NCG110136_COMPLETE FILE - HISTORICAL_20130129

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V c) 3
DOC TYPE
19 HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ o7b l 3 O I
YYYYM MDD

1
A 7-rAl
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor' "
January 29, 2013
City of Dunn
Attn: Dean Gaster
P. O. Box 1065
Dunn, NC 28335
Division of Water Quality
Charles Wakild, P. E.
Director
Subject: COMPLIANCE EVALUATION INSPECTION
City of Dunn
Black River WWTP, COC NCG110136
NPDES Stormwater General Permit-NCG110000
Harnett County
Dear Mr. Gaster:
John E. Skvarla, III
Secretary
On January 3, 2013, a site inspection was conducted for the Black River WWTP ,facility located
at 580 JW Edwards lane, Harnett County, North Carolina. A copy of the Compliance Inspection
Report is enclosed for your review. The cooperation of Mrs. Donrie Dukes, Facility ORC, was
greatly appreciated. Permit coverage authorizes the discharge of stormwater from the facility to
receiving waters designated as the Black River, a Class C; Sw water in the Cape Fear River
Basin. The site visit and file review revealed that the subject facility is covered by NPDES
Stormwater General Permit-NCG110000, Certificate of Coverage -NC G110136.
As a result of the inspection, the facility was found to be in comaliance with the conditions of
the NCGI 10000 permit. Please refer to the enclosed Compliance Inspection Report for
additional comments and observations made during the inspection.
1617 Mail Service Center, Raleigh, North Carolina 27699.1617
Location: 612 N. Salisbury St. Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone]
Internet: www.ncwaterquaIh.oro
An Equal Opportunity 1 Affirmative Acton Employer
oNtlzrally
e hCarolina

.4
Mr. Gaster
January 29, 2013
Page 2 of 2
Please be advised that violations of the NPDES Stormwater General Permit are subject to a civil
penalty assessment of up to $25,000 per day for each violation. If you or your staff has any
questions, comments, or needs assistance with understanding any aspect of your permit, please
contact me at [phone] or by e-mail at [e-mail],
Sincerely,
/ 4'
x d...
Mark Brantley
Environmental Senior Specialist
Surface Water Protection Section
Fayetteville Regional Office
Enclosure
cc: Donrie Dukes, Facility ORC
FRO -Surface Water Protection
Niki Maher-WBS Compliance & Permits Unit
DWQ Central Files

IM
Compliance Inspection Report
Permit: NCG110136 Effective: 01/02/09 Expiration: 05/31/13 Owner: City of Dunn
SOC: Effective: Expiration: Facility: Black River Wastewater Treatment Plant
County: Harnett 580 Jw Edwards Ln
Region: Fayetteville
Dunn NC 28334
Contact Person: Donrie Eldridge Dukes Title: Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
NCO043176 City of Dunn - Dunn WWTP
W00006101 City of Dunn - City of Dunn Residuals Land Application Program
Inspection Date: 01/03/2013 Entry Time: 11:00 AM Exit Time: 11:30 AM
Primary Inspector: Mark Brantley �� gA � Phone: [phone]
-� Y Ex1.727
SUGUISCItSFY
);
Rev � ewcr A : let L4 wyel.
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Municipal WWTP > 1MGD, Stormwater Discharge, COC
Facility Status: ■ Compliant ❑ Not Compliant
Question Areas:
0 Storm Water
(See attachment summary)
Page: 1

Permit: NCG110136 Owner - Facility: City of Dunn
Inspection Date: 01/03/2013 Inspection Type: Compliance Evaluation ' Reason for Visit: Routine
Inspection Summary:
Page: 2

Permit: NG0110136 Owner - Facility: City of Dunn
Inspection Date: 01/03/2013 Inspectlon Type: Compliance Evaluation
Reason for Vlsit:
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"?
■
❑
❑ ❑
# Does the Plan include a detailed site map including outfall locations and drainage areas?
■
❑
❑ Cl
# Does the Plan include a list of significant spills occurring during the past 3 years?
■
❑
❑ ❑
# Has the facility evaluated feasible alternatives to current practices?
■
❑
❑ ❑
# Does the facility provide all necessary secondary containment?
■
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# Does the Plan include a BMP summary?
■
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❑ ❑
# Does the Plan include a Spill Prevention and Response Plan (SPRP)?
■
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❑ ❑
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
■
❑
❑ ❑
# Does the facility provide and document Employee Training?
■
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❑ ❑
# Does the Plan include a list of Responsible Party(s)?
■
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❑ ❑
# Is the Plan reviewed and updated annually?
■
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❑ ❑
# Does the Plan include a Stormwater Facility Inspection Program?
■
❑
❑ ❑
Has the Stormwater Pollution Prevention Plan been implemented?
■
❑
❑ ❑
Comment:
Qualitative Monitoring
Yes
No NA
NE
Has the facility conducted its Qualitative Monitoring semi-annually?
■
❑ ❑
❑
Comment:
Analytical Monitoring
Yes
No NA
NE
Has the facility conducted its Analytical monitoring?
❑
❑ ■
❑
# Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas?
❑
❑ ■
❑
Comment:
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?
■
❑ ❑
❑
Comment:
Page: 3

