NCG180250_COMPLETE FILE - HISTORICAL_20160725

STORMWATER DIVISION CODING SHEET
RESCISSIONS
PERMIT NO.
DOC TYPE
❑COMPLETE FILE -HISTORICAL
DATE OF -
RESCISSION
❑ C�Z61 / aJ
YYYYMMDD

NORTH CAROLINA DEPARTMENT OF�y
ENVIRONMENTAL QUALITY
II �IIII�I II� II I I II II� � I I ��II II II
INVOICE * 2 0 1 6 P R 0 0 5 2 4 3
Annual Permit Fee Open
This annual fee.is required by the North Carolina Administrative Code. It covers the administrative costs associated with
your permit. It is required of any person holding'a permit for any time during the annual fee period, regardless of the facility's
operating status. Failure to pay the fee by the due date will subject the permit to revocation, Operating without a valid
permit is a violation and is subject to a $10,000 per day fine. If the permit is revoked and you later decide a permit is
needed, you must reapply, with the understanding the permit request may be denied due to changes in environmental,
regulatory, or modeling conditions.
Invoice Number: 2016PROO5243
Permit Number: NCG180260
Davidson County
Council Company -Plant 1
Tim Surratt
Councill Company LLC
PO Box 398
Denton, NC 27239-0398
Notes
Annual Fee Period: 2016-07-01 to 2017.06-30
invoice Date: 06/14/2016
Due Date: 07/14/2016
Annual Fee: $100.00
r 0i
y
1 . You may pay either by checklmoney order OR by electronic payment. " V
j✓ L
2, If payment is by checklmoney order, please remit payment to: Cott�
NCDEO -Division of Energy, Mineral and Land Resources
Attn: 5tormwater Billing
1612 Mail Service Center
Raleigh, NC 27699-1612
3. If payment is electronic, see http:llportal.ncdonr.ora/web/wolhot-topicstepayment for additional details. See
http:llportal,ncdenr.org/web/wglepayment to pay electronically. Only echeck transactions are allowed at this time. Credit card
transactions are not accepted.
4. Please include your Permit Number and Invoice Number on all correspondence. O
5. A $25.00 processing fee will be charged for returned checks in accordance with North Carolina General Statute 25-3-512. - j
6. Non -Payment of this fee by the payment due date will initiate the permit revocation process. W
7, Should you have any questions regarding this invoice, please contact the Annual Administering and Compliance Fee
Coordinator at 919.707-9220.
(RotL:rn Thins Portion With Check)
ANNUAL PERMIT INVOICE n.Q_
V ti
Invoice N+imbes; 2t1'S1:'f'005243
Permit Number: NCG180250
Davidson County
Council Company - Plant 1
Tim Surratt
Councill Company LLC
PO Box 398
Denton, NC 27239-0398
IIIIIIIIIIII IIIIIIIIII�III IIII��IIIVlllllllf
Open
AnniAal.Fne Pi,-1od: 29.9_37-01 to 2017-176-30
Invoice Date: 611412016
Due Date: 7/14/2016
Annual Fee: $100.00
Check Number:

Alexander, Laura
From: Georgoulias, Bethany
Sent: Friday, September 26, 2014 9:19 AM
To: Alexander, Laura
Subject: RE: FW: REMINDER: NPDES General Permit NCG180000 Renewal Instructions
Follow lip Flag: Follow up
Flag Status: Completed
Thanks!
13eihu»y Georgoulias, L,`nviromnewal Engineer
NCDENR / Division of I nerve-y, Mineral, and land Resources
Storrnwater Pennitting Program
1012 Mail Service Center, Raleigh, NC 27699-1612
5 12 N. Salisbury Street, Raleigh, NC 27604
919 1807-6372 (phone); 919 1807-6494 (Fax)
Websitc: h�;//VoilaLncdenr.org,'web/Ir/stormw iter
E-mail corre.eponekiwe to and, fi-out this eddre.ss stun• he sithiv et to the North Carolina Public Records Imr and »rrtr be disclosed to third parries.
From: Alexander, Laura
Sent: Friday, September 26, 2014 9:17 AM
To: Georgoulias, Bethany
Subject: FW: FW: REMINDER: NPDES General Permit NCG180000 Renewal Instructions
Yes, he did agree. I'll go ahead and rescind today and state in notes of rescission an explanation as to whythe
rescission.
From: Tim Surratt[mailto:[e-mail]]
Sent: Thursday, September 25, 2014 11:31 AM
To: Alexander, Laura; Don Barrett; Tom O'Connell; Tom O'Connell H&M
Cc: Georgoulias, Bethany; Bennett, Bradley
Subject: Re: FW: REMINDER: NPDES General Permit NCG180000 Renewal Instructions
Laura and Bethany,
That is correct. Permit #NCG180146 located at 125 N.Main St. in Denton, NC 27239 is not a facility owned by our
company. Permit #s NCG180250 for plant #1 (267 Council Access Road) and NCG180145 for plant #2 (236 N.Jones
Street) are the only two sites with active permits. Permit # NCG18046 should be rescinded/deactivated.
Thanks,
Tim
On 9/25/2014 8:56 AM, Alexander, Laura wrote:
Good Morning Tim!
I did some research on the permits in question. I think NCG180146 (plant #2) should be
rescinded/deactivated. Since the last billing records show 2004 & 2005 as waived fees and nothing
more recent than that. NCG180250 (plant #1— 267 Council Access Road, Denton) & NCG180145 (#2 —
236 N. Jones Street, Denton) look current so I'd keep those open/current.

-As long as the plan above covers all of your plants with active permits — then I think we should move
forward with this plan. Please let us know if you have any questions.
Thank you!
Laura Alexander
Stormwater Permitting Program
NC Division of Energy, Mineral and Land Resources
1612 Mail Service Center
Raleigh, NC 27699-1612
[phone]
From: Georgoulias, Bethany
Sent: Friday, September 19, 2014 1:29 PM
To: [e-mail]
Cc: Alexander, Laura; Bennett, Bradley
Subject: RE: REMINDER: NPDES General Permit NCG180000 Renewal Instructions
Hi Tim,
I just wanted to give you a heads up that we are trying to sort out the confusion about NCG180145
(Plant #2), NCG180146 (Plant #2 in our database, but we noticed it had Plant #1 on the old COC in the
file... possibly a mix up here), and NCG180250 (the more recently issued permit for Plant #1 that seems
to have all the paper work in order and was applied for by you last year).
Probably some redundancy here, and we'll to figure out which permit belongs to what. Laura Alexander
is going to do some footwork and try to work it out. She will be in touch soon.
We noticed that invoices for NCG180146 had been returned undeliverable long ago, and billing probably
stopped... it's possible this permit was supposed to be inactivated, but never actually was in our system,
and then later a misunderstanding about whether there was permit coverage at all there).
We'll sort out what to do with the on-line piece after we figure it all out. It may be that NCG180146 is
defunct for all intents and purposes, as long as all your plants are covered appropriately with active
permits.
Thanks, Tim.
Bethany
Bethany Georgoulios, Environmental Engineer
NCDENR / Division of Energy, Mineral, and Land Resources
Storrnwater Permitting Program
1612 Mail Service Center, Raleigh, NC 276994612
S12 N. Salisbury Street, Raleigh, NC 27604
919 / 807-6372 (phone); 919 / 807-6494 (fax)
Website: http://portal.ncdenr.org/web/Ir/stormwater
f-mail correspondence to and from this address may be subject to the North Carolina Public Records law and maybe disclosed to third parties.
From: Georgoulias, Bethany
Sent: Friday, September 19, 2014 10:02 AM

