NCG030224_COMPLETE FILE - HISTORICAL_20130114

STORMWATER DIVISION CODING'SHEET
NCG PERMITS..
PEWIT No.
1V b 3 a a a9
FDOC TYPE
X HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ 13
YYYYM MDD

Johnson Controls, Inc.
Power Solutions
2701 Johnson Controls Drive
PO Box 1667
Kernersville, NC 27285
Telephone: [phone]
January 14, 2013
Mr. W. Corey Basinger
Water Quality Regional Supervisor
Winston Salem Region
Division of Water Quality
Subject: NOV-2012-PC-0410
Dear Mr. Basinger
RECEIVED
N.C,Dept. of ENR
JAN L A 2013
Winston-Salem
Re ionalOffiee
Johnson 0)1�4
Controls
I am in receipt of your letter postmarked December 18, 2012 showing the results of the Compliance
Evaluation Inspection and Notice of Violation. (NOV-2012-PC-0410)
I assure you that all of us here at Johnson Controls have a strong desire to be good stewards of the
environment and will be diligent in completing the issues that were found during the inspection.
Below, you will find each finding along with our answer and the time frame needed to complete.
Documentation and Monitoring Review
Item 1: The General Location Map does not meet all requirements specified in NCG030000 Part I1,
Section A, Paragraph I (a)
JCI will obtain the proper map as laid out in Part II Section A, Paragraph I (a) of Permit
NCG0300000. The map'will be appropriately drafted to show the facility's location in relation to
transportation routes and surface waters. This item can be accomplished by January 31, 2013.
Item 2: The site map does not meet all requirements specified in NCG030000, Part II, Section A.
Paragraph 1(c).
JCI will either obtain or have created the proper site map as laid out in Part 11, Section A, Paragraph
I (c). The map will be appropriately drafted to show property boundaries, stormwater discharge points,
any adjacent surface waters, and storage areas. The map will also show site topography for drainage
and structures.
Item 3: The SDO has not been evaluated for non-stormwater discharges as required by NCG030000,
Part 11, Section A, Paragraph 1(e).
JCI will have all vegetation removed from the SDO and will provide the proper documentation. This
can be completed, weather permitting, by February 15, 2013

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Johnson Controls, Inc.
Power Solutions
2701 Johnson Controls Drive
PO Box 1667
Kernersville. NC 27285
Telephone: [phone]
Johnson 01�4
Controls
Item 4: The SP3 does not contain a Best Practices Management (BMP) Summary as required by
NCG030000, Part II, Section A, Paragraph 2(c).
While there was a BMP page in the SP3, it did not cover all topics listed in the permit. JCI will re-
write the existing BMP to reflect all requirements laid out in NCG030000, Part II, Section A.,
Paragraph 2(c). JC1 can have this completed by January 31, 2013.
Item 5: The Spill Prevention and Response Plan (SPRP), as required by NCG030000, Part 11, Section
A., Paragraph 3 should be updated to include the Division's contact numbers. In the event of a spill
that affects , or has the potential to affect surface waters, Johnson Controls should call DWQ, WSRO
at 336 771-5000, M-F 8Am to 5PM, excluding State holidays, or the NC Division of Emergency
Management (DEM) at 1 800 858-0368, during all other times
JCI will add these numbers to the Spill Response Plan and this can be accomplished by January 31,
2013
Item 6: Not all training has been conducted as required by NCG030000, Part 1I, Section A, Paragraph
6. No records of training were provided during the inspection, although it was indicated that the annual
training and initial orientation had been completed.
JCI did conduct annual training and records of that training will be forwarded to you. JCI can
complete this task by January 25, 2013
Item 7: SP3 Annual reviews, as required by NCG030000, Part If Section A., Paragraph 8 were
completed for 2011 and 2012 but no earlier records were available
JCI will make all attempts to locate and store the necessary records and will hold them for the
prescribed time. This can be completed by February 15, 2013
Item 8: Neither analytical, nor qualitative monitoring (AM and QM respectively) has been completed
as required by NCG030000, Part I1, Section B. Johnson Controls completed four AM/QM events in
2009, one in 2010, one in 2011, and three in 2012. No earlier records were available during the
inspection.
JCI will make all attempts to locate and store the necessary records and will hold them for the .
prescribed time. This can be completed by February 15, 2013

