑ 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 _
,Ifchecked,indicate_-,.�
§S
Kilograms of waste generated each m''onth:
Type(s),of.waste
How material is stored—, U0a'
Where material is stored:
Number ofwaste shipmentspe_ryear'" "' x
Name of transport/disposal vendor:`
Transport/disposal vendor EPA ID:
Vendor address:
❑ This facilit is located on a Brownfield o'S" erf'" d site-
Y p
If checked, briefly describe the site conditions Mf=`
6. Required Items (Application will be returned unless all of the following items have been included):
❑ Check for $100 made payable to NCDEQ
EI Copy of most recent Annual Report to the NC Secretary of State
0 This completed application and any supporting documentation
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
0 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).
VUnr penalty of law, I certify that:
I m the person responsible for the permitted industrial activity, for satisfying the requirements of this permit, and for any
evil 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
i ormation.
will abide by all conditions of the NCG080000 permit. I understand that coverage under this permit will constitute the
geFmit requirements for the discharge(s) and is enforceable in the same manner as an individual permit.
I hereby request coverage under the NCGO80000 General Permit.
Printed Name of Aoolicanr,"K, I ry\hef k /
Title:
of
Mail the entire package to: DEMLR—
Raleigh,
m
`a
al'Quality
P
t Vey
k'
Page 4 of 5

BUSINESS CORPORATION ANNUAL REPORT
1/fi12022
NAME OF BUSINESS CORPORATION: T. R. Vernal Paving, Inc.
SECRETARY OF STATE ID NUMBER: 0242342 STATE OF FORMATION: NC
REPORT FOR THE FISCAL YEAR END: 12/31/2021
SECTION A: REGISTERED AGENT'S INFORMATION
1. NAME OF REGISTERED AGENT: NOrdan, Richard P
2. SIGNATURE OF THE NEW REGISTERED AGENT:
E - Filed Annual Report
0242342
CA202210902895
4/19/2022 11A5
OX Changes
SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT
3. REGISTERED AGENT OFFICE STREET ADDRESS & COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS
3605 Glenwood Ave., Suite 240
Raleigh, NC 27612-3969 Wake County
SECTION B: PRINCIPAL OFFICE INFORMATION
3605 Glenwood Ave., Suite 240
Raleigh, NC 27612-3969 .
1. DESCRIPTION OF NATURE OF BUSINESS: paving Contractor
2. PRINCIPAL OFFICE PHONE NUMBER: [phone] 3. PRINCIPAL OFFICE EMAIL: Privacy Redaction
4. PRINCIPAL OFFICE STREETADDRESS
6221 Mount Herman Road
5. PRINCIPAL OFFICE MAILING ADDRESS
6221 Mount Herman Road
Raleigh, NC 27617-8958 Raleigh, NC 27617-8958
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
iECTION C: OFFICERS (Enter additional officers in Section E.)
NAME:
Kimberly Vernal
NAME:
Timothy R Vernal
NAME:
TITLE:
Vice President
TITLE:
President
TITLE:
ADDRESS:
1525 Tradescant Ct.
Raleigh, NC 27613
ADDRESS:
1525 Tradescant Court
Raleigh, NC 27601
ADDRESS:
SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business
entity.
Kimberly Vernal 4/19/2022
SIGNATURE
Form must be signed by an officer listed under Section C of this form.
Kimberly Vernal
Vice President
DATE
Print or Type Name of Officer Print or Type Title 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

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Grass
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Used Equipment
staging Area
Equipment and Commercial Vehicle staging Area O
Asphalt
Asphalt
Grass
Maintenance I
I Shop
Parking
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54.26" W
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uHazardous Material
2 Storage
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LEGEND
— Property Boundary
—► Drainage
OAST
M Overhead Doors
M Emergency Exit
O Spill Kit
® Drain
Municlpal Waste
--- Underground Piping
— Sanitary Sewer Lines
Stormwater Lines
AST I
1. 250-Gallon Used Oil
2. 300-Gallon Motor Oil
3. 376-Gallon Hydraulic Oil
4. 210-Gallon Soap --
5. 300-Gallon Propane
6. 90-Gallon and 60-Gallon Truck Tanks
7. -15.9 Mobile Equipment up to SO -
Gallons Hydraulic & Diesel Fuel
Property
2.19 Acres
7,954 Sq. Ft. of Building
0.43 Acre pervious, 10%
1.76 Acres Impervious, 80%
35 54' 50.07" N
78 45' 54.26" W
�T.R.
T.RVEANALPAVING
SITE DRAWING
VERNAL PAVING, INC.
6221 MT. HERMAN ROAD
RALEIGH, NORTH CAROLINA
DrawingBy:l.P
Date: December 1, 2022
Checked By: AY
Job No.: 01
Engineer Checked:1WX
CAI) No: N/A
'Approved By: �W
Drawing No: 2

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