Loading...
HomeMy WebLinkAboutNCG070237_Application_20240502 FOR AGENCY USEQNLY NCG070 Z 3 �+ u RECEIVED Assigned to: ARO FRO MR0 RRO WARO WIRO WSRO MA.y 0 2 2Z Division of Energy, Mineral, and Land Resources Land Quality Section National Pollutant Discharge Elimination System NCGO7O000 Notice of Intent This General Permit covers STORMWA TER DISCHARGES associated with activities under the following Standard Industrial Classifications: SIC32[Stone, Clay, Glass and Concrete Products], and like activities deemed by DEMLR to be similar in the process and/or the exposure of raw materials, products, by-products, or waste materials. SIC 3273[Ready-Mixed Concrete]is specifically excluded from coverage under this General Permit and is instead covered under NCG140000. 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: Pro-Tops Inc Legally responsible person as signed in Item (7) below: Ka*n Camargo Street address: 4001 Van Dyke Ct. City: State: Zip Code: Monroe NC 28110 Telephone number: 704 Email address: ( ) 821-3731 officemanager@pro-tops.com Type of Ownership: A El County Government ❑ County ❑ Federal ❑ Municipal ❑State "''"•'� Non-government - .10 ❑ Business(If ownership is business,a copy of NCSOS report must be included with this application) IN Individual 2. Industrial Facility(facility being permitted): Facility name: Pro-Tops-Sink Shop Facility environmental contact: Juan Santos Street address: 4001 Matthews Indian trail Rd City: Matthews State: NC Zip Code: 28104 Parcel Identification Number(PIN): County: Union Telephone number: 704-774-1787 Email address: officemanager@pro-tops.com 4-digit SIC code: Facility is: Date operation is to begin or began: 3281 ® New ❑ Proposed ❑ Existing Latitude of entrance: 35.087933° N Longitude of entrance: -80.671806°W Brief description of the types of industrial activities and products manufactured at this facility: Sinks/Countertops are grinded down, haz waste is generated, exposed materials&totes/barrels of chemicals sit outside If the stormwater discharges to a municipal separate storm sewer system (MS4), name the operator of the MS4: ❑ N/A Page 1 of 5 3. Consultant(if applicable): Name of consultant: Wes Waters Consulting firm: Environmental Services Group Inc Street address: 2300 Cottondale Ln, Suite 260 City: Little Rock State: AR Zip Code: 72202 Telephone number: 501-663-4731 Email address: wwaters@esgisafety.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. 001 South Fork Crooked Creek c ❑This watershed has a TMDL. Latitude of outfall: 35.087742 Longitude of outfall: -80.671622 W Brief description of the industrial activities that drain to this outfall: exposed metal,truck unloading, parking lot, sink grinding areas, exposed totestbarrels Do Vehicle Maintenance Activities occur in the drainage area 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 aTMDL. 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 area 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. 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 area 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. 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 area 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 NOI. Page 2 of 5 S. 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: ®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: Number of waste shipments per year: Name of transport/disposal vendor: Transport/disposal vendor EPA ID: Vendor address: ALOOF ❑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): Q Check for$120 made payable to NCDEQ Q Copy of most recent Annual Report to the NC Secretary of State ®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 ® 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 143-215.613(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 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. ® I will abide by all conditions of the NCG070000 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. ® I hereby request coverage under the NCG070000 General Permit. Printed Name ��of/Applicant: Kaitlyn Carnar90 Title: Of/' T, C-q MCr\n qz.'— - �.�,ay (Sgnature of Applicant) (Date Signed) tE 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 Outfalls 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: Do Vehicle Maintenance Activities occur in the drainage area 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. 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 area 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. 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 area 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. 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 area 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. 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 area 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 5 of 5 0 BUSINESS CORPORATION ANNUAL REPORT I/MM2 -NAME.OF-BUSINESS-CORPORATI ON:-__Pro-T.ops,_Inc. 0670063 Filing Office Use Only SECRETARY OF STATE ID NUMBER: STATE OF FORMATION: NC E-Filed Annual Report 0670063 REPORT FOR THE FISCAL YEAR END: 12/31/2024 CA202402601072 1/26/2024 12:15 SECTION A: REGISTERED AGENT'S INFORMATION Q Changes 1. NAME OF REGISTERED AGENT: Andrade, Felisberto 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 4001 Van Dyke Ct 4001 Van Dyke Ct Monroe, NC 28110-8088 Union County Monroe, NC 28110-8088 SECTION B: PRINCIPAL OFFICE INFORMATION 1. DESCRIPTION OF NATURE OF BUSINESS: Counter tops frabrlcatlon 2. PRINCIPAL OFFICE PHONE NUMBER: (704) 821-3731 3.PRINCIPAL OFFICE EMAIL: Privacy Redaction 4. PRINCIPAL OFFICE STREET ADDRESS 5.PRINCIPAL OFFICE MAILING ADDRESS 4001 Van Dyke Court 4001 Van Dyke Court Monroe, NC 28110-8088 Monroe, NC 28110-8088 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: Felisberto M Andrade NAME: Ricardo Ferreira NAME: TITLE: President TITLE: Vice President TITLE: ADDRESS: ADDRESS: ADDRESS: 3224 Long Valley Rd 6131 Gatesville Lane Charlotte, NC 28270 Charlotte, NC 28270 SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business entity M Andrade 1/26/2024 SIGNATURE DATE Form must be signed by an officer listed under Section C of this form. Felisberto M Andrade President 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