AM=
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P.E.
Governor Director
September 27, 2012
City of Dunn
Attn: Mr. Dean Gaster
P. O. Box 1065
Dunn, NC 28335
Subject: COMPLIANCE EVALUATION INSPECTION
City of Dunn
Black River WWTP, COC NCG110136
NPDES Stormwater General Permit-NCG110000
Harnett County
Dear Mr. Gaster:
Dee Freeman
Secretary
On September 18, 2012, a site inspection was conducted for the Black River WWTP located on 580 JW Edwards
Lane, Harnett County, North Carolina. A copy of the Compliance Inspection Report is enclosed for your review.
The cooperation of Mrs. Donrie Dukes, facility ORC, was greatly appreciated. Permit coverage authorizes the
discharge of stormwater from the facility to receiving waters designated as the Black River, a Class C; Sw water
in the Cape Fear River Basin. The site visit and file review revealed that the subject facility is covered by NPDES
Stormwater General Permit-NCG110000, Certificate of Coverage-NCG110136.
As a result of the inspection, the facility was found to be in non-compliance with the conditions of the NCG110000
permit. Please refer to the enclosed Compliance Inspection Report for additional comments and observations
made during the inspection.
As a result of the site inspection, the following permit conditions had not been met:
1) Stormwater Pollution Prevention Plan (SPPP
A Stormwater Pollution Prevention Plan (SPPP) has not been developed, recorded, or properly implemented.
2) Qualitative Monitoring
Qualitative monitoring has not been conducted and recorded in accordance with permit requirements.
Reguired Action:
• Develop and properly implement a Stormwater pollution prevention plan as soon as possible
• Begin the Qualitative Monitoring requirements as required by the stormwater permit, NCG110000.
Location: 225 Green Street, Suite 714, Fayetteville, North Carolina 28301
Phone: [phone] FAX: [phone] l Customer Service: 1.877.623.6748
Internet: http://partal.ncdeni.org/web/wq
NonrthCarohna
An Equal Opportunity 1 Alfirmalive Action Employer

Mr. Gaster
Page 2
September 27, 2012
Please be advised that violations of the NPDES Stormwater General Permit are subject to a civil penalty
assessment of up to $25,000 per day for each violation. If you or your staff has any questions, comments, or
needs assistance with understanding any aspect of your permit, please contact me at [phone] or by e-mail
at [e-mail].
Sincerely,
%. &Ia4
Mark Brantley
Environmental Senior Specialist
Surface Water Protection Section
Fayetteville Regional Office
Enclosure
cc: FRO -Surface Water Protection
Niki Maher-WBS Compliance & Permits Unit
DWO Central Files

3
Permit: NCG110136
SOC:
County: Barnett
Region: Fayetteville
Compliance Inspection Report
Effective: 01/02/09 Expiration: 05/31/13 Owner: City of Dunn
Effective: Expiration: Facility: Black River Wastewater Treatment Plant
680 Jw Edwards Ln .
Contact Person: Donrie Eldridge Dukes Title:
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s)-
Dunn NC 28334
Phone: [phone]
Certification: Phone:
Related Permits:
NCO043176 City of Dunn - Dunn WWTP
WQ0006101 City of Dunn - City of Dunn Residuals Land Application Program
Inspection Date: 09/18/2012 EntryTime: 10:00 AM Exlt Time: 11:00 AM
Primary Inspector: Mark Brantley AIX X't'e_ ,v _ _ Phone: [phone]
V1.t ivcl Mike Lawyer�� Phone: [phone] Ex29
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Municipal WWTP > 1 MGD, Stormwater Discharge, COC
Facility Status: ❑ Compliant ■ Not Compliant
Question Areas:
N Storm Water
(See attachment summary)
Page: 1

