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HomeMy WebLinkAboutNCG050370_COMPLETE FILE - HISTORICAL_20170525STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. IV U&(Jj U3� O DOC TYPE IYFIISTORICAL FILE ❑ MONITORING REPORTS DOC DATE ❑ a0lo QS aJ YYYYMMDD Energy, Mineral & Land Resources ENVIRONMENTAL QUALITY May 25, 2017 Mr. Allan Knight Innocor Foam Technologies ACP, Inc. 2222 Surrett Drive High Point, NC 27263 if Lf, ROY COOPER Governor MICHAEL S. REGAN Secretary TRACY DAVIS Director NC Department of Environmental C}ualitY Received JUN 0 1 2017 Winston-Salem ' Regional 0 3itf_1ce Subject: NPDES Stormwater Permit NCG050370 Innocor Foam Technologies — ACP, Inc. Formerly Advanced Comfort Products, Inc. Randolph County Dear Mr, Knight: Division personnel received your request to revise your stormwater permit Certificate of Coverage to accurately reflect your new company and/or facility name. Please find enclosed the revised Certificate of Coverage. The terms and conditions contained in the General Permit remain unchanged and in full effect. This revised Certificate of Coverage is issued under the requirements of North Carolina General Statutes 143-215.1 and the Memorandum of Agreement between North Carolina and the U.S. Environmental Protection Agency. If you have any questions or need further information, please contact the Stormwater Permitting Program at (919) 707-9220. Sincerely, Original Signed by Richard L. Riddle, Jr. for Tracy E. Davis, P.E., CPM, Director Division of Energy, Mineral and Land Resources cc: Winston-Salem Regional Office Stormwater Permitting Program Files Central Files Nothing Compares--,,, State of North Carolina I Environmental Quality I Energy, Mineral and Land Resources 512 N. Salisbury Street { 1612 Mail Service Center I Raleigh, North Carolina 27699-16]2 919 707 9200 � 0 Lg,,,t - St vlt w vok fit,-P.,-Y. a �r�s G. r� • s,.e su )e ids e �e C le{�e r, 4 STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES GENERAL PERMIT NO. NCG050000 CERTIFICATE OF COVERAGE No. NCGO50370 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, Innocor Foam Technologies — ACP, Inc. is hereby authorized to discharge stormwater from a facility located at: Innocor Foam Technologies — ACP, Inc. 2222 Surrett Drive High Point Randolph County to receiving waters designated as unnamed tributary to Uwharrie River, a class WS-III water, in the Yadkin River Basin; in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, 11, 111, and IV of General Permit No. NCG050000 as attached. This certificate of coverage shall become effective May 25, 2017. This Certificate of Coverage shall remain in effect for the duration of the General Permit. Signed this day May 25, 2017. Original Signed by Richard L. Riddle, Jr. for Tracy E. Davis, P.E., Director Division of Energy, Mineral, and Land Resources By the Authority of the Environmental Management Commission nnocor.Tc" April 21, 2017 NCDEQ— Division of Energy, Mineral and Land Resources Attn: Stormwater Billing 1612 Mail Service Center Raleigh, NC 27699-1612 To Whom It May Concern: Attached is the Annual Permit Fee for Invoice Number 2017PR002741, Permit Number HCG050370. I would also like to request that the name of the company on the records from "Advanced Comfort Products Inc." to "Innocor Foam Technologies —ACP, Inc." If you have any questions, please feel free to call me at (732) 403-4223 or email me at'konuch innocorinc.com . Sincerely, - 4"� aim Konuch, P.E., CHMM, CS? Corporate Environmental Manager 200 Schulz Drive Red Bank, NJ 07701 732-403-4223 ® Innocorinc.com Energy, Mineral & Lond Resources ENVIRONMENTAL QUALITY May 25, 2017 Mr. Allan Knight Innocor Foam 'technologies ACP, Inc. 2222 Surrett Drive High Point, NC 27263 ROY COOPER Governor MICHAEL S. REGAN Secretary 'RACY DAVIS Director Subject: NPDES Stormwater Permit NCGO50370 Innocor Foam Technologies - ACP, Inc. Formerly Advanced Comfort Products, Inc. Randolph County Dear Mr. Knight: Division personnel received your request to revise your stormwater permit Certificate of Coverage to accurately reflect your new company and/or facility name. Please find enclosed the revised Certificate of Coverage. The terms and conditions contained in the General Permit remain unchanged and in full effect. This revised Certificate of Coverage is issued under the requirements of North Carolina General Statutes 143-215.1 and the Memorandum of Agreement between North Carolina and the U.S. Environmental Protection Agency. If you have any questions or need further information, please contact the Stormwater Permitting Program at (919) 707-9220. Sincerely, Original Signed by Richard L. Riddle, Jr. for Tracy E. Davis, P.E., CPM, Director Division of Energy, Mineral and Land Resources cc: Winston-Salem Regional Office Stormwater Permitting Program Files Central Files Nothing Compares--_,- State of North Carolina I Environmental Quality I Energy, Mineral and Land Resources 512 N. Salisbury Street 11612 Mail Service Center I Raleigh, North Carolina 27699-1612 919 707 9200 STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES GENERAL PERMIT NO. NCG050000 CERTIFICATE OF COVERAGE No. NCG050370 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, Innocor Foam Technologies — ACP, Inc. is hereby authorized to discharge stormwater from a facility located at: Innocor Foam Technologies — ACP, Inc. 2222 Surrett Drive High Point Randolph County to receiving waters designated as unnamed tributary to Uwharrie River, a class WS-III water, in the Yadkin River Basin; in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II, III, and IV of General Permit No. NCG050000 as attached. This certificate of coverage shall become effective May 25, 2017. This Certificate of Coverage shall remain in effect for the duration of the General Permit. Signed this day May 25, 2017. Original Signed by Richard L. Riddle, Jr. for Tracy E. Davis, P.E., Director Division of Energy, Mineral, and Land Resources By the Authority of the Environmental Management Commission _... 1031 May 6, 2017 NCDEQ— Division of Energy, Mineral and Land Resources Stormwater Permitting Program 1612 Mail Service Center Raleigh, NC 27699-1612 To Whom It May Concern: Attached is a completed "Permit Name Ownership Change Form" for Permit Number HCG050370. The name of the facility has been changed from Advanced Comfort Products Inc. to Innocor Foam Technologies —ACP, Inc. if you have any questions, please feel free to call me at (732) 403-4223 or email me at lkonuch Q innocorinc.com . Sincerely, Jim Konuch, P.E., CHMM, CSP Corporate Environmental Manager sra FNR,IV DQU U '0ii 200 Schulz Drive Red Bank, N107701 732-403.4223 ® Innocorinc.com AF Division of Energy, Mineral & Land Resources ( Land Quality SectionlStormwater Permitting NC®ENR National Pollutant Discharge Elimination System y nffw "Arwaffims PERMIT NAMEIOWNERSHIP CHANGE FORM FORAGENCY USE ONLY Date Received Year I Month I Da 1. Please enter the permit number for which the change is requested. NPDES Permit (or) Certificate of Coverage IN19151H N I C I D 10 15 10 13 7 a 11. Permit status VL& to requested change. a. Permit issued to (company name): Advanced Comfort Products ]nc. b. Person legally responsible forpennit: Jack Holland First MI Last "Title 2222 Surretl Drive