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HomeMy WebLinkAboutNCG180238_Owner Name Update-Correction Record_20240923 1 FOR AGENCY USE ONLY �C, NCG18 tS�� Assigned to: ARO FRO MRO RRO WARD WIRO WSRO `P�p Ic 9 _ �Q Division of Energy, Mineral, and Land Resources Land Quality Section ,o National Pollutant Discharge Elimination System ;P0, NCG180000 Notice of Intent ',�� This General Permit covers STORMWATER DISCHARGES associated v'th activities under the following Standard Industrial Classifications: SIC25[Furniture and Fixtures]; SIC2434[Wood Kitchen Cabinets], and like activities deemed by DEMLR to be similar in the process, or the exposure of raw materials,products, by-products, or waste materials. You can find information on the DEMLR Stormwoter Program at deri.nc.gov/SW. Directions: Print or type all entries on this application. Send the original, signed application with all required items listed in Item (6) below to: NCDEMLR Stormwater Program,1612 MSC, Raleigh, NC 27699-1612. The submission of this application does not guarantee coverage under the General Permit. Prior to coverage under this General Permit a site inspection will be conducted. 1. Owner/Operator(to whom all permit correspondence will be mailed): Name of legal organizational entity: Legally responsible person as signed in Item (7) below: i Gnr4f^� Orn r.vr �vr e_ v; .v 'i Art�.y Street add!;ess: City: State: Zip Code: j ! G 1� ►Car.;:' /V Telephone number: Email address: 8a t3) y 8 s > /1 Q.Y±N Inj4~d J.e C.v/h f TT pe of Ownershi.p: i Government i ❑ County: © Federal 0 Municipal ❑State Non-government - �ilsiriiess(If ownership is business,a copy of NCSOS report must be included with this application) I ❑ Individual ---— - 2. industrial Facility(facility being permitted): Pac;iity,lname: ,/ -acHiitty environmental contact: -1 r�T.F?�" Ax rk Rv ,V,�T'1JLe �_( I * 1E�14�/±� S`F Il� -- i Street address: I City: State: Zi Y � p Code: 3 o Go G a X S.Fr�a ; �-E.v o ; f L /y C_ 0 6 6 g r Parrel Identification Number(PIN): Courl,ty: a'7 Telephone number: ErY�ai address: I Y-po D6 60- 29 _— 4-digit SIC code: j Facility is: W date operation is to begin or began: �� /& ❑ New El Proposed existing �rowrf �N�ryw+ct� -- --- Latitude of entracte: � ngitu�2 of entrance: Brief description of the types of industrial activities and prc61---ts manu actured at this facility: If the storrnwater discharges to a municipzi separate storm sewer system(MS4),Warne the operator of the MS4: ❑ N/A Page 1 o S 3. Consultant (if applicable): Name of consultant: Consulting firm-. Street address: City: State: Zip Code: Telephone number: Email address: 4. Outfall(s)At least one outfall is required to be eligible for coverage. 3-4 digit identifier: Name of receiving water: Classification: ❑ This water is impaired. 