NCG150013_COMPLETE FILE - HISTORICAL_20170901

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V C& � 5 oo � 3
DOC TYPE
HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ 'I � C7� �I
YYYYMMDD

ROY COOPER
Governor
MICHAEL S. REGAN
SeC'+rlary
Energy, Mineral &
Land Resources
ENVIRONMENTAL PVALITY
September 1, 2017
Lauri nburg- M axton Airport Commission.
Attn: Jo Ann Gentry
16701 Airport Rd
Maxton, NC 28364
Subject: NPDES Stormwater Permit Coverage Renewal COC #NCG150013
Dear Permittee:
TRACY DAVIS
Deirclor
For coverage under Stormwater General Permit NCG150000, the Division of Energy,
Mineral, and Land Resources (DEMLR) is forwarding herewith the reissued Certificate of
Coverage (COC). This permit is reissued pursuant to the requirements of North Carolina
General Statute 143-215.1 and the Memorandum of Agreement between the state of North
Carolina and the U.S. Environmental Protection Agency, dated October 15, 2007 (or as
subsequently amended.) A new Certificate of Coverage (COC) is included with this
letter.
You must print a copy of the new NCG150000 General Permit from our website here:
httl2i//, deg•nc goy/ outIdivisionslenergy-mineral-land-resources/energy-mineral-land-
permitslstarmwater-permits/npdes-industrial-sw. In addition to the full permit, the 2017
print package on the website includes a Technical Bulletin and Qualitative Monitoring
Report Forms.
The General Permit authorizes discharges of stormwater, and it specifies your obligations
with respect to discharge controls, management, monitoring, and record keeping. Please
review the new permit to familiarize yourself with all changes in the reissued permit. Your
facility has six months from receipt of the permit to update your Stormwater Pollution
Prevention Plan (SPPP) to reflect any new permit requirements.
-!'--Nothing Compares--,,,.,•-
SState of North Carolina I f;nvlronmental Quality I Energy. Mineral and Land Resources
512 N. Salisbury Street 1 1612 Mall Service Center I Raleigh, North Carolina 27699-1612
9l9 707 9200

y
Your coverage under the General Permit is transferable only through the specific action of
DEMLR. This permit does not affect the legal requirements to obtain other permits which
may be required by the N.C. Department of Environmental Quality (DEQ), nor does it
relieve the permittee from responsibility for compliance with any other applicable federal,
state, or local law, rule, standard, ordinance, order, judgment, or decree.
If you have any questions regarding this permit package please contact the DEMLR
Stormwater Permitting Program at [phone].
cc. Stormwater Program files
Sincerely,
T6� (/�rsoa
for Tracy E. Davis, P.E., C.P.M.
-!'''Nothing Compares,.. --A...
State of North Carolina I Environmental Quality I Energy, Mineral and Land Resources
IA2 N. Salisbury Street 1 1612 Mall Scroce Center I Raleigh, North Carollna 276n9.1612
9t97g79200

if
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
STORMWATER DISCHARGES
or: I d MA_ ' � :.► _+. a 11 Or. 1 KUo _ _u
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,
Laurinburg-Maxton Airport Commission
is hereby authorized to discharge stormwater from a facility located at:
Laurinburg-Maxton Airport Commission
16701 Airport Rd
Maxton
Scotland County
- to receiving waters -designated -as -Shoe -Heel Creek -(Big -Shoe- Heel Creek)iMaxton-Pond),- --
class C;Sw waters in the Lumber River Basin, in accordance with the effluent limitations,
monitoring requirements, and other conditions set forth in Parts 1, II, III, IV, V, and VI of
General Permit No. NCG150000 as attached.
This Certificate of Coverage (COC) shall become effective September 1, 2017.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day September 1, 2017.
rho. Vint
for Tracy E. Davis, P.E., CPM
Director, Division of Energy, Mineral, and Land Resources
By the Authority of the Environmental Management Commission

LAURINBURG - MAXTON
AIRPORT COMMISSION
[phone]
ll
irces Ord
the Laurinburg-Maxton Airport
t conducting Qualitative Monitoring of
,mphasize the Airport's intent to
ith all the requirements of NPDES
&. Lawyer's visit, there were no days
preceded by three days in which no
vas not clear requirement within the
i Prevention Plan and Spill Prevention,
ith Airport's General Permit No.
all that occurred on February 2, 2011
ng requirements are met twice per year
versight and will not happen again.
ie at 910-844-5081.
r
-
CTONN
. -. ..... —.. , - ,.,,--.�I .028364 .

