NC0028169_Renewal (Application)_20231031

6
Nziekt
ROY COOPER __
Governor >�
ELIZABETH S.BISER • ^�"'.•,.
Secretary
RICHARD E.ROGERS,JR. NORTH CAROLINA
Director Environmental Quality
October 31, 2023
Hedrick Industries
Attn: Jason Conner, VP
PO Box 425
Swannanoa, NC 28778
Subject: Permit Renewal
Application No. NC0028169
Aquadale Quarry
Stanly County
Dear Applicant:
The Water Quality Permitting Section acknowledges the October 31, 2023, receipt of your permit renewal application and
supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW permitting
branch. Per G.S. 150B-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https://deq.nc.gov/permits-regulations/permit-guidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
Sincerely, 144
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
ec: WQPS Laserfiche File w/application
D_E Q Nm ofEnvironmental Quality I n of rc
MooresvorthCarolinaille Regional Depart Officeent 610Env East Center Avenue.SuiteDivisio 301 I MooresvWaterResouille North Carolina 28115
"TM•^'"'^^^'^^"•'a"'^\ / 704 663.1699

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC00028169 B.V.Hedrick Gravel&Sand OMB No.2040-0004
Form U.S.Environmental Protection Agency
Application for NPDES Permit to Discharge Wastewater
NPDES �- EPA
GENERAL INFORMATION
SECTION 1.ACTIVITIES REQUIRING AN NPDES PERMIT(40 CFR 122.21(f)and(f)(1))
1.1 Applicants Not Required to Submit Form 1
1.1,1 Is the facility a new or existing publicly owned 1 1 2 Is the facility a new or existing treatment works
treatment works? treating domestic sewage?
If yes,STOP. Do NOT complete 0 No If yes,STOP. Do NOT ❑✓ No
Form 1.Complete Form 2A. complete Form 1.Complete
Form 2S.
1.2 Applicants Required to Submit Form 1
1.2.1 Is the facility a concentrated animal feeding 1.2.2 Is the facility an existing manufacturing,
a)
operation or a concentrated aquatic animal commercial,mining,or silvicultural facility that is
a production facility? currently discharging process wastewater?
o0 Yes 4 Complete Form 1 0 No ❑ Yes 4 Complete Form E✓ No
z and Form 2B. 1 and Form 2C.
R 1.2.3 Is the facility a new manufacturing,commercial, 1.2.4 Is the facility a new or existing manufacturing,
mining,or silvicultural facility that has not yet commercial,mining,or silvicultural facility that
commenced to discharge? discharges only nonprocess wastewater?
0 0 Yes 4 Complete Form 1 0 No 0 Yes 4 Complete Form 0 No
or and Form 2D. 1 and Form 2E.
1.2.5 Is the facility a new or existing facility whose
discharge is composed entirely of stormwater
associated with industrial activity or whose RECEIVED
discharge is composed of both stormwater and
non-stormwater?
❑ Yes-3 Complete Form 1 0 No OCT 31 2023
and Form 2F
unless exempted by
40 CFR NCDEQ/DWR/NPDES
122.26(b)(14)(x)or
b 15 .
SECTION 2.NAME,MAILING ADDRESS,AND LOCATION(40 CFR 122.21(f)(2))
2.1 Facility Name
B.V.Hedrick Gravel and Sand Company/Aquadale Quarry
0 2.2 EPA Identification Number
Co
R
0
0
J
-O
2.3 Facility Contact
Name(first and last) Title Phone number
Jason Conner VP [phone]
Q
Email address
a
[e-mail]
ai 2.4 Facility Mailing Address
Street or P.O.box
PO Box 987
City or town State ZIP code
Albermarle NC 28001
EPA Form 3510-1(revised 3-19) Page 1

