NCG140529_Application_20230913

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Division of Energy, Mineral, and Land Resources Land Quality Section
National Pollutant Discharge Elimination System
NCG140000 Notice of Intent
This General Permit covers STORMWATER AND/OR WASTEWATER DISCHARGES associated with activities under
SIC(Standard Industrial Classification)Code 3273[Ready Mix Concrete]and like activities. You can find
information on the DEMLR Storm water 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 (8) 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(9) below:
Concrete Service Company,Inc. Bob Allen,Jr.
Street address: City: State: Zip Code:
PO Drawer 1867 Fayetteville NC 28302
Telephone number: Email address:
920-483-0396 [e-mail]
Type of Ownership:
Government
❑County ❑ Federal ❑ Municipal ❑State
Non-government
®Business(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:
Concrete Service Company Plant 15
Street address: City: State: Zip Code:
306 E.McNeill St. Lillington NC 27546
Parcel Identification Number(PIN): 0559-57-7325.000 County:
Harnett
Telephone number: Email address:
910-483-0396
4-digit SIC code: Facility is: Date operation is to begin or began:
3273 1 ❑ New ❑ Proposed ® Existing 30A,. 2 20 2.D
Latitude of entrance: Longitude of entrance:
35°23'32.44"N 78°48'50.86"W
Brief description of the types of industrial activities and products manufactured at this facility:
Operation of ready mixed concrete batch plant.
If the stormwater discharges to a municipal separate storm sewer system(MS4),name the operator of the M54:
® N/A
Page 1 of 7

This facility uses:
❑ Phosphorus-containing detergents
® Non-Phosphorus-containing detergents
IN Brighteners
IN Other Cleaning Agents
❑Other:
This facility has a closed-loop recycle system that meets design requirements in 15A NCAC 02T. 1000 and hold the facilities
working volume
❑Yes—stop completion of this N01.Contact DWR Non-Discharge Permitting Program for permitting requirements
® No
3. Consultant(if applicable):
Name of consultant: Consulting firm:
Cameron Moore Mid-Atlantic Associates,Inc.
Street address: City: State: Zip code:
1125 E.Morehead St.Suite 104 Charlotte NC 28204
Telephone number: Email address:
9MSSS-1271 [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 1 Poorhouse Creek WS-IV ❑This watershed has a TMDL.
Discharge from this outfall is from:
® Stormwater Only ❑Wastewater Only ❑ Wastewater Comingled with Stormwater
7Q10 Flow of receiving waterbody(if discharging Wastewater Only or Wastewater Comingled with Stormwater to waters
classified as HQW,ORW,Tr,WS-I,WS-II,WS-III,SA,or PNA):
Discharge occurs from this outfall:
IN Only during a rainfall event ❑ Intermittently(indicate how often) ❑ Continuously(indicate flow in CFS)
Latitude of outfall: Longitude of outfall:
35'23'25.5"N 78°48'44.9"W
Brief description of the industrial activities that drain to this outfall:
Manufacturing process water and rinsing of concrete equipment
Do Vehicle Maintenance Activities occur in the drainage are 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: is water is impaired.
❑This watershed has a TMDL.
Discharge from this outfall is from:
❑ Stormwater Only ❑Wastewater Only ❑ Wastewater Comingled with Stormwater
7Q30 Flow of receiving waterbody(if discharging Wastewater Only or Wastewater Comingled with Stormwater to waters
classified as HQW,ORW,Tr,WS-1,WS-II,WS-III,SA,or PNA):
Discharge occurs from this outfall:
❑ Only during a rainfall event ❑ Intermittently(indicate how often) ❑ Continuously(indicate flow in CFS)
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 are 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 2 of 7