Other Observations:
Please refer to the enclosed Compliance Inspection Report for additional comments and observations
made during the inspection.
Requested Response:
You are asked to respond to this office, in writing, within 30 calendar days from receipt of this notice.
Your response should include a Plan of Action to address the aforementioned violation along with a
reasonable time frame that you expect to be in full compliance with the conditions of the NCG150000
general permit.
Thank you for your attention to this matter. This office requires that the violation, as detailed above,
be properly resolved. This violation and any future violations are subject to a civil penalty
assessment of up to $25,000 per day for each violation. Should you have any questions regarding this
matter, please contact Mr, Lawyer or myself at [phone].
Sincerely, ' •
C3
ca
Belinda S. Henson m
Regional Supervisor � Postage s.
Surface Water Protection Section ru Certilled Fee
o
C Return Receipt Fee
(Endorsement ReGulred)
BSH: ML/ml C3 Restricted Dellvery Fee
O (Endmement Requlmd)
Enclosure � Total Postage & Foes $
0
Postmark
SCa&' GO,
NL'C7
cc: FRO -Surface Water Protection 117 1" o ,Pl.'1. h.. , .. ...............
Katie Merritt -VMS Compliance & Permits Unit C3
DWQ Central Files
Ps rorm _„
63
■ Complete items 1, 2, and 3. Also complete
Item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mallplece,
or on the front If space permits.
1. Article Addressed to:
LAURINBIJRG MAXTON AIRPORTCOMMIS
JO ANN GENTRY
16701 AIRPORTROAD
MAXTON NC 28634
A. Signature
1,11 r,❑ Agent I
X [3r'�D p_\' 'e ❑ Addressee
B Received by (Printed Name) Ag�"\
I e�A
D. Is dellAry address dlfferant from Item 1? Yee
if YES, enter delivery address below: ❑ No
3. ce type
all
Certified MallrRotu=Mecelpt
❑ Registered for Merchandise
❑ Insured Mall .D.
4. Restricted Delivery? (&tYa Fee) ❑ Yes
2. Article Number `i�f
(rtanshsr ftm service kuw
7009 0820t'000012473. 1046'
—
�, P5 Form 3811, February 2004
'_ Domestic Retum Receipt 1025e542401-1840 f

ALIT
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
March 21, 2011
CERTIFIED MAIL: 7009 0820 0000 2473 8046
RETURN RECEIPT REQUESTED
Laurinburg-Maxton Airport Commission
Attn: Jo Ann Gentry
16701 Airport Road
Maxton, NC 28634
Subject: NOTICE OF VIOLATION (NOV-201.1-PC-0206)
Laurinburg-Maxton Airport Commission
NPDES Stormwater General Permit-NCG150000
Scotland County
Dear Ms. Gentry:
Dee Freeman
Secretary
On March 3, 2011, Michael Lawyer from the Fayetteville Regional Office of the Division of Water
Quality conducted a site inspection at the Laurinburg-Maxton Airport Commission facility located at
16701 Airport Road, Maxton, Scotland County, North Carolina. A copy of the Compliance Inspection
Report is enclosed for your review. The time and assistance provided by you, Mr. Dave Raley, and Mr.
Mickey Oxendine during the inspection is greatly appreciated. Permit coverage authorizes the discharge
of stormwater from the facility to receiving waters designated as a UT to Shoe Heel Creek, a Class C;Sw
water in the Lumber River Basin. The site visit and file review revealed that the subject facility is
covered by NPDES Stormwater General Permit-NCG150000, Certificate of Coverage-NCG150013.
Accordingly, the following observations and/or permit conditions violations were noted during the
Division of Water Quality inspection:
1) Stormwater Pollution Prevention Plan SPPP
A Stormwater Pollution Prevention Plan (SPPP) has been developed, recorded, and properly
implemented.
es■No❑
2) Qualitative Monitoring
Qualitative monitoring has been conducted and recorded in accordance with permit requirements.
es❑No■
Location: 225 Green Street, Suite 714, Fayetteville, North Carolina 28301
Phone: 91OA33-33001 FAX: 910A86-07071 Customer Service:1-877-623.6748
Internet: httpJlportal.ncdenr.orglwehlwq
An Equal Oppadunity 1 Affirnnalive Action Employer
Nturall
nehCarolina

