The URL can be used to link to this page

Home My WebLink AboutNCG030624_COMPLETE FILE - HISTORICAL_20121116STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. /v DOC TYPE HISTORICAL FILE ❑ MONITORING REPORTS DOC DATE ❑ Q01 Chi I I I U YYYYMMDD A& � - �� NC®NIt North Carolina Department of Environment and Natural Resources Division of Water Quality Beverly Eaves Perdue Charles Wakild, PE Dee Freeman Governor Director Secretary November 16, 2012 Mr. Marc Kassay Phillips Optimum 880 Facet Road Henderson, NC 27537 Subject: Stormwater Compliance Evaluation Inspection Certificate of Coverage No. NCG030624 Phillips Optimum Vance County Dear Mr Kassay: On October 25, 2012, Cheng Zhang of the Raleigh Regional Office (RRO) conducted a Stormwater Compliance Evaluation Inspection at the subject facility. Your assistance was greatly appreciated. The inspection report is attached. Findings during the inspection were as follows: 1. Certificate of Coverage (COC) No. NCG030624 of NPDES general permit NCG030000 was issued to Phillips Optimum to discharge stormwater runoff to an unnamed tributary to Martin Creek, a Class-C NSW stream, in the Tar -Pamlico River Basin. 2. The COC was issued on July 13, 2012. The facility has not developed and implemented a Stormwater Pollution Prevention Plan (SPPP). At the time of inspection, the facility had not conducted qualitative monitoring and analytical. 4. The stormwater outfall was not accessible because of thick vegetation. 5. The facility submitted application for No Exposure Exclusion from Permitting on November 5, 2012. Should the application be approved by the Division, the current COC should be rescinded; otherwise, the facility must conduct monitoring, develop and implement a SPPP, as required by the General Permit. North Carolina Division of Water Quality 1628 Mail Service Center Raleigh, NC 27699-1628 Phone (919) 791-4200 Customer Service Internet: www.ncwaterquality.org Location: 3800 Barrett Drive Raleigh, NC 27609 Fax (919) 788-7159 1-877-623-6748 An Equal Opportunity/Affirmative Action Employer— 50% RecycleclA 0% Post Consumer Paper Phillips Optimum Permit No. NCG030624 Compliance Evaluation Inspection If you have any questions regarding the attached report or any of the findings, please contact Cheng Zhang at 919-791-4200 (or email: cheng.zhang@ncdenr.gov). Sincerely, Cheng Zhang Environmental Specialist Enclosure: Compliance Evaluation Inspection Form cc: Central Files RRO SWP files Compliance Inspection Report Permit: NCG030624 Effective: 07/13/12 Expiration: 10/31/12 Owner: Philips Optimum SOC: Effective: Expiration: Facility: Philips Optimum County: Vance 880 Facet Rd Region: Raleigh Henderson NC 27537 Contact Person: Marc Kassay Title: Phone: 252-492-7198 Directions to Facility: System Classifications: Primary ORC: Secondary ORC(s): On -Site Representative(s): Related Permits: Inspection Date: 10/25/2012 Primary Inspector: Cheng Zhang Secondary Inspector(s): Certification: Phone: Entry Time: 01:00 PM Exit Time: 02:00 PM Phone: 919-791-4200 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: NCG030624 Owner - Facility: Philips Optimum Inspection Date: 10/25/2012 Inspection Type: Compliance Evaluation Reason for Visit: Routine Inspection Summary: The facility has submitted a No Exposure Exclusion from