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Johnson Controls, Inc.
Power Solutions
2701 Johnson Controls Drive
PO Box 1667
Kemersville, NC 27285
Telephone: [phone]
Site Review
Johnson 0)1�6
Controls
Item 1: There was a significant amount of miscellaneous equipment and materials in various areas
throughout the site, some of which is due to ongoing construction. Johnson Controls should minimize
exposure of such items.
Current projects dictate that the equipment be on site for use. JCI will have all contractors remove any
unnecessary material or equipment from the property which will help minimize exposure. This will be
complete by February 15, 2013
Item 2: Better House keeping
• There was a significant amount of silt and sediment located in vehicular areas throughout the
site.
JCI will have our landscaping company address this situation. Quote and time estimation for
cleaning by February 15, 2013
• There was some trash strewn about
JCI will assure that during the monthly SW3PISPCC Inspections that any trash or debris
discovered will be taken care of immediately. This is part of item 91 on the inspection sheet.
This will begin during January's inspection.
• There were a few relatively small oil stains around the site.
There are numerous semi trucks in and out of our facility each day. 1 would presume that these
small stains would be a product of that traffic. JCI employees an independent security company
that deals daily with the drivers and should any issue arise, the on duty Guard fills out a
Unusual Event Report and distributes copies to the Environmental, Facilities, and Logistics
departments. In the unlikely event of a major oil or fuel spill occurs, the Guard will activate the
Emergency Response Process, and make all of the necessary calls.
• Item 3: Some of the stormwater conveyances are experiencing erosion, which should be
repaired and minimized in the future
• JCI will have our landscaping company address this situation. Quote and time estimation for
repair by February 15, 2013

Johnson Controls, Inc.
Power Solutions
2701 Johnson Controls Drive
PO Box 1667
Kemersville, NC 27285
Telephone: [phone]
Johnson 0)1��
Controls
Item 4 : The SDO was severely overgrown and not accessible, which brings into question
whether or not AM samples are being taken from the correct location and the validity of AM
data. The SDO needs to be accessible and AM samples taken from the end of the pipe.
Contractor looked at the SDO area on Friday January 11, 2013, JCI is awaiting quote for
cleanup of the area. Quote should be here by January/31/2013
Let me assure you that these discrepancies will be taken care of and in a timely manner.
If you have any questions or further comments, please do not hesitate to call myself or Ray
Dudley.
Sincere
Dan Thompson
Plant Manager
Johnson Controls, Inc.
S 16-596-0646
Daniel. r2.thompsolgjci,com

is
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Chuck Wakild, P.E. Dee Freeman
Governor Director
December 17, 2012
Johnson Controls Battery Group
Attn: Ray Dudley, Environmental Engineer
P.O. Box 1667
Kernersville, NC 27285
Subject: Compliance Evaluation inspection and Notice of Violation
NOV-2012-PC-0410
NPDES General Stormwater Permit NCG030000
Certificate of Coverage NCG030224
Secretary
Johnson Controls Battery Group, 2701 Johnson Controls Drive, Kernersville, NC, 27285
Forsyth County A�_—
Dear Mr. Dudley:
Ron Boone and Aana Taylor -Smith, of the Winston-Salem Regional Office (WSRO) of the NC
Division of Water Quality (DWQ or the Division), conducted a compliance evaluation inspection (CEI)
of the Johnson Controls Battery Group- (Johnson) on December 11, 2012. Your assistance and
cooperation during the inspection was greatly appreciated.. An inspection checklist is attached for
your records and the inspection findings are summarized below.
The facility is located at 2701 Johnson Controls Drive, in Kernersville, Forsyth County, North
Carolina, at approximate coordinates 36.1187080N,-80.160839°W. Stormwater related to industrial
activity is discharged from stormwater' discharge outfall (SDO) 001 to Lowery Mill Creek, which is
currently classified as a Class WS-III (water supply) water located in the Yadkin Pee -Dee River Basin.
Documentation & Monitoring Review
Johnson's Stormwater Pollution Prevention Plan (SP3), documentation, and monitoring
activities were reviewed during the inspection. The following deficiencies were noted_
• The General Location Map (GLM) does not meet all requirements specified in NCG030000,
Part II, Section A, Paragraph 1(a).
• The Site Map (SM) does not meet all requirements specified in NCG030000, Part 11, Section A,
Paragraph 1(c).
• The SDO has not been evaluated for non-stormwater discharges as required by NCG030000;
Part 11, Section A, Paragraph 1(e).
• The SP3 does not contain a Best Management Practices (BMP) summary as required by
NCG030000, Part 11, Section A, Paragraph 2(c).
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107 One 1
Phone: [phone] FAX: [phone] l Customer Service: 1-877-623-6748 NofthCarolina
Intemet:www.nrwwaterquality.org �/ � at Lea/ly
An Equal opportunity 1 Affirmative Action Employer