Permit I ]older Mailing Address High Point NC 27263 City State Zip Phone Fax c. Facility name (discharge): Advanced Comfort Products Inc. d. Facility address: 2222 $urrett Drive Address High Point NC 27263 City State Zip e. Facility contact person: Burt Brown { ) First / MI I Last Phone III. Please provide the following for the requested change (revised permit). a. Request for change is a result of: [] Change in ownership of the facility M Name change of the facility or owner If other please explain: b. Permit issued to (company name): c. Person legally responsible for permit: RECEIVED NAY 10 2017 Innocor Foam Technologies - ACP, Inc. Allan Kni ht First Ml Last Plant Maraper Title 2222 Surrett Drive Permit Holder Mailing Address DEN_ 4-AND QUALITY high Point NC 27263 t"MWKTi R P.MITT-I?qG City State Zip { 662 )365-1191 aightn4innucoriny, Phone 1: mail Address d. Facility name (discharge): Innocor. Foam _Technologies-ACP, Inc,_ e. Facility address: 2222 Surrett Drive Address High Point NC 27263 City State Zip f. Facility contact person: Allan Knight First MI Last { 662 ) 365-1191 aknikht(a,innocorinc.com Phone F-mail Address IV. Permit contact information (if different from the person legally responsible for thepermit) Revised Jan. 27, 2014 -NPDES PERMIT NAME/OWNERSHIP CHANGE FORM Page 2 of 2 Permit contact: Same as person legally res onsible for the permit First MI Last "Title Railing Address City State Zip Phone E-mail Address V. Will the permitted facility continue to conduct the same industrial activities conducted prior to this ownership or name change? ❑w Yes j� No (please explain) VI. II"equired Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS ARE INCOMPLETE OR MISSING: This completed application is required for both nine 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 for an ownership change request. Articles of incorporation are not sufficient for an ownership change. The certifications below must be completed and signed by bath 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): I, , 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 APPLICANT CERTIFICATION Date 1, James Konuch, attest that this application for a name/ownership change has been reviewed and is acemww 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. 5/6/2017 Signature / O Date .Rose .............................. am .... so ... mr.po .................... 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 Revised Jan. 27, 2014 Energy, Min erol & Land Resources ENVIRONMENTAL QUALITY Mr. Allan Knight Innocor Foam Technologies ACP, Inc. 2222 Surrett Drive High Point, NC 27263 Dear Mr. Knight: ROY COOPER Governor MICHAEL S. REGAN Secretary TRACY DAVIS Director May 25, 2017 RECEIVED jUN 0 5 2017 CENTRAL FILES DWR SECTION Subject: NPDES Stormwater Permit NCG050370 Innocor Foam Technologies — ACP, Inc. Formerly Advanced Comfort Products, Inc. Randolph County Division personnel received your request to revise your Stormwater permit Certificate of Coverage to accurately reflect your new company and/or facility name. Please find enclosed the revised Certificate of Coverage. The terms and conditions contained in the General Permit remain unchanged and in full effect. This revised Certificate of Coverage is issued under the requirements of North Carolina General Statutes 143-215.1 and the Memorandum of Agreement between North Carolina and the U.S. Environmental Protection Agency. If you have any questions or need further information, please contact the Stormwater Permitting Program at (919) 707-9220. Sincerely, 74dJz* for Tracy E. Davis, P.E., CPM, Director Division of Energy, Mineral and Land Resources cc: Winston-Salem Regional Office Stormwater Permitting Program Files Central Files Nothing Compares ---,, State of North Carolina Environmental Quality I Energy, Mineral and Land Resources 512 N. Salisbury Street 11612 Mail Service Center I Raleigh, North Carolina 27699-I612 919 707 9200 STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES GENERAL PERMIT NO. NCG050000 CERTIFICATE OF COVERAGE No. NCGO50370 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, Innocor Foam Technologies — ACP, Inc. is hereby authorized to discharge stormwater from a facility located at: lnnocor Foam Technologies — ACP, Inc. 2222 Surrett Drive High Point Randolph County to receiving waters designated as unnamed tributary to Uwharrie River, a class WS-III water, in the Yadkin River Basin; in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts 1, I1, III, and IV of General Permit No. NCG050000 as attached. This certificate of coverage shall become effective May 25, 2017. This Certificate of Coverage shall remain in effect for the duration of the General Permit. Signed this day May 25, 2017. for Tracy E. Davis, P.E., Difector Division of Energy, Mineral, and Land Resources ,By the Authority of the Environmental Management Commission 1*nniocorm,c" May 6, 2017 NCDEQ— Division of Energy, Mineral and Land Resources Stormwater Permitting Program 1612 Mail Service Center Raleigh, NC 27699-1612 To Whom It May Concern: Attached is a completed "Permit Name Ownership Change Form" for Permit Number HCG050370, The name of the facility has been changed from Advanced Comfort Products Inc. to Innocor Foam Technologies —ACP, Inc. If you have any questions, please feel free to call me at (732) 403-4223 or email me at ikonuch@innocorinc.com . Sincerely, r� Jim Konuch, P.E., CHMM, CSP Corporate Environmental Manager sr44R1A 01017 200 Schulz Drive Red Bank, N) 07701 1' 732-403-4223 ® innocorinc.com AG� Division of Energy, Mineral & Land Resources 1F, Land Quality Section/Stormwater Permitting ""� NCDENRNational Pollutant Discharge Elimination System C..O���H PERMIT NAME/OWNERSHIP CHANGE FORM FOR AGENCY USE ONLY Date Received Year Month Da 1. Please enter the permit number for which the change is requested. NPDES Permit (or) Certificate of Coverage LhU g 1 S 0 N C; 10 15 10 13 1 7 1 n Il. Permit status aLiaL to requested change. a. Permit issued to (company name): Advanced Comfort Products Inc. b. Person legally responsible for permit: Jack Holland First MI last 'title 2222 Surrett Drive Permit Holder Mailing Address High Point „NC 27263 City State Zip Phone I-ax c. Facility name (discharge): Advanced Comfort Products Inc. d. Facility address: 2222 Surrett Drive Address I lish Point NC 27263 City State Zip e. Facility contact person: Burt Brown ( ) First / MI / Last Phone I1.1. 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 pen -nit: MAY 10 2017 NP-LA dD QUAUTY 'StdAM WMU P 1 tdWITZNG d. Facility name (discharge): e. Facility address: f Facility contact person: Innocor Foam Technoloqies - ACP. Inc. Allan Kni ht First MI Last Plant Mana cr Title 2222 Surrett Drive Pennit Holder Mailing Address High Point NC 27263 City State zip ( 662 )365-1 l91 aknight (t—hinnocorinc.cnm Phone F-mail Address Innocor Foarn Technolov_ies - ACP. Inc 2222 Surrett Drive Address ICA Point NC 27263 City State Zip Allan Knight. First MI Last ( 662 ) 365-1 191 aknight a innocorinc.com Phone E-mail Address IV. Permit contact information (if different from the person legally responsible for the permit) Revised Jan. 27, 2014 NPDES PERMIT NAME/OWNERSHIP CHANGE FORM Page 2 of 2 Permit contact: Same as person legally responsible for the permit First MI Last Title [ailing Address City State Zip Phone E-mail Address V. Will the permitted facility continue to conduct the same industrial activities conducted prior to this ownership or name change? 