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Home My WebLink AboutNCG060456_Application_20241106 RECEIVED FOR AGENCY USE ONLY NCG06 0 ik 5 6 �� Q V N24 Assignedto: K COOK ARO FRO MRO RRO WARD RO WSRO DEMLR-StormwaterProgram Division of Energy, Mineral, and Land Resources Land Quality Section National Pollutant Discharge Elimination System NCG060000 Notice of Intent This General Permit covers STORMWATER DISCHARGES associated with activities under the following Standard Industrial Classifications: SIC20[Food and Kindred Products],SIC 21(Tobacco Products],SIC283(Drugs],SIC284 (Soaps,Detergents,&Cleaning Preparations;Perfumes, Cosmetics, &Other Toilet Preparations],SIC422(Public Warehousing and Storage—except for4226]. 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: Legall responsible person as signed in Item(7)below: Asheville Kombucha Mamas LLC Wade Anderson Street address: City: State: Zip Code: 242 Derringer Drive Marshall NC 28753 Telephone number: Email address: 828-551-4557 wade.anderson@fedupfoods.00m Type of Ownership: Govemment ❑County ❑Federal ❑Municipal ❑State Non-government 11 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: environmental contact: FedUp Foods-Wilmington 4FLadilitv oodworth Street address: City: State: Zip Code: 715 Greenfield Street V141min to NC 28401 Parcel Identification Number(PIN): County. R05418-001-001-000 New Hanover County Telephone number: Email address: 231-250-4398 )on.woodworth@fedupfoods.co 4-digit SIC code: Facility is: Date operation Is to begin or began: 2086;2095 ❑New ❑Pro osed 91 Existin Au ust—A Latitude of entrance: Longitude of entrance: 34.217287 N 77.937565 W Brief description of the types of industrial activities and products manufactured at this facility: Kombucha, probiotic soda,cold brew coffee This facilily processes meat: O Yes Rl No If the stormwater discharges to a municipal separate storm sewer system(MS4),name the operator of the M54: ❑N/A City of Wilrnington Page 1 of 5 I Consultant(if applicable): Name of consultant: Consultin firm: Jennifer Verde Anchor&EA Street address: City: State: ZI Code: 231 Haywood Street Asheville NC 28801 Telephone number: Email address: 828-771-0328 jverde@anchorqea.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. SDO-01 I Greenfield Lake C,SW 18-76-1 fl This watershed has a TMDL. Latitude of outfall: Longitude of outfall: 34.218243 -77.938044 Brief description of the industrial activities that drain to this outfall: Generator diesel storage.wastewater Pretreatment, loading and unloading,fermentation tank and tea leaf silo 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? 3-4digitidentifier: Nameof receiving water: Classification: ❑This water isimpaired. Latitude of outfall: Longitude of outfall: El This watershed has a TMDL. Brief description oftheindustrial activities thatdrain to this outfall: Do Vehicle Maintenance Activities occucin:the drainage area of thisoutfall? ❑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. Latitude of outfall: Longitude of outfall: ❑Thls watershed has a TMDL. 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 Latitude of outfall: Longitude of outfall: has a TMDL. 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 NO1. 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: U This facility uses best management practices or structural stormwater control measures. If checked, briefly describe the practices/measures and show on site diagram: Stonnwater retention structure 0 This facility has a stormwater Pollution Prevention Plan(SWPPP). If checked,please list the date the SWPPP was Implemented: 8/2024 ❑This facility stores hazardous waste in the 100-year floodplaln. 