NCG080221_COMPLETE FILE - HISTORICAL_20171108

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
IV C& Q"gb a a�
DOC TYPE
� HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ loil I I di
YYYYMMDD

Division of Energy, Mineral, and Land Resources
Land Quality Section 1 Stormwater Program
National Pollutant Discharge Elimination System (NPDES)
Energy, Mtneral & PERMIT OWNER AFFILIATION DESIGNATION FORM 11� -`
Land Resources
14
E�JVIRONM ENTAL QUALITY (individual Legally Responsible for Permit) Arr1 V Al
•i �
Use this form if there has been: Lai
NO CHANGE in facility ownership or facility name, but the individual
who is legally responsible for the permit has changed.
If the name of the facility has changed, or if the ownership of the facility has changed,
do NOT use this form. Instead, you must fill out a Name -Ownership Change Form
and submit the completed form with all required documentation.
What does "legally responsible individual" mean?
The person is either:
• the responsible corporate officer (for a corporation);
• the principle executive officer or ranking elected official (for a municipality, state, federal or other public
agency);
• the general partner or proprietor (for a partnership or sole proprietorship);
• or, the duly authorized representative of one of the above.
1) Enter the permit number for which this change in Legally Responsible Individual ("Owner Affiliation")
applies:
Individual Permit
id iliI I S
2) Facility Information:
Facility name:
Company/Owner Organization:
Facility address:
(or) Certificate of Coverage
t�I� �)',
l.AjN"!I' I I�IG13i O D 2- dL I
&,kt. Tac,,r5, zwz-
A dress
City State Zip
To find the current legally responsible person associated with your permit, go to this website:
htth://deg.nc.izov/about/divisions/energy-mineral-land-resources/enemy-mineral_-I_and-permits/stormwater- rogram
and run the Permit Contact Summary Report.
3) OLD OWNER AFFILIATION that should be removed:
Previous legally responsible individual: r-k
Fi f
t MI Last
4) NEW OWNER AFFILIATION (legally responsible for the permit):
Person legally responsible for this permit: —Me 10n—,-, b
Page I of 2
5WU-OWN ERAFFI L-23Ma rch2017

NPDES Stormwater Permit OWNER AFFILATION DESIGNATION Form
(if no Facility Name/Ownership Change)
nee_ 6. Qw e,,jly
First Mt Last
Title
I L43 S IV 1L 14w4 / to
Mailing Address
City State Zip
Telephone E-mail Address
( 6Z2 ) yb53912_ 'MCC t42jP&.ktc�.;,f�y,•+t .�s, r...r►
Fax Number
5) Reason for this change:
A result of: ❑ Employee or management change
❑ Inappropriate or incorrect designation before
[+-Other
If other please explain:
The certification below must be completed and signed by the permit holder.
PERMITTEE CERTIFICATION:
1, o e w , attest that this application for this change in Owner Affiliation
(person legally responsible for the ermit) has been reviewed and is accurate and complete to the best of my
knowledge. I understand that if all required parts of this form are not completed, this change may not be
processed.
kk&L�� �&oWZA,
D +le.nt hel
Signature Date
PLEASE SEND THE COMPLETED FORM TO:
Division of Energy, Mineral, and Land Resources
Stormwater Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
For more information or staff contacts, please call [phone] or visit the website at:
htt ://de .nc. ov/about divisions/ener -mineral-land-
resources/stormwater
Page 2 of 2
SWU-OWNERAFFIL-23Mar2017

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E., Director
Division of Water Quality
August 23, 2002
NANCY BURKE
BURKE INTERNATIONAL TOURS INC
4643 SOUTH NC HWY 16
MAIDEN, NC 28650
Subject: NPDES Stormwater Permit Renewal
Burke International Tours Inc
COC Number NCGO80221
Catawba County
Dear Permittee:
In response to your renewal application for continued coverage under general permit NCG080000, the Division of
Water Quality (DWQ) is forwarding herewith the reissued stormwater general permit. This permit is reissued
pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement
between the state of North Carolina and the U.S. Environmental Protection Agency, dated December 6, 1983.
The following information is included with your permit package:
A new Certificate of Coverage
A copy of General Stormwater Permit NCGO80000
A copy of a Technical Bulletin for the general permit
Your coverage under this general permit is not transferable except after notice to DWQ. The Division 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 DENR or relieve the permittee from responsibility
for compliance with any other applicable federal, state, or local law, rule, standard, ordinance, order, judgment, or
decree.
If you have any questions regarding this permit package please contact Delonda Alexander of the Central Office
Stormwater and General Permits Unit at [phone], ext. 584
Sincerely,
Bradley Bennett, Supervisor
Stormwater and General Permits Unit
cc: Central Files
Stormwater & General Permits Unit Files
Mooresville Regional Office
N. C. Division of Water Quality 1617 Mall Service Center Raleigh, NC 27699-1617 [phone]
ACA
RU NR
Customer Service
1-800-623-7748

