NCG520123_Application_20180911

A o Division of Water Resources_ FOR AGENCY USE ONLY
° p National Pollutant Discharge Elimination System(NPDES) Date Received
114 _ ' ° INApplication for Coverage Under General Permit Year Month Day
pp'� ��o0
2,o1Q7 DSI
to
N CG 520000 Certificate of Coverage
Sand Dredging operations and similar point source discharges NC G 5 2 0 a
Check# Amount
NOTICE OF INTENT 5-41 QOa5r) _
[Required by 15A NCAC 02H.0127(d)]; [term definition see 15A NCAC 02H.0103(19)] Assigned To.
(Please print or type)
RECEIVED/DENR/DWR
1) Mailing address of owner/operator: (address to which all correspondence should be mailed)
Company Name—rtx_ lce'I POLY Ug GAA AS \ACd,(sf' CO SEP 4 2018
Owner Name jG41N L. cckc.0 Water Resources
Permitting Section
Street Address is to po,-W\ "Win) S•'Y cq
City 1‘etAtiscwvMe State NC ZIP ag70-a
Telephone# ( - ( Ci 3, $7H Fax# C (ci3- 2 CM
Cell/Mobile# Email
2) Location of facility producing discharge:
Facility Name No )c& e \ `J
Facility ContacfTq\,hcc\ NI1pD
Street Address app�l QGa fwV gorge
City I-\eNckcso}JV'e`\c State Nc ZIP 8 7-q g
County v e_N citzxr U
Telephone# Fax#Cga��• (a3-874t) Cga$)P 69,3-3680
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). ") \e -)�p,�('0I` OT C\AV C\f z Z &vadf C\SO a\ Oki '�p
l cci 4 1�( _l 0500 ,Oe.. 1JLl4w ) OM A-14, tc �--
(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)
4) This NPDES permit application applies to which of the following :
ew[term definition see 15A NCAC 02H.0103(16)]or Proposed
❑ Modification
Please describe the modification:
❑ Renewal
Please specify existing permit number and original issue date: Click here to enter a date.
Page 1 of 4 Revised 9/1/13

NCG520000 New Application
5) Does--esthis facility have any other NPDES permits [term definition see 15A NCAC 02H.0103(15)1?
L►1 N o
❑ Yes-If yes,list the permit numbers for all current NPDES permits for this facility:
6) Description of Discharge: [Required by 15A NCAC 02H .0105(c)(l)1
a) Is the discharge directly to the receiving water? • Yes ❑No-If no,submit a site map with the pathway
to the potential receiving waters clearly marked.This includes tracing the pathway of the storm sewer to the
discharge point,if the storm sewer is the only viable means of discharge.
b) 'Number of discharge points(ditches,pipes,channels,etc.that convey wastewater from the property):
c) Volume of discharge per each discharge point(in GPD): #1: #2: #3: #4
d) Please describe the type of process the sand dredging wastewater is being discharged from,be specific:
e-1s 0c ave SCeovcA V4vm C'rc GIJCe SekNo'k S RVa_ccd- cr., 5\CavIA\
11Ae WyvVeY bcscx, N\ -1'Ine Pm.
e) Is there any treatment bemg applied to tne wastewater before discharge(check the type of treatment in use).
❑ Settling pond
❑ Lagoon
one
❑ Other:
f) How much of the volume discharged is treated(state in percent)? O "
g) If any box in item(e)above,other than none,was checked,please include design specifics(i.e., design
volume,retention time,surface area,etc.)with submittal package. Existing treatment facilities should be
described in detail. Design criteria and/operational data(including calculations)should be provided to
ensure that the facility can comply with the requirements of the General Permit,as required by 15A NCAC
02H.0127.
The treatment shall be sufficient to meet with the limits set by the general permits. The trapping efficiency
should be greater than 75%. The surface area should be as large as possible to insure sedimentation occurs.
To secure optimum efficiency the flow length of the basin to the basin width should have a ratio of 2:1.
Note: Construction of any wastewater treatment facilities requires submission of three(3)sets of plans and
specifications along with the application. Design of treatment facilities must comply with requirements of
15A NCAC 02H.0138. If construction applies to this discharge,include the three sets of plans and
specifications with this application.
7) Discharge Frequency: [Required by 15A NCAC 02H.0105(c)(1)1
a) The discharge is: ❑ Continuous ❑ Intermittent easonal
i) If the discharge is intermittent,describe when the discharge will occur:
ii) If seasonal check the month(s)the discharge occurs: ❑ Jan. ❑Feb. Lg'l . L Apr• [ IayLy"r
[ ul ❑ Sept. ❑ Oct. ❑Nov. ❑Dec.
b) How many days per week is there a discharge? p(ik_ au ReSu�cec �A1cebC1� ects S,
c) Please check the days discharge occurs: ❑ Sat. ❑ Sun. ❑ Mon. Lfue. ❑Wed. calc. ❑ Fri.
8) Receiving waters: [Required by 15A NCAC 02H.0105(c)(1)] C '""S COC PJG} Wtipc1
a) What is the name of the body or bodies of water(creek,stream,river,lake,etc.)that the facility wastewater
discharges end up in? If the site wastewater discharges to a separate storm sewer system(4S),name the
operator of the 4S(e.g.City of Raleigh). C eekr C`rkc V( Cl�- f;,C 6&efSo{ k
b) Stream Classification: C\(` q<
Page 2 of 4 Revised 9/1/13

