NCG080760_COMPLETE FILE - HISTORICAL_20170921

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V O � aco o
DOC TYPE
HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ �DI 7 � i a'
YYYYMMDD

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO,
NCGNE
DOC TYPE
❑ HISTORICAL. FILE
DOC DATE
❑
YYYYMM DD

Division of Energy, Mineral, and Land Resources
Land Quality Section / Stormwater Program
National Pollutant Discharge Elimination System (NPDES)
Energy, M[neral:k PERMIT OWNER AFFILIATION DESIGNATION FORM
Land Resources
ENVM*NMWWAL cuter (individual Legally Responslble for Permit)
Use this form if there has been:
FOR AGENCY USE ONLY
Me Received
Year Monah
im
NO CHANGE In facility ownership or facility name, but the individual
who is legally responsible for the permit has changed.
If the name of the facility has changed, or If the ownerahlo of the facility has changed,
do NOT use this form. Instead, you must fill out a Name -Ownership Change Form
and submit the completed form with all required documentation.
What does "legally responsible individual" mean?
The person is either:
• the responsible corporate officer (for a corporation);
• the principle executive officer or ranking elected official (for a municipality, state, federal or other public
agency);
• the general partner or proprietor (for a partnership or sole proprietorship);
• or, the duly authorized representative of one of the above.
1) Enter the permit number for which this change in Legally Responsible Individual ("Owner Affiliation")
applies:
Individual Permit (or) Certificate of Coverage
—1 IMM 0$ 0 7 6 0
2) Facility Information: R C n E f t� I E D
Facility name: f ;tZ17 ABF Freight System, Inc.
Company/Owner Organization: SCP 9 1 L.t, ABF Freight System Inc.
Facility address: [)Ei R-LANC'}UALMTY 1165 N C Hwy 66 South
STORM,NAXER P=RMITTING Address
Kernersville NC 27284
City State zip
To find the current legally responsible person associated with your permit, go to this website:
htt d .nc. v a di ' io ener -mineral-land-r ou ener -mine -1 - rmits stormwater- ro
and run the Permit Contact Summary Report.
3) OLD OWNER AFFILIATION that should be removed:
Previous legally responsible individual: Michael K Rogers
First MI Last
4) NEW OWNER AFFILIATION (legally responsible for the permit):
Person legally responsible for this permit:
Mark E McMinn
First MI Last
Page 1 of 2
5W U-OW NERAFFIL-23MaMh2D7 7

NPDES Stormwater Permit OWNER AFFILATION DESIGNATION Form
(if no Facility Name/Ownership Change)
5) Reason for this change:
A result of:
If other please explain:
Sr VP Operations & Safety _
Title
PO Box 10048
Mailing Address
Fort Smith AR 72917-0048
City State Zip
[phone] xnmaninnaa abf.com _
Telephone E-mail Address
(4791785-6015
Fax Number
® Employee or management change
❑ Inappropriate or incorrect designation before
❑ Other
The certification below must be completed and signed by the permit holder.
PERMITTEE CERTIFICATION:
1, Mark McMinn, attest that this application for this change in Owner Affiliation (person legally responsible
for the permit) has been reviewed and is accurate and complete to the best of my knowledge. I understand
that if all required pans of this form are not completed, this change may not be processed.
If Date
PLEASE SEND THE COMPLETED FORM TO:
Division of Energy, Mineral, and Land Resources
Stormwater Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
For more information or staff contacts, please call [phone] or visit the website at:
htty fLq.nc.gov about/divisions/energy-mineral-land-resources/stormwater
Page 2 of 2
SW U-OW N E RAFFI L-23 Marto 17

RESEARCh & ANA1yTiCA[
LAbORATORI ESP INC.
Analytical/Process Consultations
December 1, 2015
ABF Freight System, Inc.
1165 Hwy 66 South
Kernersville, NC 27284
Attention: Dale
Chemical Analysis for Selected Stormwater Sampling Locations
Cam,
a
NC #34 :
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Project Number: Not Available
NPDES##: Not Available
Sample
RAL
Sampling
Sampling
Total
Oil
Dates
Identification
Sample
Date
Time
Suspended
&
Analyzed
Number
Solids
Grease
mg/L
[ng/L
Outfall #2
11846-01
11/19/15
0713
23.2
<5
1 1117 & 11/21/15
Outfall 95
11846-02
11/19/15
0726
38
<5
11/17 & 11/21/15
Analysts: RH & YJ
Rainfall Amount: 2.24 in.
Rain Duration: 4 hr. 15 min.
< = less than or Below Quantitation Limit (BQL)
mg/L = milligrams per Liter = parts per million (PPM) SU = Standard Units

RESEARCh & ANA[yT1CA1
LABORATORIES, INC.
Analytical 1 Process Consultations
Phone [phone]
CHAIN OF CUSTODY RECORD
WATER ! WASTEWATER I MISG.
COMPANY JOB NO.
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CITY, STATE, 23P SAMPLER NAME (P 5E PRIMg0�
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CONTACT PHONE SAMPLER SIGNATURE
SAMPLE NUMBER
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DATE TIME
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SAMPLE TEMPERATURE AT RECEIPT °C
RELINQUISHED BY DATEITIME RECEIVEDB

Michael F. Easley, Governor
William G. Ross.lr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
June 3, 2005
Mr. Chris Brown
ABF Freight System, Inc.
PO Box 10048
Fort Smith, AR 72917-0048
Subject: General Permit No. NCGO80000
ABF Freight System, Inc.
COC NCGO80760
Forsyth County
Dear Mr. Brown:
In accordance with your application for a discharge permit received on May 12, 2005 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 May 9, 1994 (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 Jonathan Diggs at
telephone number [phone] ext. 537.
Sincer ,
ORIGI. SIGNED B
BRADLEY BENNETT
Alan W. Klimek, P.E.
cc: Winston-Salem Regional Office
Central Files
Stormwater Permitting Unit Files
ow NCarolina
Natura!!if
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Phone [phone] Customer Service
Intemet: h2o.enr.state.nc.us 512 N. Salisbury St. Raleigh, NC 27604 FAX [phone]
An Equal OpportunitylAffirmaWe Action Employer — 50 % Recycled110% Post consumer Paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG080000
CERTIFICATE OF COVERAGE NO. NCGO80760
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,
ABF Freight System, Inc.
is hereby authorized to discharge stormwater from a facility located at
AB Freight System, Inc.
1165 NC Hwy 66 South
Kernersville
Forsyth County
to receiving waters designated as West Fork Deep River, a class WS-IV,* water in the Cape Fear River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II, 11I,
IV, V, and VI of General Permit No. NCGO80000 as attached.
This Certificate of Coverage shall become effective June 3, 2005.
This Certificate of Coverage shall remain in eff& for the duration'of tfft General Permit.
z
Signed this day June 3, 2005. ORIGINAL SIGNED BY
BRADLEY 13ENNETT
Alan W. Klimek, Director
Division of Water Quality
By Authority of the Environmental Management Commission

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Markers
Name: ABF Freight Systems, Inc.
Short Name: BFFrgh
Coordinates: 036° 06' 03.80" N, 080' 03' 36.98" W
Comment: ABF Freight Systems, Inc., NCG080760, Cape Fear River Basin, 03-06-08, West
Fork Deep River, Class WS-IV", Kernersville USGS