NCG080922_COMPLETE FILE - HISTORICAL_20131125

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V Coo %b9 a a
DOC TYPE
HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ J01 3 j/ d5
YYYYMMDD

PIMA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Energy, Mineral, and Land Resources
Land Quality Section
Tracy E. Davis, PE, GPM Dlv r _ Pat McCrory;''.Gbvemor
Director i ' John E.-S&irla;� III; Secretary
1^
November 2S, 2013 DEC 2013
Mr. D. F. Julian, Vice President Safety and Environmental DEI-,
Norfolk Southern Railway Company 14jr" -T l;
1200 Peachtree Street, N.E., Box 13
Atlanta, Georgia 30309-0013
Subject: General Permit No. NCGO80000
Charlotte lntermodal Facility
COC No. NCG080922
Mecklenburg County
Dear Mr. Julian:
In accordance with your application for a discharge permit received on November 4, 2013,
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).
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 Energy, Mineral and Land Resources (Division). 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 the Divisio.-I or
permits required by the Division of Water Resources, Coastal Area Management Act or any other
federal, state or local governmental permit that may be required.
If you have any questions concerning this permit, please contact Bill Diuguid, Stormwater
Program Planner at telephone number [phone].
Sincerely,
ORIGINAL SIGNED M
KEN PICKLE
for Tracy E. Davis
cc: Mooresville Regional Office
Central Files
Stormwater Permitting Unit Files
Attachments
1612 Mail Service Center, Raleigh, North Carolina 27699-1612 • Telephone [phone] I FAX: [phone]
512 North Salisbury Street, Raleigh, North Carolina 27604 - Internet: hno:LLortal,ncdenr.orci/web/Ir/land-guality
An Equal Opportunity 1 Affirmative Action Employer - 50% Recycled 110% Post Consumer Paper

a..
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES,,'����•
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
GENERAL PERMIT NO. NCG080000
J✓,
CERTIFICATE OF COVERAGE No. NCGO80922
�1s
STORMWATER DISC14ARGES
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,
Norfolk Southern Railway Company
is hereby authorized to discharge stormwater from a facility located at
Charlotte Intermodal Facility
5710 West Boulevard
Charlotte
Mecklenburg County
to receiving waters designated as an unnamed tributary to Beaverdam Creek, a Class C waterbody, Catawba River
Basin; in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I,
1I,1I1, IV, V and V1 of General Permit No. NCGO80000, as attached.
This Certificate of Coverage shall become effective November 25, 2013.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day November 25, 2013.
ORIGKENLQICKN� B1
for Tracy E. Davis, Director
Division of Energy, Mineral and Land Resources
By Authority of the Environmental Management Commission

CONTAA4ER
ONSm
(GALLUNASSIGNE6
CONTENTS
300
MOTOR Oft
UNASSIGNED
500
HYDRAULIC FLUID
UNASSIGNED
300
WASTE OR
UNASSIGNED
3DO
ANTIFREEZE
UbLAMIGNED
300
TRANSMISSKIN FLUID
LMASSIGNED
300
GASOLINE
UNASSIGNED3,0DG
DIESEL
MWACK CRANES
$10
DIESEL
M"ACK CRANESRFF
450
1 HYDRAULIC FLUID
FRS
S90B
VItLtCTRIG FLUS
7 TANKS. 3 CRAS, 7 TRANSFMMERS
TANS
STORAGE
CAPACITY b.188 GAL.
MM&A
SlapGlp dw FuW9
n
O
(WOG
HY OpAULIC
(3W GA
40W MOTOR 0
(300 GAL)
ANT}-FREF2E
(300 GAL)
;MISSION OIL
(300 GAL) /
WASTE 00-
4
GASDLAL)
w o 33,000
o�5a $pJTNERN
-
.o �rt NORFOLK SOI,'THr:RN RAILWAY COMPANY
CHARLOTTE INTERMOCAL Fiwm CYARLOTTE, NORTH CAROLINA
FACILITY LAYOUT AND 2
DRAINAGE PLAN
LEGEND
TRACKS
xlHw
®
- RAILROAD
-YARD ENTRANCE
DRAINAGE FLOW DIRECTION
O Y
-PETROLEUM STORAGE TANK
0
- SPILL RESPONSE EQUIPMENT
- STORM WATER OUTFALL
-STORM WATER PIPE
❑
-DROP INLET
-FENCE
GROUND CONTOURS
- DRANAGE AREA I (OutW 001)
972sM SQ. FT. (80% IMPERVIOUS)
- FOIE HYDRANT"
i
s f
_....................... . .