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Gregory J. Thorpe, Ph.D.
Acting Director
Division of Water Quality
Deceniher 27. 2001
NANCY 13URKE
BURKE INTERNATIONAL TOURS INC
4643 SOUTH NC HWY 16
MAIDEN, NC 28650
Subject: NPDES Sto rmwater Permit Renewal
BURKE INTERNATIONAL,roURS INC
COC Nunihcr NCG080221
Catawba County
Dear Permittee:
Your facility is currently covered for stormwater discharge under General Permit NCG080000. This permit expires
on August 31, 2002. The Division staff it currently in the process of rewriting this permit and is scheduled to have
the permit reissued by late summer of 2(1)2. Once the permit is reissued, your facility would he eligible for
continued covcragc under the reissued permit.
In order to assure your continued coverage under the general permit, you must apply to the Division of Waler
Quality (DWQ) liir renewal of your permit coverage. To make this renewal process easier, we .arc informing you. in
advance that your permit will he expiring, Enclosed you will Iind aGeneral Permit Coverage Renewal
Application Form, The application must he completed and returned by March 4, 2002 in order to assure continued
coverage under the general permit.
Failure to request renewal within this time period may result in a civil assessment ol'at (cast $250.00. Larger
penalties may he assessed depending on the delinquency of the request. Discharge ol'stormwater from your facility
without coverage under a valid storltiwater NPDES permit would constitute a violation of NCGS 143-215.1 and
could result in assessments ol'civil penalties of up tri $10,000 per day,
Please note that recent federal legislation has extended the "no exposure exclusion" to all operators of industrial
lacililies in any of the I I calegorics of "storm water discharges associated with industrial activity," (except
construction activities). If you feel your facility can certify a condition of "no exposure", i.e. the lacilly industrial
materials and operations .are not exposed to stormwater, you can apply for the no exposure exclusion. For addilional
iniirrnialion contact the Central Office Slorniwaler Staff mcniber listed below or check the Storniwater & General
Permits Unit Web Site at litlp://li2o.enr.slate.nc.us/su/storiiiw,uer.htrii]
If the subject stormwater discharge to waters of the state has been terminated, please complete the enclosed
Rescission Request Form. Mailing instructions are listed on the hottorn of the form. You will be notified when the
rescission process has been completed.
ll you have any questions regarding the permit renewal procedures please contact Mike Parker of the Mooresville
Rogional Office at 704-663-1699 or Dclonda Alexander of the Central Office Stormwaler Unit ,it (9 l 9) 733-5083,
ext. 584
Sincerely,
A7
Bradley Bennett, Supervisor
Storntwaterand General I'crmits Unit
cc: Central Files
Mooresville Regional Office
ea
NCDENK
N. C. Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 [phone] Customer Service
1-800-623-7748

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG080000
CERTIFICATE OF COVERAGE No. NCGO80221
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,
BURKE INTERNATIONAL TOURS INC
is hereby authorized to discharge stormwater from a facility located at
BURKE INTERNATIONAL TOURS INC
4643 SOUTH NC HWY 16
MAIDEN
CATAWBA COUNTY
to receiving waters designated as a UT to South Fork, a class C TR stream, in the Catawba River Basin in
accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts 1, 1I, III,
IV, V, and VI of General Permit No. NCG080000 as attached.
This certificate of coverage shall become effective September 1, 2002.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day.August 23, 2002.
for Alan W. Klimek, P.E., Director
Division ol'WaterQuality
By Authority of the Environmental Management Commission

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E., Director
Division of Water Quality
August 23, 2002
NANCY BURKE
BURKE INTERNATIONAL TOURS INC
4643 SOUTH NC HWY 16
MAIDEN, NC 28650
Subject: NPDES Stormwater Permit Renewal
Burke International Tours Inc
COC Number NCG080221
Catawba County
Dear Permittee:
In response to your renewal application for continued coverage under general permit NCG080000, the Division of
Water Quality (DWQ) is forwarding herewith the reissued Stormwater general permit. This permit is reissued
pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement
between the state of Nortb Carolina and the U.S. Environmental Protection Agency, dated December 6, 1983.
The following information is included with your permit package:
A new Certificate of Coverage
A copy of General Stormwater Permit NCGO80000
A copy of a Technical Bulletin for the general permit
Your coverage under this general permit is not transferable except after notice to DWQ. The Division 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 DENR or relieve the permittee from responsibility
for compliance with any other applicable federal, state, or local law, rule, standard, ordinance, order, judgment, or
decree.
If you have any questions regarding this permit -package please contact Delonda Alexander of the Central Office
Stormwater and General Permits Unit at [phone], ext. 584
cc: Central Files
Stormwater & General Permits Unit Files
Mooresville Regional Office
Sincerely,
Bradley Bennett, Supervisor
Stormwater and General Permits Unit
NC O Pf. OF i=N►/lR0r,:r41z, 7
1
AUG 2 9 2002
(r :
rr "�V'1�� 1 � ��� �
NCDENR`
N. C. Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 [phone] Customer Service
1- 800-623-7748