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC00028169 B.V.Hedrick Gravel&Sand OMB No.2040-0004
d 2.5 Facility Location
E ` Street,route number,or other specific identifier
Q 0 12423 Old Aquadale Rd.
0 County name County code(if known)
E Stanly
City or town State ZIP code
z m Norwood North Carolina 28128
SECTION 3.SIC AND NAICS CODES(40 CFR 122.21(f)(3))
3.1 SIC Code(s) Description(optional)
3295
N
N
'O
O
U
U,
3.2 NAICS Code(s) Description(optional)
SECTION 4.OPERATOR INFORMATION(40 CFR 122.21(f)(4))
4.1 Name of Operator
B.V.Hedrick Gravel and Sand Company
co 4.2 Is the name you listed in Item 4.1 also the owner?
€ ❑✓ Yes El No
0
4.3 Operator Status
❑ Public—federal ❑ Public—state 0 Other public(specify)
o ❑✓ Private ❑ Other(specify)
4.4 Phone Number of Operator
[phone]
4.5 Operator Address
w Street or P.O. Box
12423 Old Aquadale Rd.
o
w City or town State ZIP code
`0 0 Norwood North Carolina 28128
is U
o. Email address of operator
[e-mail]
SECTION 5.INDIAN LAND(40 CFR 122.21(f)(5))
-0 5.1 Is the facility located on Indian Land?
❑Yes ❑✓ No
EPA Form 3510-1(revised 3-19) Page 2

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC00028169 B.V.Hedrick Gravel&Sand © OMB No.2040-0004
SECTION 6.EXISTING ENVIRONMENTAL PERMITS(40 CFR 122.21(f)(6))
6.1 Existing Environmental Permits(check all that apply and print or type the corresponding permit number for each)
m NPDES(discharges to surface ❑ RCRA(hazardous wastes) ❑ UIC(underground injection of
o y water) fluids)
E NC00028169
d ❑ PSD(air emissions) ❑ Nonattainment program(CM) ❑ NESHAPs(CAA)
a
❑ Ocean dumping(MPRSA) ❑ Dredge or fill(CWA Section 404) ❑ Other(specify)
SECTION 7.MAP(40 CFR 122.21(f)(7))
7.1 Have you attached a topographic map containing all required information to this application?(See instructions for
specific requirements.)
❑✓ Yes ❑ No ❑ CAFO—Not Applicable(See requirements in Form 2B.)
SECTION 8.NATURE OF BUSINESS(40 CFR 122.21(f)(8))
8.1 Describe the nature of your business.
Processing shale material for the purpose of construction aggregate and lightweight aggregate.
w
U)
d
N
m
O
E.?7
iC
SECTION 9.COOLING WATER INTAKE STRUCTURES(40 CFR 122.21(f)(9))
9.1 Does your facility use cooling water?
❑ Yes ❑✓ No 4 SKIP to Item 10.1.
a 9.2 Identify the source of cooling water.(Note that facilities that use a cooling water intake structure as described at
40 CFR 125,Subparts I and J may have additional application requirements at 40 CFR 122.21(r).Consult with your
C "' NPDES permitting authority to determine what specific information needs to be submitted and when.)
o 03
U c
SECTION 10.VARIANCE REQUESTS(40 CFR 122.21(f)(10))
10.1 Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(m)?(Check all that
apply.Consult with your NPDES permitting authority to determine what information needs to be submitted and
when.)
Cr ❑ Fundamentally different factors(CWA ❑ Water quality related effluent limitations(CWA Section
ce d Section 301(n)) 302(b)(2))
❑ Non-conventional pollutants(CWA ❑ Thermal discharges(CWA Section 316(a))
Section 301(c)and(g))
❑✓ Not applicable
EPA Form 3510-1(revised 3-19) Page 3

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC00028169 B.V.Hedrick Gravel&Sand OMB No.2040-0004
SECTION 11.CHECKLIST AND CERTIFICATION STATEMENT(40 CFR 122.22(a)and(d))
11.1 In Column 1 below,mark the sections of Form 1 that you have completed and are submitting with your application.
For each section,specify in Column 2 any attachments that you are enclosing to alert the permitting authority.Note
that not all applicants are required to provide attachments.
Column 1 Column 2
❑✓ Section 1:Activities Requiring an NPDES Permit ❑ w/attachments
❑✓ Section 2:Name, Mailing Address,and Location ❑ wl attachments
❑✓ Section 3:SIC Codes ❑ w/attachments
❑✓ Section 4:Operator Information ❑ w/attachments
❑ Section 5:Indian Land ❑ w/attachments
❑✓ Section 6:Existing Environmental Permits ❑✓ w/attachments
cu
E w/topographic
❑✓ Section 7:Map ❑✓ map ❑ wl additional attachments
cn
o ❑✓ Section 8:Nature of Business 0 w/attachments
❑ Section 9:Cooling Water Intake Structures ❑ w/attachments
a)
❑ Section 10:Variance Requests ❑ wl attachments
❑✓ Section 11:Checklist and Certification Statement ❑ w/attachments
I
11.2 Certification Statement
U
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and evaluate the
information submitted.Based on my inquiry of the person or persons who manage the system,or those persons
directly responsible for gathering the information,the information submitted is,to the best of my knowledge and
belief,true,accurate,and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fine and imprisonment for knowing violations.
Name(print or type first and last name) Official title
Jason Conner VP
Signature Date signed
10/25/2023
EPA Form 3510-1(revised 3-19) Page 4