r.
Diu uid, Bill
From: Schweiber, Erich
Sent: Monday, November 25, 2013 10:08 AM
To: Diuguid, Bill
Cc: Khan, Zahid
Subject: FW: NCG080922 Charlotte Intermodal Facility N & S Railway Charlotte N01
'Bill,
The site has been reviewed and the permit may be issued as requested.
Thanks
From: Gibson, Gaymeon V. fmn�[e-mail]]
Sent: Friday, November 15, 2013 1:04 PM
To: Schweiber, Erich
Subject: RE: NCGO80922 Charlotte Intermodal Facility N & S Railway Charlotte NOI
Erich,
I am available to meet you Wednesday November 20`h around 10 am to look over the Charlotte Intermodal site. My
contact information is stated below, please contact me if you should have any questions or comments.
Thanks,
Gaymeon Gibson
Norfolk Southern Corp. I Environmental Compliance officer 1
1200 Peachtree Street, NE —Box 1.3 1 Atlanta, CA 30309 1
i404) 582. 4239 1 Cell (678) 91.3 39E2 i Fax (678) S12 54721
�`s�.
one &W. Awkwm poilkwN.A
From: Schweiber, Erich mailto:erich.schwelber ncdenr. ov]
Sent: Friday, November 15, 2013 9:58 AM
To: Gibson, Gaymeon V.
Subject: RE: NCGO80922 Charlotte Intermodal Facility N & S Railway Charlotte NOI
Can you meet Wednesday the 201h around 10 am so that we may look over the site 7
From: Bou-ghazale, Samar
Sent: Tuesday, November 12, 2013 11:31 AM
To: Schweiber, Erich
Subject: FW: NCGO80922 Charlotte Intermodal Facility N & S Railway Charlotte NOI
Erich,
Zahid Asked me to forward this e-mail to you since you are involved with this project. Please let me know if you have
any problems with issuing this permit.
Thanks,
Samar

From: Diuguid, Bill
Sent: Tuesday, November 12, 2013 11:01 AM
To: Bou-ghazale, Samar; Khan, Zahid
Cc: [e-mail]
Subject: NCGO80922 Charlotte Intermodal Facility N & S Railway Charlotte N0I
Samar Bou-Ghazale, Zahid Khan, Mooresville Regional Office:
Please review the attached NO1 application with the objective of responding to me with a recommendation to issue the
permit. I recognize that you may not visit each new permittee during this NOI review, but it affords you the opportunity
to log the permit into your regional database and add the facility to a future monitoring and compliance visit schedule.
Therefore, your recommendation now to issue the permit serves as your acknowledgement that (1) the facility is located
in your region, (2) that there are no current complaints outstanding about the facility that have not been dealt with, and
(3) that the facility may ultimately be inspected by the regional staff. I've also attached a scanned copy of the NOI and a
location map for your review.
COC # Facility _W location . City/County
NCG080922 I Charlotte Intermodal Facility N & S Railway Company 5710 West Blvd . Charlotte/Mecklenburg
If you need any more info, give me a call. If you could send me a recommendation to issue the permit quickly as this
facility is due to open December 2nd , 2013, I'd appreciate it, so I can issue their COC. I cannot issue the permit until
the respective regional office reviews and comments back to me with a recommendation to issue the permit.
Thanks.
Bill
Bill Diuguid, AICP, Planner
Stormwater Permitting
Land Quality Section
Division of Energy, Mineral and Land Resources I NCDENR
1617 Mail Service Center (Mail)
512 N. Salisbury St, Raleigh, NC 27604 1 9th Floor (Location & Parcels)
Raleigh North Carolina 27699-1617
Phone: [phone] Fax: [phone]
Website: http://oortal.ncdenr.org/web/wg/ws/su
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties.

