NCG030746_Application_20240222

FOR AGENCY USE ONLY '`&A"""
NCG03 6 1�9
Assigned to: Ci. COO
ARO FRO MRO RRO WARO WIRO WS
Division of Energy, Mineral, and Land Resources Land Quality 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: SIC33S[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],SIC37[Transportation Equipment], and SIC38[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,INC 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:
Amarr Company Justin Norris
Street address: City: State: Zip Code:
275 Enterprise Way Mocksville NC 27028
Telephone number: Email address: ustin.norris amarr.com
326-936-0010 1 @
Type of Ownership:
Government
❑ County ❑Federal ❑Municipal ❑State
Non-government
CY,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:
Amarr Company Justin Norris dd Street address: 275 Enterprise Way City: Mocksville State:NC Zip�fc/0�28
Parcel Identification Number(PIN): County: Davie
Telephone number: 336-655-3676 Email address: )[e-mail]
4-digit SIC code: Facility is: Date operation is to begin or began:
3442 ❑ New ❑ Proposed CI Existing 2005
Latitude of entrance: 35.928970 Longitude of entrance: -80.604578
Brief descrip i n of th types of industri I activities and products manufactured at this facility:
i anufacure of garage doors
If the stormwater discharges to a municipal separate storm sewer system(MS4),name the operator of the M54:
❑ N/A City of Mocksville
Page 1 of 5

3. Consultant(if applicable):
Name of consultant: Consulting firm:
Street address: City: State: Zip Code:
Telephone number: Email address:
4. Clutfall(s) (at least one outfall is required to be eligible for coverage):
3-4 digit identifier: Name of receiving water: Classification: ElThis water is impaired.
001 MS4 ❑This watershed has a TMDL.
Latitude ofOO M1678 Longitude of outfall: -80.604578
Brief description of the industrial activist t at drain to this Qutfal9
VafrKkm o an Ma ena ora e
3-4 d002 identifier: Name of r��e4 ing water: Classification: ElThis water is impaired.
MMSS ❑This watershed has a TMDL.
Latitude of outfall: Longitude of outfall: _80.604607
35.928484
Brief description of the industrial activities that drain to this outfall:
Parking lot and material storage
3-4 digit identifier: TNameof receiving water: Classification: ❑ This water is impaired.
003 MS4 1 ❑This watershed has a TMDL.
Latitude of outfall: Longitude of outfall:
35.927819 -80.604589
Brief description of the industrial activities that drain to this outfall:
Parking lot and material storage
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: 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

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:
❑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:
IN 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 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:
Stacked on ground and in dumpsters Side of building
Number of waste shipments per year: Name of transport/disposal vendor:
Republic Waste, Omni Source Metal, Carolina Scrap
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):
19 Check for$120 made payable to NCDEQ
Copy of most recent Annual Report to the NC Secretary of State(if applicable)
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 outfails corresponding to the drainage areas
e) runoff conveyance features
f) areas where industrial process materials are stored
g) impervious areas
h) site property lines
❑ Copy of county map or USGS quad sheet with the location of the facility clearly marked
Page 3 of 5

7. 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:
❑ 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.
❑The information submitted in this N01 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.
❑ I will abide by all conditions of the NCG030000 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 NCG030000 General Permit.
Printed Name of Applicant: Justin Norris
Title: Safety and Training Manager
1/25/2024
(Signatur o pplicant) (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 Outfails
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: 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: 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: 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: Classification: El 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: 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: 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:
Page 5 of 5

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0 BUSINESS CORPORATION ANNUAL REPORT
I/6/2022
—NAME-OF BUSINESS CORPORATION: Amarr-Company
0003348 Filing Office Use Only
SECRETARY OF STATE ID NUMBER: STATE OF FORMATION: NC E-Filed Annual Report
0003348
REPORT FOR THE FISCAL YEAR END: 12/31/2022 CA202304601811
2/15/2023 11:43
SECTION A: REGISTERED AGENT'S INFORMATION 0 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 27615-6417 Wake County Raleigh, NC 27615-6417
SECTION B: PRINCIPAL OFFICE INFORMATION
1. DESCRIPTION OF NATURE OF BUSINESS: Manufactuer of Entry Systems
2. PRINCIPAL OFFICE PHONE NUMBER: [phone] 3.PRINCIPAL OFFICE EMAIL: Privacy Redaction
4. PRINCIPAL OFFICE STREET ADDRESS 5.PRINCIPAL OFFICE MAILING ADDRESS
165 Carriage Court 165 Carriage Court
Winston-Salem, NC 27105 Winston-Salem, NC 27105
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: OFFICERS (Enter additional officers in Section E.)
NAME: Val Sigmon NAME: Joseph Hurley NAME:
TITLE: President TITLE: Assistant Treasurer TITLE:
ADDRESS: ADDRESS: ADDRESS:
165 Carriage Court 110 Sargent Drive
Winston-Salem, NC 27105 New Haven,CT 06511
SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business
entity.
Joseph Hurley 2/15/2023
SIGNATURE DATE
Forth must be signed by an officer listed under Section C of this form.
Joseph Hurley Assistant Treasurer
Print or Type Name of Officer Print or Type Title of Officer
This Annual Report has been filed electronically.
MAIL TO:Secretary of State, Business Registration Division,Post Office Box 29525,Raleigh,NC 27626-0525