Johnson Controls Battery Group
Attn: Ray Dudley, Environmental Manager
Compliance Evaluation Inspection, NCGO30224
NOV-2012-PC-0410
12117/2012, Page 2 of 3
• The Spill Prevention and Response Plan (SPRP), as required by NCG030000, Part ll, Section
A, Paragraph 3, should be updated to include the Division's contact numbers. In the event of a
spill that affects, or has the potential to affect surface waters, Johnson should call DWQ
WSRO at 336-771-5000, M-F, 8AM to 5PM, excluding State holidays, or the NC Division of
.Emergency Management (DEM) at 1-800-858-0368 during all other times. Please add these
two contact numbers to the SPRP's Emergency Contact List.
• Not all training has been conducted as required by NCG030000, Part Il, Section A, Paragraph
6. No; records of training were provided during the inspection, although you indicated that
annual training, as well as initial orientation training for new employees is conducted.
• SP3 annual reviews, as required by NCG030000, Part II, Section A, Paragraph 8, were
completed for 2011 and 2012, but no earlier records were available. Part III, Section D,
Paragraph 6 of NCG030000 requires that the permittee keep all records for a minimum of 5
years. The SP3 was dated 2008 on the front cover but there were two review sheets for 2011
and 2012 inside the binder.
• Neither analytical nor qualitative monitoring (AM and QM, respectively) has been completed as
required by NCG030000, Part II, Section B. Johnson completed four AM/QM events in 2009,
one in 2010, one in 2011, and three in 2012. No earlier records were available during the
nspection. No benchmark exceedences occurred during the listed AM events and no
significant findings were reported during the listed QM events.
Site Review
The site was fairly clean and well maintained. Mr. Boone noted the following items:
• There is a significant amount of miscellaneous equipment and materials in various areas
throughout the site, some of which is due to ongoing construction. Johnson should minimize
exposure of such items;
• The site could also use a bit better housekeeping:
There was a significant amount of silt and sediment located in vehicular areas throughout
the site;
a There was some trash strewn about (again partly due to construction);
There were a few relatively small oil stains around the site;
• Some of the stormwater conveyances are experiencing erosion, which should be repaired and
minimized in the future.
• The SDO was severely overgrown and not accessible, which brings into question whether or
not AM samples are being taken from the correct location and the validity of AM data. It
appears that the only place a sample could be taken (currently)' is from the stormwater pond
itself, outside of the overflow structure. The SDO needs to be made accessible and AM
samples must be taken from the end of the pipe.
The Division requests that Johnson reply in writing to this Notice of Violation with 30 business
days of receiving it. Johnson's written response should address each deficiency/violation listed above
and provide corrective actions with estimated implementation schedules for each. Johnson is
reminded that violations of the NCG030000 general stormwater permit are subject to civil penalty
assessments not to exceed $25,000 per day, per violation. Should you have any questions
16
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Johnson Controls Battery Group
kAtswj,Xyvadley, Environmental Manager
1 Compliance Evaluation Inspection, NCGO30224
NOV-2012-PC-0410
12/17/2012, Page 3 of 3
regarding the permit, this Notice of Violation, or the inspection, please do not hesitate to contact Mr. -
Boone or me at [phone].
Sincerely,
0.7
W. Corey Basinger
Water Quality Regional Supervisor
Winston-Salem Region
Division of Water Quality
Attachments:
1. BIMS Inspection Checklist
cc: �SWP — WSRQ -
Central Files
Stormwater Permitting Unit

