NCG050441_Ply Gem Application_20181231

NCG-0 SO 9Lf
Division of Energy, Mineral and Land Resources
Land Quality Section
r National Pollutant Discharge Elimination System
Environmental
Quality NCG050000
NOTICE OF INTENT
FOR AGENCY USE ONLY
Date Received
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Month
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Certificate of Covers
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National Pollutant Discharge Elimination System application for coverage under General Permit
NCG050000:
STORMWATER DISCHARGES associated with activities classified as:
SIC* 23 Apparel and Other Finished Products Made from Fabrics and Similar Materials
SIC* 265 Paperboard Containers and Boxes
SIC* 267 Converted Paper and Paperboard Products SIC* 27 Printing, Publishing and Allied Industries RECEIVED
SIC* 30 Rubber and Miscellaneous Products (except as specified below) NOV 2 1 2 i8
SIC* 31 Leather and Leather Products (except as specified below)
SIC* 39 Miscellaneous Manufacturing Industries S DENR-LAND QUALITY
SIC* N/A Like activities deemed by DEMLR to be similar in the process and/or the eR) ffijePbF 17T INC',
materials, products, by-products, or waste materials
The following activities are specifically excluded from coverage under this General Permit:
SIC* 301 Tires and Inner Tubes
SIC* 311 Leather Tanning and Finishing
* Standard Industrial Classification Code
(Please print or type)
1) Mailing address of owner/operator (address to which all permit correspondence will be mailed):
Name Ply Gem Insight Center
Street Address
City
Telephone No.
E-mail Address
2520 South Tri-Center Blvd.
Durham
919 237-7263
2) Location of facility producing discharge:
Facility Name
Facility Contact
Contact E-mail
Street Address
City
County
Telephone No.
State NC ZIP Code 27713
Fax:
Ply Gem Foundation Labs
Sean *Mo wwe' M& eW s
sean.rn*ha"@plygem.com se&#%, wtxt ► ;e „js Ld A to atGtrn • ca7yi
2520 South Tri-Center Blvd.
Durham
919 237-5357
3) Physical Location Information:
State NC ZIP Code 27713
Fax:
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). From RDU take 1-40 W. Follow 1-40 west to Durham -Take Exit 278 -
Continue on NC 55/Apex Hiahwav - Drive to Tri-Center Blvd.
(A copy of a county map or USGS quad sheet with facility clearly located on the map is required with this application)
4) Latitude 35° 55' 14.3508" N Longitude -78° 53' 8.5668" W (degrees, minutes, seconds)
►W
Page 1 of 4
SWU-220-071408 Last Revised 6/24/14

NCGO50000 N.O.I.
5) This NPDES Permit Application applies to which of the following:
❑ New or Proposed Facility
11 Existing
6) Standard Industrial Classification:
Date operation is to begin 12/01/2015
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: 3 9 9 9
7) Provide a brief narrative description of the types of industrial activities and products manufactured at
this facility: The facility is developing a composite panel for housing. Activities include receiving raw materials such as sand and liquid
polymers in sacks and drums. Waste management shall include outside storage in uncovered roll off containers.
8) Discharge points:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? 2
List discharge points (outfalls) that convey discharge from the site (both on -site and off -site) and location
coordinates. Attach additional sheets if necessary, or note that this information is specified on the site plan.
Stormwater Outfall No. 001
Latitude (degrees/minutes/seconds): 35' 55' 17.3784" N
Longitude (degrees/minutes/seconds): -78' 53' 7.4286" W
Stormwater Outfall No. 002
Latitude (degrees/minutes/seconds): 35' 55' 12.6834" N
Longitude (degrees/minutes/seconds): -78' 53' 11.241" W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds): N
Longitude (degrees/minutes/seconds): W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds): N
Longitude (degrees/minutes/seconds): W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds): N
Longitude (degrees/minutes/seconds): W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds): N
Longitude (degrees/minutes/seconds): W
Page 2 of 4
SWU-220-071408 Last Revised 6/24/14