Permitting to the Division. If the application is approved, the current COC needs to be rescinded. Page: 2 r, Permit: NCG030624 Owner - Facility: Philips Optimum Inspection Date: 10/25/2012 Inspection Type: Compliance Evaluation Reason for Visit: Routine Stormwater Pollution Prevention Plan Yes No NA NE Does the site have a Stormwater Pollution Prevention Plan? ❑ ■ ❑ ❑ # Does the Plan include a General Location (USGS) map? ❑ ■ ❑ ❑ # Does the Plan include a "Narrative Description of Practices"? Cl ■ ❑ ❑ # Does the Plan include a detailed site map including outfall locations and drainage areas? ❑ ■ ❑ ❑ # Does the Plan include a list of significant spills occurring during the past 3 years? ❑ ■ ❑ ❑ # Has the facility evaluated feasible alternatives to current practices? Cl ■ ❑ ❑ # Does the facility provide all necessary secondary containment? ❑ ■ ❑ ❑ # Does the Plan include a BMP summary? ❑ E ❑ ❑ # Does the Plan include a Spill Prevention and Response Plan (SPRP)? ❑ ■ ❑ ❑. # Does the Plan include a Preventative Maintenance and Good Housekeeping Plan? ❑ ■ ❑ ❑ # Does the facility provide and document Employee Training? ❑ ■ ❑ ❑ # Does the Plan include a list of Responsible Party(s)? ❑ ■ ❑ ❑ # Is the Plan reviewed and updated annually? ❑ ■ ❑ ❑ # Does the Plan include a Stormwater Facility Inspection Program? ❑ ■ ❑ ❑ Has the Stormwater Pollution Prevention Plan been implemented? ❑ ■ ❑ ❑ Comment: The COC was issued on July 13, 2012. The facility has not developed a SPPP yet. Qualitative Monitoring Yes No NA NE Has the facility conducted its Qualitative Monitoring semi-annually? ❑ ■ ❑ ❑ Comment: The facility has not concucted qualitative monitoring. Analytical Monitoring Yes No NA NE Has the facility conducted its Analytical monitoring? ❑ ■ ❑ ❑ # Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas? OSOO Comment: The facility has not concucted analytical monitoring. Permit and Outfalls Yes No NA NE # Is a copy of the Permit and the Certificate of Coverage available at the site? ■ ❑ ❑ ❑ # Were all outfalls observed during the inspection? ❑ ■ ❑ ❑ # If the facility has representative outfall status, is it properly documented by the Division? ❑ ❑ ■ ❑ # Has the facility evaluated all illicit (non stormwater) discharges? ■ ❑ ❑ ❑ Page: 3 Permit: NCG030624 Owner - Facility: Philips Optimum Inspection Date: 10/25/2012 Inspection Type: Compliance Evaluation Reason for Visit: Routine Comment: The stormwater discharge outfall was not accessible because of thick vegetation. Page: 4 Centrai Res: HPS SWP 07/11/12 Permit Number NCG030624✓ Permit Tracking Slip Program Category Status Project Type NPDES SW In review New Project Permit Type version Periiilt Ciassificatioii Metal Fabrication Stormwater Discharge COC COC Primary Reviewer Permit Contact Affiliation brian.lowther Coastal SW Rule Permitted flow Facility Facility Name Philips Optimum Location Address 880 Facet Rd Henderson Owner NC 27537 Major/Minor Region Minor Raleigh County Vance Facility Contact Affiliation Marc Kassay 880 Facet Rd Henderson NC 27537 Owner Name Owner Type Philips Optimum Non -Government Owner Affiliation Bob Campbell Manager Safety 880 Facet Rd Henderson NC 27537 Dates/Events Scheduled Orig Issue App Received Draft Initiated Issuance 05/14/12 Regulated Activities uc vim —AUIP1 i1ra I iaawia