NCG510207_Permit issuance_20161025 (2)

Water Resources
ENVIRONNL'NTRL OUAL'A Y
October 25, 2016
Mr. John W. Culbreath
Colonial Pipeline Company
P.O. Box 87
Paw Creek, NC 28130-0087
PAT MCCRORY
DONALD R. VAN DER VAART
S. JAY ZIMMERMAN
Subject: General Permit NCG510000
Certificate of Coverage NCG510207
Charlotte Delivery Facility
Mecklenburg County
Dear Permittee:
The Division received your request to renew Certificate of Coverage (CoC) NCG510207 on March 30,
2016. This CoC renewal is issued pursuant to the requirements of North Carolina General Statute 143-
215.1 and the Memorandum of Agreement between North Carolina and the US Environmental Protection
agency dated October 15, 2007.
A copy of General Permit NCG510000 is enclosed. if any parts, measurement frequencies or
sampling requirements contained in this permit are unacceptable to you, you have the right to request an
individual permit by submitting an individual permit application. Unless such demand is made, this CoC
shall be final and binding.
The CoC is not transferable except after notice to the Division. You must notify the Division if you
sell or otherwise transfer ownership of the permitted facility. The Division may require modification or
reissuance of the CoC.
If your facility ceases discharge of wastewater before the expiration date of this permit, contact the
Regional Office listed below. Once discharge from your facility has ceased, this permit may be rescinded,
This permit does not affect the legal requirements to obtain any other permit required by Federal, State, or
Local government. If you have any questions concerning this permit, please contact Charles Weaver at the
telephone number listed below, or via email [[e-mail]].
Sin rely,
G
f r S. Jay Zimmerman, P.G.
Director, Division of Water Resources
cc: Mooresville Regional Office
NPDES file
State of North Carolina I Environmental Quality I Water Resources
1617 Mail Service Center I Raleigh, NC 27699-1617
919 807 6391 919-807.6389 FAX
https:lldcq.nc. gov/about/divisions/water-resourceslwater-resources-permits/wastewater-brancIVnpdes-wastewater-permits

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
GENERAL PERMIT NCG510000
CERTIFICATE OF COVERAGE NCG510207
TO DISCHARGE PETROLEUM CONTAMINATED GROUNDWATER AND SIMILAR, WASTEWATERS
UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
Colonial Pipeline Company
is hereby authorized to operate a groundwater remediation system for petroleum -contaminated groundwater
or similar waste streams that will discharge treated wastewater from the
Charlotte Delivery Facility
7524 Kenstead Circle
Charlotte
Mecklenburg County
to receiving waters designated as an unnamed tributary to Gum Branch, a class WS-IV stream in
subbasin 03-08-34 of the Catawba River Basin.
All discharges shall be in accordance with the effluent limitations, monitoring requirements, and
other conditions set forth in Parts I, II, III and IV of General Permit NCG510000 as attached.
This certificate of coverage shall become effective October 25, 2016.
This Certificate of Coverage shall remain effective for the duration of the General Permit.
Signed this day, October 25, 2016
y 4ay Zimmerman, P.G.
Director, Division of Water Resources
By Authority of the Environmental Management Commission

RECEIVED1NCDEUDWR
AdA MAR 3 0 ZOi6
�1
F.a water Quality
NCDENR Permitting Section
North Carolina Department of Environment and Natural Resources
Division of Water Resources
Pat McCrory Thomas A. Reeder John E. Skvada, III
Governor Director Secretary
NOTICE OF RENEWAL INTENT
(Required by 15A NCAC 02H .0127td11; [term definition see 15A NCAC 02H .0103t14i1
Application for renewal of existing coverage under General Permit NCG510000
Existing Certificate of Coverage (CoQ: NCG510 2-c 7
(Please print or type)
1) Mailing address of site Owner: (address fto which all correspondence should be mailed)
Company Name Cd t- o � 1 0' c- T (PE-L t � E �A mmi-j Y
Company Contact ' d "tA Q - CU V IS P- (5 tfi- `T 0
Street Address d bc7
City �kE- State fJC Zip Z F ( 3 0
Telephone # 3 q 9 -Sz S 9 Fax #Zo 4 3?2 - I C) z 9
Email Address v C_u {o re q r'� Gc3 (D ' o e- , Co rA
2) Location of remediation site producing discharge:
Facility Name
Facility Contact
Street Address
City
County
Telephone #
ae-
H - j GJ , (f r-y 1� `�4
7.5- Z q- K E rys 7-EA .. Cr�C I- E
CdA4 -Ld 7-T 6-r State fic ZIP .2
3) System operator / Consultant 1D: (if different from Owner)
Company Name !i'1 E
Company Contact
Street Address
City
County
Telephone #
Email Address
Fax#_L6i
State: ZIP
Fax #
Page I of 2 Revised 911113

NCG510000 Renewal Application
4) Site ranking & ID: GW incident # 6 16 .. m A I 17 't
Site Ranking (if available) 0 p
Date of most recent discharge 3,Z 3 G
Additional Application Requirements:
The following information must be included in duplicate [original + 1 copy] with this application or
it will be returned as incomplete.
➢ Site map: Clearly showing the path of the remediation system effluent from the site to
its discharge point
➢ Authorization for representatives. If this application will be submitted by a consulting
engineer (or engineering firm), include documentation from the Permittee showing that
the consultant submitting the application has been designated an Authorized
Representative of the applicant.
CERTIFICATION
I certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing: VY1 t cl-Ak t L 0, COIDtJ6
Title: M A o g 4�k*� D&r2tATn o--,> (-,)
(Signature'of Applicant)
North Carolina General Statute 143-215.6 b (i) provides that:
(Date Signed)
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 Article 21 or regulations of the Environmental Management Commission implementing that Article, or who
falsifies, tampers with or knowingly renders inaccurate any recording or monitoring device or method required to be operated or maintained under
Article 21 or regulations of the Environmental Management Commission implementing that Article, shall be guilty of a misdemeanor punishable by a
fine not to exceed $25,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C. Section 1001 provides a punishment by a fine of not
more than $25,000 or imprisonment not more than 5 years, or both, for a similar offense.)
This Notice of Renewal Intent does NOT require a separate fee.
The permitted facility already pays an annual fee for coverage under NCG510000_
Mail this application and one copy of the entire package to:
NC DENR / DWR / Water Quality Permitting Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Attn: Charles Weaver
Page 2 of 2 Revised 911113