0 Yes � No (please explain) VL Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS ARE INCOMPLETE OR MISSING: O This completed application is required for both name change and/or ownership change requests. Ej 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 h1ah 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): I, , 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 APPLICANT CERTIFICATION Date I, James Konuch, 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. 5/6/2017 Signature f (% 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 Revised Jan. 27, 2014 Alexander, Laura From: Julie Hodges <jhodges@innocorinc.com> Sent: Friday, May 13, 2016 12:42 PM To: Alexander, Laura Cc: Burt Brown Subject: RE: Stormwater Permit NCG050370 & Name Change Laura, I am not the correct contact person to handle this request. I have forwarded this to Burt Brown our Environmental Health and Safety Manager for the High Point plant. He will be the one handling this matter. Burt, Please see Laura's request below. XadW Human Resources Manager motor, foam imilmologlas 2222 Surrett Dr High Point, NC 27263 Office 336.431.1171 1 Fax 336.861.4433 Lhodges@innocorinc.com innocorfoamtech.com From: Alexander, Laura[mailto:laura.alexander@ncdenr.govj Sent: Friday, May 13, 2016 11:40 AM To: Julie Hodges Subject: Stormwater Permit NCG050370 & Name Change Good Morning Julie, In May of 2015 we received the attached document stating a name change for your company. I did some research and found that you have the above mentioned Stormwater Permit. At the time, I reached out to one of the contacts in our database (Burt Brown) but did not hear back. Would you mind filling out the attached name change form and updating the contacts? If this transaction was an ownership change then I'll need a one page deed or bill of sale stating the transfer. If only a name change, filling out the form is sufficient. I appreciate your help. Let me know if you have any questions. Thank you, Laura Alexander Administrative Assistant I %ormwaler Permitting Program Forth Carolina Division of Energy, Mineral and Land Resources North Carolina Department of Environmental Quality 919 807 6368 Office 919 807 6494 Fax laura.alexander@ncdenr.go_v 512 North Salisbury Street 1612 Mail Service Center Raleigh, North Carolina 27699 "Nothing Compares,,,, E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties. O�a 0-� -duw/ Glbatk i..Pda*-R i bbr�wri.��l_0AI� cG-05 0 3p s knocor: comfort Dear Valued Partner: oco foam technologies As you may have noticed by the logos, we have adopted a new name! We are very excited to inform you, effective immediately, that the businesses you knew previously as Sleep Innovations, Inc., Advanced Urethane. Technologies, Advanced Comfort Products,_ Inc., Flexible Foam and NuFoam have been combined and`are-noun known as "Innocor, Inc.;;7 the parent company for two divisions: "Innocor Comfort"'(supporting retail sales) and "Innocor Foam Technologies" (supporting industrial and packaging fabricators). Our new name confirms our understanding of the changing needs of our marketplace. Specifically, we know it is imperative to deliver innovative products that address customer and consumer needs across all comfort product categories from bedding to furniture and much more. We will continue to be a strong and growing contender in our field because INNOvation is the CORe to our success! While our name is changing, our legal status, our office addresses and phone numbers will remain the same. Our e-mail addresses will change and we will notify you when that change occurs. Our company's business remains fundamentally unaffected by this change. All contracts with existing customers and vendors will remain unaltered, with corresponding obligations and rights assumed under the new name. As always, we are committed to providing you the best in class customer service of which you are accustomed. Enclosed please find a copy of our press release. Should you have any questions, please feel free to reach out to your regular contacts for answers. We look forward to our continued partnership as we work through this process. Best regards, Carol S. Eicher President and CEO Innocor, Inc. Enclosure 9N1111VV?J3d d31VAAv%01S A1llno ONVI-6N30 510z 6 � (13nI30-98 RECEIVED MAY 2 9 2015 DENR-LAND QUALITY STORMWATER PERMITTING 187 Route 36 - Suite 101, West Long Branch, NJ 07764 SLEEP INNOVATIONS AND FLEXIBLE FOAM COMPLETE MERGER AND REBRAND AS INNOCOR INC.; CAROL EICHER NAMED PRESIDENT AND CEO WEST LONG BRANCH, N.J. (June b, 2014) — Sleep Innovations and Flexible Foam Products Inc, two affiliated portfolio companies of Sun Capital Partners, Inc., today announced that they have completed merging their operations and have unveiled Innocor Inc., as the new name of the combined Company. The Company also announced the appointment of Carol Eicher as the President and CEO of Innocor Inc., which is now the second largest producer of flexible polyurethane foam in North America. "This is an exciting day for the Company as we adopt the name `Innocor Inc.,' to communicate that innovation is at the core of everything we do, and we appoint a new CEO in Carol Eicher,-" said Richard C. Brown, Chairman of the Board of Innocor Inc.. "The Board and I are confident Carol is the best choice to guide the business as we leverage our increased manufacturing footprint as both a retail partner and OEM supplier." Eicher most recently served as Business President of Dow's Global Coating and Construction division. Prior to that, Eicher was Global Business Director of Rohm and Haas' Primary Materials division. Previously, Eicher held several manufacturing positions at Ashland Chemical Company, a division of Ashland Inc., and at E. I. du Pont de Nemours. "I'm thrilled to come on board during this pivotal time in the company's history," said Eicher. "This Company has never viewed itself as simply a foam converter, and our new name reflects that. From our rich tradition of research -based innovations to our deep knowledge of industry trends, Innocor Inc. is committed to translating the science of foam into true product solutions for our partners." "We have the most talented sales organization in the industry, operate in the strongest manufacturing communities nationwide and are supported by a marketing team that is second to none," added Eicher. `'This organizational strength ensures Innocor Inc. will continue to lead the industry by offering customized solutions not only for the bedroom, but for the home and office as well as new, unique touch points for future applications." About Innocor Inc. Innocor Inc. is the leader in consumer -driven foam products proven to deliver comfort, relaxation and rejuvenation. The company designs and manufactures advanced memory foam products, including pillows, mattress toppers and mattresses, as well as bath, kitchen, workspace, home, loungeable and pet products under the brands Sleep Innovationsm, Novaform®, Comfort Co.TM and Stanley® Utility Mats, among others. Through extensive clinical and