Compliance Inspection Report
Permit: NCG150013 Effective: 01/22/10 Expiration: 08/31/14 Owner: Lauri nburg- Maxton Airport Commission
SOC: Effective: Expiration: Facility: Lauri nburg-Maxton Airport Commission
County: Scotland 16701 Airport Rd
Region: Fayetteville
Maxton NC 28364
Contact Person: Jo Ann Gentry Title: Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
On -site representative Mickey Lee Oxendine Phone: [phone]
On -site representative Dave Raley Phone: [phone]
On -site representative Jo Ann Gentry Phone: [phone]
Related Permits:
Inspection Date: 03/0312011 Entry Time: 10:00 M Exit Time: 12:10 PM
Primary Inspector: Mike Lawyer Phone: [phone]
Secondary Inspector(s): x 3Z9
&G vf4_Belinda S Henson Phone: [phone] Ex;,Rr
Reason for Inspection: Routine Inspection Type: Compliance Evaluation 33Z10
Permit Inspection Type: Air Transportation Stormwater Discharge COC
Facility Status: ❑ Compliant ■ Not Compliant
Question Areas:
Storm Water
(See attachment summary)
Page: 1

Permit: NCG150013 Owner - Facility: Laurinburg-Maxton Airport Commission
Inspection Date: 03/03/2011 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
Inspection conducted to ensure compliance with the conditions of the NCG150000 general stormwater permit for General
Aviation airports. Met with Ms. Jo Ann Gentry, Mr. Dave Raley, and'Mr. Mickey Oxendine. A review of the facility's
Stormwater Pollution Prevention Plan (SWPPP) was conducted, which appeared to be detailed yet easy to follow and
contain all permit -required components. The general permit contains a Compliance Schedule allowing twelve months for
the development of a SWPPP, therefore certain items such as documentation of annual employee training, annual
review/update of the SWPPP, and implementation of the SWPPP were not evaluated during this inspection, All other
conditions of the general permit such as the semi-annual Qualitative Monitoring of industrial activity outfalls became
effective upon issuance of coverage, which for this facility was on January 22, 2010. According to facility personnel,
monitoring was not conducted during the first year of coverage. A monitoring event was performed and documented in
February 2011 for the first half of the second year of coverage. Facility personnel were informed that a Notice of Violation
would be issued for failing to conduct monitoring during their first year of coverage.
Page: 2

Permit: NCG150013 owner - Facility: Laurinburg-Maxton Airport Commission
Inspection Date: 03/03/2011 Inspection Type: Compiiance 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?
❑
❑
❑
■
Comment: Since facility's SWPPP was recently completed per the 12 month
compliance schedule in the permit, items such as annual employee training, annual
review and update, and implementation were not evaluated at the time of this
inspection. These items will be reviewed during the next scheduled inspection.
Qualitative Monitoring
Yes
No
NA
NE
Has the facility conducted its Qualitative Monitoring semi-annually?
DODD
Comment: Monitoring was not conducted during the first year of coverage. A
monitoring event was conducted and documented in February 2011 for the first half of
the second year of coverage.
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: Facility has identified 5 total outfalls, however only outfall 2 and outfall 5
receive and discharge stormwater flow from industrial activity areas within the airport.
These 2 outfalls were observed at the time of inspection.
Page: 3

CER
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
January 22, 2010
Ms. Jo -Ann Gentry ®ENRFRO
Laurinburg-Maxton Airport Commission
16701 Airport Road FO i v aid
Maxton, NC 28364 ®WQ
Subject: General Permit No. NCG150000
Dear Ms. Gentry:
Dee Freeman
Secretary
Laurin burg-Maxton Airport Commission
COC NCG150013
Scotland County
In accordance with your application for a discharge permit received on December 3, 2009,
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 Jennifer Jones at
telephone number [phone]
Sincerely,
ORIGINAL SIGNED By
KEN PICKI-E
for Coleen H. SulIins
cc: Fayetteville Regional Office, Mike Lawyer
Central Files
Stormwater Permitting Unit Files
Wetlands and Stormwater Branch 011C 1017 Mail Service Center, Raleigh, North Carolina 27699.1617 NoirffiCarolt
ina
Location: 512 N. Salisbury St, Raleigh, North Carolina 27604
Phone: [phone] FAX: 919-80M4941 Customer Service: 1.87T623-6748 Xaturtilly
Internet: www.ncwaterquality.org

1 (F
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG150000
CERTIFICATE OF COVERAGE No. NCG150013
STORMWATER DISCRARGES
'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,
Laurinburg-Maxton Airport Commission
is hereby authorized to discharge storniwater from a facility located at
Laurinburg-Maxton Airport Commission
16701 Airport Road
Maxton
Scotland County
to receiving waters designated as a UT to Shoe Heel Creek, a class C, Sw water in the Lumber
River Basin, in accordance with the effluent limitations, monitoring requirements, and other
conditions set forth in Parts I, Il, III, IV, V, and VI of General Permit No. NCG 150000 as
attached.
This certificate of coverage shall -become effective January 22, 2010.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day January 22, 2010. ORIGINAL SIGNED BY
KEN PICKLE
far Coleen H. Sullins., Director
Division of Water Quality
By the Authority of the Environmental Management Commission

