NCG070231_Application_20230126

FOR AGENCY USE ONLY
NCG07 0 -13 I
Assigne to: $ - C ocV, _
ARO FRO MRO RRO WARO WIRO WSRO
;,i, ` 6 2023
Division of Energy, Mineral, and Land Resources Land Quality Section
National Pollutant Discharge Elimination System
NCG070000 Notice of Intent
This General Permit covers STORMWATER DISCHARGES associated with activities under the following Standard
Industrial Classifications: SIC32 [Stone, Clay, Glass and Concrete Products], and like activities deemed by DEMLR
to be similar in the process and/or the exposure of raw materials, products, by-products, or waste materials. SIC
3273 [Ready -Mixed Concrete) is specifically excluded from coverage under this General Permit and is instead
covered under NCG140000. You can find information on the DEMLR Stormwater Program otdea.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:
CRH Amencas, Inc.
Joe Ertel
Street address:
City: State:
Zip Code:
156 Rattlesnake Trail
Aberdeen NC_
28315
Telephone number:
Email address:
678-731-8129
[e-mail]
Type of Ownership:
Government
❑County ❑Federal ❑Municipal ❑State
Non -government
ElBusiness (If ownership is business, a copy of
report must be included with this application)
❑Individual
2. Industrial facility (facility being permitted):
Facility name:
Facility environmental contact:
Techniseel US - Aberdeen Plant
Hugh Hinton III
Street address:
City:
State:
Zip Code:
156 Rattlesnake Trail
Aberdeen
NC
28315
Parcel Identification Number (PIN):
County:
584660001012
Hoke
Telephone number:
Email address:
OIG-603-6121
[e-mail]
4-digit SIC code:
1
Facility is:
Date operation is to begin or began:
3272
❑ New [:)Proposed Existing
10/1812022
Latitude of entrance:
Longitude of entrance:
35d 2.3714m
79d 26.0280m
Brief description of the types of industrial activities and products manufactured at this facility:
Industrial Sand Bagging Plant
If the stormwater discharges to a municipal separate storm sewer system (M54), name the operator of the MS4:
O N/A
Page 1 of 5

3. Consultant (if applicable):
Name of consultant:
Consulting firm:
Thames Sipe
IOeirdelder. Inc.
Street address:
City:
State:
Zip Code:
9009 Perimeter Woods Drive
Charlotte
NC
28269
Telephone number:
Email address:
704-BOD-4578
tsipe®klelnfelder.wrn
4. Outfall(s) At least one outfall is required to be eligible for coverage
3-4 digit identifier:
Name of receiving water:
Classification:
13 This water is impaired.
001
Drowning Creek
C;Sw:HQW
13 This watershed has a TMDL
Latitude of outfall:
Longitude of outfall:
35.039140'
-79.434793'
Brief description of the industrial activities that drain to this outfall:
Unpaved roads
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? M 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:
1
Classification:
Ul This water is impaired.
002
Dr Iry Creek
C;Sw;HQW
Ul This watershed has a TMDL
Latitude of outfall:
Longitude of outfall:
35.039148
-79A34792
Brief description of the industrial activities that drain to this outfall:
Material handling (sand, rew materials), unpaved road'
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? M 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
is water is impaired.
U 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 El 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: j
U This water is impaired.
Ul 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 U No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
All outfalis must be listed and at least one outfall Is required. Additional outfalls maybe 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 aooly and explain accordinelv):
❑ 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:
❑ This facility uses best management practices or structural stormwater control measures.
If checked, briefly describe the practices/measures and show on site diagram:
O This facility has a Stormwater Pollution Prevention Plan (SWPPP).
If checked, please list the date the SWPPP was implemented:
The SWPPP is being developed in parallel to the submittal of the NOI
13 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:
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
ID Copy of most recent Annual Report to the NC Secretary of State
0 This completed application and any supporting documentation
1] 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
21 Copy of county map or USGS quad sheet with the location of the facility clearly marked
Page 3 of S

7. Applicant Certification:
North Carolina General Statute 143-215.66 (1) 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:
ISJ 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 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.
O I will abide by all conditions of the NCG0700DO 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.
El I hereby request coverage under the NCG070000 General Permit.
Printed Name of Applicant: Joe Ertel
President, National
Applicant)
_i 1 0 3
(Oat 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

