AQ_F_0400009_20220131_PRMT_PmtApp

RECEIVED
FORM A
GENERAL FACILITY INFORMATION JAN 31 2022
REVISED 04/18/19 NCDEQ/Division of Air Quality-Application for Air Permit to Construct/Operate r A
NOTE-APPLICATION WILL NOT BE PROCESSED WITHOUT THE FOLLOWING:
❑ Local Zoning Consistency Determination ❑ t rc�Fi "iv,L'-A-t is✓e-
Appropriate Number of Copies of Application ff�t�04LpUase check one option below)
(new or modification only)
✓❑ Responsible Official/Authorized Contact Signature P.E.Seal(if required) Not Required ePayment 0 Check Enclosed
GENERAL INFORMATION
Legal Corporate/Owner Name:Homwood,Inc.
Site Name:Homwood,Inc.
Site Address(911 Address)Line 1:766 Haileys Ferry Road
Site Address Line 2:
City:Lilesville state:NC
Zip Code:28091 1County:Anson
CONTACT INFORMATION
Responsible OfficiaUAuthorized Contact: Invoice Contact:
Name.Jitle:Chuck Horne,President Name/Title:Benjamin L Burr Jr,Environmental Manager
Mailing Address Line 1: 766 Haileys Ferry Road Mailing Address Line 1: 766 Haileys Ferry Road
Mailing Address Line 2: Mailing Address Line 2:
City:Lilesville State:NC Zip Code:28091 City:Lilesville State:NC Zip Code:28091
Primary Phone No.:704-848-4121 Fax No.:704-848-4555 Primary Phone No.:704-8484121 Fax No.: 704-8484555
Secondary Phone No.: Secondary Phone No.:
Email Address: Email Address:
Facility/Inspection Contact: Permit/Technical Contact:
Namamoe:Dale Kelly,Plant Engineer Namerritle:Dale Kelly,Plant Engineer
Mailing Address Line 1: 766 Haileys Ferry Road Mailing Address Line 1: 766 Haileys Ferry Road
Mailing Address Line 2: Mailing Address Line 2:
City:Lilesville State:NC Zip Code:28091 City:Lilesville State:NC Zip Code:28091
Primary Phone No.:704-848-4121 Fax No.:704-848-4555 Primary Phone No.:704-848-4121 IlFax No.:704-848-4555
Secondary Phone No.: Secondary Phone No.:
Email Address:dkelly(c),homwoodinc.com Email Address dkelly(�homwoodinc.com
APPLICATION IS BEING MADE FOR
New Non-permitted Facility/Greenfield Modification of Facility(permitted) Renewal Title V © Renewal Non-Title V
❑Name Change ❑Ownership Change Administrative Amendment Renewal with Modification
FACILITY CLASSIFICATION AFTER APPLICATION(Check Only One)
General El Small Prohibitory Small Synthetic Minor 13 Tale V
FACILITY(Plant Site)INFORMATION
Describe nature of(plait site)operation(s):
Warping,Knitting,Dyeing,Finishing and Face Finishing.
Facility ID No.040009
Primary SIC/NAICS Code:3133312 Current/Previous Air Permit No.04888R16 Expiration Date:4-30-2022
Facility Coordinates: Latitude:34d57.211 m Longitude:-79d57.6182m
Does this application contain confidential data? O YES ® NO —11 yes,please contact the DAQ Regional Office prior to submitting this application.—
(See Instructions)
PERSON OR FIRM THAT PREPARED APPLICATION
Person Name:Dale Kelly Firm Name:Homwood Inc
Mailing Address Line 1:766 Hailey's Ferry Road Mailing Address Line 2:
City_Lilesville State:NC Zip Code:28091 County:Anson
Phone No.:7044848-4121 Fax No.:704-848-4555 Email Address:[e-mail]
SIGNATURE OF RESPONSIBLE OFFICIALIAUTHORIZED CONTACT
Name(typed): Charles Home Title: President
X Signature(Blue Ink): L�il J�CiCJ /J� Date: 1-27-22
Attach Additional Sheets As Necessary Page 1 of 2
l

FORM A (continued, page 2 of 2)
GENERAL FACILITY INFORMATION
REVISED 04/18/19 NCDEQ/Division of Air Quality-Application for Air Permit to Construct/Operate A
SECTION AA1 -APPLICATION FOR NON-TITLE V PERMIT RENEWAL
Hornwood Inc (Company Name)hereby formally requests renewal of Air Permit No. 0488R16
There have been no modifications to the originally permitted facility or the operations therein that would require an air permit since the last permit was issued.
Is your facility subject to 40 CFR Part 68'Prevention of Accidental Releases"-Section 112(r)of the Clean Air Act? O YES O NO
If yes,have you already submitted a Risk Manage Plan(RMP)to EPA? O YES O NO Date Submitted:
Did you attach a current emissions inventory? O YES O NO
If no,did you submit the inventory via AERO or by mail? 0 Via AERO Mailed Date Mailed:
SECTION AA2-APPLICATION FOR TITLE V PERMIT RENEWAL
In accordance with the provisions of Title 15A 2Q.0513,the responsible official of r I(Company Name)
hereby formally requests renewal of Air Permit No. (Air Permit No.)and further certifies that:
(1) The current air quality permit identifies and describes all emissions units at the above subject facility,except where such units are exempted under the North Carolina Title V regulations at
15A NCAC 2Q.0500;
(2) The current air quality permit cites all applicable requirements and provides the method or methods for determining compliance with the applicable requirements;
(3) The facility is currently in compliance,and shall continue to comply,with all applicable requirements. (Note: As provided under 15A NCAC 2Q.0512,compliance with the conditions of the
permit shall be deemed compliance with the applicable requirements specifically identified in the permit);
(4) For applicable requirements that become effective during the term of the renewed permit that the facility shall comply on a timely basis;
(5) The facility shall fulfill applicable enhanced monitoring requirements and submit a compliance certification as required by 40 CFR Part 64.
The responsible official(signature on page 1)certifies under the penalty of law that all information and statements provided above,based on information and belief formed after reasonable inquiry,are true,
accurate,and complete.
SECTION AA3-APPLICATION FOR NAME CHANGE
New Facility Name:
Former Facility Name:
An official facility name change is requested as described above for the air permit mentioned on page 1 of this form. Complete the other sections if there have been modifications to the originally permitted
facility that would require an air quality permit since the last permit was issued and if there has been an ownership change associated with this name change.
SECTION AA4-APPLICATION FOR AN OWNERSHIP CHANGE
By this application we hereby request transfer of Air Quality Permit No. from the former owner to the new owner as described below.
The transfer of permit responsibility,coverage and liability shall be effective (immediately or insert date.) The legal ownership of the
facility described on page 1 of this form has been or will be transferred on (date). There have been no modifications to the originally
permitted facility that would require an air quality permit since the last permit was issued.
Signature of New(Buyer)Responsible Official/Authorized Contact(as typed on page 1):
X Signature(Blue Ink):
Date:
New Facility Name:
Former Facility Name:
Signature of Former(Seller)Responsible Official/Authorized Contact:
Name(typed or print):
Title:
X Signature(Blue Ink):
Date:
Former Legal Corporate/Owner Name:
in iieu of the seiier s signature on this form,a ietier may be submitted with the seiier`s signature indicating the ownership change
SECTION AA5-APPLICATION FOR ADMINISTRATIVE AMENDMENT
Describe the requested administrative amendment here(attach additional documents as necessary):
Attach Additional Sheets As Necessary Page 2 of 2