3-4 digit identifier: Name of receiving water: Classification: ❑This water is impaired.
❑This watershed has a TMDL.
Discharge from this outfall is from:
❑ Stormwater Only ❑Wastewater Only ❑ Wastewater Comingled with Stormwater
7Q10 Flow of receiving waterbody(if discharging Wastewater Only or Wastewater Comingled with Stormwater to waters
classified as HOW,ORW,Tr,WS-I,WS-II,WS-III,SA,or PNA):
Discharge occurs from this outfall:
❑ Only during a rainfall event ❑ Intermittently(indicate how often) ❑ Continuously(indicate flow in CFS)
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 are 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.
Discharge from this outfall is from:
❑ Stormwater Only ❑ Wastewater Only ❑Wastewater Comingled with Stormwater
7Q10 Flow of receiving waterbody(if discharging Wastewater Only or Wastewater Comingled with Stormwater to waters
classified as HQW,ORW,Tr,WS-1,WS-11,WS-111,SA,or PNA):
Discharge occurs from this outfall:
❑ Only during a rainfall event ❑ Intermittently(indicate how often) ❑ Continuously(indicate flow in CFS)
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 are 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.
S. Wastewater
Types of Wastewater facility will generate or discharge
Vehicle&equipment cleaning(VE) M Generate ❑ Discharge ❑ Sent to WW Treatment System
Wetting of raw material stockpiles (RM) ® Generate ❑ Discharge ❑ Sent to WW Treatment System
Mixing drum cleaning(MD) ® Generate ❑ Discharge ❑ Sent to WW Treatment System
Facility will spray-down or actively wet aggregate piles
® Yes
❑ No
Page 3 of 7

6. Wastewater treatment alternatives
What wastewaters were considered for this alternatives review: ❑VE ❑ RM ❑ MD
Are there existing sewer lines with a one mile radius: ❑ Yes ❑ No
If Yes:
❑ The wastewater,treatment plant will accept the wastewater. It is feasible to connect. Explain:
❑The wastewater treatment plant will accept the wastewater. It is not feasible to connect. Explain:
❑ The wastewater treatment plant will not accept the wastewater(attach a letter documenting)
❑ Surface or subsurface disposal is technologically feasible
❑ Surface or subsurface disposal is not technologically feasible
Explain:
❑ Surface or subsurface disposal system is feasible to implement
❑ Surface or subsurface disposal system is not feasible to implement
Explain:
What is the feasibility of employing a subsurface or surface discharge as compared to a direct discharge to
surface waters? Explain:
Discharge to surface waters.is the most environmentally sound.alternative of all,reasonably cost-effective
i
options of the wastewaters being'considered: -`•,. _� . ; __. '', «' ,
❑ Yes 'The small amount ofsh water wash generated,is not discharged to area surface waters. }
� ,.. i i :• •-_. ;. +' ;.1',ova
❑ No-contact_DEMLR's Land Application Unit to determine permitting requirements $ . ,i
If this review;included all wastewater-_d_ischarge_types,would excluding some types make of the above:ridn-
,<
dischargeloptionsfeasible?-'-
❑ Yes -- -- - -.
❑ No . '
' }r(•. iCSN � 'V ;j¢ Its=;d �[11t; . ! . .. ,
7. Other Facility Conditions (check all that apply and explain accordingly):
❑This facility has a DMLR Erosion&Sedimentation Control Permit.
If checked,list the permit numbers for all current E&SC permits for this facility:
❑This facility has a Division of Waste Management_permit.
If checked,list the permit numbers for all current DWM permits for this facility:
❑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: August 2023
Page 4 of 7

❑This facility is subject to Phase II Post-Construction Area
If checked,please list the permitting authority:
❑This facility is located in one of the 20 Coastal Counties
If checked,please indicate if the facility is adding more than 10,000 ft2 of built-upon area or is a CAMA Major Permit
❑Will add more than 10,0000 fit of built-upon area
❑ Is a CMA Major Permit
❑Yes to both
❑ No to both
❑This facility is discharging wastewater to a stormwater BMP
If checked,please indicate the permitting authority,and attach letter approval to do so:
❑This facility has wastewater treatment facilities in the 100-year floodplain
❑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
8. Required Items (Application will be returned unless all of the following items have been included):
®Check for$100 made payable to NCDEQ
® Copy of most recent Annual Report to the NC Secretary of State
®This completed application and any supporting documentation
® A line drawing of the water flow through the facility.
® Copy of county map or USGS quad sheet with the location of the facility clearly marked
N/A ❑ Letter documenting that W WTP will not accept wastewater(if applicable)
N/A ❑Approval from permitting authority to discharge wastewater to a stormwater BMP(if applicable)
Page 5 of 7

