NCG081041_Page 1 of NOI_20230803

FOR AGENCY USE ONLY
NCG08____
Assigned to:
ARO FRO MRO RRO WARO WIRO WSRO
Division of Energy, Mineral, and Land Resources Land Quality Section
National Pollutant Discharge Elimination System
NCG080000 Notice of Intent
This General Permit covers STORMWATER DISCHARGES associated with activities under the following Standard
Industrial Classifications: SIC 40[Railroad Transportation], SIC 41 [Local and Suburban Transit and Interurban
Highway Passenger Transportation], SIC 42[Motor Freight Transportation and Warehousing—except for SIC
4221-4225], SIC 43[United States Postal Services], SIC 5171 [Petroleum Bulk Stations and Terminals—when total
petroleum site storage capacity is less than 1 million gallons]. The following activities are also included:other
industrial actives where the vehicle maintenance areas) are the only area requiring permitting;stormwoter
discharges from oil water separators and/or from secondary containment structures associated with petroleum
storage facilities with less than 1 million gallons of total petroleum site storage capacity. You can find information
on the DEMLR Stormwater Program at deq.nc.gov/SW
Directions: Print or type all entries on this application. Send the original, signed application with all required
items listed in Item (6) below to: NCDEMLR Stormwater Program, 1612 MSC, Raleigh, INC 27699-1612. The
submission of this application does not guarantee coverage under the General Permit. Prior to coverage under
this General Permit a site inspection will be conducted.
1. Owner/Operator (to whom all permit correspondence will be mailed):
Name of legal organizational entity: Legally responsible person as signed in Item (7) below:
Terra Nova Solutions. Inc. Bvron Bellman
Street address: City: State: Zip Code:
901 East SDrinafield Road Hiah Point �NC �27263
Telephone number: Email address:
336 841 -5276 bbellman tnsolutions.co
Type of Ownership:
Government
❑County ❑Federal El Municipal ❑State
Non-government
❑Business(If ownership is business, a copy of report must be included with this application)
❑Individual
2. Industrial Facility (facility being permitted):
Facility name: Facility environmental contact:
Terra Nova - Byron Bellman
Street address: City: State: Zip Code:
1 Eat Sprinafield Road Hiah Point �NC �27263
Parcel Identification Number(PIN): County:
2500203001 Sumter
Telephone number: Email address:
bbellmanatnsolutions.co
4-digit SIC code: Facility is: Date operation is to begin or began:
4212 ❑New ❑Proposed ❑Existing 11/3/2021
Latitude of entrance: Longitude of entrance:
350 56' 0.9096" -790 58' 28.8876"
Page 1 of 5