001 /3'1 'L G. K W s — ! This watershed has a TMDL. Latitude of outfall: Longitude of outfall: 3S ' ' -) I/ N S/ '* Brief description of the industrial activities that drain to this outfall: .'0he 49' Aj V ,tL G;Vl e Do Vehicle Maintenance Activities occur In the drainage area of this eutfalI? ❑ Yes E-H�o If yes, how many gallons of new motor oil are used each month when averaged over the calendar year? 3-4 digit identifier: Name of receiving water: Classification: This water is impaired. 94W4Z.— Gr nA4 L This watershed has a TMDL. Latitude of outfali: I Longitude of outfall: 3S� S . 3 , / ,� g/0 3 q • ­w Brief description of the industrial activities that drain to this outfall: f Do Vehicle Maintenance Activities occur in the drainage area of this outfall? ❑ Yes EA-No If yes, how many gallons of new motor oil are used each month when averaged overthe calendar year? 3-4 digit identifier: Name of receiving water: Classification: This water is impaired. DO 3 4V4L- V I✓ This watershed has a TMDL. Latitude of outfall: Longitude of outfall: 3 S—' s Q ` __?4 r.l f9/ ° 3 ` �' _ w Brief description of three industrial activities that drain to this outfall; La00'P p�r� A./ �/✓ SK/ Y'l��•1 �D o /' N 1 FR./� .� IR-.�a. �/M' Fi G Do<Jehicle Maintenance Activities occur in the drainage'area of this outfall? s ❑ No If yes, how many gallons of new motor oil are used each month when averaged over the calendar year? 1 ry i A. >yP oN �' 4 3-4 digit identifier. Name of receiving water: Classification: This water is impaired. Do /Y);GGwr Gt e_ia' S — J f/ r This watershed has a TMDL, Latitude of outfall: „ Longitude of outfall: N Lj Brief description of the industrial activities that drain to this outfall: P kr•O d Do Vehicle aintenance Activities occur in the drainage ar Qf this outfall? ffYes If yes, how many gallons of new motor oil are used each month when averaged over the calendar year? All outfalls must be listed and at least one outfall is required. Additional outfails may be added in the section "Additional Outfalls"found on the last page of this NOI. Page 2 of 5 5. Other Facility Conditions (check ail that apply and explain accordingly): ❑This facility has other NPDES permits. If checked,list the permit numbers for all current NPDES permits: Op ElThis facility has Non-Discharge permits(e.g.recycle permit). If checked,list the permit numbers for all current Non-Discharge permits: A 0 211­Fis facility uses best management practices or structural stormwater control measures. If checked, briefly describe the practices/measures and show on site diagram: h f J. Aw s ).0 jQ.,ottz e.d An ❑This facility 4as a Stormwater Pollution Prevention Plan(S PPP). If checked, please list the date the SWPPP was implemented: AfJ ❑This facility stores hazardous waste in the 100-year floodplain. If checked,describe how the area is protected from flooding: .0 v ❑This facility is a(mark all that apply) ❑ Hazardous Waste Generation Facility Hazardous Waste Treatment Facility ❑ Hazardous Waste Storage Facility : . . . El Hazardous Waste Disposal Facility If checked,indicate: Kilograms of waste generated each month: Type(s)of waste: How material is stored: Where material is stored: Number of waste shipments per year: Name of transport/disposal vendor: i Transp(?tVdisposal vendor EPA I D; Vendor address: ❑This facility_is located on a Brownfield or Super-fund site If checked, briefly describe the site conditions 6. Required Items(Application will be returned unless all of thefoiiowing items have been included): ❑ Check for$120 made payable to NCDEQ N ,4, ❑ Copy of most recent Annual Report to the NC Secretary of State [—;,This completed application and any supporting documentation ❑ A site diagram showing,at a minimum, existing and proposed: cs o e_ 'p/g L:c,� A p,u a) outline of drainage areas b) surface waters c) stormwater management structures Sr��— M► .5�aw;..+3 vv p�F,� ( Lr d) location of stormwater outFalls corresponding to the drainage areas e) runoff conveyance features + Ap, 41,4S f) areas where industrial process materials are stored g) impervious areas h) site property lines Copy of county map or USGS quad sheet with the location of the facility clearly marked /5�di.12— -.2 p/b Page 3of5 7. Applicant Certification: North Carolina General Statute 143-215.6E(i)provides that: Any person,who knowingly makes any false statement, representation,or certification in any application,record, report,plan,or other doCUmertfiled or required to be maintained under this Article or a rule implementing this Article. . .shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars($10,000). Under penalty of law,I certify that: �a I, m the person responsible for the permitted industrial activity,for satisfying the requirements of this permit,and for any civil or criminal penalties incurred due to violations of this permit. a?f'he information submitted in this NOl is,to the best of my knowledge and belief,true,accurate, and complete based on my inquiry of the person or persons who manage the system,or those persons directly responsible for gathering the information. D-will abide by all conditions of the NCG180000 permit.l 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. L�hereby request coverage under the NCG180000 General Permit, Printed Name of Applicant:. A 4:A'1q Title: QOPgcA',v (Signature of Applicant) (Date Signed) Naab Mail the entire package to: �WEMLR—Stormwater Program Department of Environmental:Quality 1612 Mail Service Center Raleigh, NC 27699-1612 t • {� Page 4 of 5 KOTE: Tt; 2p,^ -G4L #2 FUEL 33TL AST LOCATED NORTHEAST 0 VIST_C34 2 TS NuT uYtr� MAINTAIN' 3Y rL;NnIJRE BRANDS iNTERNATMNIAL 0 300 SCALE 1M FEET 2-1 �Wo �~ a • _ ,r7 \ �• } �..:�7� . - .� �W�"n'r�E 1, �'�4?J' �D z UE.LZtiG AaCa SSTs � .. .i GARAC` ASFs v USED DeL AST -;y LNUSED •r?.iiSHING Li3u AS?s CALL S75=.�•�; - �-'_, L3JU5 ] -N!S:-1Nc +L:Qui7 AS-a _ ? -n •-i ,� of� - - � ' a.'wR Cr?A� .. .s HAZARnZ]uS wAS- STAG, A"eE, �SZAF` DRUYS .� EMLrVATER SEPA-RA7CR D,RLIM u !dAiNTcNAtaCE AR=A D.tZL:x: v WASTE .N?s-;Nc- TRANS.=-RNeR STC.R.WAMR zZdk -r �Lnw n_e cT�x MfLLER iiLL COMPLEX 7 O O 0 J 0 ® 0 0 0 0 0 0 a 0 0 0 0 a 0 , !'t-, 4 iE G s d < I7 ( ) U] i-I Z m -0 il} i= T (n r.. r JC7 � n fD � p m o O o 0 c -� r �� R, iijro m o o QL o r. _ rn Q r.t. rD C rr �-•+ f7 U- ,'�j r1'_ .