NCG060373_COMPLETE FILE - HISTORICAL_20160727

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V co r
DOC TYPE
[X HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ 8 D 1 (-e C)
YYYYMMDD

016
PAT MCCRORY
t
Govemor
DONALD R. VAN DER VAART
Secretary
Energy, Mineral
and Land Resources
July 27,20I6 TRACY DAVIS
ENVIRONMENTAL QUALITY
Oimctor
NC Department of
Environmental Quality
Shannon Maul
Received
House of Raeford
AUG 16 2016
251 Eaton Drive
Mocksville, NC 27028
Winston-Salem
regional Office
Subject: General Permit No. NCG060000
House of Raeford — Chicken Filet
COC NCG060373
Davie County
Dear Shannon Maul:
In accordance with your application for a discharge permit received on March 30, 2016, 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).
Please take notice that this certificate of coverage is not transferable except after notice to the Division of
Energy, Mineral, and Land Resources. 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 of Energy, Mining, and Land Resources, or permits required by the Division of Water
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 Richard Riddle at telephone number
[phone].
SindINAL SIGNED S'y
MICHEAL F RANDALL
for Tracy E. Davis, P.E., CPM, Director
Division of Energy, Mineral and
Land Resources
cc: Winston-Salem Regional Office
Central Files
Stormwater Permitting Program File
State of North Carolina I Environmental Quality I Energy, Mineral and Land Resources
1612 Mail Service Center 1 512 North Salisbury Street I Raleigh, NC 27699-1612
919 707 9200 T

.t
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
GENERAL PERMIT NO. NCG060000
CERTIFICATE OF COVERAGE No. NCG060373
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,
House of Raeford, Inc.
is hereby authorized to discharge stormwater from a facility located at
House of Raeford — Filet of Chicken
251 Eaton Drive
Mocksville
Davie County
to receiving waters designated as Leonard Creek, a class C water in the Yadkin Pee -Dee 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. NCG060000 as attached.
This certificate of coverage shall become effective July 27, 2016.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day July 27, 2016. ORIGINAL SIGNED BY
MICHEAL F RANDALL.
for Tracy E. Davis, P.E., Director
Division of Energy, Mineral, and Land Resources
By the Authority of the Environmental Management Commission

June 13, 2016
House of Raeford Farms, Inc.
Mocksville Division
251 Eaton Road
Mocksville, NC 27028
Dear Sir/Madam,
We are returning this check because you did not return the
invoice; therefore, we do not know which account to credit.
Please return check with the Invoice or Permit number to ensure
this check is credited to the correct Stormwater permit account.
Thank you,
kizou-,
Deborah Reese
Stormwater Billing
NCDEQ -- Division of Energy, Mineral and Land Resources
1612 MSC/Raleigh, N-C 27699-1612
Office 919-707-9220

PAT MCCRORY
t 1ve"rtir
DONALD R. VAN DER VAART
Energy, Mineral
and Land Resources
ENVIRONMENTAL. QUAUTY
March 31, 2016
Lisa Darden
House of Raeford Farms, Inc.
251 Eaton Road
Mocksville, NC 27028
Subject: Mocksville Division
Return of Check
Seercraq
TRACY DAVIS
you-s��s
Ms. Darden:
An March 30, 2016 our office received a NPDES Stormwater permit application for the House of Raeford
Mocksville Division. The application package included a check in the amount of $200,00. This is not the correct
application fee for this general permit coverage. The NPDES Stormwater Permit fee is $100.00. It appears that
maybe your process may have run to fee twice be accident. We are returning your previous check and ask that
you provide our Department with an application fee in the amount of $100.00 to complete the permit application
package.
If you have any further questions please feel free to contact me at [e-mail] or by
phone at [phone].
cc: Shannon Maul — House of Raeford
RAC fU� ��ED
o� 17 2016
BradleySr�RMwATFR QC1gU
Bennett P Ty
Stormwater Permitting Program ERMI]]ING
Sincerely
Staff of NOM Caroba I Emv7rnnlnental Quality I Energy, Mineral and Laud Resources
1612 Mail Service Center 1512 N. Salisbury Si, I Raleigh, NC 27699
919 707 9200 T
f 7:

1I
0
TWO HUNDRED AND XX
NCDENR/ Stormwater Permit Unit
Division of Water Quality
1612 Mail Service Ctr
Raleigh, NORTH CAROLINA 27699-1617
Totals for Check Number --
03-21-16- 3/21/2016 NCDENR
NCG060000 3/22/2016 STORM WATER
Totals for Check Number -- 22001912
NCDENR/ Stormwater Permit Unit 15435
3/22/2016 22004912
100.00 0.00 100.00
100.00 0.00 100.00
200.00 0.00 200.00
3/22/2016

vcn,d�- � 4 Z

NIP WIA
N EN' R
NORTH CAROUNA DCPART-7 OF
ENVIRONM�N AND N—jRAE RESoURCES
NOTICE OF INTENT
Division of Energy, Mineral and Land Resources
Land Quality Section
National Pollutant Discharge Islimination System
NCG060000
FOR AGENCY USE ONLY
Date Received
Ycar
Montle
Da
Ccrti{icatc ofCOVCIa+e
N C G 0 G
Check d 1 1 Rl'lou
Permit Assi�ncd to
1
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG060000:
STORMWATER DISCHARGES associated with activities classified as:
SIC (Standard Industrial Classification) 20 Food and Kindred Products
SIC 21 Tobacco Products
SIC 283 Drugs
SIC 284 Soaps, Detergents, & Cleaning Preparations; Perfumes, Cosmetics, & Other Toilet Preparations
SIC 422 Public Warehousing and Storage (except 4226)
For questions, please contact the DEMLR Regional Office for your area. See page 4.
Do Not use this NOI for renewals.
(Please print or type)
1) Mailing address of owner/operator (address to which all permit correspondence will be mailed):
Name
Street Address
City
Telephone No.
Shannon Maul
251 Eaton Drive W
Mocksville
336 469-8926
2) Location of facility producing discharge:
Facility Name
Facility Contact
Facility Address
Facility City
Facility County
Telephone No.
House of Raeford
Shannon Maui
251 Eaton Drive _
Mocksville
Davie
336-751-4752
Email—[e-mail]
3) Physical Location Information:
State NC ZIP Code 27028
Fax:
State NC ZIP Code 27028
Fax:
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). Turn off of 601, just down Eaton road on the left
(A copy of a county map orU CW�shie ith he facility clearly located must be s wit�is a plication.)
4) Latitude 35,52,49.26 Longitude 80,33,11.23 (deg, min, sec)
5) This NPDES Permit Application applies to which of the following:
❑ New or Proposed Facility Date operation is to begin
X Existing
Page 1 of 4
S W U-221
Last revised 6124114

NCG060000, N.O.I.
14) 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?
X No ❑ 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) Is hazardous waste stored in the 100-year flood plain?
X No ❑ Yes If yes, include information to demonstrate protection from flooding.
e) If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste:
How is material stored:
Where is material stored:
How many disposal shipments per year:
Name of transport 1 disposal vendor: _
Vendor address:
15) Certification:
North Carolina General Statute 143-215.6E (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 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.
I 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: `AQ�0,r, f wy)(Cn
Title:
�31k q A i.
(Signatur�pplicant) (Date Signed)
This Notice of Intent must be accompanied by a check or money order for $100.00, made payable to:
Page 3 of 4
SWU-221 Last revised 6124114

STORMWATER POLLUTION PREVENTION PLAN CERTIFICATION
For
Filet of Chicken
A Division of House of Raeford
251 Eaton Rd
Mocksville, NC 27012
" I certify under penalty of law that this document and attachments were prepared under my direction
or supervision in accordance with a system designed to assure that qualified personnel properly
gathered and evaluated the information submitted. Based on my inquiry of the person or persons who
manage the system, or those persons directly responsible for gathering the information, the information
is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment
for knowing violations"
Authorized Sienator
Printed Name: T1 u��.ex��� . xon Title: une a4-
Signature: 1 Date: 3/ 113 11L
Phone Number: 336 - 7SI — L4 7S7—
Facility Name: r,`It+ e� ��`G�C��• i�,✓is�.� �,�-h��se. co��o(r�

SWPPP Form 2
SWPPP Certification
" I certify under penalty of law that this document and attach ments were prepared under my direction
or supervision in accordance with a system designed to assure that qualified personnel properly
gathered and evaluated the information submitted. Based on my inquiry of the person or persons who
manage the system, or those persons directly responsible for gathering the information, the information
is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment
for knowing violations"
Authorized Signatory
Printed Name: .7—M,Xn Title: r' a„Q 3
Signature: _ Date: Al'7 //6
Phone Number: JA - 75f —I LO.Sz.
Facility Name: P`l � vT C-ke-kp .-t eA ll t5e- a t /25,Z44

y _ t
In
Awl�
NCDENR
nom+i ca�wntr�u...znr o�
CMnno�:rw+r u.o N�uvn.� Risouncee
NOTICE OF INTENT
Division of Energy„Mineral and Land Resources
Land Quality Section
National Pollutant Discharge Elimination System
NCG060000
FOR AGENCY USE ONLY
Date Ricdi ed
Ycar
Month
IJav
Certificate of Covera
ge
a
Check
Amount
Pcrmit Assi ed to
National Pollutant Discharge Elimination System application for coverage under General Permit
NC6060600: R�C[!:'� D
STORMWATER DISCHARGES associated with activities classified as:
MAR H 1JiS
SIC (Standard Industrial Classification) 20 Food and Kindred Products
SIC 21 Tobacco Products DENR-t,Ap,!r) -T,,�;7y,
SIC 283 Drugs. 5T'ORMWATER Pwrd,
SIC.284 Soaps, Detergents, & Cleaning Preparations; Perfumes, Cosmetics; &Other Toilet Preparations
SIC 422 Public Warehousing and Storage (except 4226)
For questions, please contact the DEMLR Regional Office for your area. See page 4.
Do Not use.this N01 for,renewals.
(Please print or type)
1) Mailing address of owner/operator (address to which all permit comes andence will be mailed):
Name
Street Address
City
Telephone No.
Shannon -Maul_
251 Eaton Drive
Mocksville, State NC
336-469-89M F,3A- .S-Q ~ Fax: _
2 Location of facili p roducin discharge: C'
) tY p 9 . rge:
Facility Name
Facility Contact
Facility Address
Facility City
FacilityCounty
Teleplone No.
House,of Raeford.:
Shannon Maui_
251 Eaton Drive
Mocksville
ZIP Code 27028-
State NC 21P Code 27028
Davie
336-75 i -4752
Email_shannon.maul@houseofraeford:com
3). Physical; 6cation Information:
Fax:
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 intdf' ection). Turn off of'601, just down Eaton road'on the left
(A copy of a couriV map, or USGS quad sheet with the facility dearty located must be submitted with this application.)
4) Latitude 35,52,49.26 Longitude 80,33,11.23 (deg, min, sec)
5) This NPDES Permit Application applies to which of the following:
❑ New or Proposed Facility Date operation is to begin
X Existing
Page 1 of 4
SWU-221 Last revised 6124114

NCG060000 N.O.I.
6) Standard Industrial Classification:
Provide the 4-digit Standard Industrial Classification code (SIC code) that describes the primary industrial
activity at thisfacility:
SIC code: 2 0 1 5
7) Activities
a) Provide a brief -narratige description of the. types of industrial activities and products manufactured
at this facility: We bring in fully dressed and USDA Inspected raw poultry and/or package, cook, freeze
to sell for consumption.
b) Check all activities occurring at this facility:
X use:or"process meats ❑ use or process.animal fats/byproducts
8) Discharge points I Receiving waters:
How many discharge points (ditches, pipes; channels, etc.) convey stormwater from the.property? 2
What.is the name of the body or bodies of water (creek, stream, river, lake, etc.) thafthe facility stormwater
discharges end up in? The plant storm water flows into.an U7 then to Leonard's Creek
Receiving water classification: C
Is this a 303(d):listed stream? .No Hasa TMDL been approved for this watershed?
No
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.).
9) Does this faciiity have any other NPDES permits?
X No
❑ Yes
If yes, list the permit numbers for all.current NPDES permits for this facility:
10) Does this facility have any. Non -'Discharge permits (ex: recycle permit)?
X No
Cl Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
11) Doewthis facility employ any,best management practices for stormwater control?
❑ No
X Yes (Show any structural BMPs on the•site diagram.)
If yes,, please briefly describe: We have a storm water retention pond #or'.the storm water that,flows.at the back
of the plant.
12) Daes'this'facility have a Stormwater Pollution Prevention Plan?
No,
X Yes
If yes, when was. it implemented? 4-1-2016
13) Are vehicle maintenance activities occurring at this facility?
X No ❑ Yes
Page 2 of 4
SVW-221 Last ►evimi 6124114

NCG060000 N.O.I.
14) 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?
X No ❑ 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) Is hazardous waste stored in the 100-year flood plain?
X No ❑ Yes If yes, include information to demonstrate protection from flooding.
e) If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste:
How is material stored:
Where is material stored:
How many disposal shipments per year:
Name of transport / disposal vendor:
Vendor-add(ess:
15) Certification:
North Carolina General Statute 143-215.8E (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;,orrwho
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 Commission implementing this Articleishall be guilty of a Class 2
misdemeanor which may include a fine not to exceed ten thousand dollars (S1 0,000)1
I hereby request'coverage under the referenced General Permit. I understand.that coverage under this permit
will constitute'the permit requirements'fortheidischarge(s).and is enforceable in the'same manner as an
individual permit.
I 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: j -1-_ K" Oer'
Title.
(Signature of Applicant) (Date Signed)
This Notice of.lntent must be -accompanied by a check or money order for $100.00, made payable to:
Page 3 of'A
SWU-221 Last revised.6/24/14

NCG060000 N.O.I.
Final Checklist
This application will,be returned as incomplete unless all of the following items have been included:
0 Check for $100 made payable to NCDENR:. Must be included with this application (not sent separately).
❑ This completed application and all supporting documents.
❑ A site diagram showing, at a minimum., (existing or proposed):
(a) outline of &ainage.areas, (b) stormwater:management structures, (c) location of stormwater outfalls
corresponding'to.the drainage areas, (d) runoff conveyance features, (6) areas where materials are stored,
loaded, and unloaded, (f) impervious areas; (g) site property lines.
❑ Copy of county map "or USGS quad sheet with the location of the facility clearly marked on'the map.
Mail the entire.package.to:
Stormwater Permitti.ng.Unit Program
Division of Energy, Mineral and. Land Resources
'1612 Mail Service Center
Raleigh, Ndrth Caroliha 27699-1612.
Note
The submission of this document does not guarantee coverage'under the General Permit.
For questions, please contact -the DEMLR Regional Office for your area.
DEMLR Reg lonal Office.Contact Information:
Asheville Office ......
(828) 2964'500
Fayetteville Office ...
[phone]
Mooresville Office ....
(704) 663-169.9
Raleigh Office ........
(919) 7914200
Washington Office ...(252)
946-6481
Wilmington Office ...
(910) 796-.7215
Winston-Salem:....:.
[phone]
Central Office .........(919)
607-6300
Page 5 of 4
SWU-221 last revised 6124/14

Veld gl!S eIIIAS4�0W

Mocksville Location Topography

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C [�`-OLLnK.[tJ$ L�(i5 C0oX-17)

