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HomeMy WebLinkAboutNCG030680_COMPLETE FILE - HISTORICAL_20170324STORMWATER DIVISION CODING SHEET ' NCG PERMITS PERMIT NO. DOC TYPE HISTORICAL FILE ❑ MONITORING REPORTS DOC DATE 0 4` � �0 3 ou YYYYMMDD Energy, Mineral and Land Resources ENVIRONMENTAL QUALITY Mr. Byron Bellman General Dynamics Mission Systems 3801 Boren Drive Greensboro, NC 27410 Dear Mr. Bellman: ROY COOPER Govemor M[C,qAEL S. REGAN a� Secretary DAVIS n 0- T- rr � ACY Dyj Director March 24, 2017 0 o CD Subject: General Permit No. NCG030000 General Dynamics Mission Systems COC No. NCG030680 Catawba County In accordance with your application for a discharge permit received on January 25, 2017, we are forwarding herewith the subject certificate of coverage (COC) to discharge under the subject state — NPDES general permit. This permit is issued pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement between North Carolina and the US Environmental Protection Agency dated October 15, 2007 (or as subsequently amended). Please take notice that this certificate of coverage is not transferable except upon approval of the Division of Energy, Mineral and Land Resources. The Division of Energy, Mineral and Land Resources may require modification or revocation and reissuance of the certificate of coverage. This permit does not affect the legal requirements to obtain other permits which may be required by the Division of Energy, Mineral and Land Resources, the Coastal Area Management Act, or any other federal or local government permit that may be required. If you have any questions concerning this permit, please contact Julie Ventaloro at telephone number (919) 807-6370 or by email iulie.ventaloro@ncdenr.gov. Sincerely, for Tracy E. Davis, P.E., CPM, Director Division of Energy, Mineral and Land Resources cc: Mooresville Regional Office, Zahid Khan Central Files Stormwater Permitting Program Files State of North Carolina I Emirouuternal Quality I Energy, Mineral and Land Resources 1612 Mail Service Center 1 512 North Salisbury Street I Raleigh, NC 27699-1612 919 707 9200 T STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY DIVISION OF ENERGY, MINERAL AND LAND RESOURCES GENERAL PERMIT NO. NCG030000 CERTIFICATE OF COVERAGE No. NCG030680 STORMWATER DISCHARGES NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM V1 In compliance with the provision of North Carolina General Statute 143-215.1 _fu other lawl standards and regulations promulgated and adopted by the North Carolina En%nme�l Management Commission, and the Federal Water Pollution Control Act, as atnrded, CP General Dynamics Mission Systems � a is hereby authorized to discharge stormwater from a facility located at General Dynamics Mission Systems SATCOM 1700 Cable Drive NE Conover Catawba County to receiving waters designated as Mull Creek and Long Creek, class WS-IV waters in the Catawba River Basin, in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts 1, 1I, III, and IV of General Permit No. NCG030000 as attached. This certificate of coverage shall become effective March 24, 2017. This Certificate of Coverage shall remain in effect for the duration of the General Permit. Signed this day March 24, 2017. VW'2'!=WN for Tracy E. Davis, P.E., CAI Director, Division of Energy, Mineral and Land Resources By the Authority of the Environmental Management Commission if ((( i �,A { w I k / QYO VL - .�� �~ �;hut ; �r ` .,•. + • ./ �• k "_ -yam _._.vim' � �.�� � �'` 2 -• V I r K�� . General Dynamics Mission Systems SATCOM >T� / ° • •! �'+' (- _ _ E s�w^� _ )did ex 1. ON - , � �i �_. r i �. I /`//''•- \ � /////�`'V -1 ' + J. Imo] `� � � � � fI NCG030680 N W E S Map Scale 124, 000 General Dynamics Mission Systems SATCOM Latitude: 351 42' 27" N Longitude: 810 11' 24" W County: Catawba Receiving Stream: Mull Creek & Long Creek Index No: 11-76-4 & 11-76-5-1 Stream Class: WS-IV Sub -basin: 03-08-32 (Catawba River Basin) r�r Facility Location Energy, Mineral and Land Resources ENVIRONMENTAL OUALITV March 24, 2017 Mr. Byron Bellman General Dynamics Mission Systems 3801 Boren Drive Greensboro, NC 27410 ROY COOPER Governor MICHAEL S. REGAN .Secretary TRACY DAVIS