NCG130082 - PolyReps, Inc.

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NCDENR
No- CARoI DECARTweNT or
ENVIRONMENT AND NR RAI- Rmou Rces
NOTICE OF INTENT
Division of Energy, Mineral and Land Resources
Land Quality Section
National Pollutant Discharge Elimination System
N C G 130000
FOR AGENCY USE ONLY
Date R
Year
heived
M
Certtfic t%t
NICIGI 1Kj' -,r8
Chad, AmouPt
Permit Asst ed to
Pf T -yr SO
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG130000:
STORMWATER DISCHARGES associated with activities classified as:
The wholesale trade of non-metal waste and scrap (hereafter referred to as the non-metal waste
recycling industry) a portion of SIC* 5093; 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*
WA)
The following activities are specifically excluded from coverage under this General Permit:
• Establishments primarily engaged in the wholesale trade of metal waste and scrap, iron and steel
scrap, and nonferrous metal scrap (hereafter referred to as the metal waste recRjiX,s99try)
• Establishments primarily engaged in waste oil recycling ci i t/ D
• Establishments primarily engaged in automobile wrecking for scrap JUL 07 20'
"Standard Industrial Classification Code DENR-LAND QUALITY
STORMWATER PERlvlll-TING
(Please print or type)
1) Mailing address of owner/operator (address to which all permit correspondence will be mailed):
Name
Street Address
City
Telephone No.
E-mail Address
VOL-1piePS 10C• f AdX-( 1«oPEW t✓ ' OPEaA►Z%3NS M& -►2
541 .smr-AAFr AAte
KV p -o l~ State P C_— ZIP Code ."L'g I 1 cD
70L1 23%-ti'ct'-tct Fax: 70LI ;.3C- Ssl?
13. ki0-ceAE u N e-
tb &A%T0e-4_ e
2) Location of facility producing discharge:
Facility Name
Facility Contact
Contact E-mail
Street Address
City
County
Telephone No.
Llc/
a..-( AA= -'P S , Lo w-
OL -1 tied S , c'o
G
Hank-® a State N C- ZIP Code XT 11 o
L)WON
7709 23C-01949 Fax:' 7.38
3) Physical Location Information:
Please provide a narrative description of how to get to the facility (use street names, state road numbers, and
distance and direction from a roadway intersection). `74 T -,o )AMIL-Y.-V P io
(A copy of a county map or USGS quad sheet with facility clearly located on themapis required to be submitted with this application)
A 9 #I a
4) Latitude '14 55 ) H A Longitude 90 30 I *9 (degrees, minutes, seconds)
`' I Page 1 0 4
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NCG130000 N.O.I.
5) This NPDES Permit Application applies to which of the following :
❑ New or Proposed Facility Date operation is to begin
Existing
6) Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: _S� 0
7) Provide a brief
this facility:
of industrial activities and products manufactured at
G'4SioV6NP_0..
8) Discharge points:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? 3
9) Receiving waters:
What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater
discharges end up in? ? QN", AQ\)Some cP eeV_ 3(` fJo rWA7-'d-iAL_ 1N -AS 6e N
to U ,. b ; tom+ CQI✓C V_
Ifthe site stormwater discharges to a separate storm sewer system, name the operator of the separate storm
sewer system (e.g. City of Raleigh municipal storm sewer).
10) Does this facility have any other NPDES permits?
No
❑ Yes
If yes, list the permit numbers for all current NPDES permits for this facility:
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
A No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
12) Does this facility employ any best management practices for stormwater control?
❑ No
luf
Yes
If ye , please briefly describe:
iLT 0- BA 441 K4.S AT At.L_ AvN ® A&e A $
19.sTO_A_ .r A L_ h -j 5—.. r 'V_L c.T to W S'e 3 i'e
13) Does this facility have a Stormwater Pollution Prevention Plan?
.X No
❑ Yes
If yes, when was it implemented?
14) Are vehicle maintenance activities occurring at this facility?
❑ No XYes AL�L_ vASHOawtj S o -F
A' s i -Te A -r A 660%;Uc rc I a.l_ APA -t2 Cc Par6_A.
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NCG130000 N.O.I.
15) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
ha ardous waste?
No El
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
h ardous waste?
No ❑ Yes
d) If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste:
How Is material stored:
Where is material stored:
How many disposal shipments per year:
Name of transport / disposal vendor:
Vendor address:
16) Certification:
North Carolina General Statute 143-215.6 b (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; or who knowingly makes a false
statement of a material fact in a rulemaking proceeding or contested case under this Article, or who falsifies, tampers with, or knowingly
renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
[Environmental Management] Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine not to
exceed ten thousand dollars ($10,000).
I hereby request coverage under the referenced General 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 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:
Title: _-nE (A 1 1 o �-/ S_
Applicant)
VAP-Q'jt V,P o L.4 rJ
vNAA v -A C— ✓L
(Date Signed)
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to NCDENR
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SW U-228-071408
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NCG130000 N.O.I.
Final Checklist
This application will be returned as incomplete unless all of the following items have been included:
❑ Check for $100 made payable to NCDENR
❑ This completed application and all supporting documents
❑ Copy of county map_or_USGS-quad-sheet-withaocation of facility clearly marked on map,
Mail the entire package to:
Stormwater and General Permits Unit Program
Division of Energy, Mineral and Land Resources
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Note
The submission of this document does not guarantee the issuance of an NPDES permit.
For questions, please contact the DEMLR Central Office or Regional Office for your area.
DEMLR Regional Office Contact Information:
Asheville Office ...... [phone]
Fayetteville Office .
Mooresville Office.
Raleigh Office ......
Washington Office
Wilmington Office.
Winston-Salem ...
Central Office ......
[phone]
[phone]
[phone]
... [phone]
[phone]
[phone]
... [phone]
Page 4 of 4
SWU-228-071408 Last Revised 6/24/14

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