consumer testing, Innocor Inc. has found that its breakthrough foam solutions improve the duality of its consumers lives through better comfort technology. About Sun Capital Partners, Inc. Sun Capital Partners, Inc. is a pioneer in private equity investing, uniquely combining the financial skills and resources of a traditional private equity I irm with the insight and expertise of a world class operating team. The firm focuses on market -leading companies that can benefit from its in-house professionals, resources; and expertise in their efforts to materially improve operating performance. Sun Capital affiliates have invested in more than 335 companies worldwide with combined sales in excess of $45 billion since its inception in 1995. Sun Capital has offices in Boca Raton, Los Angeles and New York, and affiliates in London, Frankfurt, Paris, Luxembourg, Shanghai and Shenzhen. NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES II I I I II I II I II j I II f I II II {I I jl INVOICE * 2 0 1 5 P R 0 0 3 3 3 8 Annual Permit Fee Open This annual fee is required by the North Carolina Administrative Code. It covers the administrative costs associated with your permit. It is required of any person holding a permit for any time during the annual fee period, regardless of the facility's operating status. Failure to pay the fee by the due date will subject the permit to revocation, Operating without a valid permit is a violation and is subject to a $10,000 per day fine. If the permit is revoked and you later decide a permit is needed, you must reapply, with the understanding the permit request may be denied due to changes in environmental, regulatory, or modeling conditions. Invoice Number: 2015PR003338 Permit Number: NCGO50370 Randolph County Advanced Comforz Proaucts inc Jack Holland Advanced Comfort Products inc 2222 Surrett Dr High Point, NC 27263 Notes: I 191 4. 5. 6. 7. Annual Fee Period: 2015-05-01 to 2016-04-30 Invoice Date: 04108/2015 Due Data: 05I08!2015 Annual Fee: $100.00 You may pay either by check/money order OR by electronic payment. If payment is by check/money order, please remit payment to: NCDENR - Division of Energy, Mineral and Land Resources Attn: Stormwater Billing 1612 Mail Service Center Raleigh, NC 27699-1612 If payment is electronic, see htt :/1 ortal.ncdenr.or twebl /hot -to iW1e a ment for additional details. See http:/lportal.ncdenr.orghvebtm/eoavment to pay electronically. Only eCheck transactions are allowed at this time. Credit card transactions are not accepted. Please include your Permit Number and Invoice Number on all correspondence. A $25.00 processing fee will be charged for returned checks in accordance with North Carolina General Statute 25-3-512. Non -Payment of this fee by the payment due date will initiate the permit revocation process. Should you have any questions regarding this invoice, please contact the Annual Administering and Compliance Fee Coordinator at 919-707-9220. 5A NCDENR North Carolina Department of Environment and Natural Resources Pat McCrory Governor Mr. Peter J Adamski Advanced Comfort Products, Inc. P.O. Box 143 Spencerville, OH 45887 Dear Mr. Adamski: John E. Skvarla, III Secretary May 7,2014 RECEIVED MAY 0 9 2014 CENTRAL FILES DWQ/BOG Subject: NPDES General Permit NCG050000 Advanced Comfort Products, Inc. Formerly Flexible Foam Products, Inc. Certificate of Coverage NCG050370 Randolph County Division personnel received your request to revise your stormwater permit Certificate of Coverage to accurately reflect your new company and/or facility name. Please find enclosed the revised Certificate of Coverage. The terms and conditions contained in the General Permit remain unchanged and in full effect. This revised Certificate of Coverage is issued under the requirements of North Carolina General Statutes 143-215.1 and the Memorandum of Agreement between North Carolina and the U.S. Environmental Protection Agency. If you have any questions or need further information, please contact the Stormwater Permitting Program at (919) 807-6300. Sincerely, for Tracy E. Davis, P.E., CPM, Director Division of Energy, Mineral and Land Resources Division of Energy, Mineral, and Land Resources Energy Section • Geological Survey Section • Land Quality Section 1612 Mail Service Center, Raleigh, North Carolina 27699-1612 - 919-707-9200 I FAX: 919-715-8801 512 North Salisbury Street, Raleigh, North Carolina 27604 - Internet: http:Ilportal.ncdenr,orglwebtlr/ An Equal Opportunity l Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper cc: Winston-Salem Regional Office, M. Gantt Stormwater Permitting Program Files Central riles STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF ENERGY, MINERAL, AND LsAND RESOURCES GENERAL PERMIT NO. NCG050000 CERTIFICATE OF COVERAGE No. NCG050370 STORM WATER 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, Advanced Comfort Products, Inc. is hereby authorized to discharge stormwater from a facility located at Advanced Comfort Products, Inc. 2222 Surrett Drive High Point Randolph County to receiving waters designated as unnamed tributary to Uwharrie River, a class WS-II1 water in the Yadkin River Basin, in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts 1, 11, III, and IV of General Permit No. NCG050000 as attached. This certificate of coverage shall become. effective May 7, 2014, This Certificate of Coverage shall remain in effect for the duration of the General Permit. Signed this day May 7, 2014. for Tracy E. Davis, P.E., Director Division of Energy, Mineral, and Land Resources By the Authority of the Environmental Management Commission `� ; : Division of Energy, Mineral & Land Resources �i�1' Land Quality Section/Stormwater Permitting � National Pollutant Discharge Elimination System NCDENR FI.—µ°NA e° PERMIT NAME/OWNERSHIP CHANGE FORM FOR AGENCY USE ONLY Date Received Year Month Da I. Please enter the permit number for which the change is requested. n$ D 37 a NPDES Permit (or) Certificate of Coverage N I G I S 1 O 1 1 1 1 N C G O 15 10 10 0 0 II. Permit status RLj2E to requested change. a. Permit issued to (company name): Flexible Foam Products, Inc. b. Person legally responsible for permit: John Steplcton First MT Last Em@1ROWM0 Chief Financial Officer Title 220 S. Elizabeth St. APR 2 5 2014 Permit Holder Mailing Address Spencerville Ohio 45887 _ DENR-WATORQUALITY City State Zip WETLMUSAM STORMINATER BRANCH ( 419 ) 647-4191 ( 419) 647-4202 Phone Fax c. Facility name (discharge): Flexible Foam Products, Inc. - High Point d. Facility address: 2222 surren Drive Address High Point North Carolina 27263 City State Zip e. Facility contact person: Burt Brown ( 336 ) 431-1171 First / MI / Last Phone III. 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: f. Facility contact person: Advanced Comfort Products, Inc. Peter J. Adamski First _ Ml Last Interim CFO, VP, secretary and Treasurer Title P.O. Box Ift 14,3 Permit Holder Mailing Address Spencerville Ohio 45887 City State Zip ( 585 ) 314-8899 _ peter.adamskiCadvisorytinandalgroup,corn Phone E-mail Address Advanced Comfort Products, Inc. 2222 S.,rm Dd e Address High Point NC 27263 City a: State Zip Burt Brown First Ml Last ( 336 )431-1171 bbrown®tlexibietoam.com Phone E-mail Address IV. Permit contact information (if different from the person legally responsible for the permit) Revised Jan, 27. 