Director Subject: General Permit No. NCG030000 General Dynamics Mission Systems COC No. NCG030680 Catawba County Dear Mr. Bellman: In accordance with your application for a discharge permit received on January 25, 2017, we are forwarding herewith the subject certificate of coverage (COC) to discharge under the subject state — NPDES general permit. This permit is issued pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement between North Carolina and the US Environmental Protection Agency dated October 15, 2007 (or as subsequently amended). Please take notice that this certificate of coverage is not transferable except upon approval of the Division of Energy, Mineral and Land Resources. The Division of Energy, Mineral and Land Resources may require modification or revocation and reissuance of the certificate of coverage. This permit does not affect the legal requirements to obtain other permits which may be required by the Division of Energy, Mineral and Land Resources, the Coastal Area Management Act, or any other federal or local government permit that may be required. If you have any questions concerning this permit, please contact Julie Ventaloro at telephone number (919) 807-6370 or by email iulie.ventaloro&cderingov. Sincerely, for Tracy E. Davis, P.E., CPM, Director Division of Energy, Mineral and Land Resources cc: Mooresville Regional Office, Zahid Khan Central Files Stormwater Permitting Program Files State oENorth Carolina I Environmental Quality I Energy, Mineral and Land Resources 1612 Mail Service Center 1 512 North Salisbury Street i Raleigh, NC 27699-1612 919 707 9200 T STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY DIVISION OF ENERGY, MINERAL AND LAND RESOURCES GENERAL PERMIT NO. NCG030000 CERTIFICATE OF COVERAGE No. NCG030680 STORMWATER DISCHARGES NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the Federal Water Pollution Control Act, as amended, General Dynamics Mission Systems is hereby authorized to discharge stormwater from a facility located at General Dynamics Mission Systems SATCOM 1700 Cable Drive NE Conover Catawba County to receiving waters designated as Mull Creek and Long Creek, class WS-IV waters in the Catawba River Basin, in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II, III, and IV of General Permit No. NCG030000 as attached. This certificate of coverage shall become effective March 24, 2017. This Certificate of Coverage shall remain in effect for the duration of the General Permit. Signed this day March 24, 2017. for Tracy E. Davis, P.E., CPM Director, Division of Energy, Mineral and Land Resources By the Authority of the Environmental Management Commission ` , t _ — • ¢ � r q :. KK (v ~r'�3 • I ' � �11 � J 1pJR1 h�;��_ s 1 \ \ General Dynamics Mission Systems SATCC , rJA - - .� � -` �\�,'� J... � �� k i"� ��� f � ' ice•• BM 79 009 .ice. •y �/!1• /��i 1L1':}- ~�"-� �...'�t, S• ;-YMt,�i r� • � F � 1 r 1 � ; � w� Ili�ek + ,ice ' SJ i`%�• 'I j' _r`- ,.� / } � �- - — / a NCG030680 N W E S Map Scale 124, 000 General Dynamics Mission Systems SATCOM Latitude: 350 42' 27" N Longitude: 810 11' 24" W County: Catawba Receiving Stream: Mu[! Creek & Long Creek Index No: 11-76-4 & 11-76-5-1 Stream Class: WS-IV Sub -basin: 03-08-32 (Catawba River Basin) r?1�+�►`� ��■fit► +�� �r# M Facility Location A r Energy, Mineral and Land Resources ENVIRONMENTAL OVALITY General Dynamics Attention: Mr. Byron Bellmaa fig: 3801 Boren Drive Greensboro, North Carolina 27410 General Dynamics Mission Systems Attention: Mr. Byron Bellman 1700 Cable Drive Northeast Conover, North Carolina 28613 ROY COOPER Governor MICHAEL S. REGAN Secrewry March 14, 2017 MAR 2 0 2017 ILt7,,, Subject: Notice of Inspection NPDES Stormwater Certificate of Coverage- NCG030680 Catawba County, North Carolina Dear Mr. Bellman: TRACY E. DAVIS Director Enclosed please find a copy of the Compliance Inspection Report for the initial inspection conducted at the General Dynamics Mission Systems site on March 8, 2017. The report should be self-explanatory, however, should you have any questions concerning these reports, please do not hesitate to contact me at (704) 663-1699 or by email at Holliday.Keen@ncdenr.gov. Sincerely, Zahid S. Khan, CPM, CPESC, CPSWQ Regional Engineer Land Quality Section Enclosure: Inspection Report W?