NCG050429_COMPLETE FILE - HISTORICAL_20160201

STORMWATER DIVISION CODING -SHEET
NCG PERMITS
PERMIT NO.
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DOC TYPE
9L HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ aoRe @a Of
YYYYMMDD

North Carolina Department -of Environmental Quality
Pat McCrory Donald R. van der Vaart
Governor Secretary
February 1, 2016
Mr. John Dortch, General Manager
Westrock Converting Company
5900-A Grassy Creek Boulevard
Winston-Salem, North Carolina 2710S
Subject: General Permit No. NCG050000
Westrock Converting Company
COC No. NCG050429
Forsyth County
Dear Mr. Dortch:
In accordance with your revised application for a discharge permit received on September 17,
2015, we are forwarding herewith the subject certificate of coverage (COC) 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).
If any parts, measurement frequencies, or sampling requirements contained in this permit are
unacceptable to you, you have the right to request an individual permit by submitting an individual
permit application. Unless such demand is made, this certificate of coverage shall be final and binding.
Please take notice that this certificate of coverage is not transferable except after notice to the
Division of Energy, Mineral and Land Resources (Division). The Division may require modification or
revocation and reissuance of the Certificate of Coverage. This permit does not affect the legal
requirements to obtain other permits which may be required by the Division or permits required by
the Division of Water Resources, Coastal Area Management Act or any other federal, state or local
governmental permit that may be required.
If you have any questions concerning this permit, please contact Bill Diuguid, Stormwater
Program Planner at telephone number [phone].
Sincerel
OR61NAL SiGNEO B1
KEN PICKLE
for Tracy E. Davis, P.E., CPM, Director
Division of Energy, Mineral and
Land Resources
cc: Winston-Salem Regional Office
Central Files
Stormwater Permitting Unit Files
Attachments
1601 Mail Service Censer, Raleigh, North Carolina 27699-1601
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Acbon Employer - Made in part by recycled paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
GENERAL PERMIT NO. NCGO50000
CERTIFICATE OF COVERAGE No. NCG050429
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,
Westrock Converting Company
is hereby authorized to discharge stormwater from a facility located at
Westrock Converting Company
5900-A Grassy Creek Blvd
Winston-Salem Forsyth County
to receiving waters designated as an unnamed tributary to Grassy Creek, a Class C waterbody, Yadkin River Basin;
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts 1, I1, III,
IV, V and VI of General Permit No. NCG050000, as attached.
This Certificate of Coverage shall become effective February 1, 2016.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day February 1, 2016.
ORIGINAL SIGNED Bi
KEN PICKLF
for Tracy E. Davis, P.E., CPM, Director
Division of Energy, Mineral and Land Resources
By Authority of the Environmental Management Commission

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NCDENRNational Pollutant Discharge Elimination System
NO 7C.AROLIMA OE TMEN OF
ENVIRONMENT AND AffURA RtS Rc Es
NCG050000
NOTICE OF INTENT
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National Pollutant Discharge Elimination System application for coverage under Gen
NCGO50000:
STORMWATER DISCHARGES associated with activities classified as:
SIC•
23
Apparel and Other Finished Products Made from Fabrics and Similar Materials
V14*
25S
Paperboard Con*ainem and Boxes
SIC
267
Converted Paper and Paperboard Products
SIC•
27
Printing, Publishing and Allied Industries
SICA
30
Rubber and Miscellaneous Products (except as specified below)
SIC•
31
Leather and Leather Products (except as specified below)
SIC•
39
Miscellaneous Manufacturing Industries
SIC*
NIA
Like activities deemed by DWQ to be similar in the process and/or the exposure of raw
materials, products, by-products, or waste materials
The following activities are specifically excluded from coverage under this General Permit:
SIC 301 Tires and Inner Tubes
SIC 311 Leather Tanning and Finishing
* Standard Industrial Classification Code
(Please print or type)
1) Mailing address of owner/operator (address to which all permit correspondence will be mailed):
Name WESTROCK CONVERTING COMPANY
Street Address 5900-A-GRASSY CREEK BLVD.
City
Telephone No.
E-mail Address
WINSTON-SALEM
336-661-7295 _
tim.williams@westrock,com
2) Location of facility producing discharge:
Facility Name
Facility Contact
Contact E-mail
Street Address
City
County
Telephone No.
WESTROCK CONVERTING COMPANY
TIM WILLIAMS
[e-mail]
5900-A-GRASSSY CREEK BLVD,
WINSTON-SALEM StateNC
FORSYTH
336-661-7295
3) Physical Location Information:
StateNC ZIP Code 27105
Fax;
ZIP Code 27105
Fax:
Page 1 of 4
SWU-220-071408 Last Revised 7l1412008

