NCG070004_COMPLETE FILE - HISTORICAL_20190107

STORMWATER DIVISION CODING SHEET
RESCISSIONS
PERMIT NO.
Afc G v /7�rb0
DOC TYPE
❑COMPLETE FILE -HISTORICAL
DATE OF
RESCISSION
❑ �� 9 U �� 7
YYYYMMDD

ENGINEERING, INC.
January 7, 2019
North Carolina Department of' Environmental Quality
Division of Energy, Mineral, and Land Resources — Stormwater Program
1612 Mail Service Center
Raleigh, North Carolina 27699
Attn: Ms. Laura Alexander
Re: Rescission Request for NCG070004;"'
.Jackson Lea DEER -LAND QUALITY
1715 Conover Boulevard East STORIAVATER PERPlrrl-I G
Conover, Catawba County, North Carolina
Dear Ms. Alexander:
On Behalf of Jason, Inc., Shield Engineering Inc. submits the enclosed Rescission Request Dorm
associated with Certificate of Coverage NCG070004. We request that the final correspondence
be sent to the following address:
Jason Industries, Inc.
Attn. Mr. Jim DeSonia
833 East Michigan Street, Suite 900
Milwaukee, WI 53202
If you have any questions or require additional information, please do not hesitate to contact the
undersigned.
Sincerely.
Shie Engine ring, Inc.
mes ai ertsfelder
Scnior Project Manger
Enclosure

yyl .
Frivirunrrienlul
Quolity
Division of Energy, Mineral & Land Resources
Land Quality Section/Stornirivater Permitting Program
National Pollutant Discharge Elimination System
RESCISSION REQUEST FORM
FOR AGENCY USE ONLY
Date Received
Year
Month Day
r?Pr..FIV r)
Please fill out and return this form if you no longer need to maintain your NPDES stormwater permit. Dr�r
1) Enter the permit number to which this request applies: DrMR-LAND OUAI..Ir(
Individual Permit (or) Certificate of Coverage STORMV,ATER PERNIIi PING
N I c I S N I c I G 10 17 10 10 10 4 M
Z) Owner/Facility Information: • Final correspondence will be mailed to the address noted below
Owner/Facility Name Jason Inc - Jackson Lea
Facility Contact
Street Address
City
County
Telephone No.
Jim De5o6a
1715 Conover Blvd East
Conover
Catawba
414 212-2215
State NC
E-mail Address
Fax:
ZIP Code 28613
joesonia@jason inc, cam
3) Reason for rescission request (This is required information. Attach separate sheet if necessary):
Facility closed or is closing on . All industrial activities have ceased such that no discharges of
stormwater are contaminated by exposure to industrial activities or materials.
❑ Facility sold to on . If the facility will continue operations under the new owner it
may be more appropriate to request an ownership change to reissue to permit to the new owner.
❑ Other:
4) Certification:
I, as an authorized representative, hereby request rescission of coverage under the NPDES Stormwater Permit for the
subject facility. I am familiar with the information contained in this request and to the best of my knowledge and belief
such information is true, co a and ac urate.
LSignature Date a �0
im OeSonia Vice President - ENBS
Print or type name of person signing above Title
Please return this completed rescission request form to
Revised 2018Jan10
DEMLR - Stormwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699-1612

\PJA Michael F. Easley, Governor
`OHO 19 William G, Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
C") 7 Alan W. Klimek, P.E. Director
Division of Water Quality
4 'C
April 28, 2003
Michael G Dehart
Jackson Lea
1715 Conover Boulevard
Conover, NC 28613
Subject: NPDES Stormwater Permit Renewal
Jackson Lea
COC Number NCG070004
Catawba County
Dear Permittee:
In response to your renewal application for continued coverage under general permit NCG070000, 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 new Certificate of Coverage
• A copy of General Stormwater Permit NCG070000
• A copy of the Analytical Monitoring Form (DMR)
• A copy of the Qualitativel Monitoring Form
• A copy of a Technical Bulletin for the general permit
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 Mack Wiggins of the Central
Office Stormwater and General Permits Unit at [phone], ext. 542.
Sincerely,
Bradley Bennett, Supervisor
Stormwater and General Permits Unit
cc: Central Files
Stormwater & General Permits Unit Files
Mooresville Regional Office
N. C. Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 [phone]
mar
Customer Service
1 800 623-7748