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 ofmraste 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): ❑check for$120 made payable to NCDEQ ❑Copy of most recent Annual Report to the NC Secretary of State ®This completed application and any supporting documentation IN 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 0 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 i Page 3 of 5 7. Applicant Certification: North Carolina General Statute 143-215.613(i)providesthat: 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: dam 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. Q 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. (i3 I will abide by all conditions of the NCG060000 permit.I understand that coverage under this permit will constitute the hermit requirements for the discharge(s)and is enforceable in the same manner as an individual permit. (31 hereby request coverage under the`NCG060000 General Permit. Printed Name of Applic,,annt:_0', V/00Z ✓cya: - Title: I LA,4-r !'IAr1A(oER lo. 23, 24 (Sig eo Applicant) (Date Signed) Mail the entire package to: DEMLR—Stormwater Program Department of Environmental Quality 1612 Mail Service Center Raleigh, NC27699-1612 Page 4 of 5 _�AdditionaWfftfal s 3-4 digit Identifier: Name of receiving water: Classification: ❑This water is impaired. Cl 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 receivingwateri - 'Classlfidatidn: ❑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 VehicleMaintenanceActivities occur in the drainage area_ofthis outfall? El Yes El 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? i 3-4 digit identffler: Name of receiving water: Classification: ❑Thls 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 t rat�� r- '�` •��e._ yl ! ILI a`a �KIDDE8.5T ii 1pS ,1 f r�F y. �•1� EE c~ E 1 O..' 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ANCHOR Figure t QEA" Site Location Map Stormwater Pollution Prevention Plan FeclUp Foods-k4 nington l i ti�`T a Yl�y Y� ; ir, �T Fr�Y,/•• •� n C. {,a ..�� "�a--, jF.. @� 777 M t -..-•`" ] T"J T a, -�J .. Y s h AS •:y-v J6 MA rvS "d 1.i al + 1.4 rk S';c.,au V�•�ui, c lr� 41$st 1s,�y� , a-.yy��`-.f ni9! - nt�® i�^t ! Y t •eYG9. �_..11 m.v.iirt x J 7a .;sgx4 9LF}M1w;.Aw wv. I L r .( ~ I� r"Durnpster _- J'�llo�"ad` /Unl ao dln l w 6 r=... -. .-a s-ag,aamw>g '� r ,' `Tt-ew-••t•a T4r't_.,-x-trtla i ati' --?DockSpentrTea7Leaves 511o�+ n (rktTi+ T� r� t � J� 1 L7ransfornnery L T7 � .J ct�•-..n•., 1 +Y ' I�t -2,000-Gallon _.' Generator Belly Tank ' 1�" sn�t�•j'�g ` t r '�� IA \ r f _ }t i Pr��ti` a •q �Ty� �: T3 Fermentation i= �# Oo .:+ 1,21 Tanks J1 Wastewater • " s Pretrea!ent •+'- 0 I y.Y' x fi , i.,-j a-a 1] ri N t 1 x f 1 l r pV JA 1 J t !i r 11 d] t. °x 3er�n 1^---OTM'��Y...s.i� v� �� •art � � �. `�i•". +'hv -*Hv.tj ,: a ?a.� -.r-. "'_••-^^sat 5 �..^' ~..a>r��a,�"•.<-`. '3 it�c: MRvY s s_>f r vtir. 1 R - '.1• �Tanks J;Tl tA 2,000-Gallon Generator Diesel Fuel Tank T2 Transformer T3 Fermentation Tanks " f \®t�Vj. 4� {' Loading and Unloading Areas A,' �•yY r, v ! a�� 11 T^ 11 _ . 1 Generator Dlesel Loading R j t\`�»'� e �'i -r xL ,y''f "k {py�us s• .fir Northwest Dock Tote and Drum T roil 2 Unloading/Product Loading ] +t±S�,., 3 Spent Tea Leaves Silo Loading/Unloadln8 4 A $� "`• l '�'t r r t t T. 9 + }4 Sulid Waste Dumpster '� "�3) I•5 Wastewater Pretreatment Sol'ds gemowl (` \ �A LEGEND: NOTE: 1.Aerial imagery from Esri(2021) o umaysvllle ® Stormdrain Manhole —► Slormwater Pipe 2.Parcel boundaries from New Hanovcr Drop -► tlGngs Grant Slormwater Count GIS. nes are approximate. O P Inlet Slormwater Swale ;.Sewery li 9 Stormwater Leland® Subsuncce5tormwater Facility yIOWilmington , Structure Discharge Line , Approximate Tank Area ,.,..•. L3 Pretreatment System 0 100 I t t Site tnwdon Parcel Boundaries , t - a .1�iln Ja1L.crlpJ:)'::Ln\L.'JJniMS'riJ'HOdiJL':"n p.,y,enn'+PIPA..