NCS000511_Permit Application_20041118

PACIF11
November 16, 2004
� r }
P. O. Box 60, Henderson, NC 27536
North Carolina Department of Environment and Natural Resources
Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27699-1617
Attention: Bradley Bennett
Reference: APPLICATION FOR INDIVIDUAL STORMWATER DISCHARGE PERMIT
Pacific Mulch, Inc.
Henderson, NC
Dear Mr. Bennett:
Pacific Mulch, Inc. is submitting this application for a permit to discharge stormwater associated with an
industrial activity from the above referenced new facility. As part of this submittal, attached please find
a signed copy of USEPA Forms 1 and 2F.
Enclosed is a $715.00 check for applicable fees.
We appreciate your review of this application. If you have any question about this application, please
contact Dena Pittman of S&ME at [phone].
Sincerely,
Pacifi?er
f�.
Larry
President
Attachments
8
NOV 18
)ENR - WA RMj,.;
Mands & 8kMWSV-.
Office: 252 - 492 - 445 1 F a x : 2 5 2 - 492 - 7278

Please print or type in the unshaded areas only
rsrtr_;n m A cnarvrr Mr eHtP tvne- i.e.- 12 characterslinch).
Form Approved. OMB No. 2040-0086. )V (.3 0t I [ {�aL� (il
FORM
U.S. ENVIRONMENTAL PROTECTION- AGENCY
1. EPA I.D. NUMBER
GENERAL (NFORMATIQNConsolidated
SOERPRA, Permits Program
F
GENERAL
(Read the "General Instructions" before starting.)
LABEL
TE
-
GENERAL INSTRUCTIONS
If label has
t. EPA I.D. NUMBER
\
`\ \
a preprinted been provided, affix
it in the designated space. Review the inform-''
ation carefully; if any of it is incorrect, cross
through it and enter the correct data in the
\
III. FAC LITY NAME
appropriate ed da area below. Also, a any e
the preprinted data is absent (the area to the
�
FACILITY
left of the label space lists the information
V. MAILING ADDRESS
PLEASE PLACE
LABEL IN THIS SPACE
that should appear), please provide it in the
\
\ \
proper fill—in area(sl below. 1f the label is.,
complete and .correct, you need not complete'.
\�
\
\
Items 1, 111, V, and VI !except VI-B which
be
must completed .regardless). Complete all
FACILITY
V I.
items if no label has.been provided. Refer to
the instructions for detailed
LOCATION
\
item descrip-',
tions and for the legalauthorizations under.
which this data is collected'.'
It, POLLUTANT CHARACTERISTICS"
iNSTRUCTIONS: Complete A through J to determine whether you need to submit any permit application forms to the EPA. If you answer "yes" to any
questions, you must submit this form and the supplemental form listed in the parenthesis following the question. Mark " ' in the box in the third column
if the supplemental form is attached. if you answer "no" .to each _question, you need not submit any of these forms. You may answer "no" if your activity`
is excluded from permit requirements; see Section C of the instructions. See also, Section 0 of the instructions for definitions of bald -faced terms.
sPECIFIC QUESTIONS-.:.YEs
nD
FORM
ATTAC.ED
.. SPECIFIC QUESTIONS :
YES
MARK
NO
'X,..
FORM .:
gTTACHED
A. 1s this facility a publicly awned treatment works
B. Dees or will this facility !either existing or proposed!
which results in a discharge to waters of the U.S.?
X
'include a concentrated animal feeding operation or.
X
(FORM 2A)
aquatic animal production facility which results rn a
discharge to waters of the U.S.? (FORM 2B)
rg
21
16
17
,t
C, is this a facility which currently results in discharges
to waters of the 'U.S. other than those described in
X
D. Is this a proposed facility (other than those described
in :A or B,abovel which will result in -a diseharge'to
l
I X
A or B above? (FORM 2C)
22
23
24
waters of the U.S.? (FORM 2D)
:6
36
n
E. Does or will this facility treat, store, or dispose of
F. Do you or.will you inject at this facility Industrial or
municipal effluent below the lowermost stratum'con•'
hazardous wastes? (FORM 3)
X
taining, within one quarter mile of the well .bore, `
X
26
26
36
underground. sources' of drinking water? {FORM 4)
G. o you or will you Infect at this Tacility any produced.H.
water or other fluids which are brought to the surface
Do you or will you Inject at this facility fluids forspe-
in connection with conventional oil or natural .gas pro-
X
dial processes such as mining of sulfur by the Frasch
duction, inject fluids used for enhanced recovery of,
process, solution rrtining of minerals, in situ combos -
tion of •fossil fuel, or recovery of geothermal energy?
X
oil or naturaf.gas,or inject fluids toratorage of liquid
(FORMA)
hydrocarbons? (FORM 4)
s4
35
36
37
I. Is this facility a proposed stationary. source which Is
J. Is this facility a proposed stationary source which is
one of the 28 industrial categories listed in the in-
NOT one of the 28 industrial categories iisted:trt the
structions and which will potentially emit 100 tons
X
instructions and which will; potentially emit 250 tons
X
per year of any :air pollutant regulated under, th.e:
per year of any air pollutant regulated under the Olean
Clean' Air Act and may affect or be located in an
Air Act and may affect or be located in an attainment
attainment area? +FORM 5)
area? 4FORM 51
.a
4,
•r
Ill. NAME OF FACILITY
c
SKIP PACIFIC MULCH, INC. -
15. 16 - 29 30 ...
IV. FACILITY CONTACT
-... - 69:
" A. NAME B: TITLE (last, first. & titie) `•- B. PHONE (area code.:& no-/
c
-rtY—�dE PRESIDENT
919 368 1 1 369
46 - 46 49 - 5t 12
2
15
16 -
•5
V. FACILITY MAILING ADDRESS
A.STREET OR P.O. BOX
-
c
3 PO T OFFTCF, 13OX0
f5 16
•5
S. CITY OR TOWN
C:STATE D. ZIP CODE -
c
-4 HN R0
S5 ,6
N 27
1., 2
Vl. FACILITY LOCATION
- A. STREET, ROUTE NO. OR OTHER SPECIFIC IDENTIFIER
c
51 PETER I R
15 16
•5
B. COUNTY NAME
- -
V CE
46
20 ..
C. CITY OR TOWN. ". -
D.STATE�
Eu ZIP CODE
F. COUNTY CODE
' knueun
6
liENDERSON . . . . . . . . . . . .
',NC
27536
EPA Form 3510-1 (8-90) CONTINUE ON REVERSE