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG070000
CERTIFICATE OF COVERAGE No. NCG070004
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,
Jason Inc - Jackson Lea
is hereby authorized to discharge stormwater from a facility located at
Jackson Lea
1715 Conover Boulevard
Conover
Catawba County
to receiving waters designated as Long Creek, a class WS-IV stream, in the Catawba River
Basin in accordance with the effluent limitations, monitoring requirements, and other conditions
set forth in Parts I, II, III, IV, V, and VI of General Permit No. NCG070000 as attached.
This certificate of coverage shall become effective May 1, 2003.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day April 28, 2003.
for Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

o�oF wArFgQ�
Michael F. Easley, Governor
William G. Boss Jr., Secretary
North Carolina Department of Environment and Natural Resources
•
MARK ZAMONI
JACKSON LEA
HWY 7()1--- PO 13OX 699
CONOVER, NC 28613
Dear Pcrmillec:
Alan W. Klimek, P.E., Director
Division of Water Quality
September 4, 2002
Subject: NPDES Stormwater Permit Coverage Renewal
Jackson Lea -
COC Number NCG070004
Catawba County
Your facility is currently covered for stormwater discharge under General Permit NCG070000. This permit expires
on March 31, 2003. The Division staff is currently in the process of rewriting this permit and is scheduled to have
the permit reissued by early spring of 2003. Once the permit is reissued, your facility would be eligible for
continued coverage under the reissued permit.
In order to assure your continued coverage under the general permit, you must apply to the Division of Water
Quality (DWQ) for renewal of your permit coverage. To make this renewal process easier, we are informing you in
advance that your permit coverage will be expiring. Enclosed you will lied a Permit Coverage Renewal
Application Form. The application must he completed and returned by October 2, 2002 in order to assure
continued coverage under the general permit. Due to slal'r and budget constraints, letters confirming our receipt of
the completed application will not he sent.
Faiiure to request renewal within the time period specified, may result in a civil assessment of at least $250.00.
Larger penalties may be assessed depending on the delinquency of the request. Discharge of stormwater from your
facility without coverage under a valid stormwater NPDES permit would constitute a violation of NCGS 143-215.1
and could result in assessments of civil penalties of up to $10,000 per day.
Please note that recent federal legislation has extended the "no exposure exclusion" to all operators of- industrial
facilities in any of the I I categories ol- °storm water discharges associated with industrial activity," (except
construction activities). If you feel your facility can certify a condition of "no exposure", i.e. the, facility industrial
materials and operations are not exposed to stormwater, you can apply for the no exposure exclusion. For additional
information contact the Central Office Stormwater Staff member listed below or check the Slorrttwatcr 8c General
Permits Unit Web Site at http://li2o.enr.sta(c.nc.us/su/storinwater.litmi
11'111c subject stormwater discharge to waters of the stale has been terminated, please complete the enclosed
Rescission Request Form. Mailing instructions are listed on the bottom of the form. You will he notified when the
rescission process has been completed.
If you have any questions regarding the permit renewal procedures please contact Mike Parker of the Mooresville
Regional Office at 704-663-1699 or Mack Wiggins of the Central Office Stormwater Unit at [phone], ext.
542
/' �t�+!� fir. -�,•� �i� fJl
Bradley Bennett, Supervisor
Stormwater and General Permits Unit
cc: Central Files
Stormwater and General Permits Unit Files
Mooresville Regional Office ©�
NCDENR
N. C. Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 [phone] Customer Service
1- 800-023-7748