U c Outfall 001 Public Notice Issue Eff ctive Expiration 7 �/3llr 1713�2 U/3�iZ Requested/Received Events RO staff report requested 05/24/12 RO staff report received 07/11 /12 Waterbody Name Stream Index Number Current Class Subbasin Martin Creek 28-78-1-3 C;NSW:+ 03-03-02 North Carolina Beverly Eaves Perdue Governor Mr. Marc Kassay CMK Ventures, LLC 886 Facet Rd. Henderson, NC 27537 Dear Mr. Kassay: NC®ENR Department of Environment and Natural Resources Division of Water Quality Charles Wakild, P.E. Director Tilly 13 2011 Subject: General Permit No. NCG030000 CMK Ventures,-LLC Philips Optimum COC NCG030624 Vance County Dee Freeman Secretary In accordance with your application for a discharge permit received on May 14,- 2012, 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. Per the requirements of the Tar -Pamlico Riparian Buffer Rule,- all- stormwater drainage to stream buffers, from portions of this site that have been constructed after January 1, 2000, must be discharged through a correctly designed level spreader or another device that meets diffuse flow requirements per 15A NCAC 2B .0259. Diffuse flow requirements are described in Chapter 8 of the North Carolina Stormwater BMP Manual, available at: http://h2o.enr.state.nc.us/su/bmp forms.htm 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. Please note that the attached permit expires on October 13, 2012. Your. COC will be - automatically renewed to cover the full 5 year term of.the soon to be reissued permit. In the interim you must abide by the terms of the expiring permit. You can review_ the proposed general permit changes at (http://portal.ncdenr.org/web/wq/ws/su/public-notices). Wetlands and Stormwater Branch 1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Location: 512 N. Salisbury St. Raleigh, North Carolina 27604 Phone: 919-807-63001 FAX: 919-807-6494 Internet: www.ncwaterquality.org An Equal Opportunity 1 Affirmative Action Employer NorthCarolina NCG030624 r' �S If you have any questions concerning this permit, please contact Brian Lowther at telephone number (919) 80/-6368 Sincerely, i� /�c.G, &.0—, for Charles Wakild, P.E. cc: Raleigh Regional Office Central Files Stormwater Permitting Unit Files STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF WATER QUALITY GENERAL PERMIT NO. NCG030000 CERTIFICATE OF COVERAGE No. NCG030624 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, CMK Ventures, LLC is hereby authorized to discharge stormwater from a facility located at Philips Optimum 880 Facet Rd Henderson, NC Vance County to receiving waters designated as an unnamed tributary to Martin Creek, a class C; NSW: + water in the Tar -Pamlico 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. NCG030000 as attached. This certificate of coverage shall become effective July 13, 2012. This Certificate of Coverage shall remain in effect for the duration of the General Permit. Signed this day July 13, 2012. for Charles Wakild, P.E., Director Division of Water Quality By the Authority of the Environmental Management Commission LOCATION MAP: NCG030624 INT Rl *.1 S Map Scale 124, 000 CMK Ventures, LLC .Philips Optimum Latitude:,360 17' 16" N Longitude: 78c' 23' 36" W County: Vance Receiving Stream:Martn Creek (UT) Stream Class: C; NSW: + River Basin: Tar -Pamlico Facility