1.:VI141.ltVUCV 1----1
VI I. SIC CODES (4•digir. in order of priority!
A. FIRST S. SECOND .
c
(specify) %
(specify)
7 242
rs 16
1 1 J
/9t•
Sawmills & Planing-Mills,General
6 t
C. THIRD - D. FOURTH ..
(specify) ° (specify)
1c
7
7
NA ,5 ,.6 ,9 N
1, 16
19
Vlll, OPERATOR INFORMATION
. A. NAME
B.Is the name listed-lim
Item VIII-A aPsoCthe
c
owner?'. ,
$
A R NEAL, SENTER
,
YES D,NO66
t5 t8
!6
C. STOAT US OF O P E R A T O R.(En ter the appropria to letter in to the answer box: if -01h er'•, specify.)
D. PHONE (area code $ no,)
F = FEDERAL M = PUBLIC (other than federal orstate)
(specify)
`
A
919 11
368
1369
S = STATE O = OTHER (specify)
+e 2a
{9 - zl
P =PRIVATE
as
1s
zz zs
.. E. STREET OR P.O. SOX
POST OFFICE BOX 60
26
F. CITY OR TOWN
G.STAT H. 21P Co.E..
iX.INDIAN LAND
c Is the facility located on:lndtan,lancis?
g HENDERSON NC 27536 -D YES LJ NO
sz
X. EXISTING ENVIRONMENTAL PERMITS
A. NPOES (Discharges to Surface Water) D.'PSD (Air Emissions from Proposed Sources]
9 N 9 P
B. uIe (Underground Injection of Fluids)
E. OTHER (specify)
c
T
I-
(specify)
PIS
fflI
30
C. RCRA (Hazardous Wastes)
E. OTHER (speCifyJ - ...
c
T
I
I9
c r., r. (Specify)
'at'. jjiIt. :30
9
1 R1
1S
1 16
1171
1A - 30
XI. MAP
Attach to this application a topographic map of the area extending to at feast one mile beyond,propertY bounderies. The map must show
the outline of the facility, the location of each of its•,existing and proposed intake and discharge structures, each of its hazardous waste •"
treatment, storage, or disposal. facilities, and each well where It injects fluids underground. Include all springs, rivers and other.surfacc, Mt
Water bodies in the map area. See, (nstructionslor- precise requirements.,
XiI:'NATURE OF BUSINESS /provide a brief description
New facility proposing to manufacture pine and hardwood mulches.
XII.I. CERTIFICATION (see instructions)
I certify under penalty of law that 1 have personally examined and am familiar with the information -submitted in this application and all
attachments and that, based on my inquiry of those persons immediately responsible for obtaining the information'contained'in the
application, I believe that the information is true, accurate and complete. l am a re that there are significant penalties for submitting
false information, including the possibility of fine and imprisonment.
A. NAME & OFFICIAL TITLE: (type or print)
Larry Neal Senter, President
B. SIGNP7)`URE C. DATE SIGNED
/0(/
AL USE ONLY
COMMENTS FOR OFFICIIS
C
1S
{6
...
EPA Form 3510-1 (s-su)