\'' r'ad'.'T',_1,-.
DocuSign Envelope ID:Al CDO6AD-00CC-432B-BBDD-8ED6B6F2047B ,y r�!
�,
'''k...2 - r : ''/!*r‹.'1' —',2,:.--":0 '
_� J
,
{ ,r,v.
�'' `4 �' /� ..- . r r. 1 z.oi oar '` ..+':
. ,/,
____,
r/door- , )
4 12* ' f '''' (.. ' 4 ., ''-'---' %//.....,' JP'-. '
�" (C ..
.. ref ri � r iT4 r i ri,
..._ ,,,,,,, ,
_ � ,,\:...7
4 } ,, ; i! ,' +':Cep-yy.‘. .,, ' / •,;!?.:
!'
, f, t !_.,-,,i--.i:: -...,_- --_''''',--.'', - -- ` y 14l:4-".1,.-
`1 \= '._i ,- .�... +l fi t
► ey- :-`"'t , ? 1 •/ \
.':'.'7-., .- ,,'''t
:.:.'....L4'
` ` J4 �-ti1 - '1.,,...�"�-`. :.s.r:i1 z /./�f� '!'`fir_ •,,>
y\
^, x :��7� i.. cif, /Jr _
. ' -mow ,4--r ---" N
`°'pproximate i
',,� ' ✓ .. -' Outfa11001 drif
/` Facility Location
t
® e. Outfa11002tAp- c�,
i ,+ �.„ , ' ``�'�`""%` ,,,„ ;is .1. -t` .. `- V
'', ,:;7 /;, [_ �� '__•,.' ?" Long Branch /� ,s
-- i •
'-arm S--. � �' � �/'�'� ��c '"-! `'�. �' � ,
�..�..r ^y.. ter' e �,:� 1 ' ` a 'f' � ,.; :%�
• J -�
9 r � i
Creek . ��
. — , , . ` ,`_ ;%: LongC ti, , ,, _ - .
t 1 if ' -!'' 't
• � 1
g-_
.,k..„/
„.___,...) ____ ,,,.,--,-.:,.., ,_ ,,,,,,, .. .—, „ ...
'.tt -"*.4•.," S' 's'L:':'..-'',x -.r.s.\"1r 'te/' i'llili 4':''') ' '''. • le.,,t,:i45-\
-*T `� ,` ,'-,` f Copy ight:©:2013 National Geograpf icRSo� Gi bed
B V Hedrick Gravel & Sand Company N cs i '` � N'
Aquadale Quarry
NPDES Permit NC0028169 15,°°°,°°° it
'
Receiving Stream:Long Branch Stream Class:C
Stream Segment: Sub-Basin#: 03-07-13 Outfall 001: 35.2292 °N, -80.2464°W
River Basin:Yadkin-Pee Dee HUC:030401050406 SCALE Outfall 002: 35.2272 °N, -80.2481 °W
County:Stanly 1:20,000