Compliance Inspection Report
Permit: NCG030224 Effective: 11/01/12 Expiration: 10/31/17 Owner: Johnson Controls Battery Group
SOC: Effective: Expiration: Facility: Johnson Controls Battery Group
County: Forsyth 2701 Johnson Controls Dr
Region: Winston-Salem
Kernersvilie NC 27285
Contact Person: Ray Dudley Title: Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 12/11/2012 KEntTime: 09:00 AM Exit Time: 11:37 AM
Primary Inspector: Ron Boone i1 Phone: [phone]
Secondary Inspector(s):
Aana Taylor -Smith Phone:
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Metal Fabrication Stormwater Discharge COC
Facility Status: ❑ Compliant ■ Not Compliant
Question Areas:
® Storm Water
(See attachment summary)
Page: 1

Permit: NCG030224 Owner - Facility: Johnson Controls Battery Group ""' �� •
Inspection Date: 12/11/2012 Inspection Type: Compliance Evaluation Reason for Visit. Routine
Inspections Summary:
Please refer to the attached inspection summary letter.
Page; 2

~� Permit: NCG030224 Owner - Facility: Johnson Controls Battery Group
Inspection Date: 12/11/2012 Inspection Type: Compliance Evaluation
Reason for Visit:
Routine
Stormwater Pollution Prevention Plan
Yes
No
NA
NE
Does the site have a Stormwater Pollution Prevention Plan?
®
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❑
# Does the Plan include a General Location (USGS) map?
®n
00
# Does the Plan include a "Narrative Description of Practices"?
®n
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# Does the Plan include a detailed site map including outfall locations and drainage areas?
# Does the Plan include a list of significant spills occurring during the past 3 years?
# has the facility evaluated feasible alternatives to current practices?
# Does the facility provide all necessary secondary containment?
# Does the Plan include a BMP summary?
# Does the Plan include a Spill Prevention and Response Plan (SPRP)?
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
# Does the facility provide and document Employee Training?
# Does the Plan include a list of Responsible Party(s)?
# Is the Plan reviewed and updated annually?
# Does the Plan include a Stormwater Facility Inspection Program?
Has the Stormwater Pollution Prevention Plan been implemented?
Comment: Please refer to the attached inspection summary letter.
Qualitative Monitoring
Has the facility conducted its Qualitative Monitoring semi-annually?
Comment: Please refer to the attached inspection summary letter.
Analytical Monitoring
Has the facility conducted its Analytical monitoring?
# Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas?
Comment: Please refer to the attached inspection summary letter.
Permit and Outfalls
# Is a copy of the Permit and the Certificate of Coverage available at the site?
# Were all outfalls observed during the inspection?
# If the facility has representative outfall status, is it properly documented by the Division?
# Has the facility evaluated all illicit (non stormwater) discharges?
Comment: Please refer to the attached inspection summary letter.
®nnn
■nnn
Yes
No
NA
NE
■nnn
Yes
No
NA
NE
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Yes
No
NA
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0 0 N 0
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Page: 3

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P. E. Dee Freeman
Governor Director Secretary
December 4, 2012
Johnson Controls Battery Group
PO Box 1667
Kernersville, NC 27285
Subject: NPDES Stormwater Permit Coverage Renewal
Johnson Controls Battery Group
COC Number NCG030224
Forsyth County
Dear Permittee:
In response to your renewal application for continued coverage under Stormwater General Permit NCG030000
the Division of Water Quality (DWQ) is forwarding herewith the reissued 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 October
15, 2007 for as subsequently amended).
The following information is included with your permit package:
• A new Certificate of Coverage (COC)
• A copy of General Permit NCG030000
• A copyof the Technical Bulletin for the General Permit
• Two copies of the Discharge Monitoring Report (DMR) Form
• Two copies of the Qualitative Monitoring Report Form
The General Permit authorizes discharges of Stormwater, and it specifies your obligations for discharge
controls, management, monitoring, and record keeping. Please review the new permit to familiarize yourself
with all the changes in the reissued permit. Your facility has six (6) months from the time of receipt of the
permit to update your current SPPP to reflect all new permit requirements.
The first sample period of your permit begins January 1, 2013. Your facility must sample a "measureable
storm event" beginning during the periods beginning January 1 and July 1 of every year (or, if applicable,
report "No Flow," as outlined in Part 111, Section E). Also, please note that Tier 3 Actions in Part 11 of your
permit are triggered by benchmark exceedances on four occasions beginning on the effective date of this
permit and do not count prior exceedances.
The more significant changes in the General Permit since your last COC was issued are noted either in the
Draft Permit Fact Sheet that accompanied the public notice (htto://oortal.ncdenr.ore/web/wq/ws/su/current-
notices), or in the Response to Comments / Summary of Changes and Technical Bulletin documents that are
posted on the Stormwater Permitting Unit's website with the new General Permit. Please visit
http://Portal.ncdenr.org/web/wq/ws/su/npdessw (click on 'General Permits' tab) to review that information
for your specific General Permit carefully.
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone: 91M07-63001 FAX: 91 M07-6492
Internet: www.nCwaterauality.ora
An Equal Opportunity 1 Affirmative Acton Employer
No hCarolina
Natura!!y