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PROJECT NO.
20233MMIA
FIGURE
DRAWN:
12J19l2022
Project Location Map
DRAWN BY:
NIL
*riyM People. Right solutions_
CHECKED BY.
TJS
Techniseal US -Aberdeen Plant
FILE NAME:22.1219-TerfNeesl
156 Rattlesnake Trail
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Aberdeen, NC 29315

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Drainage Area 2 (1.8 Ac-t, 38.9% Impervious Surface)
Drainage Area 3 (1.2 Ac.t, 25.0% Impervious Surface)
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112
,PROJECT NO. aD33752001A
FIGURE
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- DRAWN: 12/19/2022
Site Map
KLE/NFELOER' DRAWN BY N`
- CHECKED
2
BY: TJS
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Technizeal US -Aberdeen Plant
_
FILE N Unhed
155 Rettleanake Trail
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Aberdeen, NC 28315

0 AMENDEDBUSINESS CORPORATION
WN22 CRH An
NAME OF BUSINESS CORPORATION: tM� tY
SECRETARY OF STATE ID NUMBER: 1062091,
REPORT FOR THE FISCAL YEAR END: 1213112021
SECTION A: REGISTERED AGENT'SINFORMATION
SOSID: 1062091
Date Filed: 6/16/2022
Elaine F. Marshall
North Carolina Secretary of State
STATE OF FORMATION: DE
AMENDING DOC1D
®changes
1. NAME OF REGISTERED, AGENT: Corporation Service -Company
2. SIGNATURE OF THE NEW REGISTERED -AGENT:
SIGNATURE CONSTITUTES CONSENT TOTHE APPOINTMENT _
3. REGISTERED AGENT OFFICE STREET ADDRESS 8 COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS
2626 Glenwood Avenue„ Suite 550
Raleigh, NC 27608 Wake
SECTION B: PRINCIPAL OFFICE INFORMATION
1. DESCRIPTION OF NATURE OF BUSINESS: Investment
2. PRINCIPAL OFFICE PHONE NUMBER:
2626 Glenwood Avenue„ Suite 550
Raleigh, .NC.27608:Wake
company
3. PRINCIPAL OFFICE EMAIL:
o• .o
4. PRINCIPAL OFFICE STREET.ADDRESS 5. PRINCIPAL OFFICE MAILING ADDRESS
RI ..'
900 ASHWOOD PKWY, STE 600 900 ASHWOOD PKWY, STE 600
Atlanta, GA 30338-6999 Fulton Atlanta, GA30338-6999 Fulton
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 (Enteradditional officers in Section E.)
Daniel Stover David NI Toolan S'�r Plil�n
NAME: NAME; NAME
TITLE: Vice President
ADDRESS:
600 ASHWOOD PKWY, STE 600
Atlanta, GA 30338
TITLE: Secretary TITLE: Treasurer
ADDRESS:
900 ASHWOOD PKWY, STE 600
Atianta,'GA 30338
ADDRESS:
900 ASHWOOD PKWY, STE 60D
Atlanta, GA 30338
SECTION D: CERTIFICATION OF ANNUAL REPORT, Section D must be completed in Its entiretybya person/business
entity.
6/8/2022
SIGNATURE DATE
Foon must be signed byan officer fisted undersection C of this form.
David M. Toolan Secretary
Print or Type Name of Officer Print orType Tide of Officer
SUBMIT THIS ANNUAL REPORT WITH THE REQUIRED FILING FEE OF $10.00
MAIL TO. Secretary of State, Business Regkbabon Division. Post Officellox 29525, Raleigh, NC 27626-0525

SECTION E: ADDITIONAL OFFICERS
Albert Manifold
NAME: K(V(,)(
NAME: Nathan Creech
NAME:
TITLE: President
TITLE: Vice President
TITLE:
ADDRESS:
ADDRESS:
ADDRESS:
900 ASHWOOD. PKWY, STE 600
900 Ashwood Pkwy; Ste 600
Atlanta, GA 30338
Atlanta, GA 30338
NAME:
NAME:
NAME:
TITLE:
TITLE:
TITLE:
ADDRESS:
.ADDRESS:
ADDRESS:
NAME:
TITLE:
ADDRESS:
NAME:
TITLE:
ADDRESS:
NAME: NAME:
TITLE: TITLE:
ADDRESS: ADDRESS:
NAME:
TITLE:
ADDRESS:
NAME:
TITLE:
ADDRESS:
NAME:
NAME:
Name:
TITLE:
TITLE:
TITLE:
ADDRESS:
ADDRESS:
ADDRESS:
NAME:
TITLE:
ADDRESS:
NAME:
TITLE:
ADDRESS:
NAME:
TITLE:
ADDRESS:

North Carolina Department of the Secretary of State
Elaine F. Marshall, Secretary
BELOW IS THE CHECKLIST FOR BUSINESS CORPORATION ANNUAL REPORT. Please take a few minutes and read the
Information provided. The Business Coloration's Annual Renott is due by the 15th of the Afh month after the and of the
Each BusinessCorporationfiling an annual report with the NorthCarolinaDepartment of Secretary of State must
provide the following information: -
1. NAME OF BUSINESS CORPORATION
2. STATE OF FORMATION
3. ANNUAL REPORT FILING YEAR
4. THE REGISTERED AGENT STREET ADDRESS AND MAILING ADDRESS IF DIFFERENT
5. THE REGISTERED AGENT'S NAME AND SIGNATURE IF CHANGED
6. THE PRINCIPAL OFFICE ADDRESS, COUNTY AND TELEPHONE NUMBER
7. THE NAMES, TITLES AND BUSINESS ADDRESS OF THE PRINCIPAL OFFICERS
B. A BRIEF DESCRIPTION OF THE NATURE OF BUSINESS .
it 1 nE lNrUKMAI IUN REQUIRED TO BE ENTERED IN SECTION A THROUGH SECTION C HAS NOT CHANGED SINCE THE MO:
RECENTLY FILED ANNUAL REPORT, COMPLETE HEADER SECTION AND SECTION U TO CERTIFY THE ANNUAL REPORT
SECTION A: REGISTERED AGENT'S INFORMATION..
1. The name of the registered agent must be typed or printed.
2. If the registered agent has changed, the new registered agent MUST SIGN CONSENT to the appointment in the space provided. If the registered ager
name has changed due to marriage, or by any other legal means, the business corporation must indicate such change in the space provided and have i
agent sign consent to the appointment under their new namc. if the new registered agent is a business entity, then theappropriate representative of t
entity must sign and print their Dame and title. The registered agent must reside in NC. ,
3. If the street address of the registered office has -changed, .indicate the change. The address of the. registeredoffice must be a Street Address and N01
Post Office Box Address. The street address of the registered office must be a North Carolina address.
4. If the mailing address of the registered office has changed it should be indicated in this item. The registered office's mailing address may be a Post Off
Box. The registered office mailing address must be a NORTH CAROLINA ADDRESS.
SECTION B: PRINCIPAL OFFICE INFORMATION
I. Provide a brief description of the nature of the Business Corporation's business.
2. Enter the principal office telephone number.
3. Enter the principal office E-mail address.
4. The principal office address should reveal the Business Corporation's physical location. The principal office street address must be a street address a
NOT a Post Office Box Address. -
5. The principal office mailing address may be a Post Office Box.
6. You may voluntarily report whether the company qualifies as a service -disabled veteran -owned or veleranrowned small business. The annual netreccipu
cannot exceed one million dollars (SI,000,000) to report as either veteran -owned small business designation. Choose the designation of service -disable
veteran -owned small business if one or more service -disabled veterans owns more then 50%of the business. Choose the designation of veteran -owned si
business if one or more veteran owns more than 50% of the business- For further definitions see N.C.G:S. §55-140; §57D-1-03; or §59-32.
SECTION C: OFFICERS
Provide the names and addresses of each officer. Use Scotian E or a plain 1/2 X 1 I sheet of paper if more space is needed. A person listed in this section
must sign the annual report and is then authorized to sign on other documents filed with this office. '
SECTION D: CERTIFICATION OF ANNUAL REPORT
Check the annual report carefully to ensure all information required for filing has been provided. Only an officer listed on this report or past completed and
filed report may sign. Complete the signalum, date, litle and typed or printed time in the space provided on the form to certify [bat the information is accun
and current. If the Officer of the business corporation is another business entity then the appropriate representative of that business entity must certify the
annual report.
SECTION E: ADDITIONAL OFFICERS
Provide the names and addresses of each additional officer. A person listed in this section is then authorized to sign on other documents filed with this
office.
Mail the annual report to: Secretary of State, Business Registration Division, Post Office Box29525, Raleigh, NC 27626-0525. For information or assistance, car
the Business Registration Division at [phone] or Toll Free 1-888-246-7636. The all address is h0D:/1www.sosnc.aov. (Revised 1012017;