NCG081038_Application_20230426

RECEIVED
FOR AGENCY USE ONLY
NCGog 1 0 3 APR 2 6 2013
Assignedto: f
Coov DEMLR-StormwaterPro
ARO FRO r RRO WARO WIRO WSRO gam
Division of Energy, Mineral, and Land Resources Land Quality Section
National Pollutant Discharge Elimination System
NCG08O00O 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 forSIC
4211-4225], 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 orea(s) are the only area requiring permitting; stormwater
discharges from oil water separators and/or from 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, 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 assigned in Item (7) below:
Waste Connections of North Carolina, Inc.
Joshua Smaltz
Street address:
City:
State:
Zip Code:
5516 Rozzelles Ferry Rd
Charlotte
NC
28214
Telephone number:
Email address:
[phone]
[e-mail]
Type of Ownership:
Government
❑County ❑Federal ❑Municipal ❑State
Non -government
MBusiness (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:
Metromont
Joshua Smaltz
Street address:
City:
State:
Zip Code:
9925 Metromont Industrial Blvd
Charlotte
NC
28269
Parcel Identification Number (PIN):
County:
02503124
Mecklenberg
Telephone number:
Email address:
252 455-3843
[e-mail]
4-digit SIC code:
Facility is:
Date operation is to begin or began:
4212
1 ❑ New ❑ Proposed El Existing
March 1, 2022
Latitude of entrance:
Longitude of entrance:
35° 21' 16.97" N
80° 49' 52.15" W
Page 1 of 5

Brief description of the types of industrial activities and products manufactured at this facility:
The Facility is a an office and maintenance facility with storage of trucks, cars, containers, and bulk oil.
If the stormwater discharges to a municipal separate storm sewer system (MS4), name the operator of the MS4:
❑' N/A
I Consultant (if applicable):
Name of consultant:
Consulting firm:
Jeff Duncan
ONE Environmental
Street address:
City:
State:
Zip Code:
307 W Tremont Avenue
Charlotte
NC
28203
Telephone number:
Email address:
[phone]
[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
Dixon Branch Tributary
p This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
35' 21' 15.47" N
80° 49' 56.87" W
Brief description of the industrial activities that drain to this outfall:
The Facility is a an office and maintenance facility with storage of trucks, cars, containers, and bulk oil.
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 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 Il 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 Il 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

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:
❑ This facility uses best management practices or structural stormwater control measures.
If checked, briefly describe the practices/measures and show on site diagram:
Maintenance & painting performed indoors, bulk oil secondary containment, monthly inspections, routine housekeeping.
0 This facility has a Stormwater Pollution Prevention Plan (SWPPP).
If checked, please list the date the SWPPP was implemented:
March 2023
❑ This facility stores hazardous waste in the 300-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):
0
Check for $100 made payable to NCDEQ
0
Copy of most recent Annual Report to the NC Secretary of State
O
This completed application and any supporting documentation
0
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 143-215.68 (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 ($30,000).
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 N01 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 I will abide by all conditions of the NCGO80000 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 NCGO80000 General Permit.
Printed Name of Applicant: Joshua Smaltz
Title: District
(Si atureofApplicant) (Datie sighed)
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:
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 each month when averaged over the calendar year?
3-0 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? 0 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? El Yes E3 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?
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? [3 Yes E3 No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
Page 5 of 5

firY BUSINESS CORPORATION ANNUAL REPORT
1/6/INi
NAME OF BUSINESS CORPORATION: Waste Connections of North Carolina, Inc.
SECRETARY OF STATE ID NUMBER: 1087326 . STATE OF FORMATION: DE
REPORT FOR THE FISCAL YEAR END: 12/31/2022
SECTION A:
1. NAME OF REGISTERED AGENT: Corporatlon Service Company
2. SIGNATURE OF THE NEW REGISTERED AGENT:
E - Filed Annual Report
1087326
CA202306702315
3012023 11:15
❑X Changes
SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT
3. REGISTERED AGENT OFFICE STREET ADDRESS & COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS
2626 Glenwood Ave Ste 550
2626 Glenwood Ave Ste 550
Raleigh, NC 27608 Wake County Raleigh, NC 27608
SECTION B:
1. DESCRIPTION OF NATURE OF BUSINESS: Solid Waste Management
2. PRINCIPAL OFFICE PHONE NUMBER: [phone] x_ 3. PRINCIPAL OFFICE EMAIL_ Privacy Redaction
4. PRINCIPAL OFFICE STREET ADDRESS
S. PRINCIPAL OFFICE MAILING ADDRESS
3 Waterway Square Place, #110 3 Waterway Square Place, #110
The Woodlands, TX 77380-3488 The Woodlands, TX 77380-3488
6. Select one of the following.lf applicable. (Optional see Instructions)
❑ The company is a veteran -owned small business
❑ The company is a service -disabled veteran -awned small business
SECTION C: OFFICERS (Enter additional officers in Section E.)
NAME: Patrick Shea NAME: Worthing Jackman NAME:
TITLE: Secretary TITLE: President
ADDRESS:
ADDRESS:
3 Waterway Square Place, #110 3 Waterway Square Place, #110
The Woodlands, TX 77380 The Woodlands, TX 77380
TITLE:
ADDRESS:
SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business
enVitrick Shea 3/8/2023
SIGNATURE
Form must be signed by an officer listed under Section C of this form.
Patrick Shea
Pant or Type Name of Officer
Secretary
Pant or Typo Title of Officer
This Annual Report has been filed electronically. -
MAIL TO: Secretary of State, Business Registration Division. Post Office Box 29525, Raleigh, NO 27626-0525

s
;F
i
z
s
9
i
f
I
s
a
a; is
0 0.5 1Miles N P.oJed
Manager
Figure 1 A
Site Location Map * site Location
4NE RIK
By:
Waste Connections P�K
ONF FNV1RONMeNrnL GROUP Metromont harlott
9925 Metromont Industrial Blvd Receiving water: Dixon Branch via unnamed tributary CChe�ked
Charlotte, NC 28269 Turbidity TtvIDL Parameter

Mlu 55'0P
bums( sMb)
Mebilb,nrim
BwWrng
a
fiaummem.
�swregb
d PaM1m9
l\
300 q.l Dei IDlb
OCO pel Gnso4na R5i �.
.'..�s;.
Bql gel Off -Itoe4D bI MT
25W qal OrvR dD—sOASi
JJO qeI
gnNtaezb
,dw
slwm
amn
\
T'Ya
Perking �
75 ISO Z
Feet
IYvied
Figure 2 )Va^ sr°
C*N
Site Map
EI
A
K
Waste Connections
40NM„I .IN IC Metromont :J h arl V tt
Chxked '
9925 Metromont Industrial Blvd ey
Charlotte, NC 28269''
Drainage Areas:
Outfall 001 - 2.2 acres
50% impervious
350 21' 15.47" N
800 49' 56.87" W
• Outfall
AST
BMP
L7 Stormwater Pond
Storage Drum
Storage Tote
Building
Facility
Gravel Surface
Paved Surface
Paint Storage
Stormdrain
Stormwater Flow
Direction
_ Tributary to
Dixon Branch
Property
Boundary