To: '[e-mail]'
Subject: REMINDER: NPDES General Permit NCG180000 Renewal Instructions
Here is the original notice for NCG180250.
Bethany Georgoulias, Environmental Engineer
NCDENR / Division of Energy, Mineral, and Land Resources
Storrwater Permitting Program
1612 Mail Service Center, Raleigh, NC 27699-1612
512 N. Salisbury Street, Raleigh, NC 27604
919 / 807-6372 (phone); 919 / 807-6494 (fax)
Website: http://portal.ncdenr.org/web/Ir/stormwater
E-maif correspondence to and from this address maybe subject to the North Carolina Public Records law and may be disclosed to third parties.
From: Georgoulias, Bethany
Sent: Friday, September 12, 2014 11:06 AM
To: 'timsurratt(@councill.com'
Subject: NPDES General Permit NCG180000 Renewal Instructions
Dear Permit Contact:
NC DENR's stormwater Permitting Program has reissued NPDES Stormwater General Permit NCG180000
(Furniture and Fixtures), which became effective September 1, 2014. Your Certificate of Coverage (COC)
is ready for renewal and download from our website. Please follow the instructions below and be sure
to print your new COC for your records.
1. Go to the following URL link: http://go.ncdenr.gov/sw-erenewal
2. Enter your COC Permit Number and unique PIN:
Permit Number: NCG180250
Unique PIN number: 46076
3. Scroll Down and update the e-mail address information if necessary for a renewal
confirmation. These fields are pre -filled with information we have on file about the Owner (including
the e-mail, if we had one). **However, if the confirmation should be e-mailed to someone else instead
of to the e-mail in that box, PLEASE REVISE THAT E-MAIL.** You are unable to change the information in
the other fields. Please contact us if something is incorrect.
4. Click "SUBMIT." A confirmation screen should follow.
5. On this screen, click the button "DISPLAY CONFIRMATION DETAILS." Clicking this button will
automatically generate an e-mail to the address you provided on the previous screen. It will also send
you to a screen that will display details of your renewal.
6. IMPORTANT: TH15 I5 WHERE YOU PRINT YOUR COC. On this screen, you must print a copy of the
Certificate of Coverage for your facility by clicking on "Print COC." It is your responsibility to generate
this COC for your own records — we do not generate a duplicate copy centrally during this process.
By following these steps, you will have a record of continued coverage under the new general permit, as
of September 1, 2014. Please visit our website at http://12ortal.ncdenr.org/web/lr/stormwater/2014-
gpss to download a copy of the General Permit, monitoring forms, and technical bulletin.

Thank you for taking the opportunity to renew your permit on-line. We appreciate the chance to better
serve you and hope you find the process beneficial. If you have any questions, please contact:
Bethany Georgoulias, E-mail: [e-mail] Telephone: [phone], or
Bradley Bennett, E-mail: [e-mail] Telephone: [phone], or
Bridget Munger, E-mail: [e-mail] Telephone: [phone],
Bethany Georgoulias, Environmental Engineer
NCDENR I DEMER I Stormwater Permitting
1612 Mail Service Center, Raleigh, NC 27699-1617
512 N. Salisbury St, Raleigh, NC 27604
Phone: [phone]
Fax: [phone]
Website: http://portal.ncdenr.org/web/Ir/stormwater
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.

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCGI80000
CERTIFICATE OF COVERAGE No. 180250
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,
Councill Company, LLC
is hereby authorized to discharge stormwater from a facility located at
Councill Company —Plant 1
267 Councill Access Road
Denton
Davidson County
to receiving waters designated as unnamed tributary to Lick Creek, a class WS-IV water in the
Yadkin River Basin, in accordance with the effluent limitations, monitoring requirements, and
other conditions set forth in Parts I, 11, III, IV, V, and VI of General Permit No. NCG 180000 as
attached.
This certificate of coverage shall become effective July 23, 2013.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day July 23, 2013.
ORIGINAL SIGNED B1
KEN PICKLE
for Thomas A. Reeder, Acting Director
Division of Water Quality
By the Authority of the Environmental Management Commission

NCG180250
Map Scale 1:24, 000
Councill Company, LLC
Councill Company - Plant 1
Latitude: 350 37' 37.39" N
Longitude: 800 07' 17.42" W
County: Davidson
Receiving Stream: UT to Lick Creek
Index No:12-126-(3)
Stream Class: WS-IV
Sub -basin: 03-07-08 (Yadkin River Basin)
Facility Location

