NCG081042_Application_20230615

iRECEIVED
FOR AGENCY USE ONLY JUN 14 2023
NCG081Q kJ,
Assigned to: a. /ooK ILR-5tonwaterProgram
ARO FRO MRO RRO WARO IRO SRO
Division of Energy, Mineral, and Land Resources Land Quality Section
National Pollutant Discharge Elimination System
NCGO80000 Notice of Intent
This General Permit covers STORMWAT£R DISCHARGES associated with activities under the following Standard
Industrial Classifications: SIC40[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 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 area(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
an 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:
ByronTerra Nova Solutions, LLC' Bellman
Street address: City: State: Zip Code:
Telephone number: Email address:
TN [e-mail]
Type of Ownership:
Government
E3County I31'ederal E3Municipal ❑State
Non-government
OBusiness(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:
Byron Bellman
Street address: City: State: Zip Code:
Parcel Identification Number(PIN): County:
Columbus
Telephone number: Email address:
1640-2607 bbeliman tnsolutions.co
4-digit SIC code Facility is: Date operation is to begin or began:
❑New E3Proposed ElExisting 11/3/2021
Latitude of entrance: Longitude of entrance:
o r u o r u
Page 1 of 5

Brief description of the types of industrial activities and products manufactured at this facility:
Sol inf nQn-hazardous liauid waste and waste water tmatment
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:
Alessandra Braswell Geosyntec Consultants of NC, P.C.
Street address: City: State: Zip Code:
314 Walnut Street Suite 200 Wilmin ton NC 128401
Telephone number: Email address:
r sw II eos nt m
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.
1 ISouleswam Class W 1 ❑This watershed has aTMDL.
Latitude of outfall: Longitude of outfall:
340 1 7.51 8" -780 41' 41 .784"
Brief description of the industrial activities that drain to this outfall:
Solidification of n - r r in s fuelin
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? A
20 Gallons ,
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?
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 N01.
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:
i
❑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:
Silt fence and drainaae ditches are used to control stormwater flow.
O This facility has a Stormwater Pollution Prevention Plan(SWPPP).
If checked, please list the date the SWPPP was implemented:
A HI2023 -
❑This facility stores hazardous waste in the 100-yearfloodplain.
If checked,describe how the area is protected from flooding:
i
❑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):
-
El 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
0 Copy of county map or USGS quad sheet with the location of the facility clearly marked
Page 3 of 5

7. Applicant Certification:
i North Carolina General Statute 143-215.6B(i)provides that: Any person who knowingly makes any false statement,
i 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.
0 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 1 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 NCG080000 General Permit.
Printed Name of Applicant:Byron Bellman
Title: Director of Health&Safety
(Signature of Applicant) (Date 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

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? ❑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?
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?
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