NCG 150013
Map Scale 1:23,151
Laurinburg-Maxton Airport Commissio
Maxton, NC
Latitude, 34147' 33" N
Longitude: 790 21' 58" W
County: Scotland County
Receiving Stream: UT to Shoe Heel Creek
Stream Class: C, SW
Sub -basin: 03-07-55 (Lumber River Basin)
`•r`
Facility Locatio

Lawyer, Mike
From:
Lawyer, Mike
Sent:
Thursday, January 21, 2010 9:52 AM
To:
Jones, Jennifer
Cc:
Henson, Belinda
Subject:
RE: ncg150013 Laurinburg-Maxton Airport Commission Feb 12 2010
Jen,
Met with subject airport staff on Tuesday to discuss the new NCG15 permit and its requirements. The FRO recommends
issuance of permit coverage.
Thanks,
Mike
Michael Lawyer
Environmental Specialist
NCDENR-Division of Water Quality
Surface Water.Protection Section
Fayetteville Regional Office
Direct: [phone]
Main: [phone]
Fax: [phone]
e-mail: [e-mail] (please note that my e-mail address has changed)
*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: Jones, Jennifer
Sent: Friday, January 08, 2010 5:12 PM
To: Lawyer, Mike
Cc: Jones, Jennifer
Subject: ncg150013 Laurin burg -Maxton Airport Commission Feb 12 2010
Hi Mike,
I've got another airport for you. We've received an NOI from Laurinburg-Maxton Airport Commission for
their airport in Maxton (Scotland County) for coverage under NCG15 (airport permit). The site discharges
stormwater into a ut to Shoe Heel Creek Creek (C, Sw). The NOI is attached.
Does the Fayetteville Regional Office have any concerns about issuing this facility a COC for this general
permit? If we don't receive any objections, we'll issue the COC in 30 days.
Thanks,
Jen
Jennifer ]ones
Environmental Engineer

r
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]
Email: iennifer.jones(lncdenr_.gov
Website: htto://h2o.enr,state.nc.us/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.**
2

A��
NCDENR
FMagcI,NC.? M,D HRllllwt r�90, WCe3
Division of Water Quality / Surface Water Protection
National Pollutant Discharge Elimination System
NCG 150000
rOR AGENCY USE ONLY
IDaw Receiwd
Year
Monthh
na
�� �5
centrcnte of Covcmce
Checkiv
Aaxnmr
l'cmui ASa [f.
NOTICE OF INTENT
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG150000: -
- i
STORMWATER DISCHARGES associated with activities classified as: ! ;y
SIC` (Standard Industrial Classification) Code 45 Air Transportation Facilities including air transp'grtation,`
scheduled, and air courier (SIC 4512 and 4513); air transportation, non scheduled (SIC 4522); airports, :+
flying fields, except those maintained by aviation clubs, and airport terminal services including: air traffic_.t,
control, except government; aircraft storage at airports; aircraft upholstery repair; airfreight handling?at F_
airports; airport hangar rental; airport leasing, if operating airport; airport terminal services; and
operations; and airport and aircraft service and maintenance including: aircraft cleaning and janitorial
service; aircraft servicinglrepairing, except on a factory basis; vehicle maintenance shops (including
vehicle and equipment rehabilitation mechanical repairs, painting, fueling, lubrication); and material
handling facilities.
For questions, please contact the DWQ Regional Office for your area. (See page 4)
(Please print or type)
1) Mailing address of ownerloperator (address to which all permit correspondence will be mailed):
Name LAURINBURG-MAXTON"AIRPORT COMMISSION
Owner Contact JO ANN GENTRY
Street Address 16701 AIRPORT ROAD
City MAXTON State NC ZIP Code 28364
Telephone No. 910-844-5081 Fax: [phone]
E-mail Address [e-mail]
2). Location of facility producing discharge:
Facility Name LAURINBURG-MAXTON AIRPORT COMMISSION
Facility Contact JO ANN GENTRY
Street Address 16701 AIRPORT ROAD
City MAXTON State NC ZIP Code 28364
County SCOTLAND
Telephone No, 910-844--5081 Fax: [phone]
Email [e-mail]
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). FROM FAYETTEVILLE, N. C. TAKE 401 SOUTH THROUGH
WAGRAM, N.C.. TURN LEFT ON AIRBASE ROAD. TAKE A RIGHT ON AIRPORT ROAD. _ A_IR_PORT IS ON
(A copy of a county map or USGS quad sheet with lacility dearly located on the map is a required pan of this application.)—��— — LEFT.
4) Latitude° V;;?Q e e)1? Longitude rn (degrees, minutes, seconds)- ja P
5) This NPDES Permit Application applies to which of the following:
❑ New or Proposed Facility
)Existing
SW J-234.051309
" ,:n
n.
Date operation is to begi
Page 1 of 4
Last revised 5/13109