STORMWATER POLLUTION PREVENTION PLAN CERTIFICATION
For
Filet of Chicken
A Division of House of Raeford
251 Eaton Rd
Mocksville, NC 27012
"I certify under penalty of law that this document and attachments were prepared under my direction
or supervision in accordance with a system designed to assure that qualified personnel properly
gathered and evaluated the information submitted. Based on my inquiry of the person or persons who
manage the system, or those persons directly responsible for gathering the information, the information
is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment
for knowing violations"
Authorized Signatory
Printed Name: ��ab�¢x, i�1 lion Title:
Signature: LV40i, Date:
Phone Number: 336 7SI —'-I 7S2
Facility Name: F-14f m-r Ck Je, 6?(� ✓,,;,,, c� -kOuS� o- Qoo4rj

PREFACE
This Stormwater Pollution Prevention Plan (SWPPP) has been prepared for the Filet of Chicken in
Mocksville, NC and provides the information needed to guide the facility and its employees in the
identification of potential sources of pollution and implementation of work practices and other actions
that will prevent or cortrol the potential for degradation of stormwater runoff.
Implementation of the SWPPP will begin on or before April 1, 2016.
This SWPPP is intended for use by the facility and its employees. The SWPPP has been designed to
facilitate:
1. Effective management of materials related to industrial activities at the facility that can
contribute to the degradation of stormwater runoff
2. Consistent administration of the facility's SWPPP
By implementing the SWPPP, the intended result is improved water quality through the reduction of
pollutants contained in stormwater discharges. The SWPPP represents a living document that must be
routinely updated and revised to reflect changes at the facility.

I. Introduction
Filet of Chicken is owned and operated by House of Raeford Farms. House of Raeford Farms is
responsible for providing stormwater oversight for its own facility where industrial activities occur.
Figure 1 (Appendix B) depicts the general location of the facility.
The primary service that is rendered at the Filet of Chicken facility is the further processing of chicken
into cooked products.
II. Facility Location
Figure 1 shows the facility location (Appendix B).
Facility Name: Filet of Chicken
Street Address: 251 Eaton Road
City: Mocksville
County: Davie
Latitude: N 35°52'50"
Longitude: W 80°33'11"
Adjacent Land Use (North): Wooded (undeveloped)
Adjacent Land Use (South): Residential. Border on Eaton Rd.
Adjacent Land Use (East): Commercial, Davie County Humane Society
Adjacent Land Use (West): Commercial, Storage Units
Additional Information: Facility has two parking lots, and two shipping docks
III. Facility Description
The facility and its employees currently engage in the following categories of industrial activity:
o Loading and Unloading Operations
o Outdoor Storage
o Waste Management
The following Table Describes the activities performed at the facility by building.

Filet of Chicken Industrial Activities
Building
Activities
Main Building/Plant
Loading/Unloading Operations
Outdoor Storage
Waste Water
Waste Management
Outdoor Stora e
Boneyard
Outdoor Storage
Summary Description
The main building houses the production floor as well as two shipping docks. Also Ammonia, CO2,
Nitrogen and Natural Gas are unloaded into their storage vessels in the back of the building.
The Waste Water building is where the waste water is processed using a DAF unit from the plant.
There are also vessels for the storing of used oils from production.
The Boneyard houses any machines not currently in service on the production floor.
IV. Potential Sources of Pollution
Main Building/Plant
The main building is located on the southern side of the lot. It has storage tanks for used oil, refrigerant
grade anhydrous ammonia, nitrogen, CO2, and natural gas. The main building has two shipping docks,
consisting of a total of 5 docking bays. Near the rear docking bays, there is a trash compactor. The fryer
exhaust stack on the roof has oil and grease build up and has to be cleaned monthly.
Waste Water
The waste water building has an underground pit, Equalizer tank, and chemical storage.
Boneyard
The boneyard area consists of many machines and conveyors that are used for scrap/parts. They have
been decommissioned from usage in the facility.

Bulk
Oil and Hazard Substance Stora e
Qty
Location
Product
Capacity
Secondary Containment
l
West Side
Soy Oil
10,000
gal
Concrete Containment Wall
1
West Side
Used Soy Oil
5,000 gal
Concrete Containment Wall
1
Sloped Concrete Pad
Waste Oil
275 gal
None
Waste Water
Sludge Wank
12,000
al
Concrete Containment Wall
1
Waste Water
Waste Water EQ
15,000
gal
Concrete Containment Wall
1
Near Compressor Room
Anhydrous Ammonia
4,205 gal
None
1
Waste Water
Waste Water EQ
68,000
gal
Concrete Containment Wall
V. Facility Drainage
There are two drainage outfalls for the facility. Outfall #1 is located at the entrance to the facility off of
Eaton Rd. This outfall is a ditch receives water from the property. The ditch runs along parallel to Eaton
Rd along our property line and empties into Leonard Creek.
Outfall #2 is located in the rear (North) side of the facility. This outfall is a drainage pipe from the
retention pond in the back (north) end of the property. This outfall is a no flow outfall unless the pipe is
being breached during sampling.
Outfall #1
outfall Type: Ditch
Latitude:
Longitude
Outfall #2
Outfall Type: Pipe
Latitude:
Longitude
VI. List and Locations of Reportable spills or Leaks
Currently none

V1I. Locations Where Potential Spills and Leaks Could Occur
Any of the containment vessels are potential spill/leak hazards. As long as each vessel is in a
containment wall or on a containment pallet, the leak should be minimal. Where there is a containment
wall, as long as the drain valve remains closed, there should be no risk of a leak reaching the stormwater
system. The highest probability of a spill or leak occurring would be during the refilling or draining of
one of the vessels.
In Waste Water, a breach of the pit or a rupture of the Equalization tank would lead to a waste water
spill that could potentially reach the stormwater system.
The trash compactor also is a location where a potential leak could occur. If the compactor was to
become too full or damaged, its leaked material could pollute the storm water system.
Vill, Site Plan
Site plan figures showing the locations of industrial activities, stormwater outfalls, and drainage flow
directions are provided as Figures 2 and 3 (Appendix B).
IX, Best Management Practices
Best management practices (BMPs) that control or minimize the exposure of materials to stormwater
include good housekeeping practices, preventative maintenance training, and a spill prevention and
response plan.
Good housekeeping practices include inspections, maintenance, housekeeping of stormwater control
systems, facility equipment, facility area, and facility systems that present a potential for stormwater
exposure or stormwater pollution. Weekly inspections are conducted by the EHS Coordinator in and
around the facility to ensure that these areas are clean and well -maintained and that spills or leaks are
cleaned up immediately. A semi-annual site inspection will be conducted by the Operations Manager.
The completed form will be kept on -site for a period of three years.
X. Certification
Non-stormwater discharges, not authorized by a permit, are unlawful and must be eliminated. All
outfalls will be visually inspected annually for the presence of non-stormwater by the Operations
Manager and ensure that unauthorized discharges originating on the facility property have been
eliminated. The Operations Manager will obtain signature on the certification and recertify annually.