NCG050000 N.O.I.
Stormwater Outfall No.
Latitude (degrees/minutes/seconds): _
Longitude (degrees/minutes/seconds):
9) Receiving waters:
N
W
What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater
discharges end up in? Stormwater is discharged through a site storm drain to unnamed tributaries of Northeast Creek
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?
M 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)?
M 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
Yes
If yes, please briefly describe:
13) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No
91 Yes
If yes, when was it implemented? 8/2018
14) Are vehicle maintenance activities occurring at this facility?
M No ❑ Yes
15) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
e No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
M No ❑ Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
M No ❑ Yes
d) If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste:
Page 3 of 4
SWU-220-071408 Last Revised 6/24/14

NCG050000 N.O.I.
How is material stored: _
Where is material stored:
How many disposal shipments per year:
Name of transport / disposal vendor:
Vendor address:
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 this Article or a rule implementing this Article; or who knowingly makes a false
statement of a material fact in a rulemaking proceeding or contested case under this Article; or who falsifies, tampers with, or knowingly
renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
[Environmental Management] Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine not to
exceed ten thousand dollars ($10,000).
I 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: John Pacanovsky
Title: DI t2ECTD(L OF (zIWOS l T E S i Dl N
of Applicant)
'J S Zole
( ate Signed)
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to NCDEQ.
Page 4 of 4
SWU-220-071408 Last Revised 6/24/14

NCGO50000 N.O.I.
Final Checklist
This application will be returned as incomplete unless all of the following items have been included:
11 Check for $100 made payable to NCDEQ
❑ This completed application and all supporting documents
❑ Copy of county map or USGS quad sheet with location of facility clearly marked on map and nearby waters
Mail the entire package to:
DEMLR - Stormwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Note
The submission of this document does not guarantee the issuance of an NPDES permit.
For questions, please contact the DEMLR Central Office or Regional Office for your area.
DEMLR Regional Office Contact Information:
Asheville Office ...... [phone]
Fayetteville Office ... [phone]
Mooresville Office ... [phone]
Raleigh Office ........ [phone]
Washington Office ...[phone]
Wilmington Office ... [phone]
Winston-Salem ...... [phone]
Central Office .........[phone]
Page 5 of 4
SWU-220-071408 Last Revised 6/24/14

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Vendor Name:,
North Carolina Department of Environmental OUatti 3 gg
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DESCRIPTION >
Storm Water permit application fee
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a plicalion
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MAILING
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❑ < Mail Check to Vendor
p < Mail Check to Vendor wlAttached Documents
❑ < E-Mail Payment Information to Requestor
Requestor email address:
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ESCALATED HANDLING
REQUIREMENTS
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Print Name
Signature
REOUESTEDBY
Sean Mathews
....................--..._-.......__..._ .__
.; DATE:
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APPROVED BY
John Pecaraysky_
DATE;
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110V 06 2013
DENR-LAND QUALITY
STORMWATER PERMITTING