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1000 0 1000 HENDERSON, NC USGS QUADRANGLE DATED 1970, PHOTOREVISED 1982
GRAPHIC SCALE IN FEET
SCALE: 1,. _ 1, oho, //�� pp �� �/ MAP
p FIGURE NO.
VICINITY i IVIi1P
DATE: NOVEMBER 2004 w
DRAWN BY:
JCJ ENVIRONMENTAL SERVICES PACIFIC MULCH, INC.
PROJECT NO: 1054-04-978 ENGINEERING TESTING HENDERSON, NORTH CAROLINA

I EPA ID Number (copy from /rem / of Form t) 'ra Fonn Approved.
Please print or type in the unshaded areas only NA OMB No.2040-0088.
Approval expires B-31-98.
Form United States Environmental Protection Agency
,2F A Washington, DC 20460
NPDES%v E Application for Permit To Discharge Stormwater
i1�@/�II.1 /J Ml�Ae. Awww �: �L�J ._!tL- L_ -a. . _ __
Notice
Public reporting burden for this application is estimatePaperwork
to ave average hction ours per
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of ntotime for flrntat on Seninstruct 0 d
comments regarding the burden estimate, any other aspect of this collection of information, or Su2g2gestions for improving this form, including
4011 M suggestions
ins whiSW, Washington, DC increase or
reduce 20460, orliDi ector, to: Chief, Information Office of Information and�Regufl Regulatory Affairs,rUOffice of ManagemenEnvironmental t
rind Budget,
Washington, DC 20503.
A. Outfall Number
43
D. Receiving Water
(name)
to Lynch s Cre
A. Are you now required by any Federal. State, or local authority to meet any implementation schedule for the construction, upgrading or
operation of wastewater treatment equipment or practices or any other environmental programs which may affect the discharges
described in this application. This includes, but is not limited to, permit conditions. administrative or enforcement orders, enforcement
compliance schedule letters, stipulations. court orders. and grant or loan conditions.
1. Identification of Conditions.
Agreements. Etc.
number
2. Affected
of
Brief Description of Project
4. Final
B. You may attach additional sheets describing any additional water pollution (or other environmental projects which may affect your
discharges) you now have under way or which you plan. indicate whether each program is now under way or planned, and indicate your
actual or planned schedules for construction.
Attach a site map showing topography (or indicating the outline of drainage seas served by the outfall(s) covered In the
topographic map is unavailable) depicting the facility including: each of its intake and dischargeapplication if a
water outfall; paved areas and buildings within the drainage area of each storm water outfaleach kkneovvn pastro�rtpresentareaareas used of each �
outdoor storage or disposal of significant materials, each existing structural control measure to reduce pollutants in storm water run tar
materials loading and access areas, areas where pesticides, herbicides, soil conditioners and fertilizers are applied; each of its hazardous
waste treatment. storage or disposal units (including each area not required to have a RCRA permit which is used for accumulating hazardous
waste under 40 CFR 262.34); each well where fluids from the facility are injected underground; springs, and other surface water bodies which
receive storm water discharges from the facility.
EPA Form 3510-2F (11-90) Page 1 of 3 Continue on