X1. Spill Prevention and Response Plan
See Spill Prevention, Control, and Countermeasure Plan
XI1. Preventative Maintenance and Good Housekeeping Program
Oil storage vessels are inspected daily and monthly under the SPCC plan by the head Waste Water
technician under the supervision of the Maintenance Manager. Chemical transfer areas (i.e. CO2,
Nitrogen, Ammonia, etc.) located in the rear of the main building will be inspected routinely under the
supervision of the Refrigeration Manager. The Trash Compactor and pallet storage and the shipping
docks will be inspected routinely under the supervision of the Shipping Manager.
All members of the Pollution Prevention Team are responsible for inspecting all areas of the facility for
good housekeeping.
XIII. Employee Training
The EHS Coordinator is responsible for ensuring that employees engaged in industrial activities
participate in annual training. Training includes spill response, good housekeeping, and material
management practices. New employees will be trained during employee processing, and current
employees will receive annual retraining. Training will be documented in SWPPP Form 3, and records
will be kept for 5 years.
XIV. Pollution Prevention Team
Pollution Prevention Team Roster
Responsibilities: Plan owner, maintaining a
qualified inspection and maintenance staff.
Steve Mixon -Operations
Inspecting all areas of the facility for good
Manager
housekeeping. oversee amendments/revisions to
the SWPP plan. Conduct semi-annual site
inspection. Annual recertification of plan.
Responsibilities: Gathering Outfall. samples for
Shannon Maul-
testing. Inspecting all areas of the facility for good
Maintenance Manager
housekeeping.
Jeremiah Armstrong-
Responsibilities: Inspecting all areas of the facility

Refrigeration Manager
for good housekeeping. Making sure the chemical
loading/unloading inspections take place.
Craig Ward -Production
Responsibilities: Inspecting all areas of the facility
Manager
for good housekeeping.
Haley Addington-QA
Responsibilities: Inspecting all areas of the facility
Manager
for good housekeeping.
Antonio Garcia -Shipping
Responsibilities: Inspecting all areas of the facility
Manager
for good housekeeping. Making sure the shipping
docks and trash disposal areas are clean.
Responsibilities: receiving inspection and
maintenance reports, and keeping a log of all
Charles Adkins- EHS
follow-up activities. Making sure training is done.
Coordinator
Inspecting all areas of the facility for good
housekeeping.
XV. Facility Inspections
The Operations Manager is responsible for maintaining a qualified inspection and maintenance staff.
The EHS Coordinator is responsible for receiving inspection and maintenance reports, and keeping a log
of all follow-up activities.
XVI. SWPPP Implementation
To aid in the implementation of the SWPPP, SWPPP Form 1 will set an implementation schedule.
Documentation of monitoring, measurements, inspections, maintenance activities, and training
provided to employees is required. Documentation will be kept on -site for a period of five years and
made available upon request. The facility will maintain BMPs at all times.
XVII. Plan Amendment
The Pollution Prevention Team will review and amend the SWPPP whenever there is:
• A change in the design, construction, operation, or maintenance, which has a significant impact
on the discharge or potential discharge of pollutants
• A routine inspection or compliance evaluation that exposes deficiencies in the existing plan
• An inspection by a local, state, or federal official determines that modifications are necessary
• A spill, leak, or any time there is an unauthorized discharge.

Aspects of the plan will be reviewed and updated on an annual basis. The annual update shall include a
current list of significant spills or leaks of pollutants for the previous three years or the notation that no
spills have occurred. The annual update will include recertification that the stormwater outfalls have
been evaluated for the presence of non-stormwater discharges. Each annual update will include a
reevaluation of the effectiveness of the BMPs listed in the BMP Summary of the SWPPP. SWPPP Form 11
is provided to record these plan reviews and any amendments required.
Plan modifications must be made within 30 calendar days after discovery, observation, or even requiring
a modification. Implementation of new BM Ps must be initiated before the next storm even if possible
but no later than 60 days. The amount of time taken to modify a BMP or implement additional BMPs
must be documented.
Any time that the SWPPP is modified, it must be recertified using SWPPP Form 2 upon completion of the
revision. Between the annual inspection and complete SWPPP revision, the original SWPPP with the
Operations Manager's handwritten notes -for the modifications should be kept to demonstrate the
changes that will be in the revised SWPPP.
XVIII. Qualitative Monitoring Requirements
Qualitative monitoring requires a visual inspection of each stormwater discharge outfall associated with
industrial activity and will be performed as specified below in the table.
Qualitative Monitoring Requirements
Discharge Characteristics
Frequency
Locations
Color
Setni-Annual
#I, #2
Odor
Semi -Annual
#l, #2
Clarity
Semi -Annual
#l, #2
Floatin = 5olids
Semi -Annual
#1, #2
Suspended Solids
Semi -Annual
#l, #2
Foam
Semi -Annual
#1,#2
Oil Sheen
Semi -Annual
#1, #2
Erosion
Semi -Annual
Other Indicators of Pollution
Semi -Annual
Qualitative monitoring of the stormwater outfalls must be performed during a representative storm
event. Visual examinations must be made on samples collected within the first 30 minutes, or as soon as
practical without exceeding one hour, of when the runoff begins discharging from the outfall. SWPPP
Form 6 will be completed during each inspection. Completed forms will be kept on -site for a period of
three years.

Visual examination reports will be maintained on -site. The report will include the examination date and
time, inspection personnel, nature of the discharge, visual quality of the discharge, including
observations of: color, odor, clarity, floating solids, settled solids, suspended solids, foam, oil sheen,
erosion, and other obvious signs of pollution, and probable sources of any observed stormwater
contamination.

Plan Implementation
SWPP Form I Schedule
Plan Implementation Schedule
Facility
Name:
Permit
Year:
The following schedule is provided for implementation and documentation required each year
Task
Description
Required
Frequency
Completion
Documentation
Date
SWPPP Form 2
Once every
l
Certify SWPPP 5
Years
2
Appoint SWPPT members
Section XIV
Annual
3
Train Responsible Personnel
SWPPP Form 3
Annual
Perform wet weather outfall visual
SWPPP Form 6
Semi-
4
observations
Annual
SWPPP Form 7
Semi-
5
Conduct site inspection
Annual
6
Implement BMPs
SWPPP Form 8
Annual
Conduct/Certify Comprehensive Site
SWPPP Forms 4
Annual
7
Compliance Inspection
& 10
Complete/Certify Non-stormwater
SWPPP Form 5
Annual
8
Discharge Assessment
4
Review Plan/Make Revisions
SWPPP Form 11
Annual
SPCCC Management Certification and PE
SPCC Section 2
Once every
10
Certification
& 3
5 Years
Ensure Certification of Applicability of
After SPCC
Once every
I 1
Substantial Harm Criteria is Completed
Section 5
5 Years
SPCC Table 4.1-
Once every
12
Plan Review
1
5 Years
13
SPCC Monthly Site Check
SPCC Form 1
Monthly
On -going
14
Dischar e Prevention Briefing Log
SPCC Form 3
Annual
15
1 Complete Spill Response/Notification Form
SPCC Form 4
Each
incident
NIA
Release rainwater from secondary
SWPPP Form 12
Each
N/A
16
containment
& SPCC Form 2
incident
SWPPP Form 13
Each
NIA
17
Significant Spill Report
incident
Discharge Report to EPA Regional
SPCC Form 4
Each
NIA
18
Administrator
incident

SWPPP Form 2
SWPPP Certification
"I certify under penalty of law that this document and attachments were prepared under my direction
or supervision in accordance with a system designed to assure that qualified personnel properly
gathered and evaluated the information submitted. Based on my inquiry of the person or persons who
manage the system, or those persons directly responsible for gathering the information, the information
is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment
for knowing violations"
Authorized Sienator
Printed Name: L.�e.7%en - MtXor. Title: (�,rs /Waf%A$'O(- _
Signature: Date:
Phone Number: 336 - 751 -LO5Z
Facility Name: f �'� � or Ch T�,�v ���l�iS+nn �� �05e- J Ao-4;4

SWPPP Form 3
Training Documentation Sheet
Location:
Date:
Class Name:
Instructor:
Employee Name Department Signature
Training records must be retained for five years