-r 7 a cu —+ v N � - C o CD O (p O O rJ-r rD ((D in Vs b � 0- N C ni rt -0 U CL rt :3 rt r- r Sry (U 70 � (D C 3 �u (D •v p � `' `ir i Q rLn•r n i CD, �• rr i rn-r i J a Cl O co 61 T+'y "k;'skco i, :3 #_ co LG x rn K% 4 ssyy 1 1 'S Y y r c d :`X V, Al �� rt r' (G a n �y a 4aa Q N N G Y Y. 3 ��,j'. fl.kkl u = t L O a �:z, F, —4v ,• w NIA, ro ra i nLn co AD 4 v , a C'J a n , `r'o N7 JL s. 1 k f > • xiw * zu ! � s 7� cr m m LO cc Q ! 914124, 1:21 PM Caldwell County GI5 Website CALDW Etty CO VNW,:/'fit RTWeAROU"Aier of Deeds (http://72.15.246.185/CaldwellNC/) I Tax Sear MwP Search Results Layers _ ........................__..._. Results List Details - Owner Information HAMILTON SQUARE LLC •R>-"^'"' 2575PENNY RD HIGH POINT NC 27265 Account Information NCPIN: 2738974890 "T Account#: 164889 ,,, ' Parcel-id: 06170 1 2 Property Information Calculated s~~ � 66.06 rF� Acreage: Land Units: 66.06(AC) 8� BK 1952 PG 1106 YR 18 ST 8000.00 L egal: PLAI 34/215 2018 Plat Ref: 00034-00215 z. Deferred Value: -total Assessed $5,443,100 "`Mit" Value: _ Zoning Lenoir. I-2 Information: r ti property Address Information 802 VISIONARY ST SW, LENOIR NC 28645 830 COMPLEX ST SW, LENOIR NC 28645 3 4 W< r.xr' BS Gy - Zoom To Clear Buffer ~` Tax Card (https-//gis.caldwelicountync.org, h, .� Tax Search (https://www.caldwelicountync _ .k Mail To Adjolners Print Clear a � e., yyyr v;;r ► :, ' Buffer �4001`t https:/Igis.caldwellGountync.org/maps/DefaoIt.htm?pid=06231 1 6 112 W C - its R m: st � L tfhn r G .�' a . „ n Ln t.' Y mco • , � �1o� CD LA I cu `Z ix tiz cu a ro co 41 lµ 4 W La IX 22 cc a IN- . .........._...... ...... . E °vl a R a Nk r J+ - ^ta,al s r r 5 j Sul j u d p� - z 4 S $ s F , y V - yf rt qi,s`¢� f' • Y q'c pp \ U 3 r ' s C f r 'E �- r 'v ORO �,, .,..mg ti uM F " f �yh f i x. a ,x mom n 5-4 WAR rol saw cu i s .mom On O CD r-. I � N a V �� E a ON � Z 0 - BUSINESS CORPORATION ANNUAL REPORT u6i2o22 NAME OF BUSINESS CORPORATION: Craftmaster Furniture,Inc. 0841150 Filing Office Use Only SECRETARY OF STATE ID NUMBER: STATE OF FORMATION: DE E-Filed Annual Report 0841150 REPORT FOR THE FISCAL YEAR END: 12131/2023,,,• CA202409406807 t 4/3/2024 02:31 SECTION A: REGISTERED AGENT'S INFORMATION Changes 1.NAME OF REGISTERED AGENT: Schell Bray f LL6 ^ 2.SIGNATURE OF THE NEW REGISTERED AGENT: SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT 3. REGISTERED AGENT OFFICE STREET ADDRESS&COUNTY 4.REGISTERED AGENT OFFICE MAILING ADDRESS 230 N. Elm Street, Suite 1000 230 N. Elm Street, Suite 1000 Greensboro, NC 27401 Guilford County Greensboro, NC 27401 SECTION B: PRINCIPAL OFFICE INFORMATION 1. DESCRIPTION OF NATURE OF BUSINESS: Manufacturing 2.PRINCIPAL OFFICE PHONE NUMBER: (828)485-2600 3.PRINCIPAL OFFICE EMAIL: Privacy Redaction 4. PRINCIPAL OFFICE STREET ADDRESS 5.PRINCIPAL OFFICE MAILING ADDRESS 221 Craftmaster Road 221 Craftmaster Road Hiddenite, NC 28636 