NCG110153_COMPLETE FILE - HISTORICAL_20120917

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT N0.
53
DOC TYPE
HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ oS C1 I a+4 1 ,
YYYYMMDD

4" Division of Water Quality / Surface Water Protection
�� National Pollutant Discharge Elimination System
NCDENR g y
"° `y`"W7°"""�`T°' ... PERMIT NAME/OWNERSHIP CHANGE FORM
Eumwgy�i ayn Mq{Aa�. ��fy:i��
FOR AGENCY USE ONLY
Date Received
Year
Month
Da
1. Please enter the permit number for which the change is requested.
NPDES Permit (or) Certificate of Coverage
vi
II. Permit status prior to requested change.
a. Permit issued to (company name): L t'� c� f .� cc) PLA. b f ; C COO r � S
b. Person legally responsible for permit:
Sra Ism Row0
f3. Mz
c. Facility name (d
d. Facility address:
pI1v.1 A- two; !Lee-1-
l First MI / Last
�L�blirv---�a�bfKS �ir[C-t0�
Title
tJ
I 15 LD S^rrfe
Permit Holder Mailing Address
� Ir<4,n ejC_ 2�g�
City Slate Zip
(110q ) flbQS ('7o(1) /13_(a_- Sr4/99
Phone Fax
e �e �rra��lo.w+.
/1 fr S j JcL P t oa A ^L
Address
��..evin•(-o,-- YUC :2Po9Z
City State Zip
e. Facility contact person:-LQ6,3AS r [ rum {rlvQ 11L(P- 3141
First l MI / Last Phone
Ill. Please provide the following for the requested change (revised permit).
a. Request for change is a result of: ❑ Change in ownership of the facility
Name change of the facility or owner
!f other please explain:
b. Permit issued to (company name): �;,Ce 1 Co {emu b 1 t C (,Jot L•S
c. Person legally responsible for permit: _Dor\Cj Id li - L[-clm 6 fee � �r
First �1 MI I Last
1•�ir@CAor bt ?L Lt;C (AD 6r �C S
Title
S w t�Yla: S4 r-e
Permit Holder Mailing Address
City State Zip
(n6L( tj cf 4 3 de.�arY� l ice G►�1� he.lk ra...ly.
Phone E-mail Address prCl,
d. Facility name (discharge): 9 l t i o&., Cite re jy bilX 4 r Tea' *Le, -,+
e. Facility address: AD 9-S L &m L
Address
City State Zip
f. Facility contact person: � ph la 10, F, l- t t e,-,
/1First I MI Last q
' 4 9-" � 3 t �i -+4,r L"W Q�
Phone E-mail Address
Revised 2012Apr23

NPDES PERMIT NAME/OWNERSHIP CHANGE FORM
Page 2of2
1V. Permit contact information (if different from the person legally responsible for the permit)
Permit contact: �v`c� �� U . ��p"vti Wee- �r
Fi rst Last
fVr-to�f n-� u�at':c L.7oI(
Title [[ !
I Mailing Address
city 0195
+ State
-f 1 Zip r
( 0 ' f ) z 4 nl ]` a elkan, 61 f :ned L ellm Kiy .
Phone E-mail Address vr�
V. Will the permitted facility continue to conduct the same industrial activities conducted prior
to this ownership or name change?
Yes
❑ No (please explain)
V1. Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS
ARE INCOMPLETE OR MISSING:
19- This completed application is required for both name change and/or ownership change
requests,
❑ Legal documentation of the transfer of ownership (such as relevant pages of a contract deed,
or a bill of sale) is required for an ownership change request. Articles of incorporation are
not sufficient for an ownership change.
The certifications below must be completed and signed by both the permit holder prior to the change, and
the new applicant in the case of an ownership change request. For a name change request, the signed
Applicant's Certification is sufficient.
PERMITTEE CERTIFICATION (Permit holder prior to ownership change):
I, , attest that this application for a name/ownership change has been reviewed and is accurate and
complete to the best of my knowledge. I understand that if all required parts of this application are not
completed and that if all required supporting information is not included, this application package will be
returned as incomplete.
Signature Date
APAPLIi ALnT ER'1�'IFICATION
1, , attest that this application for a namelownership change has been reviewed and is accurate and
complete to the best of my knowledge. I understand that if all required parts of this application are not
completed and that if all required supporting information is not included, this application package will be
returned as incomplete.
Signature Date
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Division of Water Quality
Surface Water Protection Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Revised 7/2008

Lincoln County Department of Public works
U,,_115 West Main Street
2nd Floor Citizen's Center
Uncolnton, NC 28092
Phone [phone]
Fax [phone]
TO: NCDENR Division of Water Quality
Surface Water Protection Section
1617 Mail Service Center
Raleigh, NC 27699-1617
ATTENTION:
We are sending
via:
LETTER OF TRANSMITTAL
DATE: 09 17 12
RE: Killian Creek Waste Water Treatment Plant
SEP 2 0 2012
❑Overnight X Regular Mail Pick- DEt��t't ; rF ?H' h Deli ered
9 ❑ 9 ❑ P POEn�r s �ycff
The following
Items:
Correspondence ❑ Plans ❑ Specifications QX Other as listed below:
COPIES
DATE
NO.
DESCRIPTION
1
Permit Name/OwnershipName/Ownership Change Form
THESE ARE TRANSMITTED as checked below:
Please Analyze As requested Approved as Returned for corrections
submitted
X For your use For review and Approved as noted Forward to subcontractor
comment
REMARKS:
Donald V. Chamblee
COPY TO: SIGNED: Director of Public Works