I
FIFWA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Energy, Mineral, and Land Resources
Land Quality Section
Tracy E. Davis, PE, CPM
Director
November 25, 2013
Mr. D. F. Julian, Vice President Safety and Environmental
Norfolk Southern Railway Company
1200 Peachtree Street, N.E., Box 13
Atlanta, Georgia 30309-0013
Dear Mr. Julian:
Pat McCrory, Governor
John E. Skvarla, III, Secretary
Subject: General Permit No. NCGO80000
Charlotte Intermodal Facility
COC No. NCGO80922
Mecklenburg County
In accordance with your application for a discharge permit received on November 4, 2013,
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).
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 Energy, Mineral and Land Resources (Division). 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 the Division or
permits required by the Division of Water Resources, Coastal Area Management Act or any other
federal, state or local governmental permit that may be required.
If you have any questions concerning this permit, please contact Bill Diuguid, Stormwater
Program Planner at telephone number [phone],
Sincerely,
ORIGINAL SIGNED W
KEN PiCKI_l":.
for Tracy E. Davis
cc: Mooresville Regional Office
Central Files
Stormwater Permitting Unit Files
Attachments
1612 Mail Service Center, Raleigh, North Carolina 27699-1612 - Telephone [phone] / FAX: [phone]
512 North Salisbury Street, Raleigh, North Carolina 27604 - Internet: http:L/portal.ncdenr.ornlwebllr/land- uQ ality
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
GENERAL PERMIT NO. NCG080000
CERTIFICATE OF COVERAGE No. NCG080922
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,
Norfolk Southern Railway Company
is hereby authorized to discharge stormwater from a facility located at
Charlotte Intermodal Facility
5710 West Boulevard
Charlotte
Mecklenburg County
to receiving waters designated as an unnamed tributary to Beaverdam Creek, a Class C waterbody, Catawba River
Basin; in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I,
11, III, IV, V and VI of General Permit No. NCG080000, as attached.
This Certificate of Coverage shall become effective November 25, 2013,
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day November 25, 2013.
ORIGINAL SIGNED 61
KEN PICKLF
for Tracy E. Davis, Director
Division of Energy, Mineral and Land Resources
By Authority of the Environmental Management Commission

n'u
In
ER
(GALLONS)
CONTENTS
ED
300
MOTOR OIL
ED
500
HYDRAULIC FLUID
ED
AjD
300
WASTE OIL
ED
300
ANTWREEZE
Ep
t
300
TRANSMISSION FLUID
ED
300
GASOLINE
ED
3.000
DIESEL
MFJAES
810
DIESEL
MFJACK CRANES
I50
HYDRAULIC FCUi
S
1
DIE-
-7 TANKS. 3 CRANES, 7 TRANSFORMERS
TOTAL STOWAGE
CAPACITY.A. GAL
�r'IaiT�l?�
MM&A
shapuq ft FW=
L�
0
oEugo r.
diE. �MN]
�.ncn wo �mrr.W
LEGEND
-
4m*w omw • RAILROAD TRACKS
}}
® • YARD ENTRANCE
- DRAINAGE FLOW DIRECTION
• R - PETROLEUM STORAGE TANK
SPtUO - RESPONSE DTI
STORM
-STORM WATER OUTFACE
TFALL
-STORY VWTER PIPE
-DROP INLET
-FENCE
'G5�1� • GROUND CONTOURS
- DRAINAGE AREA I (OuffaO WI)
971096 SO. FT. (W% IMPERVIOUS)
-FIRE HYDRANTS
i
O
(sm G
HYDRAULIC I
pm"
4OIK MOTOR d
(300 GAL7
ANTFFREF2E
(M CAL)
MISSION OIL
1oGAL)�
WASTE OR
(3DD GAL)
AS fl
eo o ev /A��gp,gqFFppj�J�({
D05.� SO(J70
NORFOLK SOUTHERN RAILWAY COMPANY
CHARLOTTE INTERMODAL Figure
Boa o m
CHARLOTTE, NORTH CAROLINA
FAGILITY LAYOUT AND 2
DRAINAGE PLAN