Permit: NCG110136 Owner - Facility: City of Dunn
Inspection Date: 09/18/2012 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
As a result of the site inspection, the following permit conditions have not been met:
1) Stormwater Pollution Prevention Plan (SPPP)
A Stormwater Pollution Prevention Plan (SPPP) has not been developed, recorded, or properly implemented.
2) Qualitative Monitoring
Qualitative monitoring has not been conducted and recorded in accordance with permit requirements.
Required Corrective Actions:
Develop and properly implement a stormwater pollution prevention plan as soon as possible
Begin the Qualitative Monitoring requirements as required by the stormwater permit, NCG110000.
Page: 2

Permit: NCG110136 Owner - Facility: City of Ounn
Inspection Date: 09/18/2012 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"?
# 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?
# Does the facility provide all necessary secondary containment?
# Does the Plan include a BMP summary?
# 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?
❑■❑❑
■
❑
❑ ❑
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■
❑
❑ ❑
❑
❑
■ ❑
❑
■
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❑
■
❑ ❑
❑
■
❑ ❑
❑
■
❑ ❑
❑
■
❑ ❑
❑
■
❑ ❑
❑
■
❑ ❑
❑
■
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Comment: Permit requirements were reviewed. Facility has committed to developing
a storm water pollution and prevention plan.
Qualitative Monitoring
Has the facility conducted its Qualitative Monitoring semi-annually?
Comment: Facility has committed to begin sampling as required by the permit.
Permit and Outfails
# 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 property documented by the Division?
# Has the facility evaluated all illicit (non stormwater) discharges?
Comment:
Yes No NA NE
❑ ■ ❑ ❑
Yes No NA NE
111111000
❑ ❑ ❑ ■
❑ ❑ ■ ❑
■ ❑ ❑ ❑
Page: 3

-O 6F WA
�7
O
Mr. Dean Gaster
City of Dunn
P.O. Box 1065
Lincolnton, North Carolina 28335
Dear Mr. Gaster:
January 2, 2009
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
Division of Water Quality
DENR--FRS]
JAN 13 2009
DV Q
Subject: General Permit No. NCG110000
City of Dunn
Black River Wastewater Treatment Plant
COC NCG110136
Harnett County
In accordance with your application for a discharge permit received on December 19, 2008, 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 Cory Larsen at telephone number
[phone].
ncerely,
for C een H. lins
cc: Fayetteville Regional Office, Michael Lawyer
Central Files
Stormwater'Permitting Unit Files
i�` hCarolma
Natura!!il
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Phone [phone] Customer Service
Internet: www.ncwatctqualit ..or¢ Location: 512 N. Salisbury St. Raleigh, NC 27604 • Fax [phone]
An Equal OpportunitylAfflrmathre Action Employer — 50% Recycled110% Post Consumer Paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG110000
CERTIFICATE OF COVERAGE No. NCG110136
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 Dunn
is hereby authorized to discharge stormwater from a facility located at
Black River Wastewater Treatment Plant
580 JW Edwards Lane
Dunn
Harnett County
to receiving waters designated as the Black River, a class C; Sw water in the Cape Fear 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, NCG 110000 as attached.
This certificate of coverage shall become effective January 2, 2009.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this 2nd day of January, 2009.
fo
Division of Water Quality
By the Authority of the Environmental Management Commission

LdCA'17[ON MAP:
it I I Pk
rc zd$,
U
Black River WWTP
H
rr
OEM IWO
7-6 1,
NCG110136-..
W
1149P Scale 1.-20,000
The City of Dunn
Black River WWTP
Latitude: 350 17' 48" N
Longitude: 780 38'16" W
County: Harnett
Receiving Stream: Black River
Stream Class: C; Sw
Sub -basin: 03-06-18 (Cape Fear River Basin)
I
—22AN 'low
Facility Location

NCG 110136
N
w' E
S
i
Map Scale 1:20,000
'y � 18 4`� •. �t s I P9�
The City of Dunn '
Black River WWTP
Latitude: 351 17' 48" N
Longitude: 780 38' 16" W
County: Harnett
Receiving Stream: Black River
Stream Class: C; Sw
Sub -basin: 03-06-18 (Cape Fear River Basin)
r��i'�yaR+pa�I J
Facility Location

