NCG170037_COMPLETE FILE - HISTORICAL_20140714

.................. .
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO. Iv I bD 3•�
DOC TYPE Ct1 HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE ❑ o?� I l I I
YYYYMMDD

©r ; �^ Division of Energy, Mineral & Land Resources
�► Land Quality Section/Stormwater Permitting
National Pollutant Discharge Elimination System
NCDENR
Fes. .r,.o�.,�.�aZwE..a
c�., PERMIT NAME/OWNERSHIP CHANGE FORM
FOR AGENCY USE ONLY
Date Received
Year
Month
Day
4 " I. Please enter the permit number for which the change is requested.
NPDES Permit (or) Certificate ofCoverage
N C S 10 1 1 1 1 1 1 1 N I C. 10 1 I 17 0 0 3 7
Permit status prior to requested change.
a. Permit issued to (company name):
Fabrics Inc
b. Person legally responsible for permit: Henry P Neisler
First MI Last
c. Facility name (discharge):
d. Facility address:
e. Facility contact person:
Title
PO Box 1090
Permit Holder Mailing Address
Shelbv NC 28150
City State 'Lip
[phone] [phone]
Phone Fax
430 Neisler Street
Address
Shelbv NC 28152
City State "Lip
Richard G. Yount [phone]
First / MI / Last Phone
111. Please provide the following for the requested change (revised permit).
a. Request for change is a result of: ❑ Change in ownership of the facility
® Name change of the facility or owner
If other please explain:
b. Permit issued to (company name):
c. Person legally responsible for permit:
d. Facility name (discharge):
e. Facility address:
Fabrics Inc
David C Neisler
First MI Last
Title
PO box 1090
Permit Holder Mailing Address
Shelby NC 28150
City State Zip
[phone] dcna;ceyb tjol.corh
Phone E-mail Address
430 Neisler Street
Address
Shelby NC 28152
City State Zip
f. Facility contact person: David C Neisler
First MI Last
_(704) 487-6324 co (Y\
Phone E-mail Address
IV. Permit contact information (if different from the person legally responsible for the permit)

NPDES PERMIT NAMEIOWNERSHIP CHANGE FORM
image 2 of 2
Permit contact: D C> U_5 0 —j—e('✓1 t6( Q(1
First U MI Last
fk;tite-mitic e- . /YIarigge.
Title
PO Box 1090
Mailing Address
Shelbv NC 28150
City State Zip
[phone] A�ean Gd tce br`�S , COta
Phone E-mail Address
V. Will the permitted facility continue to conduct the same industrial activities conducted prior
to this ownership or name change?
® Yes
❑ No (please explain)
VI Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS
ARE INCOMPLETE OR MISSING:
❑ This completed application is required for both name change and/or ownership change
requests.
❑ Legal documentation of the transfer of ownership (such as relevant pages of a contract deed,
or a bill of sale) is required for an ownership change request. Articles of incorporation are
not sufficient for an ownership change.
The certifications below must be completed and signed by both the permit holder prior to the change, and
the new applicant in the case of an ownership change request. For a name change request, the signed
Applicant's Certification is sufficient.
PERMITTEE CERTIFICATION (Permit holder prior to ownership change):
1, , attest that this application for a name/ownership change has been reviewed and is accurate and
complete to the best of my knowledge. I understand that if all required parts of this application are not
completed and that if all required supporting information is not included, this application package will be
returned as incomplete.
Signature Date
APPLICANT CERTIFICATION
1, lk� , attest that this application for a name/ownership change has been reviewed and is accurate and
complete to the best of my knowledge. 1 understand that if all required parts of this application are not
completed and that if all required supporting information is not included, this application package will be
returned as incomplete.
�{ e, 1 © Zo
Signature Date
....................................
PLEASE SEND THE COMPLETE APPLICATION PACKAGE: TO:
Division of Energy, Mineral and Land Resources
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612

Ak
'A
NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor William G. Ross, Jr., Secretary
Alan W. Klimek, P.E., Director
August 4, 2004
Richard G Yount
Dicey Fabrics Inc
PO Box 1090
Shelby, NC 28150
Subject: NPDES Stormwater Permit Coverage Renewal
Dicey Fabrics Incorporated
COC Number NCG 170037
Cleveland County
Dear Permittee:
In response to your renewal application for continued coverage under general permit NCG 170000 the Division of
Water Quality (D WQ) is forwarding herewith the reissued Stormwater general permit. This permit is reissued
pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement
between the state of North Carolina and the U.S. Environmental Protection Agency, dated December 6, 1983.
The following information is included with your permit package:
• A new Certificate of Coverage
• A copy of General Stormwater Permit NCG 170000
• A copy of a discharge monitoring report form
• 5 copies of the qualitative monitoring report form
Your coverage under this general permit is not transferable except after notice to DWQ. The Division may require
modification or revocation and reissuance of the Certificate of Coverage. This permit does not affect the legal
requirements to obtain other permits which may be required by the Department of Environment and Natural
Resources, or relieve the permittee from responsibility for compliance with any other applicable federal, state, or
local law, rule, standard, ordinance, order, judgment, or decree.
If you have any questions regarding this permit package please contact of the Central Office Stormwater Permitting
Unit at [phone], ext. .
Sincerely,
for Alan W. Klimek, P.E.
cc: Central Files
Stormwater Permitting Unit
Mooresville Regional Office
Surface Water Protection Section
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
512 N. Salisbury St., Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] / Internet: http://h2o.enr.state.nc.us/su/stormwater.html
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper
NorthCarolina
naturally