®Two(2)24"x 36"site diagrams showing,at a minimum,existing and proposed:
a) outline of drainage areas
b) Stormwater/wastewater treatment structures
c) Location of numbered stormwater/wastewater outfalls(corresponding to which drainage areas)
d) Delineation of drainage areas to each discharge point
e) Runoff conveyance structures
f) Areas and acreage where materials are stored
g) Impervious area acreages
h) Locations(s)of streams and/or wetlands the site is draining to, and applicable buffers
i) Site property lines,North Arrow,and bar scale
j) If applicable,the 100-year floodplain line
k) Acreage of each stormwater and wastewater topographical area
1) Each of the facilities'wastewater or Stormwater source and discharge structures and each of its hazardous waste
treatment,storage,or disposal facilities
m) Notation of the water quality classification of the receiving water that site waters eventually discharge to
n) Site location(insert)
9. 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,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:
❑ 1 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.
❑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.
❑ 1 will abide by all conditions of the NCG140000 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.
❑ 1 hereby request coverage under the NCG140000 General Permit.
Printed ry/a)�,a of Applicant: l�� vrd �, T t'b 6, 4 r.
Title: I �e 5'
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(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 6 of 7

9 BUSINESS CORPORATION ANNUAL REPORT
IM022
NAME OF BUSINESS CORPORATION: CONCRETE SERVICE CO.,INC.
0350187 tl°9 Offim Use Only
SECRETARY OF STATE ID NUMBER: STATE OF FORMATION: NC E-Filed Annual Report
0350187
REPORT FOR THE FISCAL YEAR END: 1.2/31/2022 CA202321300517
8/1/2023 09:30
SECTION A: REGISTERED AGENT'S INFORMATION FX] Changes
1.NAME OF REGISTERED AGENT: Allen Jr, Richard R
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
130 Builders Blvd 130 Builders Blvd
Fayetteville, NC 28301-4703 Cumberland County Fayetteville, NC 28301-4703
SECTION B:PRINCIPAL OFFICE INFORMATION
1. DESCRIPTION OF NATURE OF BUSINESS: Ready Mix COnCrete
2. PRINCIPAL OFFICE PHONE NUMBER: [phone] 3.PRINCIPAL OFFICE EMAIL: Privacy Redaction
4. PRINCIPAL OFFICE-STREETADDRESS 5.PRINCIPAL OFFICE MAILING ADDRESS
130 Builders Blvd 130 Builders Blvd
Fayetteville, NC 28301-4703 Fayetteville,NC 28301-4703
6.Select one of the following if applicable.(Optional see instructions) I
❑ The company is a veteran-owned small business
The company is a service-disabled veteran-owned small business
SECTION C: OFFICERS(Enter additional officers in Section E.)
'NAME: Keith T MCFayden NAME: Richard R. Allen , Jr. NAME: Brian Coleman
TITLE: Secretary TITLE: President TITLE: Chief Financial Officer
ADDRESS: ADDRESS: - ADDRESS:-
PO Box 1867 PO Box 1867 PO Box 1867
Fayetteville,NC 28302 Fayetteville, NC 28302 Fayetteville, NC 28302-1867
SECTION D:CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business
enllkith T McFayden 8/1/2023
SIGNATURE DATE
Form must be signed by an officer listed under Section C of this form.
Keith T McFayden Secretary
Print or Type Name of Officer Print or Type Title of Officer
This Annual Report has been filed electronically.
MAIL TO;Secmtary of State, Business Registration DNision,Post Office Box 29525,Raleigh,NC 27626-0525

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CONTOUR INTERVAL=10 FEET,
REFERENCES: SCALE=1:12,000
1.LILLINGTON,NC DIGITAL RASTER GRAPHICS,USGS,
SCANNED FROM 1:24,000SCALE HARNETT COUNTY,NC
TOPOGRAPHIC MAPS,PUBLISHED 2022,USGS. O 500 1,000 2,000
2.PROPERTY BOUNDARY FROM HARNETT COUNTY GIS. Feet
3.INSET MAP DATA DOWNLOADED FROM ARCGIS ONLINE.
DRAWN .. DATE:
TOPOGRAPHIC SITE MAP BY: JUNE 2023
CONCRETE SERVICE COMPANY DRAFT JOB NO:
Mid Atlantic PLANT#15 CHECK: CMM R4323.00
304 E. MCNEILL STREET ENG. GIS NO:
LILLINGTON, NORTH CAROLINA CHECK: 07G.R4323.00.01
APPROVAL: CBH DWG NO: 1

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