A. For each outfall, provide an estimate of the area (include units) of impervious surfaces (including paved areas and building roots) drained
to the outfall, and an estimate of the total surface area drained by the outfall.
Outfall
Area of impervious Surface
Total Area Drained
Outtall
Area of Impervious Surface
Total Area Drained
m r
Number
(DMvide units)
(provide unitst
001
NONE
(+/— 19 Acres
002
NONE
+/— 9 Acres
B. Provide a narrative description of significant materials that are currently or in the past three years have been treated, stored or disposed in
a manner to allow exposure to storm water; method of treatment, storage, or disposal; past and present materials management practices
employed, in the last three years. to minimize contact by these materials with storm water runoff; materials loading and access areas; and
the location. manner. and frequency in which pesticides. herbicides, soil conditioners, and fertilizers are applied.
N/A — New Facility
C For each ou:tail provide the location and a description of existing structural and nonstructural control measures to reduce pollutants in
storm water runcff: and a description of the treatment the storm water receives, including the schedule and type of maintenance for control
and treatmenth fluid
Outfall
List Codes from
Number
Treatment
Table 2F.1
N/A N/A - New Facility «,
V. Nonstormwater Dischar es
A. I certify under penalty of law that the outfall(s) covered by this application have been tested or evaluated for the presence of
norstormwater discharges, and that all nonstormwater discharges from these outfall(s)art identified in either an accompanying Form 2C
r Form li •i n f r he outtall,
Name and Official Title (type or print)
Signature
Date Signed
B. Provide a descr:p-ion of the method used, the date of any testing, and the onsite drainage points that were directly observed during a test.
.N/A - New facility - requesting to use parameters as listed in NCG 220000.
VI. Si nificant Leaks or S ills
Provide existing information regarding the history of significant leaks or spills of toxic or hazardous pollutants at the facility in the last three
years, including the approximate date and location of the spill or leak, and the type and amount of material released.
Not aware of any —'new facility — site previously undeveloped.
EPA Form 3510.2F (11.90) Page 2 of 3 Continue on Page 3

. EPA ID Number (copy from Item I of Form 1)
Continued from Psi 2 1 AT l e
A.B.C. & D: See instructions before proceeding. Complete one set of tables for each outfail. Annotate the outfail number in the space provided.
Tables W.A. VI{-13, and %Al-C are included on separate sheets numbered VII-t and W-2.
E. Potential discharges not covered by analysis - Is any pollutant listed in Table 2F-2 a substance or a component of a substance which you
currently use or manufacture as an intermediate or final product or byproduct?
ElYes rise al! such pollutants below) rx—I No (o to Section Vill)
Vill, Biological Toxicity Testing Data
Yes (r:st resets belc4) No (o to Section IX)
Contract Anal�sis Information
1j Yes No (go ro Section X)
A Name
B. Address
C. Area Code,& Phone No.
! D. Pollutants Ana. ed
N/A
X. Certificati,
A Name & Official Title (.type or print)
Larry Neal Senter, Pr ident
B. Area Code and Phone No
919/368-1369
C. Signature
D. Date Si Yned
EPA Form 3510-2F (11.90) 'A - Page 3 of 3

