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HomeMy WebLinkAboutNCG140535_Application_20240129 FOR AGENCY USE ONLYP� �/�P NCG14 5 Assigned to: CCU G�w 411� ARO FRO FRq RRO WARD WIRO WSRO �wdierProyra'rl 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 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(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: STEVENSON-WEIR/SOUTHERN, LLC SHANNON HOUCK Street address: City: State: Zip Code: 1523 S.ANDERSON ROAD ROCK HILL Sc 29730 Telephone number: Email address: 864-363-5615 Shannon.Houck@swscarolina.com 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: STEVENSON-WEIR/SOUTHERN-HOVIS RD SHANNON HOUCK Street address: City: State: Zip Code: 5010 HOVIS ROAD CHARLOTTE NC 28208 Parcel Identification Number(PIN): County: 06311442 MECKLENBURG Telephone number: Email address: 864-363-5615 Shannon.Houck@swscarolina.com 4-digit SIC code: Facility is: Date operation is to begin or began: 3273 [2 New ❑ Proposed ❑ Existing 2024 Latitude of entrance: Longitude of entrance: 35016'6.80"N 80053'50.10"W Brief description of the types of industrial activities and products manufactured at this facility: CONCRETE DRY TRUCK MIX PLANT AND A CENTRAL MIX PLANT If the stormwater discharges to a municipal separate storm sewer system(MS4),name the operator of the M54: 9 N/A Page 1 of 7 This facility uses: ❑ Phosphorus-containing detergents 13 Non-Phosphorus-containing detergents ❑ Brighteners ❑ 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 NOI.Contact DWR Non-Discharge Permitting Program for permitting requirements 13 No 3. Consultant(if applicable): Name of consultant: Consulting firm: CHALAM PAKALA CP ENGINEERING AND ENVIRONMENTAL SOLUTION Street address: City: State: Zip code: 10017 ALLYSON PARK DR. CHARLOTTE NC 28277 Telephone number: Email address: 704-756-7451 CVPAKALA@CAROLINA.RR.COM 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. OUTFALL-01 STEWART CREEK C ❑This watershed has a TMDL. Discharge from this outfall is from: ❑Stormwater Only ❑ Wastewater Only 9 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-11,WS-111,SA,or PNA): Discharge occurs from this outfall: ❑Only during a rainfall event 13 Intermittently(indicate how often) ❑ Continuously(indicate flow in CFS) ONCE A WEEK Latitude of outfall: Longitude of outfall: 35024'51.79"N 77-58'40.13-W Brief description of the industrial activities that drain to this outFall: STORMWATR FROM THE YARD,WASH PITS WATER AND WATER FROM STONE COOLING Do Vehicle Maintenance Activities occur in the drainage are of this outfall? ❑Yes 2 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 HOW,ORW,Tr,WS-1,WS-11,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 7Q30 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-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 outfalk 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, S-11,WS-11I,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 NOL 5. Wastewater Types of Wastewater facility will generate or discharge Vehicle&equipment cleaning(VE) 9 Generate [3 Discharge ❑ Sent to WW Treatment System Wetting of raw material stockpiles(RM) 13 Generate 13 Discharge ❑ Sent to WW Treatment System Mixing drum cleaning(MD) [2 Generate 0 Discharge ❑ Sent to WW Treatment System Facility will spray-down or actively wet aggregate piles 13 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: 3 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 conned. Explain: 9 The wastewater treatment plant will not accept the wastewater(attach a letter documenting) ❑ Surface or subsurface disposal is technologically feasible 9 Surface or subsurface disposal is not technologically feasible Explain: ❑ Surface or subsurface disposal system is feasible to implement 0 Surface or subsurface disposal system is not feasible to implement Explain: QUANTITIES ARE TOO MUCH TO DISPOSE TO SURFACE/SUBSURFACE What is the feasibility of employing a subsurface or surface discharge as compared to a direct discharge to surface waters? Explain: QUANTITIES ARE TOO MUCH TO DISPOSE TO SURFACE/SUBSURFACE Discharge to surface waters is the most environmentally sound alternative of all reasonably cost-effective options of the wastewaters being