-,-fStormwater.- ermitting-Programi State of North Carolina j Environmental Quality I Energy, Mineral and Land Resources Mooresville Regional Office 1610 East Center Ave Ste 3011 Mooresville, NC 28115 704 663 1699 T Compliance Inspection Repo Permit: NCGO30680 Effective: Expiration: Owner: General Dynamics Advanced Information Systems SOC: Effective: Expiration: Facility: General Dynamics Mission Systems SATCOM County; Catawba 1700 Cable Dr Ne Region: Mooresville Contact Person: Byron Bellman Title: Directions to Facility: from 1-40 turn south on rock dam rd ne, left on McLin Creek Rd and then right on Cable Drive. System Classifications: Primary ORC: Certification: Secondary ORC(s): On -Site Representative(s): Related Permits: Conover NC 28613 Phone: 336-323-9752 Phone: Inspection Date: 0310812017 Entry Time: 04:30PM Exit Time: 05:00PM Primary Inspector: Holliday Keen Phone: Secondary Inspector(s): Reason for Inspection: Routine Inspection Type: Compliance Evaluation Permit Inspection Type: Metal Fabrication Stormwater Discharge COC Facility Status: ❑ Compliant ❑ Not Compliant Question Areas: Storm Water (See attachment summary) Page: 1 Permit: NCG030680 Owner - Facility: General Dynamics Advanced Information Systems Inspection Date: 03108/2017 inspection Type: Compliance Evaluation Reason for Visit: Routine Inspection Summary: This inspection was performed per the Notice of Intent received by our office on January 25, 2017. Upon inspection, I found that this site is in accordance with the Notice of Intent submitted. I recommend that this site be granted a certificate of coverage under the General Permit NCG030000. Page: 2 Permit: NCG030680 SOC: County: Catawba Region: Mooresville Compliance Inspection Repoli Effective: Expiration: Owner: General Dynamics Advanced Information Systems Effective: Expiration: Facility: General Dynamics Mission Systems SATCOM 1700 Cable Dr Ne Contact Person: Byron Bellman Title: Directions to Facility: from I-40 turn south on rock dam rd ne, left on McLin Creek Rd and then right on Cable Drive. System Classifications: Primary ORC: certification: Secondary ORC(s): On -Site Representative(s): Related Permits: Conover NC 28613 Phone: 336-323-9752 Phone: Inspection Date: 03108I2017 Entry Time: 04:30PM Exit Time: 05-OOPM Primary inspector: Holliday Keen Phone: Secondary Inspector(s): Reason for Inspection: Routine Inspection Type: Compliance Evaluation Permit Inspection Type: Metal Fabrication Stormwater Discharge COC Facility Status: [] Compliant ❑ Not Compliant Question Areas: Storm Water (See attachment summary) Page: 1 Permit NCG030880 Owner - Facility: General Dynamics Advanced Information Systems Inspection Date: 03108/2017 Inspection Type: Compliance Evaluation Reason for Visit: Routine Inspection Summary: This inspection was performed per the Notice of Intent received by our office on January 25, 2017. Upon inspection, I found that this site is in accordance with the Notice of intent submitted. I recommend that this site be granted a certificate of coverage under the General Permit NCG030000. Page: 2 permit: NCG030680 Owner - Facility: General Dynamics Advanced Information Systems Inspection Date: 03108/2017 Inspection Type : Complianoe Evaluation Reason for Visit- Routine Page. 3 `�- Ncco366&6 ADivision of Energy, Mineral and Land Resources Land Quality Section .A �,. NCDENR National Pollutant Discharge Mimination System NCC030000 NOTICE OF I ITENT National Pollutant Discharge Elimination System ipplloatlon for coverage under General Permit NCGO30000: STORMWATER DISCHARGES associated wlth activities classified as: SIC (Standard Industrinl Classification) 335 Rdiing, Dmwirig, and Extruding Gf Norderrom Metals BIG 3398 Metal Heat Treating BIG34 FatancatedMetal Products RECFIVED SIC 35 Industrial unit Commercial Machinery SIC 3e Electronic and Other Electrical Equipment JAN 2 B i'.7 SIC 37 Transportation Equipment SIC 39 Measuring, Analyzing, and Controlling Inotruments DENR-LMO DUALITY STORMWATER PERMI1TiNG For gussoms, planes contact the DEifl R Rsylone! OtRce Ibr your arse. Boa 4. (Pismo print or type) 1) Mailing address or ownodoperator I II Name General Pynamic ATjN: Bymg Bauman Street Address 2N Boren Oriva City GroQosborn Slate AQ_ ZIP Coda 27410 Telephone No. 33"3-9752 Fax: 335:323-g034 2) Location of facility producing discherge. Facility Name fl Facility Contact Byron Bellman Stract Address 1700 Cable Dr Ne CRY Concive Sato VC _ ZIP Code Z= County CaL4da ............ Telephone No. NO-323-9751 Fax: 330-2239&i4 Email Bvron.Bollman®nd-ms.00m 3) Physical Location Information: Pipme provldo a narrative description of how io get to the facility (use atreel names, state road numbers, and distance and direction from a roadway Intersection). From 140 turn south on Rack Dam Rd NE. Left on McUn Creek M and lhon right on Cpble Drive, (A copy of a county map or UWS quad sheaf nisi ro %ditty dsumy located must be submitted Win this apphmaan.) 4) Latitude 3S42' 2B.7" _ Longltude_-Bt W 24.1" (dog, min, sac) 35•910,13y91 lgl.lgo05�> NCGO30000 N.O.I. a) This NPDES Permit Application applies to which of the following: X Now or Proposed Facility pate operation Is to begin 0 Existing 9) Standard Industrial Classification: Provide the 4-digit Standard Industrial Classfficatlon Code (SIC Code) that describes the primary industrial activity at this facility. SIC Code: 3 0 8 3 7) Provide a brief narretive description of the types of industrial activities and products manufactured at this facility: Metal Falxlcation - Industrial qgy((i_fi3med_to storrnwater IneWdet-loadlnu-dvCk area with open dumostilm.god a layOMM area south of the building for -pintos. packaging- p daeuioment (see Photos 1 and 21. 8) Discharge points I Receiving waters: Now many discharge paints (ditches, pipes, Channels, etc.) convey stormwater from the property? 1 What Is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility atormwater discharges and up In? Mull Creek and Lorca Creek _ Receiving water cleaslficatlun: WS-IV and V S-1V Is this a 303(d) fisted stream? _ No Has a TMDL been approved far this watershed? No� If the site storrnwalw discharges to a separate storm sewer system, name the operator of the separate stone sewer system (e.g. City of Raleigh municipal storm sewer). bA 0) Does this facility have any other NPDES permits? x No ❑ Yes If yes, list the permit numbers for all current NPDES permits for this faeAtty: 10) Does this facility havo any Nan-Dischargo parmlts fox: recycle permit)? X NO ❑ Yes If yes, list the permit numbers for all current Non -Discharge permits for this facility: _ 11) Does this facility employ any bast management practices for atormwatsr control? X No ❑ Yes (Show any structural BMPs on the site diagram.) If yes, please Wefly describe: 12) Dow this facility have a Stormwatar Pollution Prevention Plan? X No ❑ Yes If yes, when was A Implemented? 13) Are vehicle maintenance activities occurring at this tactility? X NO Q Yes Page 2 of 4 SVMU-Yta-0it�0a Lest "FOOd VVIA! NCGD30000 N.O.I. 141 Hazardous Waste: a) Is this radllty a Hazardous Wasta Treatment, Storage, or Disposal FadlW X No 0 Yes b) Is this facility a Small Quantify Generator (ion than 1000 kg, ar hazardous waste generated pot morph) of hazardous waste? X No ❑ Yea c) to this faniilty a Large Quantity Generator (1000 kg, or more of hazardous waste generated per month) of hazardous waste? X No ❑ Yas d) is hazardous waste aWmdlnthe 100•yesrflood pUdn? X No ❑ Yes If yes, include information to domonstrata protxtlon from flooding. e) It you answered yes to questions b. or c., please provide the fallowing Information: T)pe(s) of wasta- Harr Is matortal slorad: Mom Is material stored: Haw many disposal shipments per year, Name of transport/ disposed vendor. Vendoraddreaw 15) Cortyflcellom North Carolina General SIBtute 143-216.t1B (1) provides that: Any person who know1r4y mama arrr false e/e*rnwd, mpraeaiddion, or cwdkzb n in end' spprulfon, record, mood, plop, or Ww doaanad lad or regeYad to he malradtad under arh Arable m a rule hwkmagang Iris Adk* er Ow kno,Avtr make a files rtammerd d a msiarrd fed In a nderneking wooeedlan or ovaeslad case under fhb Artkt; or who fohlau, u rrpws wah, or kmwfto rerrdan Inaccurate arrr mawdhp or manawft dents a meawd