NCG110040_COMPLETE FILE - HISTORICAL_20030502

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V
DOC TYPE
HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ � 0 �.3 D 5l� �"
YYYYMMDD

8tat% of North Carolina
Department of Environment
and Natural Resources
Division of Water -Quality
Michael F. Easley, Governor
William G. Ross Jr., Secretary
Gregory J. Thorpe, Ph.D., Acting Director
Coleman Keeler, Asst.
City of Shelby
824 West Grover Street
Shelby, North Carolina
Dear Mr. Kecter:
Utilities Director
28152
May 2, 2003
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
Subject: General Permit No. NCG 110000
City of Shelby
COC NCG 110040
Cleveland County
In accordance with your application for discharge permit received on March 11, 2003 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 May 9, 1994 (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 Water Quality. The Division of Water Quality 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 Water Quality 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 Ken Pickle at telephone number
919/733-5083 ext. 584.
cc: Mooresville Regional Office
Central Files
Stormwater and General Permits Unit Files
5Wk1-254.01 [DOI
Sincerely,
Alan W. Klimek, P.E.
1617 Mail service Center, Raleigh, North Carolina 27699-1617
An Equal Opportunity Affirmative Action Employer
Telephone [phone] FAX [phone]
50% recycled/ 10% post -consumer paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCGI10000
CERTIFICATE OF COVERAGE No. NCGI10040
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,
City of Shelby
is hereby authorized to discharge stormwater from a facility located at
First Broad River Wastewater Treatment Plant
1940 South Lafayette Street
Shelby, North Carolina 28152
Cleveland County
to receiving waters designated as First Broad River and Hickory Creek, class C waters in the CatXba River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts 1, 11, I11,
IV, V, and VI of General Permit No. NCG 110000 as attached.
This certificate of coverage shall become effective May 2, 2003.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day May 2, 2003.
Alan W. Klimek, Director
Division of Water Quality
By Authority of the Environmental Management Commission

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Name: Discharge Site NCG110040
Short Name: Dschrg
Coordinates: 0350 14' 36.5" N, 081 ° 34' 15.4" W
Comment: First Broad River Wastewater Treatment Plant, County: Cleveland, Map# G12NE,
Subbasin : #03-08-04, Recv. Streams: First Broad River and Hickory Creek,
C)<w" ba River Basin, Stream Classes C and C
F//ram~a74 lnd�.x 9� SU" 3D

Division of Water Quality / Water Quality Section
NCDENR National Pollutant Discharge Elimination System
rwAna..Ram kwffmi. Fmomme NCGl IO000
• �afxiLce o� Ir�r�Nr
Nation I Pollutant Discharge Elimination System application for coverage under General Permit
NC0110000: 21,1G'De, V,'60 4s3�
STQRMWATEA DISCHARG aasoclat*d with a hiss classified as:
rt
ent Wo sting domestic sewa or any other sewage sludge or wastewater treatment
deor system, used In the store ailment, recycling, and reclamation of municipal or
domestic sewage, with a design flaw 1.0 !Ilion gallons per daffy or more, or required to have an
approved pretreatment program under 44 Code of Federal Regulations (CFR) Part 403,
Including lands dedicated to the disposal of sewage sludge that is located within the confines of
e facility.
(Please print or type)
s
V��
✓l) Ma11Ing dread of ownedoperator.
Name r ssistant. tJ 1T1ties Director
Street Addre ✓
City .Shelby State ' NC ZIP Code 281.52
Telao$Me No. 704 . 484=6640 - Fes; 7fl4 484-68
. Addm a to wd9d all permitcorrespondence will ba maned
✓2) Location of facility
Facility Name
Facifity Contact
Street Address
city
County
Telephone No.
►-3) Physical Locati n
discharge:
Plant
Siste ' NE; - ZIP Code•
704 „ _484 6850 Fax: .704 484w6a72
intorhtnat�n:
Please provide 4 nanatNe description of how to get to the facility (use street names. state road numbers. and ,/"
distance and Qwobon from a roadway Intersection). Take i-85S to US- 74w: to . Shei b . Take NC 18S
AvDroxima ly - 3 miles down ' NC18S,,Atte entrance -is located on right.
to KPH of a mo or LMR wM ehmt valet � dmV boarad on the map b requh+ed to he suemftted Ws tins appllo w)
A) ThIS PIPDES it Appllca an applies to which of the following:
13 =or osed Facility Date operatlon is to begin
d ng
c.S) Standari I duatrlsi Classification:
Provide 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrtal
acftly at facility
IC Code: -L-
✓
Page 1 of 3
SWU-M-101701