Location . I WDENR North Carolina Department of Environment and Natural Resources Division of Water Quality Beverly Eaves Perdue Charles Wakild, P.E. Dee Freeman Governor Director I� Secretary July 13, 2011 D L� Cr Mr. Marc Kassay J U L 19 2012 CMK Ventures, LLC 880 Facet Rd. NC DENR Henderson, NC 27537 _ _ R:;Ipigh 4e,;icnai Office Subject: General Permit No. NCG030000 CMK Ventures, LLC Philips Optimum COC NCG030624 Vance County Dear Mr. Kassay: In accordance with your application for a discharge permit received on May 14, 2012, 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. Per the requirements of the Tar -Pamlico Riparian Buffer Rule, all stormwater drainage to stream buffers, from portions of this site that have been constructed after January 1, 2000, must be discharged through a correctly designed level spreader or another device that meets diffuse flow requirements per 15A NCAC 2B .0259. Diffuse flow requirements are described in Chapter 8 of the North Carolina Stormwater BMP Manual, available at: http://h2o.enr.state.nc.us/sulbmp forms.htm 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. Please note that the attached permit expires on October 13, 2012. Your COC will be automatically renewed to cover the full 5 year term of the soon to be reissued permit. In the interim you must abide by the to mils oftii2 expiring permit. You cart review the proposed gerierai permit changes at (http://portal.nedenr.org/web/wq/ws/su/public-notices). Wetlands and Stormwater Branch 1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Location: 512 N. Salisbuy St. Raleigh, North Carolina 27604 Phone: 9194107-63001 FAX: 919-807-6494 Internet:-;Avw.ncvaaterquality.org An Equal opportunity 1 Affirmative Action Employer NorP thCarohna Aaturally . NCG030624 If you have any questions concerning this permit, please contact Brian Lowther at telephone number (919) 807-6368 Sincerely, 't'l-' I�de, for Charles Wakild, P.E. cc: Raleigh Regional Office Central Files Stormwater Permitting Unit Files STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF WATER QUALITY GENERAL PERMIT NO. NCG030000 CERTIFICATE OF COVERAGE No. NCG030624 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, CMK Ventures, LLC is hereby authorized to discharge stormwater from a facility located at Philips Optimum 880 Facet Rd Henderson, NC Vance County to receiving waters designated as an unnamed tributary to Martin Creek, a class C; NSW: + water in the Tar -Pamlico 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. NCG030000 as attached. This certificate of coverage shall become effective July 13, 2012. This Certificate of Coverage shall rernaiii in effect for the duratiort of the General Permit. Signed this day July 13, 2012. x � ��, PC , , "I I �/ f Charles Wakild, P.E., Director Division of Water Quality By the Authority of the Environmental Management Commission LOCATION MAP: tip NCG030624 T 1E S Map Scale 124, 000 fA T. I 'IJ 14� 4P. IF "J E x, 5 L 0 4. Philips Optimum MW R't 77`7 1 LN Q .4il 31 T 7" CIMK Ventures, LLC Philips Optimum I I , Latitude: 360 17' 16" N Longitude: 780 23' 36" W County: Vance Receiving Stream:Martin Creek (UT) Stream Class: C; NSW: + River Basin: Tar -Pamlico I Facility Location Lowther, Brun From: Zhang, Cheng Sent: Tuesday, July 10, 2012 