mgurad to tw ep*rapatl a mektaked undu arh Arable a n doe of to Co nnrMsk w ki*mw the eft Arad* char he pulky de Clan 2 mbdameanor which soy Imirda a frw not to nwmW San thoueend doAKs (910,0Da). I hereby raqueet coverage under the referenced Genora4 Permit. I understand that coverage udder this pem* will, oonanttrts the permit requltoments for the dlsoharge(e) and Is enforceable In the same mariner as an Individual permit. I certify Owl I am familiar with the Information contained In this appocavo n and that to the best of my knowledge and ballet such Uftrnatiorl le true, complete, end accurate. Printed Name of Person Signing: TI((9: 1_,CAr 4L --- ( arms of Appftcen0 (Difte Signed) This Notice of Intent must be accompanied by a cheek or money ardor for $100.00, made payable to: NCDENR Page 3 of 4 aWU-216-a11405 Lea$ rawhed 7MM4 tf NCGO3000D N.O.I. Final Checklist This application will be returned as incomplete unless all of the following atoms have been Included: X Check for $100 made payable to NCI NR. X This Completed appllcatlon and all supporting documents. X A site diagram showing, at a minimum, (existing or proposed): (a) outline of drainage areas, (b) etormwater management atructures, (c) location of stormwater nutfalls corresponding to the drafnaga areas, (d) runoff conveyance features. (a) areas where materials are stored, (f) impervious areas, (9) site property lines. X Copy of County map or USG$ quad sheet with the location of the facility oleany marked on the map. Mall the entire package to: Stormweler Permitting Unit Program Division of Energy, Mineral and Land Resources 1012 Mall Service Center Raleigh, North Carolina 27809-1612 M212 The submiasion of this document does not guarantee coverage under the General Permit For quea fans please sorted Um DFMLR Regional Office lbryour arcs. I7EMLR Reafonel Office Contgyt lffR! atlon: Asheville Office ...... (828) 29&4600 Fayetle4o Office ... (910) 433-3300 Mooresville Office ... (704) 603.1099 Raleigh Office ........ (019) 791-4200 Washington Office ...(262) 948$481 Wilmington Office ... (910) 790-7215 Winston-Salem ...... (336) 771-5000 Central Office .........(919) 807-6300 Page 4 of 4 SWU-21"71409 Last rmime MV14 �1 rr VR n=Jaanmxa ia:iuwewo dopyaNldwBcdolaean Dog gngrW#oWoo gelu& mm'u a u+ebw muva WN LBl'4 454 uapwan'1 �71B '>•n'+nq�l�l+lYul v++W+u' 3 :Wool �++wN+gwa wwy 2UUOJN'J WJON'JONOIJG'j W��0-M Jak7aqM MIS04 :owc '+N� i -I 9�IvvwKL a wtp3 BD y'� - l Ux IV .#.'F0 Iwo ���r ! �. •' 4^}b" y �. I k"s++fir " i. f� �� !i Project Loc&Uon W !i 6:�ti' '.t', Z ��� �, • �'� ���4 I! �' !1� irPt,r PN7u;i t fib! i, it z�r1h�^Nir1` F� . "'� 6 � ��� •` �Y i�{y, �I �J`S -��r "n " � edli IRS its .'ru} i�'ii }a'�nS'i �Ils ,lvl�t l4 !'�.�' mow. •'yW±•:` �; w ��1:w�y�. FS Jrtt.�i"CLi`S" 1�4"�. ATQWqF Division of Energy, Mineral and Land Resources , 4 • • Land Quality Section � . National Pollutant Discharge Elimination System NCDENR rrcG030000 NOTICE OF INTENT FOICA-GENCY USE ONLY Mrarea�r:��z=«rj . ,I. m 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 RECEIVED SIC 35 Industrial and Commercial Machinery SIC 36 Electronic and Other Electrical Equipment JAN 252017 SIC 37 Transportation Equipment SIC 38 Measuring, Analyzing, and Controlling Instruments DENE?-LAND OUALITY STORMWATER PERMITTING For questions, please contact the DEMLR Regional Office for your area. See page 4. (Please print or type) 1) Mailing address of owner/operator (address to which all permit correspondence will be mail: Name Street Address City Telephone No. General Dynamic ATTN: Byron Bellman 3801 Boren Drive Greensboro 336-323-9752 2) Location of facility producing discharge: State NC _ ZIP Code 27410 Fax: 336-323-9634 Facility Name General Dynamic Mission Systems SATCOM Facility Contact Byron Bellman Street Address 1700 Cable Dr Ne City Conover State NC ZIP Code 28613 County Catawba Telephone No. 336-323-9752 Fax: 336-323-9634 Email Byron.Beliman d-ms.com 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 140 turn south on Rock Darn Rd NE. Left on McLin Creek Rd and then right on Cable Drive. (A copy of a county map or USGS quad sheet with the facility clearly located must be submitted with this application.) 