NCG030690 - Clayton Machine Development Center

Division of Energy, Mineral and Land Resources
4 • Land Quality Section
National Pollutant Discharge Elimination System
NCDENR
140 T CAROLINA DEPARTMENT OF NCG030000
E-RONMENT AND NATURAL RESOURCES
NOTICE OF INTENT
FOR AGENCY USE ONLY
Date Received
Year
Month
Da
Industrial and Commercial Machinery
SIC 36
Electronic and Other Electrical Equipment
Certificate of Coverage
N C G 0 3
Check # Amount
Peanut Assigned to
Measuring, Analyzing, and Controlling Instruments
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG030000:
STORMWATER DISCHARGES associated with activities classified as:
SIC (Standard Industrial Classification) 335 Rolling, Drawing, and Extruding of Nonferrous Metals
SIC 3398
Metal Heat Treating
SIC 34
Fabricated Metal Products
SIC 35
Industrial and Commercial Machinery
SIC 36
Electronic and Other Electrical Equipment
SIC 37
Transportation Equipment
SIC 38
Measuring, Analyzing, and Controlling Instruments
I
t_ IFor questions, please contact the DEMLR Regional Office for
� _
(Please print or type)
CEIV80
80
JAN JP 2�
area. Seepage 4.
1) Mailing address of owner/operator (address to which all permit correspondence will be mailed):
Name Caterpillar Inc.
Street Address 100 NE Adams Street
City Peoria State IL ZIP Code 61629
Telephone No. 309-675-1000" Fax:
2) Location of facility producing discharge:
Facility Name
Facility Contact
Street Address
City
County
Telephone No.
Email
Clayton Machine Development Center
Van Ellis
1167 NC 42 East
Clayton State NC _ ZIP Code 27520
Johnston
919-550-6924 Fax: [phone]
Ellis—Van—[e-mail]
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). Follow US -70 East, turn left onto 42 East.
Travel 1.3 miles and turn left onto Glen Laurel Road. Travel 1 mile to CMDC.
(A copy of a county map or USGS quad sheet with the facility clearly located must be submitted with this application.)
4) Latitude 35°38'14.05" N Longitude 78°29'05.84" W (deg, min, sec)
Page 1 of 4
SWU-218-071408 Last revised 7/2/14

NCG030000 N.O.I.
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
hazardous waste?
® No ❑ Yes
C) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
d) Is hazardous waste stored in the 100 -year flood plain?
® No 0 Yes If yes, include information to demonstrate protection from flooding.
e) 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:
15) Certification:
North Carolina General Statute 143-215.613 (1) 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 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 Peron Signing: V14 Aj
Title: �1�� /r"��tss��✓�L
(Signa(`ure ofAppfcant) (Date Signed)
This !Notice of Intent must be accompanied by a check or money order for $100.00, made payable to:
Final Checklist
Page 3 of 4
SWU-218-071408 Last revised 7/2/14

NCG030000 N.O.I.
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.
® A site diagram showing, at a minimum, (existing or proposed):
(a) outline of drainage areas, (b) stormwater management structures, (c) location of stormwater outfalls
corresponding to the drainage areas, (d) runoff conveyance features, (e) areas where materials are stored,
(f) impervious areas, (g) site property lines.
® Copy of county map or USGS quad sheet with the location of the facility clearly marked on the map.
Mail the entire package to:
Stormwater Permitting 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 coverage under the General Permit.
For questions, please contact the DEMLR Regional Office for your area.
DEMLR Regional Office Contact Information:
Asheville Office ......
[phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
[phone]
Washington Office ...(252)
946-6481
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........(919)
807-6300
Page 4 of 4
SWU-218-071408 Last revised 7/2/14

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TITLE CLIENT'
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Environment & Infrastructure, Inc. CONSTRUCTION PRODUCTS DIVISION
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Durham, NC 27703 `�A� SITE.
[phone] amec _ CATERPILLAR INC SCALE: AS SHOWN DATE 12/07/2016 PROJECT: 6480166087
CLAYTON MACHINE DRAWN BY: WBM CHECKED BY, GTJ
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CATERPIUAR INC
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PEORIA, IL 61629
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