2014 NPDES PERMIT NAME/OWNERSHIP CHANGE FORM Page 2 of 2 Permit contact: Burt n� First Ml Last Corporate Environmental Manager Title P.O. sox 40 14 3 Mailing Address SpencervUle Ohio 45887 City State Zip ( 336 )431-1171 bbrown 0 ftexiblefoam.com 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. PE 13, EE,Cf BTIFI CATION (Permit holder prior to ownership change): I, , at e� fhat 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 I CERTIFICATION 6 zt Date i,Pdw'J A --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. zx,Z/� Signature ate PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO: Division of Energy, Mineral and Land Resources Stortnwater Permitting Program 1612 Mail Service Center Raleigh, North Carolina 27699-1612 Revised Jan. 27, 2014 ASSET PURCHASE AGREEMENT by and between Advanced Comfort Products, [tic. and Flexible Foam Products, LLC Dated as of March 31, 2014 KE 2681808T21 IN WITNESS WHEREOF, the Parties hereto have caused this Asset Purchase Agreement to be duly executed under seal as of the date and year first written above. Advanced Comfort By: �. Name: Candace S Its: President Advanced Comfort Products, Inc. SEAL Delaware Flexible Foam By: Name: Candace J Its: Vice Pres Flexible Foam Products, Inc. SEAL Ohio Signature Page to Asset Purchase Agreement KE 245E 19097, 21 i Number I INCORPORATED UNDER THE LAWS OF THE STATE OF DELA WARE Advanced Comfort Pro( This Certifies That _ SLEEP INNOVATIONS, INC._ registered holder of One I i OF COMMON STOCK, PAR VALUE $0.001 PER transferable only on the books of the Corporation by the holder hereof in, Certificate properly endorsed. In Witness Whereof, the said Corporation has caused this Certifrca this 31st day of March Shares NC®ENR North Carolina Department of Environment and Natural Resources Pat McCrory Governor Mr. Peter J Adamski Advanced Comfort Products, Inc. P.O. Box 143 Spencerville, OH 45887 Dear Mr. Adamski: John E, Skvarla, III Secretary May 7, 2014 Subject: NPDES General Permit NCG050000 Advanced Comfort Products, Inc. Formerly Flexible Foam Products, Inc. Certificate of Coverage NCG050370 Randolph County Division personnel received your request to revise your stormwater permit Certificate of Coverage to accurately reflect your new company and/or facility name. Please find enclosed the revised Certificate of Coverage. The terms and conditions contained in the General Permit remain unchanged and in full effect. This revised Certificate of Coverage is issued under the requirements of North Carolina General Statutes 143-215.1 and the Memorandum of Agreement between North Carolina and the U.S. Environmental Protection Agency. If you have any questions or need further information, please contact the Stormwater Permitting Program at (919) 807-6300. Sincerely, ORIGINAL SIGNED M KEN PICKLE for Tracy E. Davis, P.E., CPM, Director Division of Energy, Mineral and Land Resources Division of Energy, Mineral, and Land Resources Energy Section • Geological Survey Section - Land Quality Section 1612 Mail Service Center, Raleigh, North Carolina 27699-1612 - 919-707-92001 FAX: 919-715-8801 512 North Salisbury Street, Raleigh, North Carolina 27604 • Internet: htt :11 ortal.ncdenr.or /web/Irt An Equal Opportunity l Affirmative Action Employer— 50% Recycled 110% Post Consumer Paper cc: Winston-Salem Regional Office, M. Gantt Stormwater Permitting Program Files Central Files STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES GENERAL PERMIT NO. NCG050000 CERTIFICATE OF COVERAGE No, NCG050370 STORM WATER 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, Advanced Comfort Products, Inc. is hereby authorized to discharge stormwater from a facility located at Advanced Comfort Products, Inc. 2222 Surrett Drive High Point Randolph County to receiving waters designated as unnamed tributary to Uwharrie River, a class WS-III water in the Yadkin River Basin, in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, I1, 11I, and IV of General Permit No. NCG050000 as attached. This certificate of coverage shall become effective May 7, 2014. This Certificate of Coverage'shall remain in effect for the duration of the General Permit. Signed this day May 7, 2014. ORIGINAL SIGNED M KEN PICKLE for Tracy E. Davis, P.E., Director Division of Energy, Mineral, and Land Resources By the Authority of the Environmental Management Commission NCDENR FirnlronMe,rt.we k� Ad ..n Division of Energy, Mineral & Land Resources Land Quality SectionlStormwater Permitting National Pollutant Discharge Elimination System PERMIT NAME/OWNERSHIP CHANGE FORM FOR AGENCY USE ONLY Date Received Year Manth Day I. Please enter the permit number for which the change is requested. 05 n 3"7 a NPDES Permit (or) Certificate of Coverage N I C I S 0 I I I I N I C I G 10 15 10 10 -[TM II. Permit status prior to requested change. a. Permit issued to (company name): Flexible Foam Products, Inc. b. Person legally responsible for permit: John Stepleton First M1 Last 9C J V � APR 2 5 1014 l7ENR. WW9 QUALITY WETLANDS STORIvWATER BRANCH c. Facility name (discharge): d. Facility address: Chief Financial Officer Title 220 S. Elizabeth St. Permit Holder Mailing Address Spencerville Ohio 45887 City State Zip ( 419 ) 647-4191 { 419 ) 647-4262 Phone Fax Flexible Foam Products, Inc. - High Point 2222 Sorrett Drive Address High Point North Carolina 27263 City State Zip c. Facility contact person: Burt Brown ( 336 ) 431-1171 First / MI / Last Phone III. Please provide the following for the requested change (revised permit). a. Request for change is a result of: ❑� Change in ownership of the facility 0 Name change of the facility or owner If other please explain: b. Permit issued to (company name): Advanced Comfort Products. Inc c. Person legally responsible for permit: Peter i Adamskl First N1I Last Interim CFO, VP, Secretary and Treasurer Title P.O. Box tt 14 3 Pennit Holder Mailing Address Spencervllle Ohio 45887 City State Zip 685 ) 314-8899 peter.adamski0advisoryfinandalgroup.cam Phone E-mail Address d. Facility name (discharge): Advanced Consort Products, Inc. e. Facility address: M2SurrenDwe Address High Point NC 27263 City State Zip f. Facility contact person: Bun Brown First Ml Last ( 336 )431-1171 bbrown®Ilexibleloam.com Phone E-mail Address IV, Permit contact information (if different from the person legally responsible for the permit) Revised Jan. 27, 2014 NPDES PERMIT NAME/OWNERSHIP CHANGE FORM Page 2 of 2 Permit contact: Burl Brown First MI Last Corporate Environmental Manager ' R Title P.O. Box op 1143 Mailing Address Spencerville Ohio 458B7 City State Zip ( 336 )431-1171 bbrown@liaxiblefoam.com Phone E-mail Address V. Will the permitted facility continue to conduct the same industrial activities conducted prior to this ownership or name change? 0 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. PERMIT,EEIUPIFICATION (Permit holder prior to ownership change): 3kr,_) I, at Le hat 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 APPIACANT CERTIFICATION Date 1,P9ie -(Ade ,kattest 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 ate PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO: Division of Energy, Mineral and hand Resources Stormwater Pennitting Program 1612 Mail Service Center Raleigh, North Carolina 27699-1612 Revised Jan. 27. 