SWPPP Form 3
Training Program Outline
Annual training in stormwater pollution prevention should be conducted for employees whose job duties involve
working with materials or equipment in stormwater discharge areas. Training topics to be addressed should
include, at a minimum, good housekeeping, spill prevention and response, proper material handling and storage,
and inspection. Training should address specific BMPs for relevant drainage areas.
Source Reduction
• Explain source reduction practices
Recycling
• Explain recycling practices
Good Housekeeping
• Review basic cleanup procedures
• Review proper disposal locations
• Remind staff of good housekeeping procedures
• Be sure employees know where routine cleanup equipment is located
• Review areas where outdoor storage of materials is and is not allowed
Spill Prevention and Response
• Identify potential spill areas and drainage routes
• Familiarize employees with pas spill events —why they happened and the environmental impact
• Review emergency contacts and telephone numbers
• Review the locations of spill cleanup equipment
• Provide incident spill response training
Proper Material Storage, Handlinjz, and Disposal
• Identify potential pollutant sources
• Be sure employees are aware of which materials are hazardous and where materials are stored
• Point out and explain container labels
• Tell employees to use the oldest materials first
• Demonstrate how valves are "tightly closed" and how drums should be sealed
Inspections
o Review inspection and monitoring procedures
Structural BMPs
o Explain structural controls including devices to control and treat stormwater, secondary containment, and erosion
and sediment controls

Exposed Significant Materials Assessment Date:
Facility:
Inspector:
Instructions: Describe the significant materials that were exposed to stormwater during the past year and/or are
currently exposed. Significant materials include, but are not limited to raw materials, fuels, solvents, detergents,
metals, hazardous substances, fertilizers, pesticides and waste products that have a reasonable potential to release
pollutants into stormwater discharge
Description of
Exposed Significant
Material
Period of
Exposure
Quantity
Exposed
Method of
Storage or
Disposal
Location
Description of Proper
Material
Management

Non-Stormwater Discharge Assessment Date:
Facility:
Inspector: _
Date of Test or
Outfall directly
Method Used to
Describe Results from
Test for the Presence
Identify Potential
Actions Taken to
Evaluation
Observed During
Test or Evaluate
of Non-Stormwater
Significant
Eliminate Discharge
the Test
Discharge
Discharge
Sources
Certification
I certify, under penalty of law, that all stormwater outfalls covered by this Permit have been tested or evaluated
for the presence of non-stormwater discharges and that this form was prepared under my direction or supervision
in accordance with a system designed to assure that qualified personnel properly gather and avaluate the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information on this form is, to the best of my knowledge and belief, accurate, and
complete. I am aware that there are significant penalties for submitting false information, including the possibility of
fine and imprisonment for knowing violations.
A. Name & Official Title B. Area Code and Telephone No.
C. Signature D. Date Signed

Stormwater Discharge Outfall
Qualitative Monitoring Report
Permit No.:
Facility Name:
County:
Inspector:
Date of Inspection:
Time of Inspection:
Total Event Precipitation (inches):
Phone
Was this a Representative Storm Event? Yes No
A "Representative Storm Event" is a storm even that measures greater than 0.1 inches of rainfall and
that is preceded by at least 72 hours in which no storm even measuring greater than 0.1 inches has
occurred. A single storm even may contain up to 10 consecutive hours of no precipitation.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. Structure (pipe, ditch, etc)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage
area:
2. Color: Describe the color of the discharge using basic colors and tint as
descriptors:
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor,
etc.):
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 2 3 4 5

S. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
8. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall? Yes No
10. Other Obvious Indicators of Stormwater Pollution:

Semi -Annual Site Inspection Checklist
Date Time Inspected by
The following areas were inspected
o Loading docks, equipment parking, outdoor storage and waste collection areas
o Chemical and material storage areas and cabinets
o Equipment and system designed to prevent contamination of surface waters
o Stormwater conveyances and outfalls
o Equipment for leaks and general condition
o Structural controls
General
o Identify potential pollutant sources
o Inspect for general compliance of the drainage area with the SWPPPP
o Inspect the condition of drainage systems
o Inspect for any evidence of pollutants entering the stormwater system
o Inspect the buildings
o Are equipment and materials that are not directly associated with load/unloading activities
stored indoors
o Are the outdoor uncovered material storage areas used for the storage of miscellaneous
industrial equipment reduce to the greatest extent practicable
Housekeeping
o Inspect for posted signs reminding staff of good housekeeping procedures
o Inspect for presence of adequate cleanup equipment
o Inspect areas where outdoor storage of materials is and is not allowed
Spill Prevention and Response
o Inspect potential spill areas and drainage routes
o Are spill control materials readily available and suitable for materials stored on -site
o Are warning signs posted in potential spill areas
o Are signs posted indicating the locations of spill cleanup equipment
Materials Handling and Storage
o Are employees aware of which materials are hazardous and where they are stored
o Are employees instructed to use the oldest materials first
o Are employees instructed on recycling practices
o Are all valves "tightly closed" and drums sealed

Industrial materials or activities exposed to stormwater, potential sources of polluted runoff,
stormwater controls, and conveyance systems
o No leaks or spills from industrial equipment, drums, tanks and other containers
o No off -site tracking of industrial or waste materials, or sediment where vehicles or equipment
enter or exit the facility
o No tracking or blowing of raw, final or waste materials from areas of no exposure to exposed
areas
o No evidence of, or the potential for, pollutants entering the drainage system
o No evidence of pollutants discharging to surface waters at outfalls, and the condition of and
around the outfall, including flow dissipation measure to prevent scouring.
o No evidence of pollutants discharging to storm system from exposed material storage areas,
loading and unloading areas, outdoor process areas, dust or particulate generating or control
processes, and waste disposal practices.
o No oily or contaminated equipment, debris, or pallets exposed to rain
o No corroded or open drums
o No corroded or damaged tanks, tank supports, or drain valves
o No torn bags of chemicals or bags exposed to rain
o No corroded or leaking pipes
o No leaking or improperly close valves or fittings
o No leaking pumps or hose connections
o No broken or cracked dikes, walls, or other secondary containment systems
o No windblown dry chemicals
Notes:
Recommended modifications to
SWPPP:

BMP Implementation
Date BMP
Identified
Location
Recommended Best
Management Practice
Ref to
Appendix B
Implement
Date

Annual Comprehensive Site Compliance Evaluation
Effectiveness of Stormwater Drainage System and Structural Controls
o Potential Pollutant sources (e.g. exposed materials) are effectively controlled
o Stormwater drainage areas were evaluated for effectiveness
o Potential pollutant sources were evaluated for non-compliance
o Storm drainage system and structural controls are effective
o No evidence of pollutants entering the storm drainage system
o Stormwater pollution prevention BMPs are effective
o New or additional BMPs were evaluated
Required Action:
Overall Evaluation Effectiveness of SWPPP
Required Action:
"I certify under penalty of law that this document and attachments were prepared under my direction
or supervision in accordance with a system designed to assure that qualified personnel properly
gathered and evaluated the information submitted. Based on my inquiry of the person or persons who
manage the system, or those persons directly responsible for gathering the information, the information
is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment
for knowing violations"
Authorized Signatory
Printed Name: Title:
Signature: Date:
Phone Number:
Facility Name:

Record of Plan Reviews/Plan Amendment Records
This plan will be reviewed each year. The permit requires a review and evaluation of this plan at least
once a year, which supersedes the SPCC regulatory plan review requirement of every five years. Blank
lines are provided on this form for each SWPPT member's review The SWPPT Leader is assigned the
responsibility of ensuring that this plan will be reviewed and amended in accordance with the
stormwater discharge permit. The SWPPT Leader may amend this plan to include more effective
pollution prevention technology and BMPs, if such technology is field proven and if implementation will
significantly reduce the likelihood of the contamination of stormwater.
Review Date Review Comments Signature
Plan Amendment Records
The plan will be amended whenever there is a change in the design, construction, process, operation, or
maintenance that has a significant effect on the potential stormwater contamination at the facility.
Amendments to this plan should be fully implemented as soon as possible, but no later than six months
after changes occur or after the review period. All technical amendmens to the SPCC Plan must be
certified by a registered Professional Engineer and satisfactorily implemented. PE seals are only required
if an SPCC amendment is technical.
This record sheet is provided to summarize amendments to the plan, The SWPPT Leader will be
responsible for ensuring that the plan is amended in strict accordance with the plan requirements
Amend Date I Amendment Comments I Signature/Seal

