NCG081040_Application_20230615

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FOR AGENCY USE ONLY
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Division of Energy, Mineral, and Land Resources Land Quality Section
National Pollutant Discharge Elimination System
NCGO8O0O0 Notice of Intent
This General Permit covers STORMWA TER 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],SIC 42[Motor Freight Transportation and Warehousing—except for SIC
4221-4225],SIC 43[United States Postal Services],SIC S171[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 area(s)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,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:
City of Durham John Young
Street address: City: State: Zip Code:
1600 Mist Lake Dr Durham NC 27704
Telephone number: Email address:
919-560-1200 [e-mail]
Type of Ownership:
Government
13County [3 Federal ElMunicipal 13State
Non-government
[3 Business(If ownership is business,a copy of NCSOS report must be included with this application)
I3 1 ndividual
2. Industrial Facility(facility being permitted):
Facility name: Facility environmental contact:
Mist Lake Maintenance Facility John Young
Street address: City: State: Zip Code:
1600 Mist Lake Dr Durham NC 7704
Parcel Identification Number(PIN): County:
0842-16-48-5469 Durham
Telephone number: Email address:
919 560-1 IJohn.Youn @Durhamnc.gov
4-digit SIC code: Facility is: Date operation is to begin or began:
9511 1 El New [3 Proposed [3Existing June 2023
Latitude of entrance: Longitude of entrance:
36.021010 -78.859534
Page 1 of S

Brief description of the types of industrial activities and products manufactured at this facility:
Vehicle and equipment storage,vehicle maintenance,vehicle wash bay,outdoor storage equipment,material storage.
If the stormwater discharges to a municipal separate storm sewer system(MS4), name the operator of the MS4:
O N/A
3. Consultant(if applicable):
Name of consultant: Consulting firm:
Street address: City: State: Zip Code:
Telephone number: Email address:
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.
DS3 UT-Goose Creek S-IV;NSW ❑This watershed has a TMDL.
Latitude of outfall: Longitude of outfall:
36.02165973967839 -78.85943062874573
Brief description of the industrial activities that drain to this outfall:
Vehicle and equipment storage,vehicle maintenance,vehicle wash bay,outdoor storage equipment,material storage.
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? 0 Yes 0 No
If yes,how many gallons of new motor oil are used each month when averaged over the calendar year?
3-4 digit identifier: I Name of receiving water: Classification: ❑This water is impaired.
DS4 UT-Goose Creek WS-IV;NSW ❑This watershed has a TMDL.
Latitude of outfall: Longitude of outfall:
36.02093083250791 -78.85987587543218
Brief description of the industrial activities that drain to this outfall:
Vehicle and equipment storage,vehicle maintenance,vehicle wash bay,outdoor storage equipment, material storage.
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? 0 Yes 0 No
If yes,how many gallons of new motor oil are used each month when averaged over the calendar year?
200
3-4 digit identifier: Name of receiving water: Classification: ❑This water is impaired.
DS5 UT-Goose Creek S-IV;NSW ❑This watershed has a TMDL.
Latitude of outfall: Longitude of outfall:
36.02049261723334 -78.85962374778128
Brief description of the industrial activities that drain to this outfall:
Vehicle and equipment storage,vehicle maintenance,vehicle wash bay,outdoor storage equipment,material storage.
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? 0 Yes 0 No
If yes,how many gallons of new motor oil are used each month when averaged over the calendar year?
200
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):
❑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:
O This facility uses best management practices or structural stormwater control measures.
If checked, briefly describe the practices/measures and show on site diagram:
Underground sand filters, underground detention system, level spreader with filter strip.
❑This facility has a Stormwater Pollution Prevention Plan(SWPPP).
If checked,please list the date the SWPPP was implemented:
❑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
❑Copy of most recent Annual Report to the NC Secretary of State
I7 This completed application and any supporting documentation
I7 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($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.
El 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.
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.
El I hereby request coverage under the NCG080000 General Permit.
Printed Name of Applicant: Don Greeley
Title: Public Utilities Director
(Signature of Applicant) (Date Signed)
Mail the entire package to: DEMUR—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.
DS6 UT-Goose Creek S-IV;NSW ❑This watershed has a TMDL.
Latitude of outfall: Longitude of outfall:
36.01950336979957 -78.86148520083941
Brief description of the industrial activities that drain to this outfall:
Vehicle and equipment storage,vehicle maintenance,vehicle wash bay,outdoor storage equipment, material storage.
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? El Yes ❑No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
200
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 O 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 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? ❑Yes [] No
If yes,how many gallons of new motor oil are used each month when averaged over the calendar year?
Page 5 of 5