Annual Report to the NC
- -Secre-ta-r-y-o#State-

SOSID:2296407
Date Filed:4/13/2023 3:25:00 Pal
-- s Elaine F.Marshall
North Carolina Secretary of State
State of North Carolina C2023 094 08297
Department of the Secretary of State
APPLICATION FOR CERTIFICATE OF AUTHORITY FOLLOWING
ADMINISTRATIVE REVOCATION OF A LIMITED LIABILITY COMPANY
Pursnaot In,qi7D-7-31(i)of the Nonh Carolina Gencral Statutes JIm undersigned limited liability comp my hereby
submits this Appliculimii.forteniftcate rfAglhority l'ollosdng Adminislmtiw Retm:ation.
I. Company Name
(a) The nmoc ofthe limited liability company as ft appears on thcNonb caroling Business Registry is
Hazmat Emergency Response and Remediation, LLC
NeanwlEmeryemy Reaeense aMRemed�atlon.
(b). The name ofllie limited liability co an currently in its home stale is: LLC
(c) If the none ofthe limited liability company has been changed in the home state since the administrative
mvbeation;
(Sae 6tsh-wrions for additional documearmtion nrededfor processing
• Ift a company's mite is unavailubie for ace in the State ofNorth Carolina.the name the limited liability
company mill.ow in North Carolina is:
2. the North Carolina SOSlD6: 2296407
3. The ellt6w date oftheadministrativerrvoiallmoftheappticimi limited liability ampony: 03/24/2023
4. Choose the statement salisfiing the grounds for administrative revocation.
❑! Thcgroundsfordhcadministmtiverevocation ofiltegpplicam limited liability company havrbecn eliminated by:
(choose all that apply)
El Prodding the required annual report and applicable filingfce,including updated Registered'Agwtlaffi c
dvsigmaoon
--DAll penalties,fees.of othcrpa}mcntr, uc tnl kpMmngoftlm Secretary of State have been paid.
❑Interrogatories propounded by the Department of the Secretary of State have been answered and provided
El The grounds for the administrative mwatim ofthe applicant Umimd Iiubirly company did not eyist.
(Onuseparateslm -Linwribriel'caplanatiatofyourclaim).
5.. Atiacbcd am:
(n) Certifteale of Existence(or document ofsimilarimport)Only nuthenticaleil by the Sgcmhuy of State or other
a0icialltadng custody of business.registration records in the stale or country ofargnhizntion. 71m Cerdfimtr of
Existence must be an orle'nnl and lees it an sir un Ibs old
(6) One(1)Annuat Report With current information signed by a company otficiat listed an the annual mpon.iI'
applicable.
6. Enclose)isafccof.S450'asrequimd.bv¢i7D-1.22ofthe Nonh Cantina Gencml Statutt&
Ibis is thc �iril _ day of 1 (w \. .2023 Hazmat Emergency Response and Rerrediation.LLC
(Nome p(Applicaut Lhulled Liobilifv Cou",ty)
Imo. -.;e Ca.'Aj�
ISignanre)
Michael L. Cauthen .CFO
(type or Print drone and Tide/
'NOTES:
I. The tiling fee lorthisApplication.is$450(Annuat Report 5200 and ApplicationS250)
2. This application must be filed with the Secmlary of5tate. ,
BUSINESS REGISTRATION DIVISION K O.BOX 29622 RALEIGH.NC 27626-0622
(Jnneaq,15,2010) (Form l:09A)

� � r
Delaware Pagel
The First State
I, JEFFREY W. BULLOCK, SECRETARY OF STATE OF THE STATE OF
DELAWARE, DO HEREBY CERTIFY "BAZMAT EMERGENCY RESPONSE AND
REMEDIATION, LLC" IS DULY FORMED UNDER TEE LAWS OF THE STATE OF
DELAWARE AND IS IN GOOD STANDING AND BAS A LEGAL EXISTENCE SO FAR
AS THE RECORDS OF THIS OFFICE SHOW, AS OF THE THIRD DAY OF APRIL,
A.D. 2023.
AND I DO HEREBY FURTHER CERTIFY THAT THE SAID "BA2MT EMERGENCY
RESPONSE AND REMEDIATZON, LLC" WAS FORMED ON TBE TWENTY—FIFTH DAY
OF OCTOBER, A.D. 2021.
AND I DO REREBY FORTHER CERTIFY THAT THE ANNUAL TADS HAVE BEEN
PAID TO DATE.
Y'4 �.• 1. ,
°r` A'te .. g{rt!srreMen.saw�naan�-
6332519 8300 Authentication:203064271
SR#20231270345 Date:04-03-23
You may veri"Is certificate online at corp.delaware.gov/authver.shtml