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{
CDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins.
Governor Director
August 5, 2011
Mr. Tommy Drum
Lincoln County ' Department of Public Works
115 West Main Street
Lincolnton, NC 28092
Dear Mr. Drum:
Dee Freeman
Secretary
Subject: General Permit No. NCG 110000
Lincoln County killian'Creek Waste Water
Treatment Plant
COC NCGlIO153
Lincoln County
In accordance with your application for a discharge permit received on July 27, 2011, 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 October 15, 2007 (or as subsequently amended).
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 Brian Lowther at
telephone number [phone]
Sincerely,
f
for Coleen H. Sullins
cc: Mooresville Regional Office
Central Files
Stormwater Permitting Unit Files
Wetlands.and Stormwater Branch
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location, 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone: [phone] FAX: 9IM07,-64941 Customer Service: 1-877.623.6748
Internet: www.ncwaterquality.org
None Carolina
Naturallb,

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG110000
CERTIFICATE OF COVERAGE No. NCGI10153
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,
Lincoln County — Department of Public Works
is hereby authorized to discharge stormwater from a facility located at
Lincoln County Killian Creek Wastewater Treatment Plant
7085 Old Plank Road
Stanley, NC
Lincoln County
to receiving waters designated as an unnamed tributary to Killian Creek, a class C water in the
Catawba River Basin, in accordance with the effluent limitations, monitoring requirements, and
other conditions set forth in Parts I, II, III, IV, V, and VI of General Permit No. NCG110000 as
attached.
This certificate of coverage shall become effective August 5, 2011.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day August 5, 2011.
4"j
for Coleen H. Sullins., Director
Division of Water Quality
By the Authority of the Environmental Management Commission

LOCATION MAP:
NCG110153
W Scale 1,-24,000
Lincoln County - Dept of Public Works
Lincoln County Killian Creek
Wastewater Treatment Plant
Lablude ° 25' 22" N
Longitude: 81" 01' 57" W
County: Linooln
Receiving Stream; Killian Creek (UT)
Stream Class: C
Sub -basin: 03-08-33 (Catawba River Bas n)
�iiw.�rr�►��3- �cR
■w�.t►ilrr�# �
Facility Location

Lowther, Brian
From:
Parker, Michael
Sent:
Thursday, August 04, 2011 3:39 PM
To:
Lowther, Brian
Subject:
RE: SW General Permit NCG110153
No concerns. Feel free to issue the COC.
From: Lowther, Brian
Sent: Wednesday, August 03, 2011 4:05 PM
To: Parker, Michael
Subject: SW General Permit.NCG110153
Mike,
We've received an NOI from Lincoln County - Department of Public Works for their site in
Stanley (Lincoln County) for coverage their site, Lincoln County Killian Creek Wastewater
Treatment Plant. The site discharges stormwater to an unnamed tributary to Killian Creek
(C). The NOI is attached.
Does.the Mooresville Regional Office have any concerns about issuing this facility a COC for
this general permit, and are there any potential impacts to wetlands? If we don't receive any
objections, we'll issue the COC in 30 days.
Thanks,
Brian
Brian C. Lowther
Environmental Engineer
NCDENR I DWQ I Stormwater Permitting Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
512 N. Salisbury St, Raleigh, NC 27604
Phone: [phone]
Email: b�ian.lc�wtiacr(c}ncdc�». �►v
Website: http://aortal.nedenr.orWwcb/wq/ws/��i' ]'
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.