4) Latitude 3542' 26.7" Longitude _-81.11' 24.1" (deg, min, sec) 3b•��'73`f of -S!. �Roob�> NCG030000 N.O.I. 5) This NPDES Permit Application applies to which of the following: X 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: 3 ti 6 3 7) Provide a brief narrative description of the types of industrial activities and products manufactured at this facility: Metal Fabrication - Industrial activity exposed to stormwater includes loading dock area with open dumpsters and a laydown area south of the building for crates, packaging, and equipment (see Photos 9 and 2).- 8) Discharge points 1 Receiving waters: How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property.? 2 What is the name of the body or bodies of water (creels, stream, river, lake, etc.) that the facility stormwater discharges end up in? Mull Creek and Long Creek Receiving water classification: WS-IV and WS-IV Is this a 303(d) listed stream? No Has a TMDL been approved for this watershed? No 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). NA 9) Does this facility have any other NPDES permits? X No ❑ Yes If yes, list the permit numbers for all current NPDES permits for this facility: 10) Does this facility have any Non -Discharge permits (ex: recycle permit)? X No ❑ Yes If yes, list the permit numbers for all current Non -Discharge permits for this facility: 11) Does this facility employ any best management practices for stormwater control? X No ❑ Yes (Show any structural BMPs on the site diagram.) If yes, please briefly describe: 12) Does this facility have a Stormwater Pollution Prevention Plan? X No ❑ Yes If yes, when was it implemented? 13) Are vehicle maintenance activities occurring at this facility? X No ❑ Yes Page 2 of 4 CWI l_91 R1171 Ann NCG030000 N.O.I. 14) Hazardous Waste: a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal i=acility? X No ❑ Yes b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of hazardous waste? X No ❑ Yes c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of hazardous waste? X No ❑ Yes d) Is hazardous waste stored in the 100-year food plain? X No ❑ 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 f disposal vendor: Vendor address: 15) Certification: North Carolina General Statute 143-215.6B (i) provides that: Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan, or other document flied 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 rulamaking 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 Braude a fine not to exceed tent 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: &d Title: e!E2& 1ik 4au1 /lJ//7 (Signature of Applicant) (Date Signed) This Notice of intent must be accompanied by a check or money order for $100.00, made payable to: NCDENR Page 3 of 4 SWU-218-071408 fast revised M14 NCG030000 N.O.I. Final Checklist This application will be returned as incomplete unless all of the following items have been included: X Check for $100 made payable to NCDENR. X This completed application and all supporting documents. X 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. X 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 ...... (828) 296-4500 Fayetteville Office ... (910) 433-3300 Mooresville Office... (704) 663-1699 Raleigh Office ........ (919) 791-4200 Washington Office ...(252) 946-6481 Wilmington Office ... (910) 796-7215 Winston-Salem ...... (336) 771-5000 Central Office .........(919) 807-6300 Page 4 of 4 5WU-218-071408 Last revised 7/2l14 ..',N tsw > s s.-a'�r.ti.,-��`. �. - _ :lt ,, �•_a� is ., T..,'r• is ?i r4 IF ' ) fir✓ } _"y - � � ^ �t� _ �a � -s-. �i-`�'. >"7 .�. p�� �„av .y'„ � . "'0Z -y"Yfr Ali 1. Al �~ r` ��•,�{ -t'S-� '•' ' ~ � s ;•�./ . 'ys• ems_ ,. fr ��.��� * `4 J� iF _ .,. J_ �'.•l"� .;� �+f ii;•�.�.. - + '4 �� �5..- -i - '���* y •�y,. - ij. �.. �� �: ..' _ hy,;yi `"t* fj.r,M1 i' ' ov A 1 .' �. `t � • Y .,r'y_� , ` v� �# T •��.L ��'� a - - T .f #a lir t � Y' 4` '� 4!iL +.A. x _ Y � V 1 � , � •�u i•Iti { _ ^'�,y..N � Y ( �� � Y � 5 � ; � a+ - * .� u: t'�t r�i � ` ;Y xr• y ,.� !![[��.. � Y��� � a , � � � ��� .{�• �yy�,� � `j , �` ��L-,. ,noµ- � � � ,� , i ".71 +�•�;.^ r � `,,�} �! 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