Rainwater Release from Containment Structure
Complete this form each time that accumulated rainwater is to be release from exposed secondary
containment structures
Building/Area: Date:
Inspected By: Time:
Description of Secondary Containment Structure:
Visual Observations of Accumulated Rainwater
Check yes or no, and provide details under comments.
Item
Yes
No
Comments
Color
Odor
Cloudy
Foam
Oil Sheen
Outfall Staining
Dry Weather Flow
Other Indicators
if accumulated rainwater appears to be contaminated, list actions taken to remove contaminants:
Release of Accumulated Rainwater:
After the Release of the accumulated rainwater, was the secondary containment drain valve properly
closed and locked?
o Yes
o No
Comments:

Spill Report
Complete this form for each significant spill incident. Keep original for with the plan.
Date:
Time:
Facility Name:
Address & Location:
Person Reporting: Phone:
Spill Location:
Type of Material:
Quantity:
Source:
Cause of Spill:
Amount of Material Recovered:
YES NO
Spill contained on premises?
Did the spill enter the stormwater drainage system?
Did the spill enter a body of water?
Nearest body of water or body of water spill entered?
Measures taken to prevent recurring incidents:
Personal injuries:
Additional pertinent information:
AGENCIES NOTIFIED OF SPILL:
Distance:
NRC Contact: Date/Time:
NCDENR Contact: Date/Time:
Other Contact: Date/Time:

Stormwater Pollution Prevention Plan
FL
for
F CHICKEN
Fully Cooked Operation
A Division of House of Raeford
Filet of Chicken
A Division of House of Raeford
Mocksville, North Carolina

I
M1,110MIM,
�i llfl l • %ti
H�ffl
House of Raeford
o
it ��.--.�i ••%�%�� t'.l
J
r • _�
I
NCG060373 House of Raeford
Filet of Chicken
N
Latitude: 350 52' 49" N
W ' E Longitude: -800 33' 11" W
County: Davie
S Receiving Stream: Leonard Creek
Stream Class: C
Map Scale I:24,000 Index Number: 12-102-16 (Yadkin Pee -Dee Basin)
9
M
on
Facility Location

STORMWATER DIVI510N CODING SHEET
NCG PERMITS
PERMIT N0.
Iv Cc, ail O U r?
DOC TYPE
HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ aol� 1008
YYYYMMDD

North Carolina Department of Environmental Quality
Pat McCrory
Governor
October 8, 2015
William Hull, Jr.
Hull Brothers Lumber Company, Inc.
579 Maple Hollow Rd
Mounty Airy, NC 27030
Subject: Compliance Evaluation Inspection
NPDES General Stormwater Permit NCG210000
Certificate of Coverage NCG210372
Hull Brothers Lumber Company, Inc.
Surry County
Dear Mr. Hull:
Donald R. van der Vaart
Secretary
Glen White of the Winston-Salem Regional Office of the NC Division of Energy, Mineral, and Land Resources
(DEMLR) conducted a compliance inspection of your facility on October8, 2015. You were unavailable at the
time of inspection. Howard Hull and Luann Boyer of the facility assisted with the inspection. Theirassistance
was greatly appreciated. An inspection checklist is attached for your records and the inspection findings are
summarized below.
1 Permit
This facility holds General Stormwater Permit No. NCG210372 to discharge Stormwater from activities
associated with Lumberand Wood Products underthe National Pollutant Discharge Elimination System
(NPDES). The permit became effective October 1, 2014 and expires September 30, 2019. Your permit
renewal package must be received in the Central Office in Raleigh no later than 180 days prior to the
expiration date of the permit.
2. Records/Reports
Part li, Section A of the permit requires the development of a Stormwater Pollution Prevention Plan (SPPP).
The plan must include all 9 sections of Part II, Section A requirements of the permit. This site is required to
provide analytical and qualitative monitoring twice yearly -as defined in Part d, Section C of the permit._ The
plan must be updated annually and monitoring must be conducted semi-annually to maintain compliance
with the permit. This facility has not developed a Stormwater Pollution Prevention Plan and has not
provided any monitoring.
Division of Energy, Mineral, and Land Resources
Energy Section • Geological Survey Section • Land Quality Section
1612 Mall Service Center, Raleigh, North Carolina 27699-1612 • 919-707-9200 / FAX: [phone]
512 North Salisbury Street, Raleigh, North Carolina 27604 • Internet: http://portal.ncdenr.org/web/Ir/
An Equal Opportunity \ Affirmative Action Employer —50% Recycled \ 10% Post Consumer Paper

LN
3. Facility Site Review
The facility mills raw timber and creates lumber and mulch, a by-product of milling. All industrial stormwater
from mill activity drains to a retention pond located at the rear of the property. The pond is surrounded by
natural vegetation and trees. Water is stain from mulch and sawmill debris but does not have a film, floating
solids or odor. Site needs to develop housekeeping and maintenance procedures.
4. Effluent/Receiving Waters
This site drains to Moores Creek, 'a Class C tributary of the Yadkin River Basin.
5. Self -Monitoring Program
Analytical Monitoring: This site is required to perform analytical monitoring. There is no evidence that the
facility has ever provided analytical monitoring. Monitoring is required to be performed twice annually.
6. Qualitative Monitoring: Qualitative monitoring is required to be completed twice a year. This facility has
not been providing any monitoring. Qualitative monitoring is completed by making observations and
recording what is observed.
The following action is needed to address deficiencies and bring the facility into compliance with its permit.
I. This facility must develop an SP3 (Stormwater Pollution Prevention Plan) immediately. The plan
needs to include all sections required by the permit. Operating and maintenance procedures,spill
prevention and response procedures must be included.
2. Begin Analytical Monitoring at next storm event. Send samples for testing to a qualified lab for
testing. Monitoring must be completed twice annually. Records must be kept with the SP3 plan and
available for review.
3. Begin Qualitative Monitoring at next storm event. Monitor twice annually and keep records with the
SP3 plan.
This office will re -inspect the facility in mid-2016 to re-evaluate permit compliance, review the new SP3 plan,
monitoring records and operating procedures. This is an opportunity to become compliant with your permit
requirements before further action is taken may include fines and fees.
If you have any questions concerning this letter or the attached inspection report, piease contact Glen White
at [phone].
Sincerely,
Matthew E. Gantt, P.E.
Regional Engineer
Land Quality Section
Attachments:
1. BIMS Inspection Checklist
CC: Division of Land Quality — WSRO

Permit: NCG210372
SOC:
County: Surry
Region: Winston-Salem
Contact Person: William Hull
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Compliance Inspection Report
Effective: 08/01/13 Expiration: 07/31/18 Owner: Hull Brothers Lumber Co Inc
Effective: Expiration: Facility: Hull Brothers Lumber Co., Inc.
579 Maple Hollow Rd
Mount Airy NC 27030
Title: Phone: [phone]
Inspection Date: 10/08/2015
Primary Inspector: Glen White
Secondary Inspector(s):
Certification: Phone:
EntryTime: 11:00AM Exit Time: 12:00PM
Phone: [phone]
Reason for Inspection: Routine inspection Type: Compliance Evaluation
Permit Inspection Type: Timber Products Stormwater Discharge COC
Facility Status: ❑ Compliant ® Not Compliant
Question Areas:
® Storm Water
(See attachment summary)
Page: 1

r
Permit:. NGG210372 Owner - Facility: Hull Brothers Lumber Co Inc
K
Inspection Date: 10/08/2015 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
This site must develop an SPPP (Stormwater Pollution Provention Plan) and begin qualitative and analytical monitoring as
soon as the next rainfall event. Sample needs to be collected during or immediately following a rainfall event.
Contact a consultant to assist with developing the plan.
Provide qualitative monitoring 2 times annually.
Contact a testing facility and begin analytical monitoring.
Provide testing per the permit requirements.
Keep the SPPP and all monitoring records in one 3-ring binder. Update SPPP annually and keep all records for a minimum
of 5 years.
Page: 2