ti-A lu rvumner (L UFy OMB No.2040.0086. -
N/A I APp� expires "I-M.
VII. Dischar a {nformation Continued from pace 3 of Form 2F
Part A - You must provide the results of at least one analysis for every pollutant in this table. Complete one table for each outtall. See
instructions for additional details.
Pollutant
and
CAS Number
(if availaGrel
Maximum Values
(include units)
Average Values
(include units)
Number
of
Storm
Events
Sampled
Sources of Pollutants
Grab Sample
Taken During
First 30
Minutes
Flow -weighted
Composite
Grab Sample
Taken During
First 30
Minutes
Flow -weighted
Composite
Oi! and Grease
N/A
B,orogical Oxygen
Demand (BOD51
N/A
Cnemicai Oxygen
Demand (COD)
N/A
Total Suspended
Solids (TSS)
N/A
Total Kjeldahl
Nitrogen
N/A
Nitrate plus
Nitrite Nitrooen
N
0 ta:
Dti0-_OtiOr,we
-
NIA
cti -nirr. Max,morn Minimum Maximum
Part B - -!st each pc:.utart :rat :s :+maec in an effluent guroeirne which the facility is subject :o or any ool!utam nsted in the facility s NPQ ES
permit for is process wastewater (if the facility is operating under an existing NPDES permit;. Compete one table for each outf$li.
ee in instruclions for adoilional Oet is and
Maximum Values Average Values I Number
(irclude units; (include units) of
a^d Grab Sample I Grab Sample ) Storm
cl CZr ..cE, . Ta e During Fiow-weighted ` Taken First 30ing Flow -weighted Events ,
(I a,a :2c e f' nutes. Ccmposite i Minutes Composite I Sampled' Sources of Pollutants
A water sam le
under i,
h
bp fnnilitF is
I
zaqu
I
(
I
I
I
I
EPA Form 3510-2F (11.90) Page VII-1 Continue on Reverse

Part C - List each pollutant shown in Tables 2F-2, 2F-3, and 2F-4 that you know or have reason to believe is present. See the
additional details and requirements. Complete one table for each outfall.
instructions for
Pollutant
and
CAS Number
(if available)
Maximum Values
(include units)
Average Values
(include units) '
Number
of
Storm
Events
Sampled,
Sources of Pollutants
Grab Sample
Taken During
rst
Minutes
Flow -weighted
Composite
Grab Sample
Taken During
ur ng
30
Minutes
Flow -weighted
Composite
TSS
NA
i
i
BOD
NA
Ian.s
OIL & GREASE
NA
T)H
NA
i
j
I
I
i
j
I
I !
i I
i
I
I
PartD - Provide data for the storm event a which resulted in the maximum values for the flow wei hted com osite sample.
t.
Date of
Storm
Event
2.
Duration
of Storm
(in minutes
3.
Total rainfall
duringstorm event
in inches
4.
Number of hours between
beginning of storm meas-
ured and end of previous
measurable rain event
5.
Maximum floe rate
during rain event
(gallons/minute or
s unhs
6.
Total flow from
rain event
(gallons or
gpecify units)
7.
Season
sample was
p
taken
8.
Form of
Precipitation
(rainfall
snowme/t)
NA
NA
NA
NA
NA
NA
NA
NA
9. Provide a description of the method of flow measurement or estimate.
001
19 acres x 43605f x 1 ft. x 7.481 gal x 1 mg x inches rainfall =
acre 12 in. 1 cf 1 x 10(6) gal
= 0.516 MG/IN x inches rainfall = MG Flow
FPe Fnr— asIn-*c ,,,_aai
' --• • -I- . --.