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC00028169 J.Hedrick Gravel and Sand Compa
OMB No.2040-0004
U.S.Environmental Protection Agency
FORM r Application for NPDES Permit to Discharge Wastewater
2E NPDES �"�EPA MANUFACTURING,COMMERCIAL,MINING,AND SILVICULTURAL FACILITIES WHICH
DISCHARGE ONLY NONPROCESS WASTEWATER
SECTION 1.OUTFALL LOCATION(40 CFR 122.21(h)(1))
1.1 Provide information on each of the facility's outfalls in the table below.
o Outfall Receiving Water Name Latitude Longitude
;7, Number
iti
0 001 Long Branch 35° 22' 92" N -80° 24' 64" W
co
002 Long Branch 35° 22' 72" N -80° 24' 81" W
0
SECTION 2.DISCHARGE DATE(40 CFR 122.21(h)(2))
t 2.1 Are you a new or existing discharger?(Check only one response.)
s El New discharger ❑✓ Existing discharger 4 SKIP to Section 3.
0 2.2 Specify your anticipated discharge date:
0
SECTION 3.WASTE TYPES(40 CFR 122.21(h)(3))
3.1 What types of wastes are currently being discharged if you are an existing discharger or will be discharged if you are a
new discharger?(Check all that apply.)
❑ Sanitary wastes ❑✓ Other nonprocess wastewater(describe/explain
ElRestaurant or cafeteria waste directly below)
0 ❑ Non-contact cooling water
0_ 1
1- 3.2 Does the facility use cooling water additives?
N
❑ Yes ❑✓ No 4 SKIP to Section 4.
3.3 List the cooling water additives used and describe their com aosition.
Cooling Water Additives Composition of Additives
(list) (if available to you)
SECTION 4.EFFLUENT CHARACTERISTICS(40 CFR 122.21(h)(4))
4.1 Have you completed monitoring for all parameters in the table below at each of your outfalls and attached the results to
this application package?
❑✓ Yes ❑ No;a waiver has been requested from my NPDES permitting authority
(attach waiver request and additional information)4 SKIP to Section 5.
4.2 Provide data as requested in the table below) (See instructions for specifics.)
1 u Number of Maximum Daily Average Daily Source
N Parameter or Pollutant Analyses Discharge Discharge (use codes
'a (if actual data (specify units) (specify units) per
cu
5 reported) Mass Conc. Mass Conc. instructions)
m
s Biochemical oxygen demand(BOD5)
Total suspended solids(TSS) 2 monthly 45 mg/I
m Oil and grease 2 monthly 60.0 mg/I
E.
►%r Ammonia(as N)
Discharge flow Weekly
pH(report as range) 2 Monthly 6.0-9.0
Temperature(winter) 2 Monthly
Temperature(summer) 2 Monthly
I Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant
parameters or required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2E(revised 3-19) Page 1

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC00028169 J.Hedrick Gravel and Sand Compa OMB No.2040-0004
4.3 Is fecal coliform believed present,or is sanitary waste discharged(or will it be discharged)?
❑ Yes ❑✓ No 4 SKIP to Item 4.5.
4.4 Provide data as requested in the table below. (See instructions for specifics.)
Number of Maximum Daily Average Daily Source
Parameter or Pollutant Analyses Discharge Discharge (Use codes
(if actual data (specify units) (specify units) per
reported) Mass Conc. Mass Conc. Instructions.)
Fecal coliform
E.coli
= Enterococci
0 4.5 Is chlorine used(or will it be used)?
in ElYes ❑✓ No 4 SKIP to Item 4.7.
N 4.6 Provide data as requested in the table below.1 (See instructions for specifics.)
w Number of Maximum Daily Average Daily Source
El o Parameter or Pollutant Analyses Discharge Discharge (use codes
- (if actual data (specify units) (speci units) per
o reported) Mass Conc. Mass Conc. instructions)
= Total Residual Chlorine
w 4.7 Is non-contact cooling water discharged(or will it be discharged)?
❑ Yes ❑✓ No 4 SKIP to Section 5.
4.8 Provide data as requested in the table below.1 (See instructions for specifics.)
Number of Maximum Daily Average Daily Source
Parameter or Pollutant Analyses Discharge Discharge (use codes
(if actual data (specify units) (specify units) per
reported) Mass Conc. Mass Conc. instructions)
Chemical oxygen demand(COD)
Total organic carbon(TOC)
SECTION 5.FLOW(40 CFR 122.21(h)(5))
5.1 Except for stormwater water runoff,leaks,or spills,are any of the discharges you described in Sections 1 and 3 of this
application intermittent or seasonal?
0 Yes-' Complete this section. ✓❑ No 4 SKIP to Section 6.
c 5.2 Briefly describe the frequency and duration of flow.
SECTION 6.TREATMENT SYSTEM(40 CFR 122.21(h)(6))
6.1 Briefly describe any treatment system(s)used(or to be used).
E
NAll processing water and stormwater from processing area A and B is diverted to dike A. The water is then pumped
vni from this location to existing concrete cells which can handle over 1-million gallons of water. We use a flocculent(O'B
c FLOC AE-612)to treat the water in the concrete cells. The water is then gravity feed from the cells to the pit. The water
m
E is then pumped from the pit to the waters of the State(outfall 002). There is also an outfall 001 from the dike area in
4
m case of a possible discharge during a 5-year storm event.
r-
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant
parameters or required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2E(revised 3-19) Page 2