Hiddenite, NC 28636 6. Select one of the following if applicable. (Optional see instructions) ❑ The company is a veteran-owned smah business ❑ The company is a service-disabled veteran-owned small business SECTION C:OFFICERS(Enter additional officers in Section E.) NAME: Chenkun Shih NAME: lTSUAN-CHIEN CHANG NAME: Oscar Juan TITLE: Chief Financial Officer TITLE: Secretary TITLE: Assistant Secretary ADDRESS: ADDRESS: ADDRESS: 221 Craftmaster Road 2575 PENNY ROAD 2575 Penny Rd. Hiddenite, NC 28636 HIGH POINT, NC 27265 High Point,NC 27265 SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business enti enkun Shih 4/3/2024 SIGNATURE DATE Form must be signed by an officer listed under Section C of this farm. Chenkun Shih Chief Financial Officer Print or Type Name of Officer Print or Type Ti1Ie of Officer MAIL TO:Secretary of State, Business Registration Division,Post Office Box 29525,Raieigh,NC 27626-0525 SECTION E: ADDITIONAL OFFICERS NAME: Alex Reeves NAME: NAME: TITLE: President TITLE: TITLE: ADDRESS: ADDRESS: ADDRESS: 221 Craftmaster Road Hiddenite, NC 28636 NAME: NAME: NAME: TITLE: TITLE: TITLE: ADDRESS: ADDRESS: ADDRESS: NAME: NAME: NAME: TITLE: TITLE: TITLE: ADDRESS: ADDRESS: ADDRESS: NAME: NAME: NAME: TITLE: TITLE: TITLE: ADDRESS: ADDRESS: ADDRESS: NAME: NAME: Name: TITLE: TITLE: TITLE: ADDRESS: ADDRESS: ADDRESS: NAME: NAME: NAME: TITLE: TITLE: TITLE: ADDRESS: ADDRESS: ADDRESS: ' HICKORY SPRINGS MANUFACTURING COMPANY , INVOICE DATE P.C.BOX 128•HMCKORY NO 2800"128-M3M2201 www.hsnteawfone.cam RI 7326554 1 8/26/2024 I PAGE 11 OF 11 SOLUTIONS TAX IA@ 5904843B6 SHIP TO TERMS:2%10 NET 30 8018250 1A BRANCH PLANT: 607000 PCRAFT01 CRAFT28 nRANCH NAME: HIDDENIT[FOAM DIVISION O BOX 759TER FURNITURE INC 83 CO OMPLEX STRE�r PHA#; 820-632-9733 TAYLORSVILLE NC 28681 LENOIR NC 28M SALES REP: LIN r:#/ ITEM# PRODUCT DESCRIPTION UNITS PER SHIP li SHIP QTY o PRICE o AMOUNT GRADE CUSTOMERPART# UOM G BDFT/WGT M M CU iTOMER PO#:610766 SHIP DATE: 8I261202 PS#:3457958 SOi#:13752973 SA Sot SotP VIA: 1.000 356484 H0215 ST HR20028TN N 1.000C PC 24.9100 PIR 24,91 H0215 0215 2.000 356483 HD215A 10030N 2,0000 PC 5,25 PC 10.60 M0215A 215 'OUR YUR4-THANE rOAUS VEMNAI D dl'"rW RfG=UMN eaVE COW=MW THE=If Di FT.OF CONSU,7{FR AFFA RS MMEAU OF NDME FURA PW I& 7td4s 1117.'2Df9UNDEROVRTLsrLA ORYCaNnITYMS.ASK?THAUPOLYUREMHANE Co aUSYIONUA WRrFE70'O3EoM riEArn DPENr-+ruusAspFr�>3ucLETu f1r. frovusnr�erEsrsnmr5rwr.wYcaNr�usmuaNr rNccuarnrcaDfis s. 111.20131SASMOLOE C Y 7EST.J ER f}7.201SPROTOCOL,NDWEN AM E 7ES71NGfSPCRFOAW-D,MSrOMISMDUrZI)W HOUrH;?ERE7AW F CIEvED AUG 2024 GRAY ASTER .PLEASE MAKE CHECKS PAYASLE&REMIT TO: MINOR! us$ IU,396.