Division of Energy, Mineral and Land Resources
Land Quality Section
- National Pollutant Discharge Elimination System
Environmental
Quality NCGO50000
NOTICE OF INTENT
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG050000:
STORMWATER DISCHARGES associated with activities classified as:
SiC' 23 Apparel and Other F,Inishe_&Prod66fs1'Made from;Fabrics and Similar Materials
SIC' 265 Paperboard Containers a d�Boxes
SIC' 267 Converted Paper and Paperboard Products:,,,,-
SIC' 27 Printing, Publishing and'Allied,Industrfes,'
SIC' 30 Rubber and Mlscellaneous,Produpts (s);cepf'a6,specmed�below) -
SIC' 31 Leather and Leather Products.(excepf as specffied.below)
SIC' 39 Miscellaneous Manufacturing `Inddstrles'
SIC" NIA Like activities deemed by DEMLR to be, similar in'the process and/or the exposure of raw
materials, products, by-products, or waste materials
The following activities are specifically exc_ ludgd from coverage under this General_Permlt: SIC'301 Tires and Inner Tubes RECEIVED
SIC' 311 Leather Tanning and Finishing
- NOV o s 2013
• Standard Industrial class ication Code
(Please print or type) DENR-LAND QUALITY
ST�RMW T
1) Mailing address of owner/operator (address to which al! permit correspon once
Name Ply Gem Insight Center
Street Address 2520 South Tri-Center Blvd.
City
Durham State NC ZIP Code 27713
-
Telephone No. 919 237-7263 Fax:
E-mail Address
2) Location of facility producing discharge:
Facility Name Ply Gem Foundation Labs
Facility Contact Sean Matthews
Contact E-mail [e-mail]
Street Address 2s20 south Tri-center Blvd.
City Durham State NC ZIP Code 27713
County
Telephone No. g19 237-5357 Fax:
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). From RDU take 1.40 W. Fallow 1-40 West to Durham -Take Exit 278 -
Continue on NC 55/ADex Hlahwav - Drive to Tri-Center Blvd.
(A copy of a county map or USGS quad sheet with facAfty cieady located on the map is required with this application)
4) Latitude 35' 55' 14.3508' N Longitude -78. 53' 8.566W W (degrees, minutes, seconds)
Page 1 of 4
SWU-220-071408 Last Revised 6/24114

NCGO50000 N.O.I.
Stormwater Outfall No.
Latitude (degrees/minutes/seconds): N
Longitude (degrees/minutes/seconds): W
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? Stormwater Is discharged through a atte storm drain to unnamed tributaries of Northeast Creek
If the site stormwater discharges to a separate storm sewer systefn, name the operator of the separate storm
sewer system (e.g. City of Raleigh municipal storm sewer).
10) Does this facillity have any other NPDES
No
❑ Yes
If yes, list the permit numbers for -ail current NPDES jermits for{thls;facility: -
11) Does this facility have any Non -Discharge pernnits(eX: iecycle permits)?
e No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
12) Does this facility employ any best managerppnt,practices for stormwateucontrol?-tla.
❑ No
� Yes
If yes, please briefly describe: ,
e
O
13) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No
Yes
If yes, when was it implemented? 812018
14) Are vehicle maintenance activities occurring at this facility?
9 No ❑ Yes
15) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
e No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
I No ❑ Yes
c) Is this facility a urge Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
4 No ❑ Yes
d) If you answered yes to questions b. or c., please provide the following Information:
Type(s) of waste:
Page 3 of 4
SWt1-220-071408 Last Revised 6124/14

NCGO50000 N.O.I.
Final Checklist
This application will be returned as incomplete unless all of the following items have been Included:
9 Check for $100 made payable to NCDEC
O This completed application and all supporting documents
❑ Copy of county map or USGS quad sheet with location of facility clearly marked on map and nearby waters
Mail the entire package to:
DEMLR - Stormwater Program
Dept. of Environmental Quality
1512 Mall Service Center
Raleigh, North Carolina 27699-1612
Note
The submission of this document does not guarantee the issuance of an NPDES permit.
For questions, please contact the DEMLR Central Office or Regional Office for your area.
DEMLR Reolonal Office Contact Information:
Asheville Office ......
[phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
(919) 7914200
Washington Office ...(252)
946-6481
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........[phone]
Page 5 of 4
SWU-220-071408 lest Revised 6/24/14

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Bianca Smith
From:
Sean Mathews
Sent:
Wednesday, October 10, 2018 9:26 AM
To:
Bianca Smith
Cc.
John Pacanovsky
Subject:
Stormwater check request and permit application
Attachments:
Check Request and documents.pdf
Hi Bianca,
I attached a check request for storm water permit, could we get a check cut and sent to the following address along with
the supporting application documents?
DEMLR—Storm water Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
Let me know if you need anything else from me.
Best Regards,
Sean
Sean Mathews
Operations Generalist
Ply Gem Industries Inc.
2520 S Tricenter Blvd, Durham, NC 27713 1 p: 919-237-5357
e-mail: sean mathews�a plygem.com
f,,."PlyGeill.
UILDING PRODUCTS