4:45 PM To: Lowther, Brian Subject: RE: SW General Permit NCG030624 rrlan, I do not have any concerns about issuing the COC. Thanks, Cheng Zhang Environmental Specialist NCDENR- Raleigh Regional Office Surface Water Protection 1628 Mail Service Center. Raleigh, NC 27699-1628 Office (919) 791-4259 Fax (919) 788-7159 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 From: Lowther, Brian Sent: Tuesday, July 10, 2012 4:30 PM To: Lowther, Brian; Zhang, Cheng Cc: Smith, Danny Subject: RE: SW General Permit NCG030624 Chen, It has been more than 30 days and I wanted to check to see if I should wait to issue this permit until I hear back from you. Please let me know. Brian From: Lowther, Brian Sent: Thursday, May 24, 2012 10:06 AM To: Zhang, Cheng Cc: Smith, Danny Subject: SW General Permit NCG030624 Chen, We've received an NOI from CMK Ventures, LLC for their site in Vance County requesting coverage of under an NCG03. The site discharges stormwater to the an unnamed tributary to Martin Creek (C; NSW: +). The NOI is attached. 1 Please let me know if the Raleigh Regional Office has 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 (919)807-6368 brian.lowther(a�nedenr.eov http://portal.ncdenr.or�/web/wq/ws/s u ,E-mail correspondence to and from this address may be subject to the North caroiina Public Records Law and may be disclosed to third parties unless the content is exempt by statute or other regulation. 2 Division of Water Quality / Surface Water Protection Section 0.' ef N, R- National Pollutant Discharge Elimination System NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES NCG030000 NOTICE OF INTENT FOR AGENCY USE ONLY Date Received= Year Month Day " 'CertificateofUdkra'e NCGO 13D 16 11.4 ;. Check N, ,f ' Amount , Permit Assigned to ' LOU-) National Pollutant Discharge Elimination System application for coverage under General Permit NC G030000: STORMWATER DISCHARGES associated with activities classified as: SIC (Standa-d Industrial Classification) 335 Rolling, Drawing, and Extruding of Nonferrous Metals SIC 3398 "Metal Heat Treating SIC 34 Fabricated Metal Products =`• SIC 35 Industrial and Commercial Machinery SIC 36., Electronic and Other Electrical Equipment SIC 37 Transportation Equipment SIC 38 Measuring, Analyzing, and Controlling Instruments 1-or.questions, please contact the DWQ.Regional Office for your area. See page 4. 1 (Please print or type) 1) Mailing address of owner/operator (address to which all permit correspondence will.be mailed): Name - .e Ciik 11�.i�.res G fv .,- Street Address City ,�%y�5,� Pts tea, State ZIP Code1-2 Telephone No. 2SZ- Fax: 2) Location of facility producing discharge: Facility NamerJ, Facility Contact ie' k 4A Street Address d?C 7` � City ac f sort State if%L ZIP Code 2 2"7. County Telephone No. ?rd'Z y` 12- 7/ ,7 0 Fax: Email Xgpe-, f(,�sS,4Ile 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). 77- (A copy of a county map or USGS quad sheet with the facility'clearly located must be submitted with this application.) `� ( 4) Latitude/Y 3�p�/%.