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC00028169 J.Hedrick Gravel and Sand Compa OMB No.2040-0004
SECTION 7.OTHER INFORMATION(40 CFR 122.21(h)(7))
7.1 Use the space below to expand upon any of the above items.Use this space to provide any information you believe the
reviewer should consider in establishing permit limitations.Attach additional sheets as needed.
0
•
E
I-
0
C)
a�
O
SECTION 8.CHECKLIST AND CERTIFICATION STATEMENT(40 CFR 122.22(a)and(d))
8.1 In Column 1 below,mark the sections of Form 2E that you have completed and are submitting with your application.
For each section,specify in Column 2 any attachments that you are enclosing to alert the permitting authority.Note that
not all applicants are required to provide attachments.
Column 1 Column 2
❑✓ Section 1:Outfall Location ❑ w/attachments(e.g.,responses for additional outfalls)
❑ Section 2:Discharge Date ❑ w/attachments
❑ Section 3:Waste Types ❑ wl attachments
❑✓ Section 4:Effluent Characteristics ❑ wl attachments
R 0 Section 5:Flow ❑ w/attachments
cn
❑✓ Section 6:Treatment System ❑ wl attachments
0 Section 7:Other Information ❑ wl attachments
c' ❑✓ Section 8:Checklist and Certification Statement 0 wl attachments
-0
8.2 Certification Statement
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information
submitted.Based on my inquiry of the person or persons who manage the system,or those persons directly
responsible for gathering the information,the information submitted is,to the best of my knowledge and belief, true,
accurate,and complete. I am aware that there are significant penalties for submitting false information,including the
possibility of fine and imprisonment for knowing violations.
Name(print or type first and last name) Official title
Jason Conner VP
Signature Date signed
10/25/2023
EPA Form 3510-2E(revised 3-19) Page 3

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC00028169 B.V.Hedrick Gravel&Sand OMB No.2040-0004
U.S.Environmental Protection Agency
Form1 Application for NPDES Permit to Discharge Wastewater
NPDES ��EPA
GENERAL INFORMATION
SECTION 1.ACTIVITIES REQUIRING AN NPDES PERMIT(40 CFR 122.21(f)and(f)(1))
1.1 Applicants Not Required to Submit Form 1
Is the facility a new or existing publicly owned Is the facility a new or existing treatment works
1.1.1 12
treatment works? 1. . treating domestic sewage?
If yes, STOP.Do NOT complete ❑✓ No If yes, STOP.Do NOT ❑✓ No
Form 1.Complete Form 2A. complete Form 1.Complete
Form 2S.
1.2 Applicants Required to Submit Form 1
1.2.1 Is the facility a concentrated animal feeding 1.2.2 Is the facility an existing manufacturing,
operation or a concentrated aquatic animal commercial, mining,or silvicultural facility that is
a production facility? currently discharging process wastewater?
w ❑ Yes 4 Complete Form 1 ❑✓ No 0 Yes 4 Complete Form �✓ No
and Form 2B. 1 and Form 2C.
1.2.3 Is the facility a new manufacturing,commercial, 1.2.4 Is the facility a new or existing manufacturing,
mining,or silvicultural facility that has not yet commercial,mining,or silvicultural facility that
commenced to discharge? discharges only nonprocess wastewater?
El Yes 4 Complete Form 1 0✓ No �✓ Yes 4 Complete Form ❑ No
CD
and Form 2D. 1 and Form 2E.
cn
1.2.5 Is the facility a new or existing facility whose
discharge is composed entirely of stormwater
associated with industrial activity or whose
discharge is composed of both stormwater and
non-stormwater?
❑ Yes 4 Complete Form 1 ❑✓ No
and Form 2F
unless exempted by
40 CFR
122.26(b)(14)(x)or
b 15 .
SECTION 2.NAME,MAILING ADDRESS,AND LOCATION(40 CFR 122.21(f)(2))
2.1 Facility Name
B.V.Hedrick Gravel and Sand Company/Aquadale Quarry
0 2.2 EPA Identification Number
R
O
J
R 2.3 Facility Contact
Name(first and last) Title Phone number
Jason Conner VP [phone]
Email address
a
[e-mail]
2.4 Facility Mailing Address
Street or P.O.box
PO Box 987
City or town State ZIP code
Albermarle NC 28001
EPA Form 3510-1(revised 3-19) Page 1