8ANN~
aw JIM irwte Aosshe t
Norfolk Southern Corporation
1200 Peachtree Street, NE Box 13
Atlanta, GA 30309-0013
(404) 582- 4239 (o)
[phone] (f)
gaymeon.gibson@nscorp-com
North Carolina Dept. Environmental and Natural Resource,
Stormwater Permitting Unit
Division of Water Quality
1617 Mail Service Center,
Raleigh, North Carolina 27699-1617
Gaymeon Gibson
Environmental Compliance officer
Safety and Environmental Department
October 28, 2013
Subject: Notice of Intent -NPDES General Permit Application- Norfolk Southern Railway Company
Facility- Charlotte Intermodal, NC
Dear Sir/ Madam:
Enclosed please find the Norfolk Southern Railway Company —Notice of Intent for NPDES General Permit
application for a new Charlotte Intermodal Facility to obtain coverage under North Carolina NPDES
General Permit prior to date operation is to begin on December 2, 2013. Check number 9017261 from
Norfolk Southern Railway Company in the amount of $100.00 for the permit application fee was sent to
NCDENR on October 22, 2013. Should any questions or issues with the enclosed document arise, please
do not hesitate to call me [phone].
Sincerely, A`—
Gaymeon Gibson
Environmental Compliance Officer
0�
Gam` \1\3 a��—%J--
Attachments: �,�
�0 V i
Cc: Gilbert Turner �� T ^
Mark Neal J 0 013

Schweiber, Erich
From: Bou-ghazale, Samar
Sent: Tuesday, November 12, 2013 11:31 AM
To: Schweiber, Erich
Subject: FW: NCG080922 Charlotte Intermodal Facility N & S Railway Charlotte NOI
Attachments: NCGO80922 Charlotte Intermodal Facility N&S Railway Charlotte NOI Nov 12 13.pdf
Erich,
Zahid Asked me to forward this e-mail to you since you are involved with this project. Please let me know if you have
any problems with issuing this permit.
Thanks,
Samar
From: Diuguid, Bill
Sent: Tuesday, November 12, 2013 11:01 AM
To: Bou-ghazale, Samar; Khan, Zahid
Cc: [e-mail]
Subject: NCGO80922 Charlotte Intermodal Facility N & S Railway Charlotte NOI
Samar Bou-Ghazale, Zahid Khan, Mooresville Regional Office:
Please review the attached NOI application with the objective of responding to me with a recommendation to issue the
permit. I recognize that you may not visit each new permittee during this NOI review, but it affords you the opportunity
to log the permit into your regional database and add the facility to a future monitoring and compliance visit schedule.
Therefore, your recommendation now to issue the permit serves as your acknowledgement that (1) the facility is located
in your region, (2) that there are no current complaints outstanding about the facility that have not been dealt with, and
(3) that the facility may ultimately be inspected by the regional staff. I've also attached a scanned copy of the NOI and a
location map for your review.
COC # Facility Location City/County
NCG080922 Charlotte Intermodal Facility N & S Railway Company 5710 West Blvd Charlotte/Mecklenburg
If you need any more info, give me a call. If you could send me a recommendation to issue the permit quickly as this
facility is due to open December 2nd , 2013, I'd appreciate it, so I can issue their COC. I cannot issue the permit until
the respective regional office reviews and comments back to me with a recommendation to issue the permit.
Thanks.
Bill
Bill Diuguid, A1CP, Planner
Stormwater Permitting
Land Quality Section
Division of Energy, Mineral and Land Resources I NCDENR
1617 Mail Service Center (Mail)
512 N. Salisbury St, Raleigh, NC 27604 1 9th Floor (Location & Parcels)
Raleigh North Carolina 27699-1617
Phone: [phone] Fax: [phone]
Website: htti)://T)ortal.ncdenr.org/web/M/ws/su
E-mail correspondence to and from this address may be subject to the !North Carolina Public Records Law and may be disclosed to third parties.