�: /�, 32L`3 LongitudeW 1g�i z3� ��•�I' � (deg, min, secOD MAY 1 4 201DENR Page 1, of 4�==-a—►�W? SWU-218-071408 Last revised NCG0.30000 N:O.I. 5) This NPDES Permit Application applies to which of the following: '1 ❑ New or Proposed Facility Date operation is to'begin I� Existing 6). Standard Industrial Classification: Provide the 4-digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial activity at this facility. LL// SIC Cod.e:P 7) Provide a brief narrative description of the types of industrial activities and products mariufactured'ot this facility: %A�y f a <i o� �rJG f/��.? _.w%sssi' l.?I-y car - d sJae> 4as fik iy,rs / 8) Discharge points / Receiving waters: How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? i What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater discharges end up in? Receiving water classification: Is this a 303(d) listed stream? Has a TMDL been approved for this watershed? 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). 9) Does this facility have any other NPDES permits? 2 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)? ® 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? ® 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? ® No ❑ Yes If yes, when was it implemented? 13) Are vehicle maintenance activities occurring at this facility? 1.Z No ❑ Yes, 14) Hazardous Waste: a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? -- --- -- -No—❑-Yes -- ----- - Page 2 of 4 SWU-218-071408 Last revised V14/08 NCG030000 N.O.I. Final Checklist This application will be returned as incomplete unless all of the following items have been included: Check for $100 made payable to NCDENR. This completed application and all supporting documents. 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. d 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 Division of Water Quality 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Note The submission of this document does not guarantee coverage under the General Permit. For questions, please contact the DWQ Regional Office for your area. DWQ 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 SWU-218-071408 Last revised 7/14/08 NCG030000 N.O.I. b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of hazardous waste? ❑ No ® Yes c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of hazardous waste? ® No ❑ Yes d) Is hazardous waste stored in the 100-year flood plain? JA 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 / disposal vendor: Vendor address: 15) Certification: North Carolina General Statute 143-215.613 (i) 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 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 accratee. Printed Name of Person Sig ing: RUnp-? � 4l�( / Title: nF&6y�/ A4 1010 (Signature Signed) This Notice of Intent must be accompanied by a check or money order for $100.00, made payable to: NCDENR Page 3of4 SWU-218-071408 Last revised 7/14/08 �! r �� ,,, �n8�,r:. ,ri,.,r ,cf ,•��r• "i.a ^f r `,�' " �'` �±' ia, its $e,'t. gt,�eF�, A �,, 'Y�'.�,.� ,+` , '�•- 4 t `r ,NJ � .�.«,"• q,: ,t r'[�' ij �' a � t�>ak z' ia• �.,;a �. � r ti ��,�.,�,�� N yt W +h LL L, w. �� j;,�� • - .. . .r'"�'�'a`Asa'x�t4 «d m �' P ��b t Iti� ' ., ��i,„'q `' �`.. y X*� e 5' W x fq"h xx S' c ,, 'E 5 i+,�,t .,� �a. is � O 1• Sd xdy e _o ' _ �� r�'.'�rr` . � � .� a � r dr ,,_ �,d r t rr+• � .� .,ry t"t `t �r,� ,�`' o.�-. � y t •' 8' w".�� '>�-� y - � r�l�r "�t'�' (:" ,. �t : a d 5 -�s.-s ;. �,,'"�„` p ' as .r,"�`"'e • 1`'�k�� IX` `., r�t,..(.r�1+ e;.�• :z•�Skti' t;rY e ''`„s it'i -�tr 'r ' Rr i:ji0 . 