December 4, 2012
Page 2 of 2
Some of the changes include:
Part II:
• Section A: The Stormwater Pollution Prevention Plan (SPPP) section, if applicable, has been updated
to the most current language of our permits. Additional conditions for specific industry sectors have
been added to the SPPP requirements in some cases.
• Sections B, C: Failure to perform analytical stormwater monitoring may result in the Division requiring
that the permittee begin a monthly sampling scheme.
• Sections 8, C: A lower TSS benchmark of 50 mg/I for HQW, ORW, PNA and Tr Waters applies to these
more sensitive waters.
• Sections B, C. The monitoring parameter Oil & Grease (O&G) has been replaced by the parameter
Total Petroleum Hydrocarbons (TPH) for vehicle maintenance areas, and in some cases, other
analytical monitoring requirements.
• Sections B, C, D: Inability to sample due to adverse weather must be recorded in the SPPP, or in
separate on -site records if your General Permit does not require an SPPP. Adverse weather is defined
in the "Definitions" section of the permit.
• Sections B, C: The term "Representative Storm Event" has been replaced by "Measurable Storm
Event." A measurable storm event is defined in the permit.
• Section D: If the permittee fails to respond effectively to problems identified by qualitative
monitoring, DWQ may require the permittee to perform corrective action.
Please review Parts III and IV to understand the Standard Conditions of your new NPDES General Permit,
including Compliance and Liability, Repo rting,'Monitoring and Records requirements; Operation and
Maintenance obligations; and Definitions. Please note that all samples analyzed in accordance with the terms
of this permit must be submitted to the Division on Discharge Monitoring Report (DMR) forms available on
the Stormwater Permitting Unit's website above. DMR forms must be delivered to the Division no later than
30 days from the date the facility receives the sampling results from the laboratory. Also note that existing
permittees do not need to submit a renewal request prior to expiration unless directed by the Division.
Your coverage under the General Permit is transferable only through the specific action of DWQ. This permit
does not affect the legal requirements to obtain other permits which may be required by DENR, nor does it
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 the Division's Stormwater Permitting Unit at [phone].
Sincerely,
/I
for Charles Wakild, P.E.
cc: DWQ Central Files
Stormwater Permitting Unit Files
Winston-Salem Regional Office

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG030000
CERTIFICATE OF COVERAGE No. NCG030224
STORMWATER
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,
Johnson Controls Battery Group
is hereby authorized to discharge stormwater from a facility located at:
Johnson Controls Battery Group
2701 Johnson Controls Dr
Kernersville
Forsyth County
to receiving waters designated as Lowery Mill Creek, a class WS-III waterbody in the Yadkin
River Basin in accordance with the effluent limitations, monitoring requirements, and other
conditions set forth in Parts I, 11, II1, and IV of General Permit No. NCG030000 as attached.
This certificate of coverage shall become effective December 4, 2012.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this 4e' day of December, 2012.
for Charles Wakild, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