"J'LA'
ri
NCDENR
Nm— CA"ou HA t)O'M NM or
- VIP NHt! T AND NaTuMA, RKsnuRms
NOTICE OF INTENT
Division of Water Quality / Water Quality Section
National Pollutant Discharge Elimination System
NCG 110000
FOR AGENCY USE ONLY
Date Received
Year
I Month
Da
Certificate of Covera c
i i
f
Check 9
1 Amount
OD.
Permit li ed to
V_
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG110000:
STORMWATER DISCHARGES associated with activities classified as:
Treatment Works treating domestic sewage or any other sewage sludge or wastewater treatment
device or system, used in the storage, treatment, recycling, and reclamation of municipal or
domestic sewage, with a design flow of 1.0 million gallons per day or more, or required to have an
approved pretreatment program under Title 40 Code of Federal Regulations (CFR) Part 403,
including lands dedicated to the disposal of sewage sludge that is located within the confines of
the facility; and like activities deemed by DWQ to be similar in the process and/or the exposure of
raw materials, products, by-products, or waste materials.
(Please print or type)
1) Mailing address of ownerloperator (address to which all permit correspondence will be mailed):
Name Lincoln County — Department of Public Works
Street Address 115 West Main Street
City Lincolnton State` NC ZIP Code128092 1
Telephone No. 1704-736-8495 Fax: � 704-736-8499
E-mail Address bmckinnon(Mlincolncoun .or
2) Location of facility producing discharge:
Facility Name
Facility Contact
Contact E-mail
Street Address
City
County
Telephone No.
,Lincoln County Killian Creek Wastewater Treatment Plant
Tommy Drum (Operator of Record Charge)
tdrumO,Iincolncounty.org
17085 Old Plank Road
Stanley State NC it
tLincoln
1704-748-2314 ' Fax:
ZIP Code 128164
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).1lnterstate Hwy 77 to NC Hwy 73 (West); NC Hwy 73 —
10.4 miles to NC Hwy 16; Left on NC Hwy 16 — 2.3 miles to Old Plank Road; Right on Old Plank Road —1.4
miles. See Attached Map j
(A copy of a �county map or USGS quad sheet with facility clearly located on the map is required to be submitted with this application)
4) Latitude I"�° 25' 24` N Longitude 1810 01' 50" W I (degrees, mirl
5) This NPDES Permit Application applies to which of the following❑ New or Proposed Facility Date operation is to begin 10/11/2011iUL 2 7 2011
X Existing
DENT{ - A
Wetlands d a Warmh
Page 1 of 4
SWU-226-071408 Last Revised 7/14/2008

NIDG110000 N.O.I.
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: 14 9 5 2
7) Provide a brief narrative description of the types of Industrial activities and products manufactured at
this facility: I Wastewater Treatment Plant with design flow > 1.0 m$d "'
8) Discharge points 1 Receiving waters:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? 2
9) Receiving waters:
What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater
discharges end up in?,Unnamed tributaries to Killian 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 NIA
10) Does this facility have any other NPDES permits?
❑ No
X Yes
i
If yes, list the permit numbers for all current NPDES permits for this facility:'NC0088722
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
X No
�0 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?
I❑I No
X Yes
If yes, please briefly describe: �u plant stormwater drainage flows through stormwater retention ponds.
13) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No
X Yes
If yes, when was it implemented?; August 1, 2011
14) Are vehicle maintenance activities occurring at this facility?
X No ❑I Yes
15) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
X No �131 Yes
Page 2 of 4
SWU-226-071408 Last Revised 7/14/2008

. NdG110000 N.O.I.
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
X No I❑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) 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:l
Name of transport / disposal vendor.
Vendor address:
16) Certification:
North Carolina General Statute 143-215.6 b (1) 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 knowingly
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: LBarry McKinnon.
Title: l Sr. Utility Engineer
of Applicant)
72
(Date Signed)
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to NCDENR
Page 3 of 4
SWU-226-071408 Last Revised 7/14/2008

NiyG I I Ob00 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 NCDPNR
X This completed application and all supporting documents
X Copy of county map or USGS quad sheet with location of facility clearly marked on map
Mail the entire package to:
Stormwater and General Permits Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Note
The submission of this document does not guarantee the issuance of an NPDES permit.
For questions, please contact the DWQ Central Office or Regional Office for your area.
DWQ Regional Office Contact Information:
Asheville Office ...... [phone]
Fayetteville Office ...
[phone]
Mooresville Office...
[phone]
Raleigh Office ........
[phone]
Washington Office ...(252)
946-6481
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........
[phone]
Page 4 of 4
SWU-226-071408 Last Revised 7/1412008

Lincoln County Department of Public Works
115 West Main Street
2nd Floor Citizen's Center
Lincolnton, NC 28092
Phone [phone]
`"*° Fax [phone]
TO: NCDENR Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27699-1617
ATTENTION: Stormwater and General Permits
LETTER OF TRANSMITTAL
DATE: 07 26 11
RE: Killian Creek Wastewater Treatment Plant
Unit
We are sending
via:
Overnight QX Regular Mail Q Pick-up Q Hand Delivered
The following
items:
Q Correspondence Q Plans 0 Specifications Q Other as listed below:
COPIES
DATE
NO.
DESCRIPTION
1
Check No.: 026246 in the amount of $100.00 made payable to NCDENR
1
Notice of Intent NCG110000
THESE ARE TRANSMITTED as checked below:
Please Analyze
X For your use
REMARKS:
As requested
For review and
comment
Approved as Returned for corrections
submitted
Approved as noted Forward to subcontractor
Barry L. McKinnon, PE
COPY TO: SIGNED: Senior Utility Engineer _

-LINCOLN COUNTY LINGOLNTON, . NC WATER FUND
026246'
DATE INVOICE NO. NET AMOUNT CHECK NO,
7/1155/2011 PERMIT - i0olo()
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LINCOLN COUNTY LINCOLNTON, NC
WATER FUND
DATE INVOICE NO, I NET AMOUNT
026246
CHECK NO.