NCG150000 N.O.J.
6) Standard Industrial Classification:
Provide the 4 dig1 Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code:
T) Services and Activites
a) Provide a brief narrative description of the types of industrial activities and products
manufactured at this facility.
b) Check all services and activities offered or allowed at this facility
• Scheduled air transportation
❑ Air courier
❑ Non-scheduled air transportation
M Airport terminal services
iq- Aircraft storage
❑ Aircraft upholstery services
,$j"Airfreight handling
Airport hangar rental
L(Airport teasing
8) Discharge points 1 Receiving waters:
.'Aircraft service and maintenance
❑ Aircraft cleaning and janitorial services
❑ Aircraft and/or vehicle rehabilitation
.'Aircraft and vehicle maintenance
!'Aircraft and/or vehicle fueling
Aircraft and/or vehicle lubrication
❑ Aircraft and/or vehicle painting
<Aircraft and/or vehicle mechanical repair
❑ Material handling facilities
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? 5
What is the name of the body or bodies of water (creek, stream, river, lake, etc,) that the facility stormwater
discharges end up in? STIOEHEEL CREEK AND LUMBER 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).
Receiving water classification (if known):
9) Does this facility
1P
a) Have an untreated wastewater discharge? �No ❑ Yes
b) Have a treated wastewater discharge? ❑ No Yes .
If yes, list the permit number.NCOO_4417- 5
c) Have a wastewater discharge from a recycle system? ,Jq No ❑ Yes
If yes, list the permit number,
d) Have a non -discharge permit? .f(No ❑ Yes
If yes, list the permit number.
e) Discharge wastewater to a municipal wastewater collection system? ❑ No ,Yes
If yes, list the municipality and permit number 1+tf C, 0 0 j 2
21T A&A&C4C W�Jt i t Maa l �xa W duo z S 5
wa Note: Stormter aischarge'permit NddIS0000 does not authorize the discharge of any wastewater.
If this site discharges wastewater, you must obtain the appropriate wastewater discharge
permit in addition to coverage for stormwater discharges under NCG150000.
10) Does this: facility employ any best management practices for stormwater control?
KIN o ❑ Yes
If yes, please briefly describe:
Page 2 of 4
SWU-234-030909 Last revised 3I9109

NCG150000 N.0.1.
11) Does this facility have a Stormwater Pollution Prevention Plan?
© No ❑ Yes >(Being Developed
If yes, when was it implemented?
12) Hazardous Waste:
If being developed, when will it be implemented?
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
5(No CI Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month)
of hazardous waste?
qNo CI Yes
c) Is this facility a large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
j(No 13 Yes
d) Is hazardous waste stored in the 100-year flood plain?
1(No O 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 I disposal vendor:
Vendor address:
13) 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 Article or a rule implementing this Article: or who knowingly makes a false
statement of a material fact in a rulemsking 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 Managementl 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.
PrintedT�e of Person Signing;
of Applicant)
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to:
NCDENR
Page 3 of 4
SWU-234.030909 Last revised 319109

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Airport Reference Point
34047'30.98"N
79021'57.05"W
/ 0-
NOT A PRECISION DRAWING
APPROXIMATE SCALE
6
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--'= 0 5K'lOK' 2 K'
15K 0
This Sheet is a composite of portions of the
Laurinburg, Wakulla, Johns, and Malux.ton
Quadrangles from the DeLorme collection.
Sections were joined for best fit; Errors in distance:
ca. 2%. Some artifacts removed for clarity. Area of
Airfield was cut from Base Map to better show
Runway details.
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Design for Building.
LAURINBURG-MAXTON AIRPORT, MAXTON, NC
AIRPORT VICINITY
FOR PRELIMINARY DISCUSSION
+*S� ,oLWN
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1120
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HECKED
DMR
REVISION
David M. Raley, PE
POB7
Laurel Hill, NC 28351
910-462-2292
www.daveraley_eom
SHEET #
I OF 1