OnoGne fi�lhReAossfNmkl,
Norfolk Southern Corporation
1200.Peachtree Street, NE Box 13
Atlanta, GA 30309jgoiil'
(404) 582- 4239 ((0)
(678) 512.547Z (n'
gaymeon.oson@ nscorp.com
North Carolina Dept. Environmental and Natural Resource,
Stormwater Permitting Unit
Division.ofVater Quality•
1617 Mail Service Center,
Raleigh, North Carolina_27699-1617
Gaymeon Gibson
Environmental Compliance offker
Safety and Environmental, Department
October 28, 2013
Subject: Notice of Intent.,,-NPDES'General Permit Application- Norfolk Southern Railway Company.
Facility- Charlotte Intermodal; NC
Dear Sir/ Madam:
Enclosed please find the Norfolk Southern Railway Company —Notice of Intent.for.NPDES General Permit
application for anew Charlotte Intermodal Facility to obtain coverage under North Carolina NPDES
General Permit prior to date operation Is to begin on December ,2; 2013. Check number 9017261 from
Norfolk Southern Railway Company:in the amount.gf,$1pD.00•for the permit application,fee;was sent to
NGDENR on October 22, 2013. Should any questions or issues with the enclosed;document arise, please
do not hesitate to call me [phone].
Attachments:
Cc: Gilbert Turner
Mark Neat
Sincerely,
r
Gaymeon Gibson
Environmental Compliance Officer
...,

I
bivision;of Watci•.,QuWily I Surface Water Protectiani
Section
National Pollutant Discharge Eli NC, " R'
' MIiEr11A 4M N/1MM= M4R�AM1. . .
NCGq§0000
1,9F ran, HFURE1
:NOTICC'OFjYTENj;,
National Pollutant Discharge 'Elimination System appllbetionJor coirerage.under ,General Permit
NCG0B0000.
STORMWATER DISCHARGES from-Vehiole Malntenance Areas .(Includingcvehicle rehabilliatian,
mechanical repairs, painting, fueling;.lubrlcatI6.kand equipment cleaning oeeratibns areas) associated.. -
with activities. classifled as:
SIC 40(Standa'rd^Industrial•Classification) Railroad Transportation
SIC.41 Lodal and Suburban Transit and Interurban Highway Passenger Transportation:
SIC 42 Motor Freight7ransportation and Warehousing (except SIC 42214225)
SIC 43 United States Postal Service
.The following activities arg;elso Included:
• Other industrial activities,where the vehicle maintenance area(s) is the only area:requiring permitting
Petroleum Bulk Stations and Terminals (SIC 5171) with total petroleum site storage capacity of less than 1.
million.gallons
Stormwater,,discharges from oil water separators and/or from secondary containment structures.,
associated with petroleum storage facilities with less•than 1 million gallons,of'totai petroleum site,storage-
capacity.
Discharges ,associated with vehicle maintenance;operations at activities, which are otherwise designated
on a case -by case balls for permitting.
l For questions, please contact the AW4' Regional Oftice tar your area. See page a.
(Please,iprint�or type)
1) Mailing address of owner/gperator (ad res .to which all corres onderice will be filed):
Name __Norfolk Souiilem R, ' _
Street -Address 1,200•Peachtree Sfreet,'iJAAOX 113'. -
City Atianta _ w. State - A.' ZIP Code., 30309-0013
Telephone No, 40 . 82-4239- -- Fax: 6Zf3 512-5472 ..__
2) Location of facillty,producing discharge:
Facility Name "
Facility Contact _
5treet•Address - _vd
aQ to
-Stao _ ZIP -Code ,2820CitY
County. ,.Mccklenbui�- _ .,.^.,.,
Telephone No, (ri{l4}G3tilil.=9523.> W .� Fax:..
Email
0 CtCf� rra; rJ
Page 1'of4
swu zz3-o7,aoa,1 4108