$4 HShQ WELLS FARGO BANK NA PO BQX 80331E ACH: ABA#12100D248 ACCT#4695866740 OR WIRE ABAff 121000246 ACC•f#469888874E CHARLOTTE_NO 2828D,3310 EMAIL REMITTO:REMIT@HSMSOLUTIONS.COM 13646951S00010DD ANY OBJECTIONS TOTH8BILL,RETUMS,CLAIMS OR DISPUTES OFANYKINA MUST BEREMAM IMMM�N'BLYTO SAME-TERM MOCCNDITIONson REYERsESIOE, HICKORY SPRINGS MANUFACTURING COMPANY "TAX INVOICEAATEP.O.SOX 128-HICKORYNC M0&0128-BZB-328.2201 PAGE 10 OF 11 uwxAsmsokfims.am RISOLUTIEONS U4494M StttQ 70 TERMS:2%10 NET 30 SOLD TO BRANCH PLANT: 6070M 80182501 701/32526 BRANCH NA61E: HIDDENrlE FOAM DIV18K)N PX79FURNITUREINC 60MEXS PLANT 8 O5 3 OPLTREET PHONEay: $28-892-9733 7KYLORSVILLE NG 28681 LENOIR NO 28645 SALES REP: LINE W 17EII PRODUCT DESCRlPT1aJN UNITS PER SHIP R SHIP CITY u RICE o AMOUNT GRADE CUSTOMER PART# UOki a BD FTIWGT a ns 10,000 823 7 F106fliFA ARM 1003 1 6,000t Pr, 4.780C PC T6.48 H061310A 061310A 11.000 484682 H0613108 SACK 1501779N N 8.000c PC 132600 P 106,00 H061310B 061310E 12-000 824493 1-1078200 OTT HR2303OTN N 1.000C PC 24.700C PC 24.70 H078200 0782011 13.000 1829 H7117BOARM PANEL 1003ON i 14.00OC PC 0.500 P 57.00 H71176DAP H711750 / 14.000 958463 H712708RFAARM 15033N N 1.00c PC 7.o9oo PC 7.69 H712708RFA H712708RFA 15.000 957600 H712709LF'A ARM 15033N N -1.0000{1C 7.69 PC 1.60 H712709LFA 712709LFA 16.000 999845 H736450A 10030N N 1 0=00 PC 6,300 P 53.00 H736450A 736460A 17.000 805376 H78395DLFA 10030N N 3,0000 PC 7.1L221,1.36 H78395OLFA 7839SOLFA 18.000 95377 H76396ORFA1D030N N 3A00 P 7.1 .36 HY8395ORFA 783DURFA19.000 98070 H93E450ARM 10030N N 4.000 4-7 ,88 H936450A 936450 PLEASE MAKE CHECKS PAYABLE&REMIT TO: CONTINUED CN NEXT PAGE HSM WELLS FARGO BANK NA 19 ACH: ABA4121000248 ACCT'*4696868748 PO BOX 6033 CHARLOTTE 19 28260.9319 OR WIRE:ABA#121 OW248 ACCT#4696860748 EMAIL REMIT TO:REMIT@HSMSOLUTIONS.COM 1384MISOODIOM �_ AWoniECTI4NSTOTHM EILL.RETUM4%CL.QPdS OR DISPUTES OFANY KIND FA STSEREPORTEDWMEPW ELYTO SAA1E-TERMS AND CCNDMONS ON REVERSE SIDE. CRAFIMASTER FURNITURE INC. NMSER 170328 WELLS FARGO BANK,N.A. 56-024 SAN FARKISCO,CA 210 DATE CHECKAMOUNT 23•-Jul-24 $ *****116,923.46 One Hundred Sixteen Thousand Nine Hundred Twenty-Three Dollars And Forty-Six Cents***** PAY TO THE HICKORY SPRINGS MFG CO ORDER OF PO sox 603319 CHARLOTTE, NC 28260-3319 Authorized Signature I1F 1 70 3 28iI' I: 1 2 1000 2 48ix 20000 2 7000 P30 9115 CRAFTMASTER FURNITURE.INC. 170328 HICKORY SPRINGS MFG CO r r �, ;, .:.,�,inas4v...'n•'a sl•,�•_' '•, I aici _. . . ...._ ' �. TPIO OR0984_14 ;V O. 1C.�.. DEDUCTION' _ 2024/07/ 9 7314441 11,079.69 221.69 10,858.10 2024407/15 7315810 r 10.123.73 202.47 9,921,26 2024/07115 7315811 12,265.43 245.11 12.010.32 2024/07/15 7315813 '-14,489.37 289.79 14,199.58 2024/07/15 7316205 7 17,077.07 341.64 16,735.53 2024/07/16 7316206 22,151.24 443.02 21,708.22 2024/07/16 7316207 774.87 15.50 759.37 2024/07/17 7316569 9,961.0E 199.22 9,761.84 2024/07/17 7316571 i 11.260.35 226.01 11,026.34 2024/07/18 7316925 10,146.84 202.94 9,943.90 TOTl LS`:; �I 9;349.6 :: '`' 2,386.19 ''y; 11.6,923.4$ HICKORY SPRINGS MANUFACTURING COMPANY INVOICE DATE F.o.Iaoxlza-ncxoaY Nczesos ntza.sze rzasm1 "TAXIDA.'58-D494a95 7/912024 PAGE 10 OF 10 �,�nchxneaWpone,00,,, RE SOLUTIONS sIiIP Tp TERMS:2%10 NET 30 SOLO TO BRANCH PLANT: 607000 801826D1 70182526 BRANCH NAME: HIDOENITE FOAM DIVISION PO SOX 759TER FURNITURE INC $30 COMPLEX Spf 