NCG030742_Application_20230818

FOR AGENCY USE ONLY
NCG03 0 74 7
Assigned to: coo K c
ARO FRO MRO RRO WARD WIRO WSRO
Division of Energy, Mineral, and Land Resources Land Quay Section
National Pollutant Discharge Elimination System
NCG030000 Notice of Intent
This General Permit covers STORMWATER DISCHARGES associated with activities under the following Standard
Industrial Classifications: SIC335 [Rolling, Drawing, and Extruding of Nonferrous Metals], SIC3398 [Metal Heat
Treating], SIC34 [Fabricated Metal Products], SIC35 [Industrial and Commercial Machinery], SIC36 [Electronic
and Other Electrical Equipment], SIC 37[Transportation Equipment], and SIC 38 [Measuring, Analyzing, and
Controlling Instruments]. 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:
ACI Holding, LLC
David Brinkley
Street address:
City:
State:
Zip Code:
1480 Point Harbor Road
Wilmington
NC
28401
Telephone number:
Email address:
[phone]
[e-mail]
Type of Ownership:
Government
E3County E3Federal ©Municipal [3State
Non -government
0Business (If ownership is business, a copy of NCSOS report must be included with this application)
Dlndividual
2. Industrial Facility (facility being permitted):
Facility pp�eGG�
Facility environmental contact:
Atlantic'�`ifTndustrial, LLC
David Brinkley
Street address:
City:
State:
Zip Code:
1480 Point Harbor Road
Wilmington
NC
28401
Parcel Identification Number (PIN):
County:
RG4700-003-004-000
New Hanover
Telephone number:
Email address:
[phone]
[e-mail]
4-digit SIC code:
Facility is:
Date operation is to begin or began:
New E3Proposed © Existing
2013
Latitude of entrance:
Longitude of entrance:
34014'54.18"N
I -77"57'22.58"W
Brief description of the types of industrial activities and products manufactured at this facility:
Various metal fabrication including painting and light sandblasting
If the stormwater discharges to a municipal separate storm sewer system (MS4), name the operator of the M54:
O N/A
Page 1 of 5

3. Consultant (if aoolicable):
4.
Name of consultant:
Consulting firm:
Debbie Wilson
Street address:
City:
State:
Zip Code:
P. O. Box 16275
Wilmington
NC
28408
Telephone number:
Email address:
[phone]
[e-mail]
outtau(s) (at least one outtall is regwrea to De eugiole for coverage)
3-4 digit identifier: Name of receiving water: Classification: ❑ This water is impaired.
Northeast Cape Fear River SC, Sw ❑ This watershed has a TMDL.
Latitude of outfall: Longitude of outfall
34°14'53.33"N 77057' 18.73"W
Brief description of the industrial activities that drain to this outfall:
Paint, sand from sandblasting
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:
3-4 digit identifier: -Name of receiving water: I 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:
3-4 digit identifier: Name of receiving water: I Classification: ❑ This water is impaired.
❑ This watershed has a TMDL
Latitude of outfall:
Brief description of the industrial activities that drain to this
Longitude of outfall:
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:
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 NOI.
Page 2 of 5

S. Other Facilitv 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:
❑ 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 lOD-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):
El
Check for $100 made payable to NCDEQ
❑
Copy of most recent Annual Report to the NC Secretary of State (if applicable)
O 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
O
Copy of county map or USGS quad sheet with the location of the facility clearly marked
Page 3 of 5

Applicant Certification:
North Carolina General Statute 143-215.6E (i) provides that: Any person who knowingly makes any false statement,
representation, or certification in any application, record, report, plan, qr pther 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:
f] 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 NO1 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.
ID I will abide by all conditions of the NCG190000 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 NCG190000 General Permit.
Printed Name of Applicant: David Brinkley
Title: Owner
Mail the entire package to: DEMLR — Stormwater Program
Department of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
Page 4 of 5

Q] LIMITED LIABILITY COMPANY ANNUAL REPORT
1/6/2022
NAME -OF -LIMITED -LIABILITY- COMPANY:TAGI-HOLDING-LLC,-- -_ --
SECRETARY OF STATE ID NUMBER: 1309689 STATE OF FORMATION: NC
REPORT FOR THE CALENDAR YEAR: 2022
SECTION A: REGISTERED AGENT'S INFORMATION
E - Filed Annual Report
1309689
CA202231202567
11/8/2022 03:30
1. NAME OF REGISTERED AGENT: Brinkley David
2. SIGNATURE OF THE NEW REGISTERED AGENT:
SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT
3. REGISTERED AGENT OFFICE STREET ADDRESS & COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS
1480 Point Harbor Rd.
Wilmington, NC 28401-2573 New Hanover County
SECTION B: PRINCIPAL OFFICE INFORMATION
1. DESCRIPTION OF NATURE OF BUSINESS: Real Estate
1480 Point Harbor Rd.
Wilmington, NC 28401-2573
2. PRINCIPAL OFFICE PHONE NUMBER: [phone] 3. PRINCIPAL OFFICE EMAIL: Privacy Redaction
4. PRINCIPAL OFFICE STREET ADDRESS
5. PRINCIPAL OFFICE MAILING ADDRESS
1480 Point Harbor Rd. 1480 Point Harbor Rd.
Wilmington, NC 28401-2573 Wilmington, NC 28401-2573
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: COMPANY OFFICIALS (Enter additional company officials in Section E.)
NAME: David Brinkley NAME:
TITLE: Managing Member TITLE:
ADDRESS:
1400 Point Harbor Rd.
ADDRESS:
NAME:
TITLE:
ADDRESS:
Wilmington, NC 28401
SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business entity.
David Brinkley 11/8/2022
SIGNATURE
Form must be signed by a Company Official listed under Section C of This form.
David Brinkley Managing Member
Print or Type Name of Company Official Print or Type Title of Company Official
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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