NCG080000-N:OJ.
3) Physical Locationinformation:
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). -4 ,take Blvd Uit
.(A copy of,a county map or USGS quad sheet with faoiflty,clearty located must, be submitted with this application),
4) Latitude: .50 11'�5 Longitude .(deg, min,;8ec)
5). ThIsiNPpES Permit Application applies 10 which of the -following;
IN New or Proposed Facility Date operation is to begin December 2, 2013
❑ aistin9
6) Standard Industrial. Classificatlon.: ~
Providei:the_4•digit Standard Industrial Classification Code (SIC Code).that describes the primary ipdustrial
activity at this facility
SIC Code-., 4 ..Q_.:TF.1 .:-:......1, .
7) Provide a brief narrative description of,fhe types of industrial activilligA,pnd products manufactured at
facility: The,facility is an interinodal facility where. frdi heir loaded and unloaded from railcary:io:
Uactor. ratters.
8). Discharge polnts / Receiving waters;;
How manydischarge.. points (ditches, pipes, channels; etc.) convey stormwater from the property? .1'.
What.is the,name of the bgdy or bodies of water fcreek, stream, river, lake, etc.) that ihe,1fa_cility stormwater
discharges'end up in? Unpargd THbutary to E}eaticr_dam Creek
Receiving water classification: _Class C
Is this a 303(d) listedstream?,_____�_ Has a TMpL,been approved for this;watershed? NA
{f^the site stormwater discharges to a separate'storm sewer system, name the operatorloi the separate storm
sewer syste,m'(e.g. City of Raleigh municipal storm sewer). NA
9) Does this facility have any other NPDES permitsT.
No
•❑ Yes:
Ifiyes, list the permit -numbers for all current NPD1 .b'permits for this facility:
10}, Does this facility have any Non -Discharge permits (ex: recycle permit)?
OF, No
a Yes
Ifyes, list the permit numbers for all current Non -Discharge permits for this'facility:
11) Does this facility employ any,best management -practices foi stormwater apntrol?
,p: No
[A Yes, (Show any structural BMPs on the slte diagram.)
Yf: es, please briefly describe: Maintains gbod housekee„ Zing, semi annual inspections, and training.
12) Does this:facility have a Stormwater.Pollution Prevention Plan?
t©No
,® Yes
If yes, when was it -implemented? . .Novctnber.2013
Page.-2 of 4
swu-223.071 408 Last revised 714106

NCG080000 NAL.
13j_Are vehicle maintenance activities occurring at this facility?,
© No -M Yes
14j_Hazardous Waste:;
a) Is this facility,a HazardousAaste Treatment; Storage, or Disposal Facility?
%I No ❑ Yes
b) is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste,genOrated per month) ot.
hazardous waste? -
0 No M Yes
Is,this facility a i_arge Quantity Generator (1000 kg. or more of hazardous waste generated per month) of.
. ' hazardous waste?
DO No ❑ Yes _
d), Is,hazardous waste stored in the 100-year flood plain?
CC: 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:
T " ype�s) of waste:,...
How Is material stored; -. -/5
Where Is material stored:
How many disposal shipments per year._ ..., _
Name of transport 1 disposal vendor:
Vendor address:. k'4Z
15).Certific®tiom
North Carolina General Statute 141-2 S.68 (1) provides that.
Any person who knowingly makes any false statemenl„ ropresentatlon, or cerilficatfon !n any application, record, report,
plan,,oi�othar document flied or required�to be maintained under thls Arlicle or a rule implementing this Article; or who.
knowingly makes'_a lalso statement of a rgaterial fact in a rulamaking proceeding or contested case,under this Article;.or
who falsifies, tampers witr, or knowingly re ders inaccurate any recording ormonitoOg device or mothod required to be.:;
oporated Ormalgtalned under this Article or rules of the Commission implomenting this Article shall he guilty of a -Class
2 misdemeanor which may inclutle a fine not to exceed ten dhousarld dollars ($10,000).
I hereby request coverage under the referenced General Permit. I understand that coverage under. this permit
will constitute the permit.requiremenis for the discharge(s) and iq.,enforceabie 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, eoml6lete, and accurate.
Printed Name of Person Signing tp:ulriin __
Title: Vice President -Safety and'Environnlental,­
of A, plica ij ; (Date Sfgned)
Notice of. Intent must be accompanled'by a check or money order for `b f 00.00 made payable to: • #,
NCDENR,
Page 3 of 4 '
SWu-223-07140a' last revisod 71t4108

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INVOICE DATE
INVOICE AMOLW 7711
164 AMOUNT PAID
DISCOL14 TAKEN u`='be
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Type
Data
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Reference
s
lance Discount
Pay Amount
J
i
NCC7090 a � 3 712
MARSHALL MILLER & ASSOCIATES HSBC <D 3712
DBA CARDNO MM&A
PHONE [phone].1230
534 INDUSTRIAL PARK ROAD
BLUEFIELD, VA 24605
[phone] i
;xactly One hundred and no / 100 Dollars DATE CONTROL NO. AMOUNT
M1
TO THE NCDENR
ORDER
OF 1617 Mail Service Center
Raleigh NC 27699-1617
NS1789/164
11/1/2013
1i'
00I