4 . nIX7 PO },}al`J� - `_✓ ��_ a e �. a r� 'r3 t t t �d`v , �.. � t �s � k,�`•-!'+ g � " e 5"^`� _ ,� k B r, ' ey ti� y� � �f a•�iF` d �+r P'� k"' �'� i '�, p, "' i t"$ �"r a "i . e'' ' . �p� "� 1 � z � "� ,'.�,rA" � v� ;%,5p n � S" �u � i?"i � '.C�'k t . r r M .� a"+ �; '� � > },� ri°F i .• is � {" +� :' �k � �O .b.. Mf't u?';.. ��y, k�'. - +vPe' �tkt t•' 3. r'.,.+ a e,�i 't .{' a C'7 .�*••.r 'i.'�r�'.'i o "�a-} t ��,-7,eot,� E-. w � s '� p.$;r"c r �4�. ,r 5'@�_�1�J' w„v"; .� a� �� E.tf'�.t�f'. ,r,� ',a't`°� ��rr A� w RY g•'� e., . ,�^f"�.� •.� a ��'i � ��} `:.;'r r �� w w y^•,`vay.e� . ..�+ br 1-_, ��xc-r�§+� 1 r" Esc S�-�;` --, . x,'r. , '.• � '..,�.� � .^, i �.�� , _"-Rr Ea .*i vE�,� rF`il, t i}c ecvi '•esf 1 x ram'". s s"* w; al „ rl "�"<t SY i O , to r� �•Y r t rye '+ ' ,S�,t,)� a'�' e. � R'f ��'n /�'r �'-•.'s✓ i s° r �� * : � .rR";.i,r� ;sq d- r` �� ,+r, d ."� 'v 4-j 3yt".�im' `� s��'_L 'e,Z �'y�r�. K `�• ', t'l+''�. 6� '� rt �L { '�, a`=� - '4.�'M sy >rt a �•'"�+.'a 3 '� �. °� �R*.r � rM �.ym r f�'',t r ',�? F ti'. .. ,�� h♦� (,��',�°8,��i.��j :1�� d+air .�xtt `` Q o � J.` �jP Tom; ^`d i+`�f' Nl i P .'k !'. k9 Sy A �. •4' 'M "f 5 � :i � <1 ,,r ,y ^ 'g' i Nn O c .�•a x >,:,^ x `n ,ra" r�Rl� °�N x� � � � .�� ° r� _+C� �'S k� �x��x a"� •` Sf �t � � .�� y r .. � r� �.�,.:. ...fl - +'r�,F c <y,-�.; ,• r t �. s" F-w ti v. w 10, +`te'. ."r rs.. � � a �- „�. ..,�•v *W ,.� ""'"�` tfi 't�''a �""u �.x!' �# � cbt "� 1 r �" xs „�.��,�',� - _ �u _ ��_ � :.�`• r�+• s^-w„ �.� r { �rhti . ''.h? �r a 9 � 1� � � ..r J7"� � �'� 7 3 r�i r ' a -,, �.^citxa� :Qa. '.-w. •7,lUl;JL'w s.. ,r' , •c p •.�-' is ril lid, } .�,•°'� -� r7h ..Sags .,,'t"' �•' _ ��.k.:p r ..6A b IF ,.• � 4�e��i �� 6�-F"'ilr! • .� �., pj �', _ � b 4 '"M _ �"'� �'�`" L Fi,,�„ sb t'tl#'� A ' •' F Cf �.rf w� . at f ,• n _ $id la '�' i �rQ �.` �y,�'dr.. d+ °,°fir $ {IJ ��i 4� • °' � t,��« �+�,r ;M .�„ •r r ---J e:, F x .�� 'R' V.- of . fQ }%�� .- r� t � a,� k�u§a .r ` � � ". � � • � s< as ., � - . r y v t �x t � r♦ J''h ! i, a 'y _ 1 r` �� 7 ' ' r°aY h f 'y♦ 3 91i `C q 1 � r 4 " r S a't � �f'd r - • F 5 � } t .{•�Y�`y-i ��[ �, � rti^•, a �{q �'" ,,� ;�� f i� l E{ � � � .. {r ... = ra"v ��y �, _ i IX,at�.r,��,7�a,,9ra �- 4IF ",;1 �,4 °r f"'��'s s% :: �y�;'fi .»;,,��,��' :*�, a- s. y�fy, � rr .;`';f,,.�a�,�,'.� a� a-� 't'? sti;��"",�.�. ,*', -c� ,�� .;��:•'�-max ,.,rR vc, ! N' � .• � •..�^� L� ni`l ,y� k fl'. �. a C i .fi � � ; .Y,�, �' n ea :. � 5 � r�z '�i. t *�'` :zs � ' �, ✓,� . s h"�k.,�� c74L'* k 9 ry�+ �`�,� a ^n. + r ,� 1 a �. � -i +,� �sr'r � a ' � S" x3^ x �S "�`-�t'`� r'�a• t.V- +'"'4L^. rs �'� r ...�� *�� :i il i�� ,��SrdIXar `� tr• ,�'^" ��c '# '�� ;p p. l �ti'kr . •s e r3 :", { % ..� '�" � � � � ^� '➢ 1:�'e � s.p r,.. � .r + s �.. r ,, :a i� s t,� ��'N � ;�F"', '�.h �- P � �• � ,.�. !� �'h ,e. *t ,;n '. '�'�SvF :y+. SIX. i,'�5k �r2!xrii � �-sa:M+r ��` 'S'�� rs�°T �'. >'' ', ',r„n��tr ,ri »• �. .':; 'IX`^S 1'";' !'S,.,�'nx,1' ,,8 rm+t.7;k ♦r ^' +A�4,�,.! iy `�r ,i�?,r+t r�'F' E„* � ai ><...4 7:7;, '�+r; fi; r„ dr t.: 'w ""r•i -Y �� . s � �. • '- ` �( L ii fr y��k � + � t�� -yb, r e'" � t.!� •c ��.. .k. �� $'�,.d cam"' �ti � 'a.> � 4' " ti4L < _ n;'' �i "' s r r� ,�,. � • �±,, y' � •r G ` � �.. � ��5 +,,w� r r .4 ', 4 ' s r ,�( 4 's .