0 LIMITED LIABILR Y COMPANY ANNUALREPORT
NAME OF LIMITED LIABII.IW COMPANY: Hamot E0320mm Hosoonse an hemedlation,LLC
Ffatitloes Name,iFany,umd in North Q"bna
SWRETARYOF.STATEJO.NUMBER:2298407 STATFOFFORMA'RON:. D
REPORT FOR THE CALENDAR YEAR: 2022 T
a' Chm%m
8EcnDN A:REGISTERED AGENr'3INFORdAAT10N.
4.NAME OF REGISTE WAGENT. URS Agents,LLC
I .
2.SIGP ATURE OFTHE NEW REGISTERED AGENT: (���`` Ksnethe Map.Asa Surretal
— a�Essw t�tls WTOTREAPPONMERr
•3.REGISTERFOAGENT OFFICE STREET ADDRESS&CO1WY- 4.REGISTERED ArENTI0FFlCE NIA4IN0 ADDRESS
I
176 Mine LakeCeuR'Ste 10O 176 acme Lake Cou&Ste 100
RalelgNNC27615 Wake Raleigh NC 27615
SECTION B.PRINCIPAL OFFICE RIFORM MAN
t.DESCRIPTIONOPkATUREOFBUSINESS: FlrvimmrtatdefeeMcea OtilustrtaleaMmsenswasteamylma
2.PRINCIPAL OFFICE PNONENutaBER: (910)B83-M •3.PRINcIpALO CEEM Privacy Redaction
4-PRINCIPAL OFFICE WREETADDRESS S.PRINCIPAL OFF]3E l9ARIN0 ADDRESS
303 South MBuitsbY Street 303 South Maul Y Street
.Whiteviile,NC28472 Columbus Whiteville,Ni:21472 Columbus
kBelect one of the fbllow Irapplicabte.{Optionalseeinsoucogna)-El The The oompanyIS B veteren-awed smog WeInM
❑ The cmf!PBnY'Js a$Mlc BbWVeteran4oned sm6R twsiness
.SECTION C:COMPANY OFFICIALS(Enteradd10a1N eempany9$dels In SOCOM E) '
NAME Chrir Vaimian NAME: Bden Timmy j NAME: Wclmel Ceulhen
71TLE CEO TITLE: SVPofbpmaetms I Ttil.£ CFO
ADDRESS: 961E !SpdngRelO Read ADDRESS: 9p1&SpdngReid Road I ADDRESS: gp1 ESprotgRelz(goed
IIIgh Polnt,N027263 'FQgh Potnt NC272ffi WOR)KA t W
i
1 '
SECTION D:CERTIFICATION OF Aettvt ttAY REPORT�88d10A D'matt be.Colapleted fn Rs IyTnaty by p pan;anlbuefnees ey:
C?, A.► 0410312M
Faaaaantaau�eaa3a s�NATwtE DATE
l:drapaq DtEaY Eam,oiae tteplm c al Ttl•tma
MldtaetLCauihm Chief Financial Off
,
PrtMb rypoNmaeolCoapanyt>eldtl aTmTm mcvmwogkm
SUBMIT THIS ANNUAL REPORT WITH THE REQUIRED FILING F E OF$200
AWLL74s.efuzryal.Etet4 a"uYANaW �aM1RoddCmBo<�51a.AafaI7T.Ne a7 If-0si!
I
--i

Figures

Acreage
Site Acreage: 7.63 ac '
Acreage exposed
to Industrial Activity. 3 78 ac
`� J� ♦ t\
r 7
r-
J ►
Outfall 001
Lat.- 34° 19' 37.6168" Loadin Do kwRIF Su p
Long: -78'41'41 784" -"Curb in Truck Loading Area Silt Fence
Impervious Drainage Area: 6.01 ac `:,_ -
- X
To downstream catch basin
Leg
end d Feet
9 0 50 100 200
-4 Spill Kits Stormwater Ditch Vehicle Maintenance Area Truck Parking Area Site Map
303 South Maullsby Street
Drain — Topographic Contours Water Treatment Area Impervious Surfaces Whiteville, North Carolina 28472
Outfall Secondary Containment Structures Solidification Area Site Boundary
Notes'.
1.Site boundary estimated using the Columbus County GISI N w Geosyntee° r,�w�w��«<: ��•����+���� �_
https'//mangomap.mm/mlumbusmis/maps/16952/land-records 1t �c❑:.... �•.ae.... �.,;�, FlgUre
2.Aerial imagery obtained through ESRI online database. consultants
3.Site is comprised of Columbus County Parcel PIN No.061480 and 100074.
4.Building and road labels sourced from Google Maps
5.Site features locations are based on observations made from Geosyntec personnel during 11 October 2022 site visit. Wimington.NC January 2023
N:1T1Tena NovetGN9050 Compliance Program\Environmental ComplianceWvhiteville NC\StormwaterlPermits and PlansISWPPPTigureslMXDTjgure 2-SWPPPI Map mxd 1/19/20234'04:56 PM

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