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG170000
CERTIFICATE OF COVERAGE No. NCG170037
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission,
and the Federal Water Pollution Control Act, as amended,
Dicey Fabrics Inc
is hereby authorized to discharge stormwater from a facility located at
Dicey Fabrics Incorporated
430 Neisler St
Shelby
Cleveland County
to receiving waters designated as the First Broad River, a class C stream, in the Broad River Basin in
accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts
1, II, 111, IV, V, and VI of General Permit No. NCG 170000 as attached.
This Certificate of Coverage shall become effective August 1, 2004.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day August I, 2004.
for Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management
Commission

d I
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
Kerr T. Stevens, Director
RICHARD G. YOUNT
DICEY FABRICS INC
P.O. BOX 1090
SHELBY, NC 28150
Dear Permittee:
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
July 28, 1999
Subject: Reissue - NPDES Stormwater Permit
Dicey Fabrics Inc
COC Number NCG170037
Cleveland County
In response to your renewal application for continued coverage under general permit NCG170000, the Division of
Water Quality (DWQ) is forwarding herewith the reissued stormwater general permit. This permit is reissued
pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement
between the state of North Carolina and the U.S. Environmental Protection Agency, dated December 6, 1983.
The following information is included with your permit package:
* A copy of general Stormwater permit NCG170000
* A Stormwater Pollution Prevention Plan (SPPP) Certification Form. Completion of this form is required to
certify that you have developed and implemented the SPPP as per the conditions of the permit. This form
must be completed and returned to the Division within 30 days of receipt of this letter.
DO NOT SEND the SPPP with the signed form.
* Five copies of the Analytical Monitoring form and five copies of the Qualitative Monitoring form
* A copy of a Technical Bulletin for the general permit which outlines changes in the permit, key requirements,
and addresses frequently asked questions
* A Certificate of Coverage
Your coverage under this general permit is not transferable except after notice to DWQ. The Division may require
modification or revocation and reissuance of the Certificate of Coverage. This permit does not affect the legal
requirements to obtain other permits which may be required by DENR or relieve the permittee from responsibility
for compliance with any other applicable federal, state, or local law, rule, standard, ordinance, order, judgment, or
decree.
If you have any questions regarding this permit package please contact Bill Mills of the Central Office Stormwater
and General Permits Unit at [phone], ext. 548
Sincerely,
for Kerr 1'. Stevens
cc: Central Files
Stormwater and General permits Unit Files
Mooresville Regional Office
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] Fax [phone]
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STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG170000
CERTIFICATE OF COVERAGE No. NCG170037
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1. other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
DICEY FABRICS INC
is hereby authorized to discharge stormwater from a facility located at
DICEY FABRICS INC
430 NEISLER STREET
SRELBY
CLE VELAND COUNTY
to receiving waters designated as the First Broad River in the Broad River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, 11, 111,
IV, V. and \11 of General Permit No. NCG170000 as attached.
This certificate of coverage shall become effective August 1, 1999.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day July 28, 1999.
for Kerr T. Stevens, Director
Division of Water Quality
By Authority of the Environmental Management Commission

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
April 21, 1995
Bobbie Jaycox
Dicey Fabrics Inc
P.O. Box 1090
Shelby, NC 28150
�EHNR
Subject: General Permit No. NCG 170000
Dicey Fabrics Inc
COC NCG170037
Cleveland County
Dear Bobbie Jaycox
In accordance with your application for discharge permit received on January 13, 1995, we are
forwarding herewith the subject certificate of coverage to discharge under the subject state - NPDES general
permit. This permit is issued pursuant to the requirements of North Carolina General Statute 143-215.1 and
the Memorandum of Agreement between North Carolina and the US Environmental Protection agency dated
December 6, 1983.
If any parts, measurement frequencies or sampling requirements contained in this permit are
unacceptable to you, you have the right to request an individual permit by submitting an individual permit
application. Unless such demand is made, this certificate of coverage shall be final and binding.
Please take notice that this certificate of coverage is not transferable except after notice to the Division
of Environmental Management. The Division of Environmental Management may require modification or
revocation and reissuance of the certificate of coverage.
This permit does not affect the legal requirements to obtain other permits which may be required by the
Division of Environmental Management or permits required by the Division of Land Resources, Coastal
Area Management Act or any other Federal or Local governmental permit that may be required.
If you have any question concerning this permit, please contact MR. BILL MILLS at telephone number
919/733-5083.
Sincerely,
Original Signedcfy
Coleen H. Sullins
A. Preston Howard, Jr. P.E.
cc: Mooresville Regional Office
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
GENERAL PERMIT NO. NCG170000
CERTIFICATE OF COVERAGE NO, NCG170037
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
Dicey Fabrics, Inc.
is hereby authorized to discharge stormwater from a facility located at
Dicey Fabrics, Inc.
430 Neisler Street
Shelby
Cleveland County
to receiving waters designated as First Broad River in the Broad River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts 1, II, III
and IV of General Permit No. NCG170000 as attached.
This Certificate of Coverage shall become effective April 21, 1995.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed tl»s day April 21, 1995.
Original Signed -By
Coleen H. Sullins
A. Preston Howard, Jr., P.E., Director
Division of Environmental Management
By Authority of the Environmental Management Commission

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