NCG081056_Application_20240826

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FOR AGENCY USE ONLY `j
NCG081O b 6 `' 03AI3Jn 3a
Assigned to: S- Co 1`
ARID FRO MRO ® WARO WIRO WSRO
Division of Energy, Mineral, and Land Resources Land Quality Section
National Pollutant Discharge Elimination System
NCGO80000 Notice of Intent
This General Permit covers STORMWATER DISCHARGES associated with activities under the following Standard
Industrial Classifications: SIC 40[Railroad Transportation],SIC 41[Local and Suburban Transit and Interurban
Highway Passenger Transportation],SIC 42[Motor Freight Transportation and Warehousing—except for SIC
42214225],SIC 43[United States Postal Services], SIC 5171[Petroleum Bulk Stations and Terminals—when total
petroleum site storage capacity is less than 1 million gallons]. The following activities are also included.other
industrial actives where the vehicle maintenance area(s)are the only area requiring permitting;stormwater
discharges from oil water separators and/or from secondary containment structures associated with petroleum
storage facilities with less than 1 million gallons of total petroleum site storage capacity. 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:
Imo' Ronnie White
Street address: City: State: Zip Code:
5708 HWY NC 96W Youngsville NC 27596
Telepphone number: Email address:
919-556-6810 [e-mail]
Type of Ownership:
Government
❑County ❑Federal ❑ Municipal ❑State
Non-government
®Business(If ownership is business,a copy of NC505 report must be included with this application)
❑Individual
2. Industrial Facility(facility being permitted):
Facility name: Facility environmental contact:
Ronnie White's Towing and Tire Kristie White
Street address: City: St Zip Code:
5708 HWY NC 96W YoungsvilleC 27596
Parcel Identification Number(PIN): County:
1843-65-9908 Franklin
Telephone number: Email address:
919-556-6810 [e-mail]
4-digit SIC code: Facility is: Date operation is to begin or began:
751 1 ❑ New ❑ Proposed ® Existing 1984
Latitude of entrance: Longitude of entrance:
36002'43.3"N 78030'11.7"W
Page 1 of 5

Brief description of the types of industrial activities and products manufactured-at this-facility: - - - - - - -
General automotive repair shop, oil changes,brakes,tires, and vehicle towing. Nothing is manufactured.
If the stormwater discharges to a municipal separate storm sewer system(MS4),name the operator of the MS4:
® N/A
3. Consultant(if applicable):
Name of consultant: Consulting firm:
n/a
Street address: City: State: Zip Code:
Telephone number: Email address:
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.
SW1 Horse Creek Swale ❑This watershed has a TMDL.
Latitude of outfall: 36.045812 Longitude of outfall:
-78.503831
Brief description of the industrial activities that drain to this outfall:
Vehicle storage, maintenance and repair
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? 2 Yes ❑ No
If yes,how many gallons of new motor oil:are used each mo#i'when averaged over the calendar year? x
s: a 3 0'
3-4 digit identifier: Name of receiving water m r Classification ❑This water is impaired'
❑This watershed.has"aTMDL.
Latitude of outfalli € y., Lon itude of outfall "
Brief desOlfi bn of theindustrial activities that drainao this outfall ='
........-' .._ oW fir.
r ai'r a- - ; m a . - — - - e
Do Vehicle Maintenance Activities occur iri the drainage area°ofahis 66t#a117 _ ❑Yes ❑ No
" 3•[a» :
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 calendaryear?
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: n/a
❑This facility has Non-Discharge permits(e.g.recycle permit).
If checked,list the permit numbers for all current Non-Discharge permits: n/a
❑This facility uses best management practices or structural stormwater control measures.
If checked, briefly describe the practices/measures and show on site diagram: n/a
❑This facility has a Stormwater Pollution Prevention Plan(SWPPP).
If checked, please list the date the SWPPP was implemented: n/a
❑This facility stores hazardous waste in the 100-year floodplain.
If checked, describe how the area is protected from flooding: n/a
®This facility is a(mark all that apply)
❑ Hazardous Waste Generation Facility
❑ Hazardous Waste Treatment Facility n/a
❑ Hazardous Waste Storage Facility
❑ Hazardous Waste Disposal Facility-�-,
" If checked,indicate.-
Kilograms of waste generated each month Type(s) of-waste '
e
How material is�stored +�. Where"material Wstorbd:
Number of.waste sh:pmen&,'Oer year'-_� t ;I Name of transport/disp5sal vendor`f
4
b ,
Transport/disposal vendor EPA+ID t f F Vendor address ,
riofc
This facilihecked,briefly describe the site conditions n/a
6. Required Items (Application will be returned unless all of the following items have been included):
0 Check for$120 made payable to NCDEQ
Copy of most recent Annual Report to the INC Secretary of State
0 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
2 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 143-215.6B(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:
2 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.
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.
2 1 will abide by all conditions of the NCG080000 permit.1 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.
g I hereby request coverage under
the NCG080000 General Permit.
Printed Name of JJA//p''plicant: /y( �5��F alm !lPC
Title: of�
(Signat re of Applicant) 4„ (Date Signed) :r
1 a F f' u
Mail the entire.package to: DEMLR 5tormwater Program F i
Vim: v-Departmettt if Environmental Quality '.._
0,
1612MadServiceCenter ') � ,.
E -Raleigh,NC 27699-1612 L
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 Classficauon This water is impaired.
w `� -, �r c
-�- F. _. *�"❑7hiswatershetlha"s;aTMDL.
Latitude of outfall: P ' rm — Longitude of outfall q
Brief description_of the industrial activities that drain to this outfall '.
- s
Do Vehicle[vlm ate. anttce Activities occur in the drainage area of this outfalh Yes ❑ No
i "—
If yes,how many gallons of new,motor oil,are usedeachinohtii when averaged over the calendar�year7 '
c
x2= g",
3-4 digit identifier: Name of receiving water: - Classification: ' , . s ❑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