�'•- t' '�'; 'a. ->,r •+' � `r ,� r:. h + •5- f�`,. �, �,� r.,ti t'r,�."; �r "A '� •,r > 'A � r"" tl`', rJ .'.'``'&f r rc7ae'p 5 of"e 4" o s&j; va s t a Raa'.� •. „�, :. 's' '�3`. .t;,> 'V '" .,� �`� 3 ern •'7� 9:, a A9'.' �r,�''4 � `»" ^t�S x« � � > p i ' i7 � � .Bv" 'R n •:, :t; � �! °±...,,.. M �t+Ag ''7' �� •;:w`'�- �w r dr, i h', s ,�*�y�«,.�yy .�ia*j, �. f i!` �� ., tea�. � k F_n J . ; +� 'k'r # �:...= !_ s+Ra xb- a� r ti. r, a d 1 'i'- a+ �e a' `'^ rY Y'.;��KY �'a r"�� .v fia•r' r, �-! i lkr�'�"a- ,�,, e x#x a+.Y "y, l f�^ ..^R� �,.�'�'s�n.'?*,. :`'r �""i��r(. P ar ✓s'b�s*u r�.. ,. .t~".,�.",`,P# �! ;-r ��r t, ,fit � „ r � r ,. ,. I e;,k • `r �d� r t ya. �, .� �. t r ,.'t`r•., nr: i' .,,} t`'} t","'t ! "R a rt,4 ' - t 1 -prY }, ''�, i=`r b,', e r �s 1 wt; 3''� -Ffl° .Y'T :. ! P 7' S,:s� 4 .,y�•y,. '�i`=.,x'k t wlB xrF iA 1� J.,, �7b rry 0' ' 7 c ' r b ..a * _ ��.tfit % a '4. 2r y,,,r`` a,P s, - ,� p"r .y, #- xa r, �+,k�'.•"' ` ,r t, -"F�t,t'�r ' �' _ :r �'rrufi� ,_ ;,^�✓tom `v�,gS�i`IX rr' «;auk as � �� ddor* �.."ft''1��`'$' P-t» vR ��. � _��a^�`s yt;� f t a rr k - �"� � 1. �.. i- �y �, � 2 � h l� ,�ia'n�,f d`�•-K 9-= �' �,,�L+•%t,d'v-w t`A," 1 i t �� S .1 � `_ = c q"r: _i 'T...d :t' .4 i •t v-'^ '� " .✓' iur`y Ja'8 `- .a V: s' r'W.-�'w < ] f4 ,Fp ``7" 1: E Y [ c - _ G _ - •Y fr � t � � ".1 �t�.�. 7 14 :,, '*�. r�4'z �y„'i]15 �w* ; .,,8, 2 '3ry `�k�f + _ _ _> ' � t •. � �z<. �; d tom' � fir,, x°r f" `� a �� '-. _ >••: a r C r ,a* 8m, vt;.� 4jM� s 'i zZie, p.,a• �,C -d € - ut IF € E :lf vn6 v °" r pit rm' a s»5 r2+t ' , '��—'•' . - �. , a4:' �".:.'^iv-.. i�`�++. ..,.. ...�' -.. 5.'�,. ,. ;n!:.' -.e .� x1 i. ,. -. rrry .. a� 'tt �.. ... - .. 7G�7f�i�i4x?s'r ,.�-.�.�---"---"`_... g.3,`K� p4, 3•� �"�. .,93, AmoxitAw- '_� �.._..�.YxQ�y_.__x—X__.x--x�r".._-s---s—x..-._.x�.��r$� _—_ ._ .-x._--•�___ _... x FH Ecm LP fF vz-t \ giPlfid - \. O pf •S IF l -35 yN?RC4t t•2d.:�E{4t. x3. F(;. 4'.6 ,j \, ��\ ` -iiii�,itinirtit''K. .'.if'.v \ nJ.i•:.+(i. Qti• zr,9 k}}y ` i� •Y 1 '.._ j( t t� BEEN PftfPARED ,wn"QUT fSiil i AOF A TiS1E ttEP04ii KECESS�Y VP i c rat TNEREFOt2£ KOT THE 6N ii cF' [E ALL EKCUVB-''DES ___ K.c pzmpr:fe�% iyf Gcry �in.�te M:CTirsa � ffe 1\�.,, t •t!fi �w6;�Ji i:+�is PIS`" k f' � �' 3-., o py .iai"s faucti<i K tim: Sat n� ' s ��# Exst.tr, geCct Faura og.g"t' _-� t 4ct++ Rabcr er.� 5 kr= Fy.tn;S svA -wv A fxiHti:tri Na f �f o..s�d .. �pacw tra' If664 S 5"tYc WA;E52 VSI:t=;r WAN f 300 0 CA?C;� 0F6 tit -t- • , _`�t-.. __" _-'----"--." 1 . _. FTi t t ep +{ LP f ;:f3 F•ri i fi3'+ �fV cH O+-W EF-E'•K'!3 -----'..} _ _1`--T••7 VIA 4;rA siartk+ i t I 23 288 ACRES a r� P,;. TAS i i WV i i E f O cq } ON 4�M x t a} LP 4� ,-.6- e.91 u_a. a3a, Ps 1 k A T U'S SSt1:1- so-, PRES miNARY SURVEY 'OR PROPOSAL NUT FOR SALES; CONVEYANCES OF RECORDATION ' •..a dro s�o� of:Phrhp§ E( ct en cs-'A r+h Ams ca Corp 880!Facet Road:• He ,derso NC 275�7 ; (252) 1�2 7.138 ,?..RwNUMBER; a,NUR. 'IBATCIt 5,- FV UMBER ..i 'p:.., ,GROSS AMOUNT - DISCOUNT ` NET AMOUNT st 0040641. 5/11/2012 NGDENR NCDENR -= 0 00 ' PHILIPS OPTIMUM HENDERSONNG 27537 101' e- ■• a •• a •e e e -..e._ -e• :e•e e .. OPtimum Lighting(, G�3 . division of_his -:Electronics North'America Corp.,,_ f 880 Facet; Road , Henderson'; NC 27537 VENDOR NO DATE CHECK NUMBER i, CDENR /11/2012 I D04064:' -" THE;REVERSE SIDE,OFTHIS DOCUMENT•INCL''UDES,A�WATERMARK ,,' *