7 PLANT 6 PHONE M $23-632-9733 TAYLORSVILLE NC 28681 LENOIR NC 2WS SALES REP: ' UNE 40 ITEM# PRODUCT DESCRIPTION' UNITS PER SHIP k 'SHIP QTY o PRICE o AMOUNT GRADE CUSTOMER PART# UOM a SO FTNIIGT M N CU 1TOMER PO It 610266 SHIP DATE: 7/9/2024 PS#:3437099 309:13245421 Sp S VK: 1.000 903614 H783921BD CD SNST HR2002STN N 1.0000 PC 102.090C C 102.09 H703921.813 783021 BD -OUR P YURETHRNE'FCALTS CESIGm7m 8Y OV RA;COLUMn HAVE COMPLIED Wf7T17HE C".Di Pr OP CONSUMERAFFARS SURFAV OF HOW FUR• G WCN 9 ALFUN f 17:2013 UNO1:R OUR TEST ORATORY CONDITIONS.AS WTH ALL POLYURETHANE COMBUSTM diA 0 UR IF EXPOSED 70 E TWAT 0 Z OPEN FLAME.AS PER BULi--nN.ii7.01.3,FOAMS ARE TESTED WITHOUT ANY CRYTAW 1NCL.UOIN9ADHESIVFS. W Wi7201JSA6MOL Y TgS7:OERfi7:20(3 PROTOCOL,NO OPEN F 799T G13POWORWEd..77NSPOAM75PRODUL1EDw FIRERETAR CRA��tj STAR PLEASE SNAKE CHECKS PAYABLE 8 REMIT TO: US$ 1'l,079.69 msm WELLS FARGO BANK NA ACH• ABA#1210OQ248AOCTff4696B68748 PO BOX 603319 OR WIRE:ABAS 121000248 ACCT#4696866748 CHARLOTTE NC28260.3318 EMAIL REMIT TO.REMlTQHSMSOLLMONS.COM 1281170250001000 ANY=EurioNS 70 TM BILL.ReMRN6,=MS OR DISPUTES OF ANY KIND MOST BE REPORTED IMMECNTELY TO SAME-TERVS AND CONDITIONS ON REVERSE SIDE. j HICKORY SPRINGS MANUFACTURING COMPANY INVOICEDATE P.0.BOX12B-Hlq(cRYNc2&L'09.072B-RxB•2201 •PAGE 1 OF' 10 wyw.T�wncoh+eanacom RI 7314441 7/912024 SOLUTIONS 'AXI.D :80.0494395 54E D TO S'i3P TO BRANCH 2%10 NE-r 30 BRANCH PI.,ANT: 607000 80182501 70182526 BRANCH NAMEt MI)MITE FOAM DIVISION CRAFiMASTER FURNITURE INC CRAFTMASTER FURN-PLANT 6 PHONE a, g2a e32-9733 PO BOX 759 830 COMPLEX STREET SALES RFC: TAYLORSVILLE NC 28681 LENOIR NC 26645 LINE Ell ITEM PRODUCT DESCRIPTION UNITS PER SHIP R SHIP QTY o PRICE o AMOUNT CUSTOMER PART 9 UOM C BD FTIWGT M M CIS 3TOMER PO#:610302 SHIP DATE: 71 M24 PS#:3430980 BO#:12811702 30 P VIA: 1.000 932079 HVBD PILL PLW 5195 FDN Abooc P 5.5000 PF 16.50 H VBD VBD 2.000 944240 HYDPT-KP 5195 FILL COVER 17.000c PC 4.880OPe 82.96 H-YBD-KID YDPT-KP 3.000 900294 HOG-54 BD CT SNST HR20025TN N I=0 PC 44A8MPC 44A8 HC9-54BDC C9-54 4.000 900295 HC9-54 BD END SNST HR20025TN. N Z0000 PC ,f 48.34M PC 96.68 HC9-540DE C9-54 (/ 5.000 472M HL0080 CLSIN OTT HR18031TN N 1.0m PC 34A9OC PC 34.49 HL0080CL HL0080 6.000 977511 HL75655OBDCL SNST CVR FROM CM Ci �`'� N 6.0000 PC ` 31.030C PC 186.18 HL756550BDCLST L756550BDCL V 7.000$58557 HP7088BOBD CTR SNST HR20025TN ,� ��y N 1.000, PC 63.7 PC 63.72 HP70885013DC P708850 8,000 368558 HP708BSOBD END SNST HR20025TN PSG N 2.00 P 47.250C PC 94•50 HP708850BIDE P708850 R� 9.000 000523 HP992000 SN OTT HRIC03M N 1.0000 PC 28.480C PC �� 28,4 HP992000 P992000 PLEASE MAKE CHECKS.PWABLE&REW 70: CONTINUED ON NEXT PAGE HSAA WELUL FARGO BANK NA PO SOX 603319 ACH: ABA#121 D00248 ACCT#4696866748 CHARLOTTE NC 28260-3319 OR WIRE:ABA#121000248 ACCT#4696860748 MAIL REMIT TO:REMIT@HSMSOLUTIONS.COM 1201170MOM000 ANY OBJECTIONS TO THIS 131U,RETURNS,CLAIMS OR WPUTES OF ANY KIND MUST BE REPORTED WUA WWELYTO SAME-TERMS AND CONDITIONS ON REVERSE EWE,