NCS000543_SIGNED Renewal Application_20170925

Permit Coverage
NCDENR Renewal Application Form
National Pollutant Discharge Elimination System
Stormwater Individual Permit
NPDES Permit Number
NCS nnnS43
Please provide your permit number in box in the upper right hand corner, complete the information in the space provided
below and return the completed renewal form along with the required supplemental information to the address indicated.
Owner Information
* Address to which permit correspondence will be mailed
Owner / Organization Name:
Carus Corporation
Owner Contact:
Mack Cochran
Mailing Address:
181 Woodlawn Street, Belmont, NC 28012
Phone Number:
704-822-1441
Fax Number:
E-mail address:
[e-mail]
Facility Information
Facility Name:
Carus Corporation
Facility Physical Address:
181 Woodlawn Street
Belmont, NC 28012
Facility Contact:
Mack Cochran
Mailing Address:
181 Woodlawn Street, Belmont, NC 28012
Phone Number:
704-822-1441
Fax Number:
E-mail address:
[e-mail]
Permit Information
Permit Contact:
Mack Cochran
Mailing Address:
181 Woodlawn Street, Belmont, NC 28012
Phone Number:
704-822-1441
Fax Number:
E-mail address:
[e-mail]
Discharge Information
Receiving Stream:
UT to South Fork of the Catawba River
Stream Class:
WS -V
Basin:
Catawba River
Sub -Basin:
03-08-35
Number of Outfalls:
1
Facility/Activity Changes Please describe below any changes to your facility or activities since issuance of your permit. Attached a
separate sheet if necessary.
Additional BMPs have been installed including outside canopies over several unloading areas and a large concrete stormwater
Detention basin has been constructed to replace the earthen basin.
CERTIFICATION
I certify that I am familiar with the information contained in the application and that to the best of my knowledge and belief
such information is true, complete and accurate.
Signature )Ie4 �_ c�4o r-- Date ;7
mark Cochran Plant Mgr_
Print or type name of person signing above Title
Please return this completed application form SW Individual Permit Coverage RenewalStormwater Permitting Program
and requested supplemental information to: 1612 Mail Service Center
Raleigh, North Carolina 27699-1612