2014 NC®ENR North Carolina Department of Environment and Natural Resources Pat McCrory John E. Skvarla, III Governor Secretary 4 RECEIVED a May 7, 2014 - ` N.C. Dept of ENR MAY 1 Mr. Peter J Adamski i 4 2014 f: Advanced Comfort Products, Inc. WINSTQN-SAt EM VE' NO �lAL OFFICE ., P.O. Box 143 Spencerville, OH 45887 Subject: NPDES General Permit NCG050000 Advanced Comfort Products, Inc. I'ornierly Flexible Foam Products, Inc. Certificate of CoveragefNCG050370 Randolph County Dear Mr. Adamski: Division personnel received your request to revise your stormwater permit Certificate of Coverage to accurately reflect your new company and/or facility name. Please find enclosed the revised Certificate of Coverage. The terms and conditions contained in the General Permit remain unchanged and in full effect. This revised Certificate of Coverage is issued under the requirements of North Carolina General Statutes 143-215.1 and the Memorandum of Agreement between North Carolina and the U.S. Environmental Protection Agency. If you have any questions or need further information, please contact the Stormwater Permitting Program at (919) 807-6300. Sincerely, ORIGINAL SIGNED F3) KEN PICKLE for Tracy E. Davis, P.E., CPM, Director Division of Energy, Mineral and Land Resources Division of Energy, Mineral, and Land Resources Energy Section • Geological Survey Section - Land Quality Section 1612 Mail Service Center, Raleigh, North Carolina 27699-1612.919-707-9200 / FAX: 919-715-8801 512 North Salisbury Street, Raleigh, North Carolina 27604 • Internet: httpalportaI.ncdenr,orglweblfrl An Equal opportunity I Affirmative Action Employer— 50% Recycled 110% Post Consumer Paper cc: Winston-Salem. Regional Office, A Gantt Stormwater Permitting Program Files Central Files i STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES GENERAL PERMIT NO. NCG050000 CERTIFICATE OF COVERAGE No. NCGO50370 STORM WATER 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, Advanced Comfort Products, Inc. is hereby authorized to discharge stormwater from a facility located at Advanced Comfort Products, Inc. 2222 Surrett Drive High Point Randolph County to receiving waters designated as unnamed tributary to Uwharrie River, a class WS-III water in the Yadkin River Basin, in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, 11, III, and IV of General Permit No. NCG050000 as attached. This certificate of coverage shall become effective May 7, 2014. This Certificate of Coverage shall remain in effect for the duration of the General Permit. Signed this day May 7, 2014, ORIGINAL SIGNED Bl KEN PICKLE for Tracy E. Davis, P.E., Director Division of Energy, Mineral, and Land Resources By the Authority of the Environmental Management Commission r NC Division of Water Quality `/ 1 fy NPDES Stormwater Permit Contacts Summary \C DWO has the following contact Information in our Permit Database for your oernnit as of 5128/2013. Permit Number; NCGO50370 Permit Type: Apparel/Printing/PaoerlLggther/Rubber5tormwat9EQischargeCOC Facility Name: Flexible Foam Products. LnC-HIO Point Facility Addressl: 2222 5ururrett Dr V Facility Address2: City, State & Zip: High Point, NC 27263 Owner Name: l V r Ow lie Type: Non•Goyemmgnt Owner Type Group: Qrflanization Owner AfPillation: Addressi: Address2: City, State & Zip: Work Phone: Email Address: ***'LegAy ResponsibleforPermit (Responsiblecorpprateofiicer/pxi►rioL executive officer orranking elected official/genera! partirr•or. proprietor, or.anyother. person witfi'delegatedsignatory autha9ty.fr+}n►tt ]poly responiMeperson.} HiQhjI0KL ws Title: Gen_eral_Manauer Fax: 336-861.4433 Owner Contact Persons) Qntact_Name jjIk Address Phone Fax r Email f Bob Gragg gen mgr 222 Surrett Dr, High Point, NC 27263 336-431-1171 336-861-4433 bgragg@r flebbiefoam . Com Facil y Contact,Petsbn(s) Contact Nam- Title Address Phone Fax Email Burt Brovrn envir mgr regional 2222 Surrett Dr, High Point, NC 27263 336-431-1171 336-861-4433 bbrovrn@fle)dblefoam .corn Perrnit,ContaicuPersbn(s), Contact Name Mile Addrfss Pie EAX Mau ✓ Burt Brov►n envir mgr regional 2222 Surrett Dr, High Point, NC 27263 336-431-1171 336-861-4433 bbrovin@flexible€oam. COW 5/28f2013 Page 159 Montalvo, Sheri A From: Georgoulias, Bethany Sent: Friday, June 07, 2013 9:21 AM To: bbrown@flexiblefoam.com Cc: Bennett, Bradley; Munger, Bridget; Montalvo, Sheri A Subject: NPDBS Stormwater Permit NCG050000 Renewal Instructions Attachments: NCG050370_permitcontact_summary.pdf Mr. Brown: We recently received your request to renew your COC electronically. Below are instructions to do that. Also, please review the attached summary of contact information and provide us updates on the three last sections: Owner Contact, Facility Contact, and Permit Contact. Please update all three if possible and include current e-mail addresses. You can make corrections right on the sheet and scan/e-mail it back to sheri.montalvo ncdenr. ov, or fax it to (919) 807-6494, Attn: Sheri Montalvo. You may also just e-mail her the information for the contacts. Dear Permit Contact: N.C. DWQ has reissued.NPDES Stormwater General Permit NCG050000, which becomes effective June 1, 2013. Your Certificate of Coverage (COC) is ready for renewal and download from our website. Please follow the instructions below and be sure to print your new COC for your records when you complete the renewal step. 1. Go to the following URL link: http://portal.ncdenr.org/web/wg/ws/su/permit- renewal 2. Enter your COC Permit Number and unique PIN: Permit Number: NCG050370 Unique PIN number: 54133 3. Scroll Down and update the name and e-mail address information if necessary for a renewal confirmation. NOTE: These fields will be pre -filled with information we have on file about the Owner. **However, if the confirmation should be e-mailed to you instead of the email in the box, please revise it accordingly.** You are unable to change the information in several fields. Please contact us if something else is incorrect. 4. Click "SUBMIT." A confirmation screen should follow. 5. On this screen, you can click the button "DISPLAY CONFIRMATION DETAILS." Clicking this button will automatically generate an e-mail to the address you 1 provided on the previous screen. It will also send you to a screen that will display details of your renewal. 