NCG050000 N.4-1.
Please provide a narrative description of how to get to the facility (use street names, state road numbers, and
distance and direction from a roadway intersection). US 52 NORTH TO EXIT #116 HANES MILL RD. GO
WEST TO BETHANAIA STATION RD, TURN RIGHT ON GRASSY CREEK BLVD.
(A copy of a county map or USGS quad sheet with facility clearly located on the map is required with this application)
4) Latitude 36 10 9 Longitude 80,17.4 (degrees, minutes, seconds)
5) This NPDES Permit Application applies to which of the following :
❑ New or Proposed Facility Date operation is to begin
X Existing
6) Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: _2653 , 7319_
7) Provide a brief narrative description of the types of industrial activities and products manufactured at
this facility: PRODUCTION OF PAPER BASED POINT OF PURCHASE CORRUGATED DISPLAYS
INVOLVING FORMING, CUTTING, GLUING, AND PRINTING
8) Discharge points:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? 8
9) Receiving waters:
What is the name of the body or bodies of water (creek, streamrriver, lake, etc.) that the facility stormwater
discharges end up in? GRASSY CREEK V A-DKt,y r-% Vt&% . S")S6 , 03-07_ D4-
C L—N S 5 G; 5t#L-c_-,►4 Y.t dcu. r Z— 9 H-- 7 - 3
If the site stormwater discharges to a separate storm sewer system, name the operator of the separate storm
sewer system (e.g. City of Raleigh municipal storm sewer). NA
10) Does this facility have any other NPDES permits?
X No
❑ Yes
If yes, list the permit numbers for all current NPDES permits for this facility:
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
X No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
12) Does this facility employ any best management practices for stormwater control?
No
X Yes
If yes, please briefly describe: WEEKLY HOUSEKEEPING AS NEEDED ALONG WITH PERIODIC INSPECTIONS
13) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No
X Yes
Page 2 of 4
SWO-220-071408 Last Revised 7/14/2008

NCGO50000 N.O.I.
If yes, when was it implemented?2010
14) Are vehicle maintenance activities occurring at this facility?
❑ No X Yes
15) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
X No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
❑ No X Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
X No ❑ Yes
d) If you answered yes to questions b, or c., please provide the following information:
Type(s) of waste:waste from vendors due to TCLP of material
How is material stored: corrugated boxes
Where is material stored: inside building
How many disposal shipments per year:12
Name of transport 1 disposal vendor:Stericycle
Vendor address:2670 Executive Dr. Indianapolis, IN 46241_
16) Certification:
North Carolina General Statute 143-215.6 b (i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan, or other
document filed or required to be maintained under this Article or a rule implementing this Article; or who knowingly makes a false
statement of a material fact in a rulemaking proceeding or contested case under this Article; or who falsifies, tampers with, or knowingly
renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
[Environmental Management] Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine not to
exceed ten thousand dollars ($10,000).
I hereby request coverage under the referenced General Permit. I understand that coverage under this permit
will constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an
individual permit.
certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing: _John Dortch
Title: General Manager
(Sign ure o f A podicant) (Date Signed)
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to NCDENR.
Page 3 of 4
SWU-220-071408 last Revised 7/14/2008

WestRock
Send Via Certified Return Receipt Mail
September 4, 2015
Stormwater and General Permits Unit
Division of Water Duality
1617 Mail Service Center
Raleigh, NC 27699-1617
Re: Notice of Intent
5900 A -Grassy Creek 336.661,7295
Winston-Salem, NC 27105
[e-mail]
I am submitting an NO1 for inclusion in the general industrial storm water permit. I requested a check
for $100 to accompany the N01. However, our accounting department sent the check, minus the actual
NOI. I have included a copy of the cashed check with this NOI,
Please contact me at the above address or phone number, if you have any questions.
Sincerely,
Tim Williams
Safety Manager

DATE=0812012015 SEQUENCE=74007443
Account=8800633276 Serial Number=14347631 Amount=$100.00
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WestRock
Send Via Certified Return Receipt Mail
September 4, 2015
Stormwater and General Permits Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27699-1617
Re: Notice of Intent
5900 A -Grassy Creek 336.661,7295
Winston-Salem, NC 27105
[e-mail]
I am submitting an NOI for inclusion in the general industrial storm water permit. I requested a check
for $100 to accompany the NOI. However, our accounting department sent the check, minus the actual
NO1. I have included a copy of the cashed check with this NOI.
Please contact me at the above address or phone number, if you have any questions.
Sincerely,
Tim Williams
Safety Manager