A��
NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Pat McCrory
Governor
Mr. Tim Surratt
Councill Company, LLC
P.O. Box 398
Denton, NC 27239
Dear Mr. Surratt:
Thomas A. Reeder
Acting Director
July 23, 2013
Subject: General Permit No. NCG 180000
Councill Company, LLC
Councill Company —Plant I
COC NCG180250
Davidson County
John E, Skvarla, Ill
Secretary
In accordance with your application for a discharge permit received on July 2, 2013, 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 Land Quality Section of the
Division of Energy, Mining and 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 Julie Ventaloro at telephone
number [phone] or [e-mail].
Sincerely,
ORIGINAL SIGNED M
RK
for TFiomassl eeder
cc: Winston-Salem Regional Office, Corey Basinger
Central Files
Stormwater Permitting Unit Files
1617 Mail Service Center, Ralegh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Ralegh, North Carolina 27604
Phone: 91 M07-63001 FAX: [phone]
Internet: www.ncwaterouality.org
o11e
NorthCarolina
Naturvii
An Equal Opportunily 1 Afrormative Action Employer

Ventaloro, Julie
From:
Carter, Jenifer
Sent:
Thursday, July 18, 2013 3:39 PM
To:
Ventaloro, Julie
Subject:
Councill Company NCG180250 NOI
Follow Up Flag:
Follow up
Flag Status:
Flagged
Julie,
I visited plant #1 today and decided that they do in fact need a permit. They have an indoor room at a loading dock full
of mostly 5-gallon, and some 55-gallon, containers full of stains and paints. There are no floor drains, but the floor is not
sloped away from the loading door to keep spills from getting outside. There is another 55-gallon drum storage area
outside with technically the correct size secondary containment that is locked; however, the containment is only about
2-inches high. A heavy rain event could overtop it easily, and if something was spilled in there, it would escape with the
rain. Overall, I'm just not comfortable saying they could qualify for No Exposure.
The funny thing is, even though they had NOE certification, they were still paying someone to update the SPPP annually,
and Tim Surratt was stilling filling out the semi-annual Qualitative monitoring forms.
Jenifer
E3eiorc printing this email please consider your budget and the environment.
II you roust print, please print only what you need and save ink with the free Eco-Pont.
NC DENR Winston-Salem Regional Office
Division of Water Quality
585 Waughtown Street
Winston-Salem, NC 27107
Voice: [phone]
FAX: [phone]
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.

Ventaloro, Julie
From: Carter, Jenifer
Sent: Wednesday, July 10, 2013 4:00 PM
To: Ventaloro, Julie
Subject: RE: Councill Company permit confusion
got the impression that business has picked up, so I'm just assuming that conditions have changed on the ground
haven't been back out there to say for sure.
Before printing this email, please consider your budget and the environment.
If you must print. ptease print only what you need and savo ink with the free Eco-Font.
NC DENR Winston-Salem Regional Office
Division of Water Quality
585 Waughtown Street
Winston-Salem, NC 27107
Voice: [phone]
FAX: [phone]
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: Ventaloro, Julie
Sent: Wednesday, July 10, 2013 3.10 PM
To: Carter, Jenifer
Subject: RE: Councill Company permit confusion
Thanks. Did you ever get an explanation as to why they applied for No Exposure in the first place? If they met the
criteria then, why wouldn't they now?
From: Carter, Jenifer
Sent: Wednesday, July 10, 2013 2:59 PM
To: Ventaloro, Julie
Subject: Councill Company permit confusion
Julie,
In order to explain why Council Company is asking for a permit for a facility that has NOE, you'll need to follow the
emails below, starting at the bottom. It's a little confusing but, in short, they do need the permit they are applying for.
Let me know if you still have questions.
Jenifer