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Gregory J. Thorpe, Ph.D.
Acting Director
Division of Water Quality
December 27, 2001
NANCY BURKE
13URKE INTERNATIONAL TOURS INC
4643 SOUTH NC HWY 16
MAIDEN, NC 28650
Subject: NPDES Stormwater Permit Renewal
BURKE ENTERNATIONAE_ "POURS INC
COC Number NCG080221
Calawha County
Dear Permitice:
Your facility is currently covered for storrmwaler discharge under General Permit NCG080000. This permit expires
on August 31, 2002. The Division staff is currently in the process of rewriting this permit and is scheduled to have
the permit reissued by late summer ol' 2002. Once the permit is reissued, your facility would he eligible I()r
continued coverage under the reissued permit.
In order to assure your continued coverage under the general permit, you must apply to the Division of Water
Quality (DWQ) for renewal of your Permit coverage. To make this renewal process easier, we arc informing you in
advance that your permit will he expiring. Enclosed you will find a General Permit Coverage Renewal
Application Form. The application must be completed and returned by March 4, 2002 in order to assure continued
coverage under the general permit.
Failure to request renewal within this time period may result in a civil assessment of at least $250.00. Larger
Penalties may he assCsscd depending on the delinquency of Uic request. Discharge of stormwatcr from your facility
without coverage under a valid storrnwater NPDES permit would constitute a violation of NCGS 143-215.1 and
could result in assCssmCnts ol'civil penalties of up to $10,000 per day.
Please note that recent Icderal legislation has extended the "no exposure exclusion" to all operators of industrial
facilities in any of the I I categories of "storm water discharges associated with industrial activity," (except
construction activities). 11' you I'Cel your facility can certify a condition of "no exposure", i.e. the facilly industrial
materials and operations arc not exposed to storinwater, you can apply for the no exposure exclusion. For additional
information contact the Central Office Storrnwater Staff' member listed below or check the Stormwaler & General
Permits Unit Web Site at Itllft://h2o.etrr.state.nC.us/su/Stormwater.html
If the subject storntwater discharge to waters ol'the stale has been lernlinated, please complete the enclosed
Rescission Request Form, Mailing instructions are listed on the bottom ofthe forrn. You will he notified when the
rescission process has been completed.
ll'you have ,any questions regarding the permil renewal procedures please contact Mike Parker of the Mooresville
Regional Office at 704-663-1699 or Delonda Alexander of tlic Central Office Stormwater Unit at [phone].
ext. 584
Sincerely,
131adlCy &1111 tl, Supervisor
Slormwater and General Permits Unit
cc: Central Filcs
Mooresville Regional Office
N. C. Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 [phone]
jAv
NCDENR
Customer Service
1-800-623-7748

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
September 16, 1994
Ms. Nancy Burke
Burke International Tours, Inc.
4643 South NC Highway 16
Maiden, NC 28650
Subject: General Permit No. NCGO80000
Burke International Tours, Inc.
COC NCG080221
Catawba County
Dear Ms. Burke:
In accordance with your application for discharge permit received on July 1, 1994, we are forwarding
herewith the subject certificate of coverage 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
December 6, 1983.
If any parts, measurement frequencies or sampling requirements contained in this permit are
unacceptable to you, you have the right to request an individual permit by submitting an individual permit
application. Unless such demand is made, this certificate of coverage shall be final and binding.
Please take notice that this certificate of coverage is not transferable except after notice to the Division
of Environmental Management. The Division of Environmental Management 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 Environmental Management or permits required by the Division of Land Resources, Coastal Area
Management Act or any other Federal or Local governmental permit that may be required.
If you have any questions concerning this permit, please contact Aisha Lau at telephone number 919/733-5083.
Sincerely,
Original Signed By
Coleen H. Sullins
A. Preston Howard, Jr., P. E.
cc: Mooresville Regional Office
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
GENERAL PERMIT NO, NCGO80000
CERTIFICATE OF COVERAGE .No, NCGO80221
STORMWATER DISCHARGES
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,
Burke International Tours Inc.
is hereby authorized to continue operation of an oil water separator and discharge stormwater from a facility located at
Burke International Tours Inc.
4643 South NC 16 Highway
Maiden
Catawba County
to receiving waters designated as an unnamed tributary to South Fork 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. NCGO80000 as attached.
This certificate of coverage shall become effective September 16, 1994.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day September 16, 1994.
Original gigned BY
Cnleen H. Sullins
A. Preston Howard, Jr., P.E., Director
Division of Environmental Management
By Authority of the Environmental Management Commission

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EXPIRATION DATE ql-1/ 17