r�
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P.E.
Governor Director
March 14, 2012
Johnson Controls Battery Group
PO Box 1667
Kernersville, NC 27285
Subject: NPDES Stormwater Permit Coverage Renewal
Johnson Controls Battery Group
COC Number NCG030224
Forsyth County
Dear Permittee:
Dee Freeman
Secretary
Your facility is currently covered for Stormwater discharge under General Permit NCG030000, This permit expires on 10/31/2012.
The Division staff is currently in the process of renewing this permit. When a draft is available for notice and public comment, it will
be posted on our website at http://portal.ncdenr.org/web/wq/ws/su/public-notices. Please continue to check this website to review
and comment on proposed changes to the permit. Once the permit is reissued, your facility would be eligible for continued coverage
under the reissued permit.
To assure consideration for continued coverage under the general permit, you must apply to the Division of Water Quality (DWQ) for
renewal of your permit. Enclosed you will find a Permit Coverage Renewal Application Form. The application must be completed
and returned by May 4, 2012. Letters confirming our receipt of the completed application will not be sent.
Failure 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
$25,000 per day. Our records indicate that your facility has outstanding annual fees in the amount of $100. We cannot
renew permit coverage until you have corrected this situation. We have enclosed copies of the unpaid invoice(s) that must be
returned with payment. Failure to pay annual fees is a violation of your permit and may result in revocation of your permit coverage.
"No exposure exclusion" is now available to industrial facilities in any of the categories of "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 Stormwater Permitting Unit Web Site at
http;//portal.ncdenr.org/web/wq/ws/su/npdessw#tab-5.
If the subject stormwater discharge to waters of the state has been terminated, please complete the enclosed Rescission Request
Form. Mailing instructions can be found on the bottom of the form. You will be notified when the rescission process has been
completed.
If you have any questions regarding the permit renewal procedures please contact Jennifer Jones of the Central Office Stormwater
Permitting Unit at [phone].
1617 Mail Service Center, Ralegh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raiegh, North Carolina 27604
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748
Internet: www.nmaterquality.org
Sincerely,
�.� 'Ile /:56��
Bradley Bennett
Supervisor, Stormwater Permitting Unit
NorthCarolina
An Equal opportunity 4 Affirmative Action Employer

Cr
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,w
o4 WATp, G Permit Coverage
Renewal Application Form
T National Pollutant Discharge Elimination System Certificate of Coverage Number
Stormwater General Permit NCG030000 NCG030224 Rl
The following is the information currently in our database for your facility. Please review this information carefully and make all
corrections/ additions as necessary in the space provided to the right of the current information.
Owner Affiliation Information * Reissued Permit will be mailed to the owner address
Owner / Organization Name
Owner Contact:
Mailing Address:
Phone Number:
Fax Number:
E-mail address:
Johnson Controls Battery Group
PO Box 1667
Kernersville, NC 27285
336-734-2320 Ext.
FacilitvlPermit Contact Information
Facility Name: Johnson Controls Battery Group
Facility Physical Address: 2701 Johnson Controls Dr
Kernersville, NC 27285
Facility Contact:
Mailing Address:
Phone Number:
Fax Number:
E-mail address:
Discharge Information
Receiving Stream:
Stream Class:
Basin:
Sub -Basin:
Number of Outfalls:
Lowery Mill Creek
WS-III
Yadkin River Basin
03-07-04
Impaired WatersfrMDL
Does this facility discharge to waters listed as impaired or waters with a finalized TMDL? ❑ Yes ❑ No ❑ Don't Know
for information on these waters refer to http y/portal ncdenr. org/web/wq/w4lsu#tab-3
CERTIFICATION
I certify that I am familiar with the information contained in the application and that to the best of my knowledge and
belief such information is true, complete and accurate.
Signature
Print or,type name of person signing above
Date
Title
SW General Permit Coverage Renewal
Please return this completed renewal application form to: Stormwater Permitting Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

O�tlF W A 1p?
Permit Rescission Request Form
National Pollutant Discharge Elimination System
General Permit NCG030000
Certificate of Coverage Number
NCG030224
Please fill out and return this form only if you no longer need to maintain your NPDES stormwater permit.
The following is the information currently in our database for your facility. Please review this information carefully and
make all corrections as necessary in the space provided to the right of the current information.
Owner Affiliation Information
Owner / Organization Name:
Owner Contact:
Mailing Address:
Phone Number:
Fax Number:
E-mail address:
* Rescission Correspondence will be mailed to the owner address
Johnson Controls Battery Group
PO Box 1667
Kernersville, NC 27285
336-734-2320 Ext.
Facility/Permit Contact Information
Facility Name: Johnson Controls Battery Group
Facility Physical Address: 2701 Johnson Controls Dr
Kernersville, NC 27285
Facility Contact:
Mailing Address:
Phone Number:
Fax Number:
E-mail address:
Reason for rescission request (This is required information. Attach separate sheet if necessary):
REQUEST AND CERTIFICATION
I, as an authorized representative, hereby request rescission of certificate of coverage NCG030224 under NPDES
Stormwater General Permit NCG030000 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, complete and accurate.
Signature
Print or type name of person signing above
Date
Title
Please return this completed rescission request form to: SW General Permit Coverage Rescission
Stormwater Permitting Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617