or
Before printing this email, please consider your budget and the environment.
Ifyou mu.t print. p[case print only Mini you need vtd save ink with the tree taco -Pont.
NC DENR Winston-Salem Regional Office
Division of Water Quality
585 Waughtown Street
Winston-Salem, NC 27107
Voice: [phone]
FAX: [phone]
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: Carter, Jenifer
Sent: Monday, June 17, 2013 9:51 AM
To: Jack Garrison
Subject: RE: permit confusion
Jack,
It looks like our central office received a No Exposure Application for plant #1 in September 2011 (see attached), which
was subsequently approved based on the information given. When such an application is approved, the related permit
is automatically rescinded.
So it looks like Councill will have to reapply for the permit after all. Maybe things have changed since late 2011 to make
them no longer qualify for No Exposure (?).
Let me know if you have any questions.
Jenifer
Before printing this email, please consider your budget and the environment.
If you must print, please print only what you need and save ink with the free Eco-Font.
NC DENR Winston-Salem Regional Office
Division of Water Quality
585 Waughtown Street
Winston-Salem, NC 27107
Voice: [phone]
FAX: [phone]
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: Jack Garrison[maiIto: jack(a)bandgenvironmental.com]
Sent: Friday, June 14, 2013 4:02 PM
To: Carter, Jenifer
Subject: RE: permit confusion
2

In 2009, Councill received notices about renewing three stormwater permits that were about to expire. I have copies of
the notifications that were returned to the Central Office that only corrected the contact name, from Steve Gallimore to AJ
Oettinger. All three should have been renewed as requested.
Since the problem occurred at the Central Office, it should be easy for them to fix it.
Please ask them again to renew the permit for Plant 1 (NCG180147) as Councill properly requested in 2009. If there is
documentation requesting otherwise, please provide a copy and I will rectify any confusion that exists.
Jack H. Garrison, Jr.
Senior Environmental Consultant
Bensinger & Garrison Environmental, Inc.
[phone] Phone
[phone] Fax
Bensinger & Garrison Environmental, Inc.
Notice of Confidentiality
The information contained in and transmitted with this electronic communication (including attachments) is subject to attorney and/or
client privileges or is otherwise confidential. It is intended solely for the addressee designated by the sender. If you are not the
intended addressee or receive this communication in error, any dissemination, distribution, copying, or other use or reliance on any
information contained or transmitted herein by or to anyone other than the addressee designated by the sender is unauthorized and
prohibited. If you receive it in error, please notify Bensinger & Garrison Environmental, Inc., by return email or by telephone at (919)
484-8536.
From: Carter, Jenifer fmailto jenifer.carter(&ncdenr.gov]
Sent: Friday, June 14, 2013 3:21 PM
To: [e-mail]
Subject: FW: permit confusion
Good luck Jack!
Jenifer
From: Georgoulias, Bethany
Sent: Friday, -June 14, 2013 2:40 PM
To: Carter, Jenifer; Bennett, Bradley
Subject: RE: permit confusion
Jenifer,
Because we are feeding into EPA's ICIS system, it's going to be hard to move those turtle shells around. If Plant #1 isn't
in the same location as Plant #2, there's no way we can shuffle one plant's permit to another.
I'd advise them to (1) apply for a new permit for Plant #1 [we cannot re -activate their old permit; ICIS precludes that]
and indicate that they will need the NCGNE08.15 rescinded in that application so we can take care of that too;
(2) Request a rescission of the spare Plant #2 permit [we need a request in writing from them, with an explanation]; and
Wish we could be more flexible, but between BIMS and ICIS, we're tied.
Hope that helps,

Bg
Bethany Georgoulias
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]
NEW Website: http://portal.ncdenr.org/web/wq/ws/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.
From: Carter, Jenifer
Sent: Thursday, June 13, 2013 11:37 AM
To: Bennett, Bradley; Georgoulias, Bethany
Subject: permit confusion
A contractor working for a company out of Denton, Council Company LLC, just called. They used to have four plants, but
now has three. They are numbered Plant #1, #2 and #3. The fourth plant, called Council Access Plant #2 (which used to
be called plant #3) is the one that closed.
Somewhere along the way, the numbers got all jumbled and now:
Plant #1 was given a No Exposure Certification (NCGNE0815), which they admit it shouldn't have and would like their
permit back (NCG180147) or will apply for a new one. (?)
Plant #2 now has two active permits (NCG180146 and NCG180145)
Plant #3 is correct in the system (it's really just a warehouse now, with an NOE... they may ask to have it rescinded since
they technically wouldn't.need a permit in the first place anymore)
So, my question... can one of Plant #2's permits be given to Plant #1 so they don't have to reapply for a permit they
never intended to get rid of? They have a site -specific SPPP at plant #1 that they have been maintaining, and they have
been acting as if they had the permit... I just wasn't sure if BIMS would allow for such a 'correction'.
Jenifer