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC00028169 B.V.Hedrick Gravel&Sand OMB No.2040-0004
d 2.5 Facility Location
Street,route number,or other specific identifier
Q o 12423 Old Aquadale Rd.
c o County name County code(if known)
M Stanly
ar
City or town State ZIP code
z A Norwood North Carolina 28128
SECTION 3.SIC AND NAICS CODES(40 CFR 122.21(f)(3))
3.1 SIC Code(s) Description(optional)
3295
N
G7
O
U
3.2 NAICS Code(s) Description(optional)
c
SECTION 4.OPERATOR INFORMATION(40 CFR 122.21(f)(4))
4.1 Name of Operator
B.V.Hedrick Gravel and Sand Company
0 4.2 Is the name you listed in Item 4.1 also the owner?
w
❑✓ Yes ❑ No
4.3 Operator Status
R ❑ Public—federal 0 Public—state ❑ Other public(specify)
CD
o ❑✓ Private 0 Other(specify)
4.4 Phone Number of Operator
[phone]
4.5 Operator Address
w Street or P.O.Box
E m 12423 Old Aquadale Rd.
o 2
City or town State ZIP code
v Norwood North Carolina 28128
R
Q Email address of operator
[e-mail]
SECTION 5.INDIAN LAND(40 CFR 122.21(f)(5))
R 0 5.1 Is the facility located on Indian Land?
0 J ❑Yes ❑✓ No
EPA Form 3510-1(revised 3-19) Page 2

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC00028169 B.V.Hedrick Gravel&Sand OMB No.2040-0004
SECTION 6.EXISTING ENVIRONMENTAL PERMITS(40 CFR 122.21(f)(6))
6.1 Existing Environmental Permits(check all that apply and print or type the corresponding permit number for each)
d m NPDES(discharges to surface ❑ RCRA(hazardous wastes) El UIC(underground injection of
water) fluids)
o •� NC00028169
❑ PSD(air emissions) 0 Nonattainment program(CM) ❑ NESHAPs(CM)
cn
w ❑ Ocean dumping(MPRSA) ❑ Dredge or fill(CWA Section 404) 0 Other(specify)
SECTION 7.MAP(40 CFR 122.21(f)(7))
7.1 Have you attached a topographic map containing all required information to this application?(See instructions for
R specific requirements.)
❑✓ Yes ❑ No ❑ CAFO—Not Applicable(See requirements in Form 2B.)
SECTION 8.NATURE OF BUSINESS(40 CFR 122.21(f)(8))
8.1 Describe the nature of your business.
Processing shale material for the purpose of construction aggregate and lightweight aggregate.
m
"6
E.?7
i0
SECTION 9.COOLING WATER INTAKE STRUCTURES(40 CFR 122.21(f)(9))
9.1 Does your facility use cooling water?
L d 0 Yes ❑✓ No 4 SKIP to Item 10.1.
R a 9.2 Identify the source of cooling water.(Note that facilities that use a cooling water intake structure as described at
40 CFR 125,Subparts I and J may have additional application requirements at 40 CFR 122.21(r).Consult with your
YNPDES permitting authority to determine what specific information needs to be submitted and when.)
O
U 5
SECTION 10.VARIANCE REQUESTS(40 CFR 122.21(f)(10))
10.1 Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(m)?(Check all that
(11 apply.Consult with your NPDES permitting authority to determine what information needs to be submitted and
d when.)
❑ Fundamentally different factors(CWA ❑ Water quality related effluent limitations(CWA Section
Section 301(n)) 302(b)(2))
❑ Non-conventional pollutants(CWA ❑ Thermal discharges(CWA Section 316(a))
Section 301(c)and(g))
❑✓ Not applicable
EPA Form 3510-1(revised 3-19) Page 3