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NCQ110000 N.O.I. /
✓ 6) Provide a bi
this facility;
mirror vef
✓ ) Discharge points 1 Receiving waters:
Industrial activities and products manufactured at
t plant with compost production facility;
How many discharge points (ditches apes, channels, etc.) y stormwater from the property?
What is the name of the body or ies of water (creek, str ,river, fake, etc,) that the facility st0 er
discharges end up In? HickoryCreek and First 8 ad River
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). NSA
8) Does this facility have any other NPDES permits? G l2 Bla�s�ur� ery NC- SC
Ili33, (e1=
❑ Na
it Yes
If yes, list the permit numbers for all current NPDES permits for this faci • �QQ . astewttter)/
9) Does this facility have any Non -Discharge permits (ex: recycle permits)? a°1'' B1Ajs v
❑ No
X Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility. OLa77 dteSa+.��
10) Does this facility employ any best management practices for stormwater control? ��� �� S ✓
No
91 Yes
If yes, please briefly describe: Detention_' and . ocated on sate
x11) Doss this faclifty have a Stormwater Pollution Prevention Plan?
M) No
❑ Yes
If yes, when was It implemented? Anti cl Oate: S�Jmpjftntatjcg in go day-,-
12) Are vehicle maintenance activities occurring at this facility?
❑ No M Yes
✓13) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
® No ❑ you
IKb) Is this facllity a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
91 No ❑ Yes
c) Is this facility a Largo 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.,_piease provide the following informatlon.
Pape 2 of 3
&W1��2&i41701

11
NCGI I MO N.O.I.
Type(s) of waste:
Flow is material stored:
Where is material stored:
How many disposal shipments per year.
Name of transport 1 disposal vendor:
Vendor address: _
K 14) Cartfflaation:
North Carolina General Statute 143-216.0 b (1) provides that:
Any person who Iviowingfy makes any fai9e statement, representation, or certillcetlos in any applimtIon, reeoid, report,
plan or other darxmanl filed or required is be maintained under Artkle 21 or regulations of the E tw Wonrnental
Maropment Oammiselon implementing that Article, or who falsifies, tempers with or knowfngfy rendem IrnaMrste any
MOWOV or monitoring davlce or method mqufred to be operated or maintained under Ankle 21 cr regulatbns of the
F.nvganmental Management Commission implamantirg that Article, strap be guilty of a misdemeanor punishable by a
fine not to exceed $10,000, or by Imprleenment not to emceed six month% or by both. (1 a U.S.C. Section tool provides
a punishment by a fine of not more than $10,000 or Imprleornnert not more than s years, or both, for a similar offense.)
l hereby request coverage under the referenced General Permit. 1 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 applicatlon and that to the best of my knowledge
and belief such Information is true, complete, and accurate.
Printed Name of Person Signing:
Title:
(Slgnatur+e ofApplicW0
or S f, c I �,-
3
Z& d
(Date SOW)
elk Pc,r ✓.i �n�ry
✓ J
Notice of Intent must be accompanied by a check or money order for $W.00 made payable to:
NCDENR
This application will be n tamed as inoonlplets, unless all of the folkiwIng Items have been Includeck
✓® Check for $80 made payable to NCDENR
✓® This completed application and all supporting documents Cm Ap
✓IM Copy of oardy map or USGS quad sheet with location of facility dearly marked on map
Mail the entire package to:
Stormwater and General Permits Unit
Division of Water duality
1617 Mail Service Center
Hatteigh, North Carolina 276WI617
NOR
Page 3 of 3
SW1F2M101701

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