ti
M' Division of Water Quality / Water Quality Section
NCDENR National Pollutant Discharge Elimination System
Ncr m GROL— DEn nrneNT or
ENV nFl meN mo 144 RC]OINIcn
NCGI80000
NOTICE OF INTENT
FOR AGENCY USE ONLY
Date Received
Year
Month
I Da
Cettilicale of Coverage
Check N
Amount
'j
Pennit Assi ed to
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG180000:
STORMWATER DISCHARGES associated with activities classified as:
SIC* 25 Furniture and Fixtures
SIC+ 2434 Wood Kitchen Cabinets
" Standard Industrial Classification Code
(Please print or type)
1) Mailing address of ownerloperator:
Name Tim Surratt Councill Company LLC
Street Address PO Box 398
City Denton State NC ZIP Code 27239
Telephone No. 336 859-2155 Fax: [phone]
" Address to which all permit correspondence will be mailed
2) Location of facility producing discharge:
Facility Name Councill Company — Plant 1
Facility Contact Tim Surratt
Facility Address 267 Councill Access Road
City Denton State NC ZIP Code 27239
County Davidson
Telephone No. 336 859-2155 Fax: [phone]
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). Denton Road to Councill Access Road
(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 35' 37' 12" Longitude 800 07' 18" (degrees, minutes, seconds)
5) This NPDES Permit Application applies to which of the following:
❑ New or Proposed Facility Date operation is to begin
X Existing
6) ' Standard Industrial Classification:
I JUL - 2 Z013 I
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: 2 5 1 2
7) Provide a brief narrative description of the types of industrial activities and products manufactured at
this facility: Wood processing (machining, sanding, etc.), assembly, finishing, and packing of custom
wood furniture. T
Branch
SWU-233-081511
Page 1 of 4

r
NCG 9 80000 N.O.I.
It
8) Discharge points I Receiving waters:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? 3
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? Bulla Bay Creek in the Lower Yadkin 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).
10) Does this facility have any other NPDES permits?
X No
❑ Yes
If yes, list the permit numbers for all current NPDES permits for this facility:
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
X 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
X Yes
If yes, please briefly describe: SPCC Plan in effect since July 1999.
Other BMPs are described in the SWP3 (good housekeeping, PM, runoff and erosion control, etc.)_ _
13) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No
X Yes
If yes, when was it implemented? SWP3 since 1997
14) Are vehicle maintenance activities occurring at this facility?
X No ❑ Yes
15) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
X No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
❑ No X 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: Finishing material
Page 2 of 4
5WU-233-081511

NCG 180000 N.O.I.
How is material stored: 55—gallon drums_
Where is material stored: Pump House
How many disposal shipments per year: 4
Name of transport/ disposal vendor: North Star Logistics
Vendor address: Canton, NC
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 Article 21 or regulations of the Environmental
Management Commission implementing that Article, or who falsifies, tampers with or knowingly renders inaccurate
any recording or monitoring device or method required to be operated or maintained under Article 21 or regulations of
the Environmental Management Commission implementing that Article, shall be guilty of a misdemeanor punishable
by a Fine not to exceed $10,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C. Section 1001
provides a punishment by a fine of not more than $10,000 or imprisonment not more than 5 years, or both, for a similar
offense.)
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: Tim Surratt
Title:
H.R.H./ffManager
�(.vriLJ CoZ7— o l3
_tore of Applicant) (Date Signed}
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to:
NCDENR
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 NCDENR
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.
Page 3 of 4
S W U-233-081511

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Environmental, Inc.
Bluefield Engineering, P.C.
Councill Craftsmen Plant No. 1
Denton, North Carolina
SCALE: ,•• = 2000'
PROJECT Np. ,05,97
DATE: November 1997
DRAWN BY; RES
FILE: CoV'Cill Crofts_.n
Ploni No. ,
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