r
Permit: NCG210372 Owner - Facility: Hull Brothers Lumber Co Inc
Inspection Date: 10/0812015 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 outfali locations and drainage areas?
❑ ®❑ ❑
# Does the Plan include a list of significant spills occurring during the past 3 years?
❑ ®❑ ❑
# Has the facility evaluated feasible alternatives to current practices?
❑ ®❑ ❑
# Does the facility provide all necessary secondary containment?
❑ ®❑ ❑
# Does the Plan include a BMP summary?
❑ ®❑ ❑
# Does the Plan include a Spill Prevention and Response Plan (SPRP)?
❑ ®❑ ❑
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
❑ ®❑ ❑
# Does the facility provide and document Employee Training?
❑ ®❑ ❑
# Does the Plan include a list of Responsible Party(s)?
❑ ®❑ ❑
# Is the Plan reviewed and updated annually?
❑ ®❑ ❑
# Does the Plan include a Stormwater Facility Inspection Program?
❑ ®❑ ❑
Has the Stormwater Pollution Prevention Plan been implemented?
❑ ®❑ ❑
Comment: This site is required to develop a SPPP (Stormwater Pollution Prevention Plan). The plan must
include all information listed in the questions above. The SPPP must be kept on site and
updated annually. Records of spills and all monitoring records must be kept with plan for a
minimum of 5 years. The SPPP should be availalbe for review at any time.
Qualitative Monitoring Yes No NA NE
Has the facility conducted its Qualitative Monitoring semi-annually? ❑ E ❑ ❑
Comment: No monitoring has been done
Qualitative monitoring is required to be com2lleted twice (2x) year and records must be kept on
site with the SPPP.
Analytical Monitoring Yes No NA NE
Has the facility conducted its Analytical monitoring? ❑ E ❑ ❑
# Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas? ❑ 0 ❑ ❑
Comment: No monitoring has been done. Analytical monitoring must be provided twice (2x) year and
records need to be -kept onsite for a minimum ofears with the SPPP,
Permit and outfalls Yes No NA NE
# Is a copy of the Permit and the Certificate of Coverage available at the site? ❑ E ❑ ❑
# Were all outfalls observed during the inspection? ■ ❑ ❑ ❑
# If the facility has representative outfall status, is it properly documented by the Division? ❑ ❑ ❑ E
# Has the facility evaluated all illicit (non stormwater) discharges? ❑ ❑ ❑
Page: 3

Permit: NCG210372 owner - Facility: Hull Brothers Lumber Co Inc
inspection Date: 10/0812015 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Comment: All industrial stormwater from mill activity drains to a retention pond at the tear of the property__
The pond is surrounded by natural vegetation and trees. Water is stained from mulch and
sawmill debris. Begin analytical monitoring below pond outlet must before the point where
stormwater exits property, Do not collect samples in the pond itself._ Results_ would be
excessive. Collect Oust below the pond.
Page: 4

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Departriwnt of Environment and Natural Resources
Coleen H. Sullins, Director
Division of Water Quality
September 12, 2008
V iVdiam;Hull
'Hull :BrotherS-11mber 1Co_Inc
579 MapleHolloW';Rd
Mount Airy` , NC 27030
Subject: NPDES Stormwater Permit Coverage Renewal
HullBrothers�Cumber'Cti.,-lnc.
COC Number NCG210372
ru ry County
Dear Permittee:
In response to your renewal application for continued coverage under stormwater General Permit NCG210000 the Division of
Water Quality (DWQ) is forwarding herewith the reissued stormwater General Permit. This permit has been reissued pursuant to
the requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement between the state of North
Carolina and the U.S. Environmental Protection Agency, dated October 15, 2007.
The following information is included with your permit package:
• A new Certificate of Coverage
• A copy of stormwater General Stormwater Permit NCG210000
• A copy of the Technical Bulletin for the General Permit
• Five copies of the Discharge Monitoring Report (DMR) Form
• Five copies of the Qualitative Monitoring Report Form
The General Permit authorizes discharges of stormwater only, and it specifies your obligations with respect to stormwater
discharge controls, management, monitoring, and record keeping. Please review the new permit to familiarize yourself with all
the changes in the reissued permit.
The more significant changes to the General Permit include the following:
• Permit cover page, second paragraph - The General Permit now may cover activities that DWQ determines to be similar in
either the process, or in the exposed materials, to the Timber Products Industry.
• Part I Section A - A new provision that facilities draining to 303(d) listed waters, or in watersheds with an approved TMDL,
may not be eligible for continued coverage at the next renewal of the General Permit.
• Part I Section B second paragraph - A new clarification that the permit does not authorize discharges that DWQ determines
are wastewaters.
• Part II Section A - The required contents of the Stormwater Pollution Prevention Plan have been expanded and clarified.
• Part II Section B Table 1 - A new requirement to sample stormwater discharges twice per year for those facilities with
exposed piles of certain materials remaining on site longer than seven days.
• Part 11 Section B Tables 2 and 3 and following - For permittees with exposed piles, there are new provisions requiring the
permittee to execute Tier One and Tier Two response actions, based on the first benchmark exceedence (Tier One) and the
second consecutive benchmark exceedence (Tier Two). Tier Two requires that the permittee institute monthly monitoring
instead of twice -per -year monitoring, until three consecutive monitoring events show no benchmark exceedences.
• Part 11 Section B - For permittees with exposed piles, a new provision that four exceedences of any particular benchmark
will trigger increased DWQ involvement in the permittee's stormwater management and control actions. DWQ may direct
the permittee to apply for an individual permit, or may direct the implementation or installation of specific stormwater control
measures.
• Part II Section C - Clarification that under the qualitative monitoring provisions of the permit, the permittee is obligated to
respond to repeated observations of stormwater pollution. DWQ may impose additional stormwater management
requirements if the permittee is non -responsive, or if the responses are ineffective.
Your coverage under the General Permit is transferable only through the specific action of DWQ.
One
N r hCarolina
Antutwilif
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Phone [phone] Customer Service
lntemet: h2o.enr.state.nc.us/sulstormwater.html 512 N. Salisbury St. Raleigh, NC 27604 FAX [phone]
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NPDES Stormwater Permit Coverage Renewal
Permit Number NCG210372
Page 2
This permit does not affect the legal requirements to obtain other permits which may be required by NCDENR, nor does it relieve
the permitlee from responsibility for compliance with any other applicable federal, state, or local law, rule, standard, ordinance,
order, judgment, or decree.
If you have any questions regarding this permit package please contact Bethany: Georgoulias of the Central Office Stormwater
Permitting Unit at [phone].
Sincerely,
fa• Coleen H. Sullins
cc: DWO Central Files
Stormwater Permitting Unit Files
Winston-Salem Regional Office