•...(i..,".p�. ANCHOR Figure OEA w Stormwater Layout Map FedUp Foods-Wilmington Stormwater Pollution Prevention Plan LIMITED LIABILITY COMPANY ANNUAL REPORT 1/6n022 --_ NAME DELIMITED-L-IABILITY-COMPANY: Asheville Kornbucha Mamas, LLC only SECRETARY OF STATE ID NUMBER: '1089900 STATE OF FORMATION: NC E- nine 6ce use Filed Annual Report 1089900 REPORT FOR THE CALENDAR YEAR: 2024 CA202410614921 4/15/2024 01:49 SECTION A: REGISTERED AGENT'S INFORMATION Changes 1. NAME OF REGISTERED AGENT: Buscher, Jeannine 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 242 Derringer Drive 242 Derringer Drive Marshall,NC 28753 Madison County Marshall,NC 28753 SECTION B: PRINCIPAL OFFICE INFORMATION 1.DESCRIPTION OF NATURE OF BUSINESS: Beverage Manufacturer 2. PRINCIPAL OFFICE PHONE NUMBER: (828) 505-5645 3.PRINCIPAL OFFICE EMAIL: Privacy Redaction 4.PRINCIPAL OFFICE STREET ADDRESS 5.PRINCIPAL OFFICE MAILING ADDRESS 242 Derringer Drive 242 Derringer Drive Marshall, NC 28753 Marshall, NC 28753 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: COMPANY OFFICIALS(Enter additional company officials in Section E.) NAME: Jeannine Buscher NAME: Angela Timm NAME: David Gray TITLE: Founder TITLE: Chief Financial Officer TITLE: Chief Executive Officer ADDRESS: ADDRESS: ADDRESS: 242 Derringer Dr 242 Derringer Dr 242 Derringer Dr Marshall, NC 28753 Marshall, NC 28753 Marshall, NC 28753 SECTION D:CERTIFICATION OF ANNUAL REPORT Section D must be completed in its entirety by a person/business entity. Jeannine Buscher 4/15/2024 SIGNATURE DATE Farm must be signed by a Company Official listed under Section C of This form. Jeannine Buscher Founder Print or Type Name of Company Officlal Print or Type Title of Company Official SUBMIT THIS ANNUAL REPORT WITH THE REQUIRED FILING FEE OF$200.00 MAIL TO:Secretary of State, Business Registration Division,Post Office Box 29525.Raleigh,NC 27626-0525 SECTION E:ADDITIONAL COMPANY OFFICIALS SAME: Sarah Mullins NAME: NAME: TITLE: Founder TITLE: TITLE: ADDRESS: ADDRESS: ADDRESS: 242 Derringer Dr Marshall, NC 28753 NAME: NAME: NAME: TITLE: -TITLE: TITLE: ADDRESS: ADDRESS: ADDRESS: NAME: NAME: NAME: TITLE: TITLE: TITLE: ADDRESS: ADDRESS: ADDRESS: NAME: NAME: NAME: TITLE: TITLE: TITLE: ADDRESS: ADDRESS: ADDRESS: NAME: NAME: Name: TITLE: TITLE: TITLE: ADDRESS: ADDRESS: ADDRESS: NAME: NAME: NAME: TITLE: TITLE: TITLE: ADDRESS: ADDRESS: ADDRESS: " ' NORTH CAROLINA pe ��Y�A� partment of the secretary of State CERTIFICATE OF EXISTENCE (Limited Liability Company) 1, ELAINE R MARSHALL, Secretary of State of the State of North Carolina, do hereby certify that ASHEVILLE KOMBUCHA MAMAS, LLC is a limited liability company duly formed, and existing under the laws of the State of North Carolina, having been formed on 25th day of March, 2009 I FURTHER certify that, as of the date of this certificate, (i) the said limited liability company is not dissolved under the terms of its articles of organization, (ii) the said limited liability company's articles of organization are not suspended for failure to comply with the Revenue Act of the State of North Carolina, (iii) that said limited liability company is not administratively dissolved for failure to comply with the provisions of the North Carolina Limited Liability Company Act, (iv) that this office has not filed any decree of judicial dissolution, articles of dissolution, articles of merger, or articles of conversion for said limited liability company. pEPARiM IN WITNESS WHEREOF,I have hereunto set my hand and affixed my official seal at the City of Raleigh, this 25th day of June,2024. Scan to verify online. Certification# 120487373-1 Reference#21643719- Page: 1 of 1 Secretary of State Verify this certificate online at htlps://% w .sosne.gov/verification