CA202411301655
SOSro:0302470 i
BUSINESS CORPORATION ANNUAL REPOI Date Filed:4122/2024
Elaine F.Marshall
___ __ __ _ _ _ _ _ _ _ _North Care-lima Secretary ot'Stat_e
NA2024 113 01655
612022
NAME OF BUSINESS CORPORATION: RW Associates,Inc.InC
SECRETARY OF STATE ID NUMBER: 0302470 STATE OF FORMATION: NC Flling Oath Use Only
REPORT FOR THE FISCAL YEAR END: 2024 ■ �` M .
SECTION A:REGISTERED AGENTS INFORMATION IJ4L�� ® Changes
1.NAME OF REGISTERED AGENT: Kriste K. White
2.SIGNATURE OF THE NEW REGISTERED AGENT:
SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT
3.REGISTERED AGENT OFFICE STREET ADDRESS S COUNTY 4.REGISTERED AGENT OFFICE MAILING ADDRESS
5708 NC 96 WEST 5708 NC 96 WEST
Youngsville, NC 27596-8609 Franklin Youngsville, NC 27596-8609 Franklin
SECTION B:PRINCIPAL OFFICE INFORMATION
1.DESCRIPTION OF NATURE OF BUSINESS: TIRE &WRECKER SERVICE
2.PRINCIPAL OFFICE PHONE NUMBER: [phone] 3.PRINCIPAL OFFICE EMAIL Privacy Redaction
17' N.
4.PRINCIPAL OFFICE STREET ADDRESS 5.PRINCIPAL OFFICE MAILING ADDRESS
r
5708 NC 96 West 5708 NC 96 West
Youngsville,NC 27596-8609 Franklin Youngsville,NC 27596-8609 Franklin
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
II SECTION C:OFFICERS(Enter additional officers in Section E.)
I
NAME: Kristie K. White NAME: Ronald L White , Jr. NAME:
TITLE: Corporate Secretary TITLE: President TITLE:
ADDRESS: ADDRESS: ADDRESS:
8105 Rockhind Way 8105 Rockhind Way
Wake Forest,NC 27587 Wake Wake Forest,NC 27587 Wake
SECTION D:CEPJIFICATION OF ANNUAL REPORT, Section D must be completed in Its entirety by a person/business
entity. d
SIGNATURE DATE i
Form must be signed by an officer listed under Section C of this forth.
Pdnt or Type Name of Officer Print or Type Title of Officer
SUBMIT THIS ANNUAL REPORT WITH THE REQUIRED FILING FEE OF$25
MAILTO:Secretary of State, Business Registration Division,Past Office Box 29525,Raleigh,NC 27626-0525

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