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
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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