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr,, Governor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
April 30, 1998
REGGIE PITTS
JACKSONLEA
HWY 70E PO BOX 699
CONOVER, NC 28613
[DE N R
Subject: Reissued Stormwater General Permit for Certificate of Coverage No. NCG070004
Catawba County
Dear Permittee:
In response to your renewal application for continued coverage under the subject permit, 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 North Carolina and the US Environmental Protection agency
dated December 6, 1983.
The following information is included with your permit package:
■ A copy of the stormwater general permit.
■ A Stormwater Pollution Prevention Plan Certification Form. This form certifies that you have
developed and implemented the Stormwater Pollution Prevention Plan (SPPP) required in your
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 Analytical Monitoring forms.
Five copies of Qualitative Monitoring forms.
A copy of a Technical Bulletin on the stormwater program which outlines program components
and addresses frequently asked questions.
w A corrected Certificate of Coverage if you indicated a name or address change on the Renewal
Form returned to the Division.
Your certificate of coverage is not transferable except after notice to DWQ. The Division of Water
Quality 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
DWQ or permits required by the Division of Land Resources, Division of Air Quality, Coastal Area
Management Act or any other Federal or Local governmental permits that may be required.
If you have any questions concerning this permit or other attached documents, please contact the
Stormwater and General Permits Unit at telephone number [phone]
Sincerely,
foA. Preston Howard, Jr., P. E.
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
512 North Salisbury Street - Raleigh, North Carolina 27604
James B. Hunt, Jr., Governor Jonathan B. Howes, Secretary
March 12, 1993
Paul Headrick
Hwy 70 East
P O Box 699
Conover, NC 28613
Subject: General Permit No. NCG070000
JacksonLea
COC NCG070004
Catawba County
Dear Mr. Headrick:
In accordance with your application for discharge permit received on September 10, 1992, 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.
Pollution Prevention Pays
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone]
An Equal Opportunity Affirmative Action Employer

If you have any questions concerning this permit, please contact Mr. Bill Mills at telephone
number 919/733-5083.
Sincerely,
Originaf Signed By
Cofeen H. Sullins
A. Preston Howard, Jr.
Acting Director
cc: Mooresville Regional Office

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
' ►1 ► I IIII
' 1. 1 _;: ►� ► I III
STORMWATER DISCHARGES
In compliance with the provision of North Carolina General Statute I43-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
JacksonLea
is hereby authorized to discharge stormwater from a facility located at
JacksoI
Intersection of Highway 70 East and McLin Creek Road
Conover
Catawba County
to receiving waters designated as Long Creek in the Catawba 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. NCG070000 as attached.
This certificate of coverage shall become effective March 12, 1993.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day March 12, 1993.
Original Signed By
Coleen H. Sullins
A. Preston Howard, Jr., P.E., Acting Director
Division of Environmental Management
By Authority of the Environmental Management Commission

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State of North Carolina
Department of Environment, Health and Natural Resources
Division of Environmental Management
512 North Salisbury Street • Raleigh, North Carolina 27604
James B. Hunt, Jr„ Governor Jonathan B. Howes, Secretary
March 12, 1993
Paul Headrick
Hwy 70 East
P O Box 699
Conover, NC 28613
Subject: General Permit No. NCG070000
JacksonLea
COC NCG070004
Catawba County
Dear Mr. Headrick:
In accordance with your application for discharge permit received on September 10, 1992, 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.
Pollution Prevention Pays
P.O. Box 29535. Raleigh, North Carolina 27626-0535 Telephone [phone]
An Equal Opportunity Affirmative Action Employer

If you have any questions concerning this permit, please contact Mr. Bill Mills at telephone
number 9191733-5083.
SinrOF�*Fal Signed By
Coleen H. Sullins
A. Preston Howard, Jr.
Acting Director
cc: Mooresville Regional Office

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
►. `u._ a allm ►K 1 Ills
: ! 1 �: 01► I III2
STORMWATER DISCHARGES
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,
JacksonLea
is hereby authorized to discharge stormwater from a facility located at
J acksonL.ea
Intersection of Highway 70 East and McLin Creek Road
Conover
Catawba County
to receiving waters designated as Long Creek in the Catawba River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I,11,1I1
and IV of General Permit No. NCG070000 as attached.
This certificate of coverage shall become effective March 12, 1993.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day March 12, 1993.
Original Signed. P
Coleen H e
A. Preston Howard, Jr., P.E., Acting Director
Division of Environmental Management
By Authority of the Environmental Management Commission

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