NCG210459_NOI Application_20180201

Division of Energy, Mineral and Land Resources
�AStormwater Permitting Program
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� National Pollutant Discharge Elimination System
NCDENR NCG210000 Y40*)7-(0931$9�
NORTM CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
NOTICE OF INTENT
FOR AGENCY USE ONLY
Date Received
Year Month
Da
[e-mail]
Street Address
Certfficate ofCoverage
NCG 11
Check # I AytoiTnt
Permit Assigned to
Fayetteville State NC_
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG210000:
For STORMWATER DISCHARGES associated with activities classified as:
SIC* 24 Timber Products (except as specified below), including Wood Chip Mills;
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.
The following activities are specifically excluded from coverage under this General Permit:
• Wood Kitchen Cabinets (SIC 2434)
• Wood Preserving (SIC 2491) RECEIVED'
• Logging (SIC 2411) (C Er11 n9
* Standard Industrial Classification Code FICA V 1 20 i3
(Please print or type) c DENR-LAND QUALITY
1) Mailing address of owner/operator (address to which official permit coMMOMMMIEUN ailed):
Name Damm Services Corp.
Owner Contact (a person) Jaume Bonavia Bermejo
Street Address 880 Technology Drive Suite 110
City Fayetteville
Telephone No. 011 34 91 535 83 30
E-mail Address [e-mail]
2) Location of facility producing discharge:
State NC ZIP Code 28306
Fax:
Facility Name
Damm Services Group — Fayetteville Service Center
Facility Contact (a person) Jaume Bonavia Bermejo
Contact E-mail
[e-mail]
Street Address
880 Technology Drive Suite 110
City
Fayetteville State NC_
County
Cumberland
Telephone No. 011 34 91 535 83 30
3) Permit Contact
Permit Contact (a person) Jaume Bonavia Bermejo
Contact E-mail [e-mail]
Contact phone number 011 34 91 535 83 30
4) Physical Location Information:
ZIP Code 28306
Fax:
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). From 1-95 BUSS, Left onto Snow Hill Rd, Right onto
Claude Lee Rd, Right onto Research Dr, Left onto Tom Starling Rd, Right onto Production Dr, Right
onto Technology Dr, Destination on the left.
(A copy of a county map or USGS quad sheet with facility clearly located on the map is required to be submitted with this application)
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NCG210000 N.O.I. 3q. q 1 5� q6/ _ r, ff. Opygs­q i
5) Latitude 34056'43.6"N Longitude 78053'25.3"W (degrees, minutes, seconds)
6) This NPDES Permit Application applies to which of the following :
. New or Proposed Facility
❑ Existing
7) Standard Industrial Classification (SIC):
Date operation is to begin January 2018
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: 2448
8) Provide a brief narrative description of the types of industrial activities and products manufactured at
this facility: Procurement, reconditioning and distribution of wood pallets.
9) Discharge points / Receiving waters:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? 3
10) 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? Rockfish Creek
If the 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).
11) Does this facility have any other water quality permits?
. No
❑ Yes
If yes, list the permit numbers for all current water quality permits for this facility:
12) Does this facility have any Non -Discharge permits (ex: recycle permits)?
. No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
13) Does this facility employ any best management practices for stormwater control?
❑ No
. Yes
If yes, please briefly describe: Planned BMPs include maintaining pallets indoors to avoid exposure and
implementation of a housekeeping plan
14) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No
. Yes
If yes, when was it implemented? To be implemented upon beginning of operations in January 2018
15) Does this facility have exposed accumulations of sawdust, bark, mulch, wood chips, or similar size
woody material on-site for longer than seven (7) days? (Exposed directly to rainfall or to run-on from
other areas of the facility.)
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NCG210000 N.O.I.
. No ❑ Yes
16) Are vehicle maintenance activities occurring at this facility?
❑ No . Yes
17) 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
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?
. 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:
18) 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 i same manner as an
individual permit.
I certify that I am familiar with the information contained in this
knowledge and belief such information is true, complete, an 9"'1
Printed Name of Person Signing: Jaume Bonav[a Ber ejo
Title: Director
(Signature of Applicant)
and that to est of my
t�� AM",.
a�
2-012.01 g
(Date Signed)
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to:
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NCG210000 N.O.I.
NCDENR
Final Checklist
This application will be returned as incomplete unless all of the following items have been included:
IC Check for $100 made payable to NC DEN
RI This completed application and all supporting documents
9 Copy of county map or USGS quad sheet with location of facility clearly marked on map
Mail the entire package to:
Stormwater Permitting 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.
To visit our website, go to http://portaLncdenr.orq/weblirlstormwater
DEMLR Regional Office Contact Information:
Asheville Office .. [phone]
Fayetteville Office ... [phone]
Mooresville Office .. [phone]
Raleigh Office .. ... [phone]
Washington Office ..[phone]
Wilmington Office .. [phone]
Winston-Salem ... [phone]
Central Office ....... [phone]
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Recply
FSB 01
201,1
STpRMWA E D QUAt1Ty
SRM1171NG
North Carolina Department of Environment and Natural Resources
Division of Energy, Mineral and Land Resources
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, NC 27699-1612
To Whom It May Concern:
This letter serves to designate the specifically described position listed below as an authorized
person for signing reports, evaluations and performing certain activities requested by the
NCDENR as required for compliance with the National Pollutant Discharge Elimination System.
Position: Plant Manager
By signing this consent I confirm that I have the authority to make such a designation.
I certify under penalty of law that this document and all attachments were prepared under my
direction or supervision in accordance with a system designed to ensure that qualified personnel
properly gathered and evaluated the information submitted. Based on my inquiry of the person
or persons who manage the system, or those persons directly responsible for the gathering the
information, the information submitted, is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting false information,
including the possibility offine and imprisonmentfor knowing violations.
Company N
Project or Si
Signature:
Print Name:
Title:
Director
Date: o l / 2 0/ 20 4