6. IMPORTANT: PRINT YOUR COC. On this screen, you must print a copy of the Certificate of Coverage for your facility by clicking on "Print COC" After renewing your permit on-line, the facility will automatically be covered under the new general permit, effective on June 1, 2013. Please visit the Stormwater Permitting Unit's website at http://portal.ncdenr.orgZweb/wq/wsZsu/2013- ps to download a copy of the General Permit, monitoring forms, and technical bulletin. Thank you for taking advantage of the opportunity to renew your permit on-line. We appreciate the chance to better serve you and hope you find the process beneficial. If you have any questions, please contact: Bethany Georgoulias email: bethany.georgoulias(@ncdenr.gov phone: (919) 807-6372 or Bradley Bennett Email: bradly.bennett(@ncdenr.gov Phone: (919) 807-6378 or Bridget Munger email: _bridRet.mungerpncdenr.Rov Phone: (919) 807-6363 Bethany Georgoulias Environmental Engineer NCDENR I DWQ I Stormwater Permitting Unit 1617 Mail Service Center, Raleigh, NC 27699-1617 512 N. Salisbury St, Raleigh, NC 27604 Phone: (919) 807-6372 Fax: (919) 807-6494 Website: http://portal.ncdenr.orgZweb/wq/ws/su E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties. -----Original Message ----- From: stormwater(@ncdenr.gov [mailto:stormwaterpncdenr.gov] Sent: Friday, May 31, 2013 3:34 PM T T To: SVC_DENR.stormwater Subject NPDES SW General Permit Renewal and E-mail Update 2 NPDES Stormwater General Permit : NCG050000 General Permit COC No. (Ex.: NCG050001. Last 3 digits should NOT be '000') : NCG050370 Facility Name Flexible Foam Products, Inc - High Point Your Name : Burt Brown E-mail Address bbrown@_flexiblefoam.c_om Contact Phone Number : 3364311171 Yes, I am interested in renewing my permit. : on I prefer to renew my permit the following way (REQUIRED): : electronically I do NOT want to renew this permit. Tell me how to rescind this permit. : null I am interested in signing up for updates about my permit renewal. : null I would like a confirmation e-mail from DWQ. : on 3 MCDER North Carolina Department of Environment and Natural Resources Division of Water Quality Beverly Eaves Perdue Charles Wakild, P.E. ' Dee Freeman Governor Director Secretary January 27, 2012 Jack Holland Flexible Foam Products, Inc. 2222 Surrett Drive High Point, NC 27263-8508 Subject: General Stormwater Permit Inspection — NPDES Permit No. NCG050370 _Flexible Foam Products,_lnc. -- Randolph County Dear Mr. Holland: On January 20, 2012, Jenny Graznak of this office performed a Stormwater Permit Inspection at Flexible Foam Products, Inc. located at 2222 Surrett Drive in High Point, North Carolina. This facility holds General Stormwater Permit No. NCGO50370 under the National Pollutant Discharge Elimination System (NPDES) to discharge Stormwater. You were present for the inspection. This type of inspection consists of two basic parts: an in -office review of. facility files and self -monitoring data and an on -site inspection of the facility's discharge: This particular inspection evaluated five (5) areas, and observations from each area are addressed below: 1. Permit The permit became effective June 1, 2008 and expires May 31, 2013. A copy of the permit was available for review during the inspection. 2. Records/Reports As required by the permit, the facility has a Stormwater Pollution Prevention Plan (SPPP) that was available for review during the inspection. The SPPP was created by Blue Ridge Geological Services, Inc. in November 2008. It is updated on an annual basis and included all of the components required by the permit. Employee Training is conducted by the corporate office and was last held on January 10, 2012. 3._Faciiity Site Review The facility has four stormwater discharge outfalls (SDO). SDO #1 is a storm drain that collects stormwater from the employee parking lot and chemical truck unloading area. SDO #2 is a storm drain that collects stormwater from the rail car unloading area and the truck unloading area. SDO #3 is a concrete lined ditch that collects stormwater from the gravel driveway that runs behind the building. SDO #4 is a ditch that collects stormwater from the gravel/dirt trailer parking lot. The site has some chemical storage outside. Two rail cars sit outside the building; one containing toluene diisocyanate (TDI) and the other containing polyol. The outfall adjacent to the rail cars has a valve that can be manually switched on or off if a spill should occur during loading or unloading. There is also a tank of liquid carbon dioxide located outside. The site has North Carolina Division of Water Quality, Winston-Salem Regional Office Location: 585 Waughtowr St. Winston-Salem, North Carolina 27107 One Phone: 336-771-5000 i FAX: 336.771-46301 Customer Service: 1.877.62M748 NorthCarolina Intemet: www.ncwaterquality.org ' VatuHl /"/f An Equal Opportunity 1 Affirmative Action Employer �/ L two abandoned above ground storage tanks that are now empty (once contained fuel oil). The site has a large water tank for fire suppression, a trash compactor, and a covered dumpster for scrap metal. 4. Effluent/Receiving Waters Stormwater from the property discharges to an unnamed tributary to the Uwharrie River (Class WS-111) in the Yadkin -Pee Dee River Basin. Some stormwater was visible at each outfall on the day of the inspection due to recent rain events. No problems were visibly apparent with the quality of the stormwater. 5. Self -Monitoring Program The stormwater permit requires semi-annual qualitative monitoring at both stormwater outfails. An on -site review of the monitoring data during the inspection showed that all parameters are evaluated per the specifications of the permit. The last monitoring event was performed on September 22, 2011. This facility is exempt from the annual analytical monitoring requirements since no vehicle maintenance activities occur on -site. If you have any questions concerning this letter or the attached inspection report, please contact Ms. Graznak or me at (336) 771-5000. Sincerely, W. Corey Basinger Regional Supervisor Surface Water Protection Section cc: SWP —Central Files SWP — WSRO ' I Permit: NCG050370 SOC: I County: Randolph Region: Winston-Salem Compliance Inspection Report Effective: 06/01/08 Expiration: 05/31/13 Owner: Flexible Foam Products Inc Effective: Expiration: Facility: Flexible Foam Products, Inc. -High Point 2222 Surrett Dr Contact Person: Jack Holland Directions to Facility: System Classifications: Primary ORC: Secondary ORC(s): On -Site Representative(s): On -site representative Related Permits: Jack Holland Title: Inspection Date: 0112012012 Entry Time: 10:00 AM Primary Inspector: Jennifer F Graznak Secondary Inspector(s): High Point NC 27263 Phone: 336-431-1171 Certification: Exit Time: 11:30 AM Phone: Phone: 336-431-1171 Phone: 336-771-5000 Reason for Inspection: Routine Inspection Type: Compliance Evaluation Permit Inspection Type: Apparel/Printing/Paper/Leather/Rubber Stormwater Discharge COC Facility Status: ■ Compliant ❑ Not Compliant Question Areas: Storm Water (See attachment summary) Page: 1 Permit: NCGO50370 Owner - Facility: Flexible Foam Products Inc Inspection Date: 01/20/2012 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? ■ ❑ ❑ ❑ # Does the Plan include a General Location (USGS) map? ■ ❑ ❑ ❑ # Does the Plan include a "Narrative Description of Practices"? ■ ❑ ❑ ❑ # Does the Plan include a detailed site map including outfall locations and drainage areas? ■ n ❑ ❑ # Does the Plan include a list of significant spills occurring during the past 3 years? ■ ❑ ❑ ❑ # Has the facility evaluated feasible alternatives to current practices? ■ ❑ Cl ❑ # Does the facility provide all necessary secondary containment? ■ n n n # 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? ■ n n n Has the Stormwater Pollution Prevention Plan been implemented? ■ ❑ ❑ ❑ Comment: Qualitative Monitoring Yes No NA NE Has the facility conducted its Qualitative Monitoring semi-annually? ■ Cl ❑ ❑ Comment: Permit and Qutfalls Yes No NA NE # Is a copy of the Permit and the Certificate of Coverage available at the site? ■ ❑ ❑ ❑ # Were all outfalls observed dur'ing 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? 