Michael F. Easley, Governor
William 0. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
Division of Water Quality
January 2, 2009
Mr. Dean Gaster
City of Dunn
P.O. Box 1065
Lincolnton, North Carolina 28335
Subject: General Permit No. NCG110000
City of Dunn
Black River Wastewater Treatment Plant
COC NCG110136
Harnett County
Dear Mr. Gaster:
In accordance with your application for a discharge permit received on December 19, 2008, 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 Cory Larsen at telephone number
[phone].
Sincerely,
or Cts Mullinseen)
f
cc: Fayetteville Regional Office, Michael Lawyer
Central Files
Stormwater'Permitting Unit Files
_M"'Carolina
orally
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Phone [phone] Customer Service
Internet: www,newatemuality.org Location: 512 N. Salisbury St. Raleigh, NC 27604 Fax [phone]
An Equal Opportunity/Affirmative Action Employer- 50% Recycled110°/, Post Consumer Paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG110000
CERTIFICATE OF COVERAGE No. NCGI10136
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 Dunn
is. hereby authorized to discharge stormwater from a facility located at
Black River Wastewater Treatment Plant
580 JW Edwards Lane
Dunn
Harnett County
to receiving,waters designated as the Black River, a class C; Sw water in the Cape Fear River
Basin, in accordance with the effluent limitations, monitoring requirements, and other conditions
set forth in Parts I, It, III, IV, V, and VI of General Permit No. NCG110000 as attached.
This certificate of covefage shall become effective January 2, 2009.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this 2nd day of January, 2009.
for Coleen H. Sullins., Director
Division of Water Quality
By the Authority of the Environmental Management Commission

LOCATPON MAP:
7 fy i�
j� • h
Black River WWTP
u
)q, PikIN-
Vill
.fir. P
a fir• '� � .,� ,�<�� '��
NCGI10136
Mdap Scale 1: 20 000
The City of Dunn
Black River WINTP
Lad tulle; 350 17' 48" N
Longitude: 780 38' 16" W
Gounty: Harnett
.Rece%AngStream: Black River
Stream Class: C; Sw
Sub -basin: 03-06-18 (Cape Fear River Basin)
Facility Location

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tea, � rtw �- ♦ o-.�:. ra" ,�� _ � � i C� : +,�'�i`r[.: + .
!' � '� { •�� r�pp�� � f`t �' � L><�` �.'��t'j��j�t[u-1! r �1,11�, y��:t:,y'er�"�` NO
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:I
NCG110136
N
W E
S
Map Scale 1:20,000
The City of Dunn
Black River WWTP
Latitude: 35° 17' 48" N
Longitude: 78138' 16" W
County: Harnett
Receiving Stream: Black River
Stream Class:. C; Sw
Sub -basin: 03-06-18 (Cape Fear River Basin)
'
Facility Location

Re: FRO Input Requested -Black River WWTP NCG110136 imap://cros.ncmail.net:993/fetch%3EUID%3E/INBOX%3E800?head...
Subject: Re: FRO Input Requested - Black River WWTP NCG110136
From: Mike Lawyer <[e-mail]>
Date: Mon, 29 Dec 2008 09:24:23 -0500
To: Cory Larsen <[e-mail]>
CC: Mark Brantley <[e-mail]>, Belinda Henson <[e-mail]>
Cory,
Mark Brantley from our office conducted a site visit/inspection at this WWTP earlier
in the year and discovered that they did not have stormwater permit coverage. He
advised them to submit the NOI. The Fayetteville office recommends proceeding with
issuance of permit coverage.
Thanks,
Mike
Cory Larsen wrote:
I Mike,
I received an NOI from the City of Dunn for the Black River WWTP under general
permit NCG11. The site discharges stormwater to, of course, the Black River
(C;Sw). I've attached the location map and NOI for your review.
Does your regional office have any concerns about issuing a COC for this
facility? I'll move forward if there are no objections within 30 days. Thanks.
Cory Larsen 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] Fax: [phone]
Michael Lawyer
Environmental Specialist
NCDENR-Division of Water Quality
Surface Water Protection Section
Fayetteville Regional Office
Direct: [phone]
Main: [phone]
Fax: [phone]
1 of 1 12/29/2008 9:21 AM