considered: 0 Yes ❑ No—contact DEMLR's Land Application Unit to determine permitting requirements If this review included all wastewater discharge types,would excluding some types make of the above non- discharge options feasible? [� Yes ❑ No 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: 0 This facility uses best management practices or structural stormwater control measures. If checked,briefly describe the practices/measures and show on site diagram: SECONDARY CONTAINMENT DIKES AND STEEL CONTAINERS TO STORE ADMIX TANKS ❑This facility has a Stormwater Pollution Prevention Plan(SWPPP). If checked,please list the date the SWPPP was implemented: IN THE PROCEESS OF COMPLETION 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 ft 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): EZ Check forrSJ 25 ade payable to NCDEQ 13 Copy of most recent Annual Report to the NC Secretary of State 0 This completed application and any supporting documentation 0 A line drawing of the water flow through the facility. 12 Copy of county map or USGS quad sheet with the location of the facility clearly marked 9 Letter documenting that WWTP will not accept wastewater(if applicable) ❑Approval from permitting authority to discharge wastewater to a stormwater BMP(if applicable) Page 5 of 7 12 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 300-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 143-215.68(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($30,000). Under penalty of law,I certify that: 0 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. D 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. 12 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. Ea I hereby request coverage under the NCG140000 General Permit. SHANNON HOUCK Printed Name of Applicant: DIRECTOR OF COMPLIANCE Title: ,( - 0 I Z3 ' 20 z4 (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 6 of 7 Additional Clutfalls 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-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 HOW,ORW,Tr,WS-I,WS-II,WSIII,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 HOW,ORW,Tr,WS-1,WS-II,WSIII,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 7 of 7 FIGURES Figure— 1 Site USGS TOPO Map Figure—2 Site Drainage Maps Map Name: MOUNTAIN ISLAND LAKE Scale: 1 inch =2,000 ft. Print Date: 12/02/23 Map Center: 0350 16' 07.41" N, 0800 53'49.79"W s , Oa • er �. � � e�R a !(Alili f + Sat WIRoad Old• � / �� ="s �'��-' ' o MtHolly,oad 11l} tI a , a Macon S a• Lis 5 <� f- d, e �. e ytr • S M M - Us�ct j• S P CONCRETE LOCK PLA w � 20 0aSt Ire;. F oda Z yo a s ,. Bealer,Ro d r, �� � °Of U ar Z o WP-HO IS RD PLANT•• b T uth q o �y Eo �� kt %b�hAv_e:ue� �t .` INoodway.P ® `Co'�1)L J��O� O�Cr e5ti 0 ,50➢ v RowaANt M r f Key`S Declination V'm�4 \' rn�ry ` ': (-;�•s ��. Q / i/� fit„ *" \ (i°o`n •' 1 Hoouek�r��S�(,t_,�„ %��d� `�� , d , o z s ddl'ein � � �'P ainview-'Road 1 `fake F S 0 J , s' o uQkas ,�' If o� Q �mce�Ra� M 0 GN 1"0.06"E W 0"54'30.00"W 080-54'00.00"W 080-53'30,00"W 080-53-00.00"W MN 7.6 SCALE 1:24000 SITE LOCATION MAP 0 1000 2000 3000 4000 5000 6000 STEVENSON-WEIR/SOUTHERN-HOVIS PLANT FEET CHARLOTTE, NC FIGURE 1 JOB NO. 1129-001 ! 1l���J,�;J�Ja=� J 13�JeJ►J�J '� � ; � ; ; ; 'I ' ��iol i°� �1� �I I►�PI�L��i��llu►{�I�! o!°il��,s,l,lislii►�►II►�la►���► Ilk �\ II y I 1 1 F � ° I p P t t COPY OF MOST RECENT ANNUAL REPORT TO THE NC SECRETARY OF STATE 0r 't' g LIMITED LIABILITY COMPANY ANNUAL REPORT 0 0612022 NAME OF LIMITED LIABILITY COMPANY: Stevenson-Weir Companies, LLC Fling Office Use Only SECRETARY OF STATE ID NUMBER: 2024756 STATE OF FORMATION: SC E-Filed Annual Report 2024756 REPORT FOR THE CALENDAR YEAR: 2023 31/6/2023 07 46 SECTION A: REGISTERED AGENT'S INFORMATION Changes 1. NAME OF REGISTERED AGENT: CT Corporation System 2.SIGNATURE OF THE NEW REGISTERED AGENT: SIGNATURE CONSTITUTES CONSENT TO THE APPONTMENT 3. REGISTERED AGENT OFFICE STREET ADDRESS&COUNTY 4.REGISTERED AGENT OFFICE MAILING ADDRESS 160 Mine Lake Ct Ste 200 160 Mine Lake Ct Ste 200 Raleigh, NC 27615 Wake County Raleigh, NC 27615 SECTION B: PRINCIPAL OFFICE INFORMATION 1.DESCRIPTION OF NATURE OF BUSINESS: CONCRETE/SAND/STONE 2. PRINCIPAL OFFICE PHONE NUMBER: (803) 324-4455 