0130 0 Comment: Page: 3 F Mr. Dale Walters Flexible loam Products, Inc. 2222 Surrett Drive High Point, NC 27263 Dear Mr. Walters: Michael F. Easley, Governor William G. Ross Jr., Secretary North Carolina Department of Environment and Natural Resources Coleen H. Sullins, Director Division of Water Quality <R1WeEIY1r0 May 16, 2008 x.c. Ge°t. Of SSR 22'20� W}naton•Salom �eg4ona4 f_ Subject: General Permit No. NCG050000 Flexible Foam Products COC NCG050370 Randolph County In accordance with your application for a discharge permit received on March 18, 2008, 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 October 15, 2007 (or as subsequently amended). At your request, the current No Exposure Certification NCGNE0012 for this facility has been rescinded and replaced by this COC NCG050370. Please take notice that this certificate of coverage is not transferable except after notice to the Division of Water Quality. 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 the Division of Water Quality 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 questions concerning this permit, please contact Robert Patterson at telephone number (919) 733-5083 ext. 360. Sincerely, ORIGINAL SIGNED BY BRADLEY BENNETT for Coleen H. Sullins cc: Winston Salem Regional Office, Mike Mickey Central Files Stormwater Permitting Unit Files one NorthCarolina 'A'aturnllil North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Phone (919) 733-5083 Customer Service Internet: www.newaternuality.ore Location: 512 N. Salisbury St. Raleigh, NC 27604 Fax (919) 733-9612 I-877-623-6748 An Equal OpportunitylAffirmaUve Action Employer —50% Recycled110% Post Consumer Paper STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF WATER QUALITY GENERAL PERMIT NO. NCG050000 CERTIFICATE OF COVERAGE No. NCG050370 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, Flexible Foam Products, Inc. is hereby authorized to discharge stormwater from a facility located at. Flexible Foam Products 2222 Surrett Drive High Point Randolph County to receiving waters designated as a UT of the Uwharrie River, a class WS-III water in the Yadkin Pee -Dee River Basin, in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I,1I, I1I, IV, V, and VI of General Permit No. NCG050000 as attached. This certificate of coverage shall become effective ,tune 1, 2008. This Certificate of Coverage shall remain in effect for the duration of the General Permit. Signed this 16"' day of May, 2008. ORIGINAL SIGNED BY BRADLEY BENNETT for Coleen H. Sullins., Director Division of Water Quality By the Authority of the Environmental Management Commission Michael F, Easley, Governor William G. Ross Jr., Secretary North Carolina Department of Environment and Natural Resources Coleen H. Sullins, Director Division of Water Quality May 16, 2008 Mr. Dale Walters Flexible Foam Products, Inc. 2222 Surrett Drive High Point, NC 27263 Subject: General Permit No. NCG050000 Flexible Foam Products COC NCG050370 Randolph County Dear Mr. Walters: In accordance with your application for a discharge permit received on March 18, 2008, 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 October 15, 2007 (or as subsequently amended). At your request, the current No Exposure Certification NCGNE0012 for this facility has been rescinded and replaced by this COC NCG050370. Please take notice that this certificate of coverage is not transferable except after notice to the Division of Water Quality. 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 the Division of Water Quality 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 questions concerning this permit, please contact Robert Patterson at telephone number (919) 733-5083 ext. 360. Sire"AL SIGNED BY BRADLEY BENNETT for Coleen H. Sullins cc: Winston Salem Regional Office, Mike Mickey Central Files Stormwater Permitting Unit Files No `thCarolina )V!!t!lU711!f North Carolina Division of Water Quality 1617 Mail service Center Raleigh, NC 27699-1617 Phone (919) 733.5083 Customer service Internet: Nvw%v.ncwaterctuality.orx Location: 512 N. Salisbury St. Raleigh, NC 27604 Fax (919) 733-9612 1-877-623-6748 An Equal OpportunitylAffirmaUve Action Employer — 50% Recycled/10% Post Consumer Paper STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF WATER QUALITY GENERAL PERMIT NO. NCG050000 CERTIFICATE OF COVERAGE No. NCGO50370 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, Flexible Foam Products, Inc. is hereby authorized to discharge stormwater from a facility located at FIexible Foam Products 2222 Surrett Drive High Point Randolph County to receiving waters designated as a UT of the Uwharrie River, a class WS-III water in the Yadkin Pee -Dee 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. NCG050000 as attached. This certificate of coverage shall become effective June 1, 2008. This Certificate of Coverage shall remain in effect for the duration of the General Permit. Signed this 16"' day of May, 2008. ORIGINAL SIGNED 8Y SRADLEY SENNETT for Coleen H. Sullins., Director Division of Water Quality By the Authority of the Environmental Management Commission NCG050370 - Flexible Foam Products, Randolph County Subject: NCGO50370 - Flexible Foam Products, Randolph County From: Robert Patterson <Robert.Patterson@ncmail.net> Date: Mon.. 24 Mar 2008 08:48:22 -0400 To: Mike Mickey <Mike.Mickey a ncmail.net> Mike, We have received an application for coverage of an existing facility under NCG 05 from Flexible Foam Products. The facility drains to a UT of the Uwharrie River (class WS-TIT) in High Point (Randolph County). They manufacture urethane foam. They are currently covered under NCGNE0012, but the new owners would like to be covered under NCG 05. Does the Winston-Salem Regional Office have any concerns about issuing this facility a COC for this general permit? Thanks! Robert D. .Patterson, PE Environmental Engineer NCDENR I DWQ 15tormwater Permitting Unit 1617 Mail Service Center, Raleigh, NC 27699-1617 512 N. Salisbury St, Raleigh, NC 27604 Phone: (919) 733-5063 ext. 360 Fax: (919) 733-9612 Email: robert.pattersrr,@ncmail.net Website: httP://h2o.enr.state.nc.us/su/sLormwarer.h ml i or] 3/24/2008 9:04 AM Re: NCG050370 - Flexible Foam Products, Randolph County Subject: Re: NCG050370 - Flexible Foam Products, Randolph County From: Mike Mickey <Mike.Mickey a ncmail.net> Date: Mon, 24 Mar 2008 09:04:32 -0400 To: Robert Patterson <Robert.Patterson@ncmai1.net> No concerns. Go ahead and issue the COC. Thanks, Mike. On 3/24/2008 8:48 AM, Robert Patterson wrote: Mike, We have received an application for coverage of an existing facility under NCG.05 from Flexible Foam Products. The facility drains to a UT of the Uwharrie River (class WS-III) in High Point (Randolph County). They manufacture urethane foam. They are currently covered under NCGNE0012, but the new owners would like to be covered under NCG 05. Does the Winston-Salem Regional Office have any concerns about issuing this facility a COC for this general permit? Thanks! Mike Mickey NC DENR Winston-Salem Regional Office Division of Water Quality, Water Quality Section 585 Waughtown Street Winston-Salem, NC 27107 Main Office: (336) 771-5000 Voice: (336) 771-4962 FAX: (336) 771-4630 1 of 1 3/24/2008 9:07 AM