NCG050443_Application_20190307

NCUC.)t5o4��
Qaulrt y
Division of Energy, Mineral and Land Resources
Land Quality Section
National Pollutant Discharge Elimination System
NCGO50000
FOR AGENCY USE ONLY
Date Received
Year
Month Da
0_7
Certificate ofCovera e
N G
Check #
Amount
Permit Assigned to
s•
NOTICE OF INTENT
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG050000:
STORMWATER DISCHARGES associated with activities classified as:
Wv
51(;, L;i Apparel and Other Finished Products Made from Fabrics and Similar Mftj% Gd 811dMVWIS
SIC* 265 Paperboard Containers and Boxes ADIVII10 ONVTINK
SIC* 267 Converted Paper and Paperboard Products A
SIC" 27 Printing, Publishing and Allied Industries 6191 LID 8VW
SIC* 30 Rubber and Miscellaneous Products (except as specified below) �. ������,�
SIC* 31 Leather and Leather Products (except as specified below) V
SIC* 39 Miscellaneous Manufacturing Industries
SIC* N/A 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:
SIC* 301 Tires and Inner Tubes
SIC' 311 Leather Tanning and Finishing
Standard Industrial Classification Code
(Please print or type)
1) Mailing address of owner/operator (address to which all permit correspondence will be mailed):
Name DS Smith Packaging -Asheboro
Street Address 3021 Taylor Drive
City Asheboro State NC ZIP Code 27203
Telephone No. 336 498-1700 Fax; 336 498-1972
E-mail Address [e-mail]
2) Location of facility producing discharge:
Facility Name DS Smith
Facility Contact Kimberly Bostic
Contact E-mail [e-mail]
Street Address 3021 Taylor Drive
City Asheboro State NC ZIP Code 27203
County Randolph
Telephone No. 336 391-6365 Fax: [phone]
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). From US 311 S, turn right onto Wesleyan Rd, turn right onto US-220 BUS
S/S Main St., turn right onto Commerce PI., turn right onto Taylor Dr.
(A copy of a county map or USGS quad sheet with facility clearly located on the map is required with this application)
4) Latitude 35°46'57" Longitude-079°49'01° (degrees, minutes, seconds)
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NCGO50000 N.O.I.
5) This NPDES Permit Application applies to which of the following :
❑ New or Proposed Facility Date operation is to begin
0 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: 2 6 5 3
7) Provide a brief narrative description of the types of industrial activities and products manufactured at
this facility: F;3Qiib prQduGQ5 QQrrUg.ated paper ah �Cl� I�min�tQ� porr�g�tQ�.paper sheet. Manufacturina
processes include: processing paper through a corrugating machine, gluing fluted sheets to paper, cutting
corrugated board to specified widths and print board using water -based inks.
8) Discharge points:
How rriany discharge pulirls (ditches, pipes, uhaimels, eic.) convey stunnwater from [Ile properly'?
t ist discharge points (cxitfallS) that convey discharge from the. site. (both on -site. and off -site) and location
coordinates. Attach additional sheets if necessary, or note that this information is specified on the site plan.
Stormwater Outfall No. 01
Latitude (degrees/minutes/seconds): 35°46'58"
N
Longitude (degrees/minutes/seconds): -079°49'04"
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds):
N
Longitude (degrees/minutes/seconds):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds):
N
Longitude (degrees/minutes/seconds):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds):
N
Longitude (degrees/minutes/seconds):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds):
N
Longitude (degrees/minutes/seconds):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds):
N
Longitude (degrees/minutes/seconds):
W
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NCG050000 N.O.I.
Stormwater Outfall No.
Latitude (degreeshninules/se(xiids). _
Longitude (degrees/minutes/seconds):
9) Receiving waters:
N
W
What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater
discharges end up in? An unnamed creek that potentially drains in to Back 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). "I^
10) Does this facility have any other NPDES permits?
0 No
❑ Yes
If yes, list tllo permit nuirlhurs for all cuireirl NPDES pennlls rur llllry raclllly.
11) 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:
12) Does this facility employ any best management practices for stormwater control?
❑ No
11 Yes
If yes, please briefly describe: Raw materials and finished product are stored indoors or under cover.
Routine inspections are conducted to ensure good housekeeping measures are implemented.
13) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No
Yes
If yes, when was it implemented? August 2018
14) Are vehicle maintenance activities occurring at this facility?
❑ No 4 Yee
15) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
11 No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
11 No ❑ Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
11 No ❑ Yes
d) If you answered yes to questions b. or c., please provide the following information:
Types) of waste: N/A - Facility is a Very Small Quantity Generator
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NCGO50000 N.O.I.
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 krrowiiigly
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: Jeff McNeill
Title; Qen r Manager
c - — la-g% i�
( g t e of Applicant) (Date Signed)
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to NCDEQ.
.Fr,EI V ED
Ili 07 2019
DENR-LAND QUALITY
S I ORMWATER PERMITTING
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NCGO50000 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 NCDEQ
�1 This completed application and all supporting documents
l� Copy of county map or USGS quad sheet with location of facility clearly marked on map and nearby waters
Mail the entire package to:
DEMLR - Stormwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699 1612
Nate
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
... [phone]
Mooresville Office
... [phone]
Raleigh Office ........
[phone]
Washington Office
...[phone]
Wilmington Office
... [phone]
Winston-Salem ......
[phone]
Central Office .........(919)
807-6300
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KLEINFELDER 9009 Perimeter Woods Dr., Suite H ( Charlotte, NC 1704.598.1049 1 www.kleinfelder.com

KL E/NFEL LEER
Bright People. Right Solutions.
February 26, 2019
Kleinfelder Project No. 20190687.001A
DEMLR-Stormwater Program
Department of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27669-1612
P�^1�l
i47 07 7019
DENR_LAA1.ra Q#1gllTy
<STQRMWATER PER1,il1'i7NG
Subject: DS Smith — Stormwater Permit Notice of Intent
Asheboro, North Carolina
Dear Sir or Madam:
On behalf of DS Smith Packaging - Asheboro, Kleinfelder is submitting the enclosed NDPES
application for coverage under General Permit NGGO50000 and associated facility location map.
Should you require any additional information, please contact Ms. Christine Brenk at
704.378.9175 or Ms. Kimberly Bostic at 336.391.6365.
Sincerely,
KLEINFELDER, INC.
Christine K. Brenk, CHMM
Principal Professional
20183644.001A { CLt18L74867 Page 1 February 26, 2019
G 2019 Kleinfelder www.kleinfelder.com
9009 Perimeter Woods Dive, Suite H. Charlotte, NC 26216 N 1 704.593.1049 F 1704.598 1050