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC00028169 B.V.Hedrick Gravel&Sand OMB No.2040-0004
SECTION 11.CHECKLIST AND CERTIFICATION STATEMENT(40 CFR 122.22(a)and(d))
11.1 In Column 1 below,mark the sections of Form 1 that you have completed and are submitting with your application.
For each section,specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note
that not all applicants are required to provide attachments.
Column 1 Column 2
❑✓ Section 1:Activities Requiring an NPDES Permit ❑ w/attachments
ElSection 2:Name, Mailing Address,and Location 0 w/attachments
❑✓ Section 3:SIC Codes ❑ w/attachments
❑✓ Section 4:Operator Information 0 w/attachments
0 Section 5:Indian Land ❑ w/attachments
❑✓ Section 6: Existing Environmental Permits ❑✓ w/attachments
w/topographic
as ❑✓ Section 7:Map ❑✓ map ❑ w/additional attachments
co
c ❑✓ Section 8:Nature of Business ❑ w/attachments
w 0 Section 9:Cooling Water Intake Structures ❑ w/attachments
0 Section 10:Variance Requests 0 w/attachments
as
N ❑✓ Section 11:Checklist and Certification Statement 0 w/attachments
11.2 Certification Statement
U
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and evaluate the
information submitted.Based on my inquiry of the person or persons who manage the system,or those persons
directly responsible for gathering the information,the information submitted is,to the best of my knowledge and
belief,true,accurate,and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fine and imprisonment for knowing violations.
Name(print or type first and last name) Official title
Jason Conner VP
Signature Date signed
10/25/2023
EPA Form 3510-1(revised 3-19) Page 4

11111.111111111111111
DocuSign Envelope ID A1CD06AD-00CC-432B-BBDD-8ED6B6F2047B
-_//11.7"4 ":" Yi '''''f'' ILL___sst 4 s,,Zs.--:-*) irrs.. "----7?, .7 - ‘T)\---_,
piroahr::111 c_
[[ - .� ./., •.ram [ \---(3'sN,
-
1 / -� c 1
c.
,... .c 4-?7,---Q- . (7/\--,, ilPetdfli't ,. ,A6 i,
i (-;___J--- . 4.11010 i C-- N; .
.Tr
..._ / ,-", • -7 • ',/ '• .- 11 V 1 ...f Ar!*,, A, --,
4:1;:V'''')/e":/1 ,-- 1 V
',111r4
f r� 4.}6A.,..Ya--
Ste; ' 3. �� -I�� �.1q %
1 , ....„,y
n 'ter: !� % ,'� l� Illt / %!� i� ,f
• L '� ` , y• - �4 /` -�-� Approximate r p.'y4 • (0(
- , ,-`--. _ — - _ Outfa11001 ` Q r :-)' Facility Location . .,, -
(-"," i,f "x` (I,41111ILOW ' sil' "41.1 ' ' '
Outfall -- x Wit.. , .
�' / G�SP�
• •• , - - Long Branch -
y
/ s i._
g
p'
1 rI
r ,
1 �;
1
r
•, _ 1 ,�.�,� J - .may = l .J.•��
t. �'`- / ., Long Creek �'" ��
r.
I _\„\;....z:-----,. .-._. :,\j, ,,, illi• .I i ,c:_,j_..,• ', -,4),_ ..,,, . _ -___ _ _„Roeky:R1 -• i
3 4, "i ?Y..- r 11 ;Pt '''''.......44.2 "--01Q u a resi:,- .-- ,', 1 •'. ,c(1./1( 4 ).. ' 7-, -S\ ----, ,
- ` �" Y" � ' 2i�� ��Copyrights©k2013 National,Geographic S bed
B V Hedrick Gravel & Sand Company N :_r
Aquadale Quarry
NPDES Permit NC0028169 115000000
Receiving Stream:Long Branch Stream Class:C
Stream Segment: Sub-Basin#:03-07-13 Out fall 001: 35.2292 °N, -80.2464 °W
River Basin:Yadkin-Pee Dee HUC:030401050406 SCALE
County: Stanly 1:20,000 Outfall 002: 35.2272 °N, -80.2481 °W