NCG120121_Application_20240816

FOR AGENCY USE ONLY
RECEIVED
NCG120 Lj 1 411616 2024
Assigned to: - COO
ARO FRO MRO RRO WARO WIRO WSRO DEMLR
Division of Energy, Mineral, and Land Resources Land Quality Section
National Pollutant Discharge Elimination System
NCG120000 Notice of Intent
This General Permit covers STORMWATER DISCHARGES associated with activities classified as:Landfills that are
permitted by the North Carolina Division of Waste Management under provisions and requirements of North
Carolina General Statue 130A-294.
Stormwater discharges from open dumps, hazardous waste disposal sites,or discharge of waste(including
leachate)to the waters of the state are specifically excluded from coverage under this General Permit.
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: Legally responsible person as signed in Item(7)below:
Washington County Jason Squires
Street address: City: State: Zip Code:
PO Box 1007 Plymouth NC 27962
Telephone number: Email address:
(252) 793-5823 [e-mail]
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:
Washington County Landfill Jason Squires
Street address: City: State: Zip Code:
718 Landfill Rd. Roper NC 27970
Parcel Identification Number(PIN): County:
6799188519 Washington
Telephone number: Email address:
gg(252) 793-5823 [e-mail]
4-di
95t Sic 11 code: Facility is: Date operation is to begin or began:
❑ New ❑ Proposed ®Existing 1 1996
Latitude of entrance: Longitude of entrance:
35. 918439 —76. 664970
Brief description of the types of industrial activities and products manufactured at this facility:
C&D Landfill
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: Consulting firm:
Pieter Scheer, P.E. Smith Gardner, Inc.
Street address: City: State: Zipp Code:
14 N. Boylan Ave. Raleigh NC 276003
Telephone number: Email address:
(919) 828-0577 [e-mail]
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.
SDO-01 UT to Albemarle Sound SB ❑This watershed has aTMDL.
Latitude of outfall: Longitude of outfall:
35. 922037 —76. 660987
Brief description of the industrial activities that drain to this outfall:
C&D Landfill
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?
All outfalls must be listed and at least one outfall is required.Additional outfalls may be added in the section
"Additional Outfails"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:
NCG020277, To Be Rescinded.
❑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:
Infiltration Basin
®This facility has a Stormwater Pollution Prevention Plan(SWPPP).
If checked,please list the date the SWPPP was implemented:
08/2024
❑This facility stores hazardous waste in the 300-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
6. Required Items(Application will be returned unless all of the following items have been included):
IN Check for$120 made payable to NCDEQ
❑ Copy of most recent Annual Report to the NC Secretary of State
M 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 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.
0 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 NCG 120000 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 NCG120000 General Permit.
Printed Name of Applicant: Jason Squires
Title: Assistant County Manager
(Signature of App icant) (Date Signed) -
Mail the entire package to: DEMLR—Stormwater Program
Department of Environmental Qua ,+�
1612 Mail Service Center
Raleigh, NC 27699-1612 ,
Page 4 of 5

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1 ' SS NOTES
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- 647E 1. THE TIRE MONOFILL IS NO LONGER USED BY THE COUNTY, THIS AREA
WAS PREVIOUSLY INCORPORATED INTO THE C&D LANDFILL FOOTPRINT.
2. 100-YEAR FLOODPLAIN IS AT ELEVATION 7.0.
3 BMW-4 0 3. THIS AREA IS DESIGNATED AS A DISASTER DEBRIS HANDLING AREA.
MAIiVff MMdle TORAGE BUILDING REFERENCES z a
(LLEC IROVICS STORAGE) 1. OVERALL SITE BASE TOPOGRAPHY FROM AERIAL SURVEY DATED o
OCTOBER 10, 2016 BY GEODATA CORPORATION, ZEBULON, NC.
2. COORDINATE SYSTEM IS STATE PLANE GRID. z
_. 3. SITE PROPERTY LINE (NORTHEASTERN HALF) OBTAINED FROM DRAWING
3 ^ r 'PROPOSED CDLF CAP SECTION' BY THE WOOTEN COMPANY, DATED z a c~
c / DECEMBER 2004. SITE PROPERTY LINE (SOUTHEASTERN HALF) FROM x
DRANNG 'MAP OF WASHINGTON COUNTY SANITARY LAND' SURVEYED a
AND PREPARED BY DOWNEAST LAND SURVEYS. c
4. WELL LOCATIONS OBTAINED FROM FROM THE WASHINGTON COUNTY
W LANDFILL MONITOR WELL SURVEY REPORT DATED APRIL 24, 20D9.
m 5. FLOODPLAIN INFORMATION FROM NC FIRM MAP NO. 37206788ODJ. a
3 0 400' 800,
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© 2024 S ith Gardner Inc