NCG520000 New Application
CERTIFICATION
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 Q.xviCKgct.CC
Title:
(Please review 15A NCAC 02H.0106(e)for authorized si gn=cials)
Click here to enter a
date.
(Signature of Applicant) pate Signed) Og/20tF
North Carolina General Statute$143-215.6B 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). 18 U.S.C. Section
1001 provides a punishment by a fine or imprisonment not more than 5 years, or both,for a similar offense.
This application must be accompanied by a check or money order for$100.00 [per G.S..$143-
215.3(a)(tb)]made payable to:
NCDENR
® © eoe
Mail this application and one copy of the entire package (with check) to:
NC DENR/DWR/Water Quality Permitting Section
1617 Mail Service Center
Raleigh,North Carolina 27699-1617
Attn: Charles Weaver
Final Checklist
This application will be returned as incomplete, as allowed by 15A NCAC 02H.0107(b),unless all of the
following items have been included:
17,--Complete application with all supporting documents(plus one copy of entire package)
❑✓Check or money order for$100.00,payable to NCDENR
©-3-copies of county map or USGS quad sheet with location of facility clearly marked on map
sets of plans and specifications signed and sealed by a North Carolina P.E.
2- horough responses to items 1-10 on this application
❑ Alternatives analysis including present value of costs for all alternatives
Note: The submission of this document does not guarantee the issuance of an NPDES permit
Page 4 of 4 Revised 9/1/13

NCG520000 New Application
9) Alternatives to Direct Discharge:
[Evaluation required by G.S. § 143-215.1(b)(5)(a)and 15A NCAC 02H.0105(c)(2)]
Address the feasibility of implementing each of the following non-discharge alternatives
a) Connection to a Municipal or Regional Sewer Collection System
b) Subsurface disposal(including nitrification field,infiltration gallery,injection wells, etc.)
c) Spray irrigation
The alternatives to discharge analysis should include boring logs and/or other information indicating that a
subsurface system is neither feasible nor practical as well as written confirmation indicating that connection to a
POTW is not an option. It should also include a present value of costs analysis as outlined in the Division's
"Engineering Alternatives Analysis(EAA) Guidance Document".
Additional Application Requirements:
For new or proposed discharges,the following information must be included in triplicate with this
application or it will be returned as incomplete. Per 15A NCAC 02H.0105(c)
a) 7.5 minute series USGS topographic map(or a photocopied portion thereof)with discharge
location clearly indicated.
b) Site map, if the discharge is not directly to a stream,the pathway to the receiving stream must be
clearly indicated. This includes tracing the pathway of a storm sewer to its discharge point.
c) If this application is being submitted by a consulting engineer(or engineering firm), include
documentation from the applicant showing that the engineer(Or firm)submitting the application
has been designated an authorized Representative of the applicant;per 15A NCAC 02H
.0138(b)(1).
d) Final plans for the treatment system(if applicable). The plans must be signed and sealed by a
North Carolina registered Professional Engineer and stamped-"Final Design-Not released for
construction;"per 15A NCAC 02H .0139.
e) Final specifications for all major treatment components(if applicable). The specifications must be
signed and sealed by a North Carolina registered Professional Engineer and shall include a
narrative description of the treatment system to be constructed; per 15A NCAC 02H.0139.
Page 3 of 4 Revised 9/1/13

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