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NGG210000
CERTIFICATE OF COVERAGE No. NCG210372
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,
Hull,Brothers Lumber Co lnc
is hereby authorized to discharge stormwater from a facility located at
H611"Brothers'LumbeT, Co , inc
579 Maple Hollow Rd
Mor untiAiry`
Surry C nuo ty
to receiving waters designated as Ste aw�rts�Creek, a class IN,S 1V stream in the Yad ink 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. NCG210000 as attached. .
This certificate of coverage shall become effective September 15, 2008.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day September 12, 2008.
for Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Frivironment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
January 13, 2006
Mr. Bill Hull
Hull Brothers Lumber Company, Inc.
579 Maple follow Road
Mount Airy, NC 27030
SUBJECT: Hull Brothers Lumber Company
NPDES General Stormwater Permit
Certificate of Coverage No. NCG210372
Surry County
Dear Mr. Hull:
The above Certificate of Coverage was issued to Hull Brothers Lumber Company effective January 6,
2006. The purpose of this letter is to advise you of the two major requirements of the stormwater general
permit. Please note the following permit conditions:
•3 The stormwater permit requires that a Stormwater Pollution Prevention Plan be developed as
described in Part II Section A of the permit text. The plan must address all relevant items listed in
Section A and must be kept on file at the facility for review during inspections. The plan can be
prepared in-house, or you may wish to hire an outside consultant.
The permit also requires that qualitative (visual) monitoring of the stormwater outfall be performed
and documented semi-annually, The permit text in Part II Section B explains this monitoring
requirement more thoroughly. In addition, if the sawmill facility uses more than 55 gallons of new
motor oil per month (as averaged over the calendar year), then the on -site vehicle maintenance
monitoring requirements listed in Section C of the permit would also apply.
Please be advised that the failure to comply with all permit conditions is a violation of the General
Permit. Per permit text in Part III Section A.2, "The permittee must comply with all conditions of this general
permit. Any permit noncompliance constitutes a violation of the Clean Water Act and is grounds for
enforcement action; for certificate of coverage termination, revocation and reissuance, or modification; or
denial of a certificate of coverage upon renewal application."
Attached to this letter is a qualitative monitoring report form to use for the semi-annual visual
observations as well as the on -site vehicle maintenance form if needed. Should you have any questions or
need any assistance, please contact me at [phone].
�Sincerely, .
Michael M. Mickey
Environmental Specialist II
cc: NPS Assistance & Compliance Oversight Unit
Central Files
WSRO Facility Files
t Carolina
Naturally
North Carolina Division of Water Quality 585 Waughtown Street Winston-Salem, NC 27107 Phone [phone] Fax [phone]
Internet: h2o.enr.state.nc.us
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Michael F, Easley, Governor
William G. Ross Jr„ Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
January 6, 2006
Mr. Ff. William Hull, Jr.
Vice President
Hull Brothers Lumber Co. Inc.
579 Maple Hollow Road
Mount Airy, NC 27030
Subject: General Permit No. NCG210000
Hull Brothers Lumber Co. Inc.
COC No. NCG210372
Surry County
Dear Mr. Hull:
In accordance with your application for a discharge permit received on December 12,
2005 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 May 9, 1994 (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 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 penult that may be required.
If you have any questions concerning this permit please contact Aisha Lau at telephone
number [phone] ext. 578.
Sincerely,
ORIGINAL SIGNED BY
B.RADLEY BENNE T T
Alan W. Klimek, F.E.
cc: Winston - Salem Regional Office
Central Files
Stormwater Permitting Unit Files NorehCarolina
Att2rhmcnke - - Natrtrtr!!y
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Phone [phone] Customer Service
4ntemeL h2o.enr.state.nc.us 512 N. Salisbury St, Raleigh, NC 27604 FAX [phone]
An Equal OpportunitylAffirma6ve Action Employer — 50% Recycled110% Post Consumer Paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG210000
CERTIFICATE OF COVERAGE No. NCG210372
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,
H. William Hull Jr., Chadley D. Hull, and Brent S. Hull
is hereby authorized to discharge stormwater from a facility located at
Hull Brothers Lumber Co. Inc.
579 Maple Hollow Road
Mount Airy
Surry County
to receiving waters designated as an unnamed tributary to Stewarts Creek, a class WS - IV stream in the Yadkin —
Pee Dee River Basin in accordance with the effluent limitations, monitoring requirements, and other conditions set
forth in Parts 1, 11, 111, IV, V and V1 of General Permit No. NCG210000 as attached.
This Certificate of Coverage shall become effective January 6, 2006.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day January 6, 2006.
ORIGINAL C1'G,Ni=1D BY
BRADLEY BENNETT
Alan W. Klimek, P.E. Director
Division of Water Quality
By Authority of the Environmental Management Commission

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Markers
Name: NCG210372 - Hull Brothers Lumber Co. Inc.
Short Name: 210372
Coordinates: 036' 30' 2.52" N. 080' 41' 23.99" W
Comment: Hull Brothers Lumber Company, Inc., subbasin 03-07-03, Yadkin - Pee Dee River
Basin, Surry County, UT to Stewarts Creek, Class WS - IV, A16SW

,:F WA9 4lichael F. Easley, Governor
� Q
Wiliam G. Ross Jr., Secretary
North Carolina Department o`Environment and Natural Resources
.0 Alan W. Klimek, P.E. Director
Division of Water Quality
December 8, 2005
CERTIFIED MAIL ##7002 3150 0000 7961 8641
RETURN RECEIPT REQUESTED
Mr, Bill Hull
Hull Brothers Lumber Company, Inc.
579 Maple Hollow Road ,
Mount Airy, NC 27030
Subject: Notice of Violation
Failure to Obtain a Stormwater Permit
Hull Brothers Lumber Company, Inc.
Surry County
Dear Mr. Hull:
On November 30, 2005, Mike Mickey of the State's Division of Water Quality, Winston-Salem
Regional Office, met with you at Hull Brothers Lumber Company to discuss the State's stormwater permitting
requirements. The intent of the stormwater general permit is to encourage timber product operations to use
Best Management Practices (BMP's) in order to minimize the entry of pollutants into surface waters, The
permit, issued by the Division of Water Quality, requires each facility to develop and implement a Stormwater
Pollution Prevention Plan (SPPP) and to regularly monitor stormwater discharges from the site.
A review of our files revealed that Hull Brothers Lumber Company does not possess a general
stormwater permit, which is required for establishments engaged in "Timber Products" (standard industrial
classification 24). Please be advised that the failure to obtain a stormwater general permit is a violation of
North Carolina General Statute 143-215.1. The enforcement options available to the Division for failure to
obtain a required permit include a civil penalty assessment of up to $25,000 per day, per violation. In order
to preempt the initiation of such an enforcement action, you must take immediate action to obtain General
Permit NCG210000,
Attached, please find a Notice of Intent form to apply for coverage under General Permit
NCG210000. The completed Notice of Intent form to should be submitted to the Division on or before
December 30, 2005. The mailing address is specified on the application.
Should you have any questions or need additional information, please do not hesitate to contact
Mr. Mickey by phone at [phone] or by email at [e-mail].
5w ' e .
Steve W . Tedder
Water Quality Regional Supervisor
cc: NIPS Assistance & Compliance Oversight Unit
Central Files
WSRO
1 fo `hCarolina
Naturally
North Carolina Division of Water Quality 585 Waughtown Street Winston Salem, NC 27107 Phone [phone] Customer Service
Internet: h2o.enr.state.nc.us FAX (336)77I-4630 1-877-623-6748
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t
CERTIFIED MAIL,. RECEIPT
.a(Domestic
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Mr. Bill Hull
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579 Maple Hollow Road
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Hull Brothers Lumber Co. Inc.
HOWARD HULL
CHAD HULL
BRENT HULL
BILL HULL
579 Maple Hollow Rd.
Mount Airy, NC 27030
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Surry Co., NC' -- Printable Map
http:"lar•eiriis.%k'ebgis.net;nclsur-rylpritlt.able.asp'?process—id&.x2-=1503221.71 18 3771 &y2 10...
Parcel ID: 5000-00-25-9492
Owner:
HULL HOWARD W
HULL BETTY JEAN
613 MAPLE HOLLOW RD
MOUNT AIRY,NC 270306281
Deed Book: 0584 Pg: 0212
Surry Co., NC
Parcels
Subdivision:
Township: STEWARTS CREEK
Location: MAPLE HOLLOW RD
Calculated Acreage: 15.42AC
Building Value: $414,480
Outbuildings Value: $9,970
Land Value: $91,750
Assessed value: $516,200
1 of 2 1 1 ' 101;.?005 2:26 I'M