3. PRINCIPAL OFFICE EMAIL: Privacy Redaction 4.PRINCIPAL OFFICE STREET ADDRESS 5.PRINCIPAL OFFICE MAILING ADDRESS 1523 S Anderson Road 1523 S Anderson Road ROCK HILL,SC 29730 ROCK HILL,SC 29730 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: JM STUART STEVENSON NAME: THOMAS KENDRICK STEVENSON NAME: TITLE: President TITLE: Vice President TITLE: ADDRESS: ADDRESS: ADDRESS: 621 DEBERRY HOLLOW 2165 EAKLE DR. ROCK HILL,SC 29732 ROCK HILL,SC 29732 SECTION D:CERTIFICATION OF ANNUAL REPORT, Section D must be completed in its entirety by a person/business entity. JM STUART STEVENSON 1/23/2024 SCIIATURE DATE Form must be signed by a Company Offoltil listed under section C of This form. JM STUART STEVENSON President Print or Type Name of Company OfFx:ial 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,INC 27626-0525 TMDL AND 303 D MAPS COUNTY GIS MAP ' 1 a Surface Wale CI ificarlons: [ NC Surface Water Classifications �..... m Gl Q88 _... Surface Water daniflcaHom: O , me. earn 9x S• h ,. nw Fr2,�.rm ece,a fi @ sfmammh: ib13743 ' �3 � �odc wmw r-sy Stnem Namo- Nexerz Gr«I Fmmwur Whin Cr k CUavifi— C ...v, P� l s 6rted Chlc: F .31,1414 "may. r. WFndoes AnCWs.meaN Vew u k � � - " fNwrBatin Cuaxba NC TMDL and TMOL Alternative Watersheds Protect List IN a w ...rwh.muw wm c�:Y t�.nae,r.�o-navp:.<vxams `s w,q MW ww.� we. kin iarc„eue q �'` wp�o.avzxrmm w xw�»e 4 Wy':eTNL.EY>AVMewtlxlY l4l! 4O �•� 4� Gk4 HMf rlmi mion on tM1e Statewide Menu TMDL Project Details sma•wmwxamm.an.m.. norms. R.ex Map-> a..a.a�.e..m m.xm...m.mau. e:.wmn u.s .T..am.Cxrv.n.LnMxrv: oMa�Yn�Mt. v..e s.suwMnwL aY Imo" R.«eeur Fn Polaris 3G Map — Mecklenburg County, North Carolina SWP- HOVIS RD - GIS MAP Date Printed: 1/5/20243:28:52='M E I r. =£ Oiwnazronlnc� ��� f OLL391 p �s '�1 1 r d 1 435 �1 t it .5130 5513 0 4 v1s 51th 5136 5430 5 v i J i 9• 1 - 5 + +119 063Y1441' 0570022�04 3 063 3 � Y 4e `r -Y 4 946 [mawba W6.1114 4 49u 4 i.. Sanmxv 5100Vis - - Iv� 1428 9 9 4 J 7 2 n � i• ' 0 30 1 2- U 8008 �, D S .� Me� Ha HSnshx�ale �} op`t�au., ` rranpud :DV Tra s Dxd,as 05;02304 .. ka 4 Dressura l 1 5 S .r�, Inc Wash 0��1�3• 4tc � 1•Y�� oa<o lnc�.- Po L -0631Y440 Y 05702303 3 :.'� qr lty Mpressions Og . pNpLmstrletion _ eusa,xss � Teelnaapes i 1 0 O.OY25 026 „005 Miles k rs' w Is Fwlnc°p ec 5 6 The map+or report is prepared forte imeMory a real property within Measenburg County and a Whopped from recorded deeds,pats,tax maps,surveys,planimetric maps,antl other publk remrds antl data. USMS of Nis map or report are hereby notified that me abrementbned publk pri nary informaton sources should be consu ted for veriRcffilon.Metic'enburg County and its mapping contractors assume no legal responsibifry for ete information contained herein. 0�1 17t k LIMITED LIABILITY COMPANY ANNUAL REPORT A"' F u6non NAME"OF'LIMITED LIABILITY-COMPANY. SteVenSon-Weir CofnpaflleSr LLC Filing Office Use Only SECRETARY OF STATE ID NUMBER: 2024756 STATE OF FORMATION: SC E-Filed Annual Report 2024756 REPORT FOR THE CALENDAR YEAR: 2023 35/2023 01:46 SECTION A: REGISTERED AGENT'S INFORMATION Changes 1.NAME OF REGISTERED AGENT: CT Corporation System 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 160 Mine Lake Ct Ste 200 160 Mine Lake Ct Ste 200 Raleigh, NC 27615 Wake County Raleigh, NC 27615 SECTION B: PRINCIPAL OFFICE INFORMATION 1. DESCRIPTION OF NATURE OF BUSINESS: CONCRETE/SAND/STONE 2.PRINCIPAL OFFICE PHONE NUMBER: (803) 324-4455 3.PRINCIPAL OFFICE EMAIL: Privacy Redaction 4.PRINCIPAL OFFICE STREET ADDRESS 5.PRINCIPAL OFFICE MAILING ADDRESS 1523 5 Anderson Road 1523 S Anderson Road ROCK HILL,SC 29730 ROCK HILL,SC 29730 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: JIM STUART STEVENSON NAME: THOMAS KENDRICK STEVENSON NAME: TITLE: President TITLE: Vice President TITLE: ADDRESS: ADDRESS: ADDRESS: 621 DEBERRY HOLLOW 2165 EAKLE DR. _— -ROCK HILL,,SC 29732 -ROCK HILL,SC 29732 SECTION D:CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business entity. JM STUART STEVENSON 3/15/2023 SIGNATURE DATE Form must be signed by a Company Official listed under Section C of This form. JM STUART STEVENSON President 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 NPDES STORMWATER GENERAL PERMrr (NCG14000) NOI FORMS