N'C-'DEN'R'.�
Division of Water Quality / Water Quality Section
National Pollutant Discharge Elimination System
NCG110000
FOR AGENCY USE ONLY
❑a[c. Rccewcd
Year
Mpmh
Da,
Ce,fi lCilfe ofoveraee
10GII It 1) 1
Chcck 4 AAmnnount��
Yermil Assigned 70
arse r�
NOTICE OF INTENT
National Pollutant Discharge Elimination System application for coverage under Gener I Per! tr•t
NCG110000:�`°
,.
STORMWATER DISCHARGES associated with activities classified as:,�;y� q �� J
Treatment Works treating domestic sewage or any other sewage sludge or wastewaler,'% lr1 Lit
device or system, used in the storage, treatment, recycling, and reclamation of municipal or "''),,�r���L
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 DWO 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 owner/operator (address
Name L r • 04 U64.,0/
Street Address A D '
City _ • '
Telephone No. 5 110 �') a —a jq R
E-mall Address n LT ,L-5 eI- O A1,nI'll -- N1c'.
2) Location of facility producing discharge:
Facility Name
Facility Contact
Contact E-mail
-Street Address
City
County
Telephone No.
State N, [: , ZIP Code
Fax: 9 / DIf? 9 a — is 7 i -
w
Stale Ill. e_-. ZIP Code a C3�y_�__
9/0 1_?1C'31 - a- G 3 5 Fax: 9 / 0 6 c3 -
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).). %�4r' rl _ jaF. �' fr_ o ��,�. c /L O• r' c"aci
Y?ii 'tO J, kV. •/b r114 G:/LGIf
(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)
r, / P 0 1.11 /-cr-y¢L 39'. zlk4 --79. 4377
4) Latitude. 1 It' Longitude ,:� -!±' _W(degrees, minutes, seconds) �(�c
5) This NPDES Permit Ap cation applies to which of the following
❑ New or Proposed Facility Date operation is to begin
9 Existing
Page 1 of 4
SWU-226-071408 Last Revised 7/1412008

NCG110000 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 Code: facility
SIC _ n lj 0-
7) . Provide a brief narrative description of the types of industrial activities and
this facility: ! DL.st 1 1i14A 16�1,Aa-II j, -J SU,
8) Discharge points I Receiving waters:
ucts manufactured at
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property?
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? R I c�c:- k. A ✓Gt`
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).
10) Does this facility have any other NPDES permits?
❑ No
Yes
If yes, list the permit numbers for all current NPDES permits for this facility: j G c1Ca IJ 31 I
Iun0 H in/L2 JUO
11) 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:
12) Does this facility employ any best management practices for stormwater control?
❑ No
54 Yes
If yes, please briefly describe: Rerrn 1 n�j Mvt--er,ek +g We
13) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No
mYes ''r�''
If yes, when was it implemented? i r r LJO 64')o'• k,.
14) Are vehicle maintenance activities occurring at this facility?
M No ❑ Yes
15) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
% No ❑ Yes
Page 2 of 4
SWU•226.071408 Last Revised 7/14/2008

NCG110000 N.O.I.
b) Is this facility a Small Ouantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
f9 No ❑ Yes
c) Is this facility a Large duantlty Generator (1000 kg. or more of hazardous waste generated per mcnlh) of
hazardous waste?
$ 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:
Name of transport 1 disposal vendor:
Vendor address;
16) Certification:
North Carolina General Statute 143-215.6 b (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 Artlde or a rule implementing this Article; or who knowingly makes a false
statement of a material fact in a rulemaking proceeding or conlested case under this Article; or who falsities, tampers with, or knowingly
renders inaccurate any recording or monitoring device or method required io 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: on ram/ P_ 1)r_,Kes
Title: D A 1rr) •t�:).a,r jj tTr_ �rlc?y1I
(Signature of Applicar,t) (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

NCG110000 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
❑ 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 DWO Central Office or Regional Office for your area.
DWO Reaional Office Contact Information:
Asheville Office ...... [phone] win :00-5f110m
Fayetteville Office ... [phone] Rul:igl
Mooresville Office ... [phone]
Raleigh Office ........ [phone] nsr,l:viri, hloo,c5vinc
Washington Office ...[phone] = - -
Wiimington Office ... [phone]
Winston-Salem ...... [phone] ruy�rr� iu.,
Central Office .........[phone]
4V ii nilrgrn�,
Page 4 of 4
SVVU•226-071408 Las[ Revised 7114/2008

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Map Scale 1:20,000
The City of Dunn
Black River WWTP
Latitude: 350 17' 48" N
Longitude: 780 38' 16" W
County: Harnett
Receiving Stream: Black River
Stream Class: C; Sw
Sub -basin: 03-06-18 (Cape Fear River Basin)
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1"ungifilde: k74
Receiving Streunit Cape Fear River DrnivaLe MI.Jim: Cape Few River
Stream Class: ws-v Sub -Basin: 03.00-15
North
Facility Locatiou A01w, not to Scale
NPDES Permit No. NCO043176
Harnett Countv

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Map Scale 1: 20, 000
The City of Dunn
Black River WWTP
Latitude: 350 17' 48" N
Longitude: 780 38' 16" W
County: Harnett
Receiving Stream: Black River
Stream Class: C; Sw
Sub -basin: 03-06-18 (Cape Fear River Basin)
Facility Location