NCG210438_COMPLETE FILE - HISTORICAL_20160201

STORMWATER DIVISION CODING SHEET
NCG PERMITS .
-PERMIT NO.
IV CG, 104 3�
DOC TYPE
HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
Ct Da 0 I
YYYYM M DD

North Carolina Department of Environmental Quality
Pat McCrory
Governor
Ms. Lynn Bell
Pallet Express, Inc.
6306 Old 421 Road
Liberty, North Carolina 27298
Dear Ms. Bell:
Donald R. van der Vaart
Secretary
February 1, 2016
Subject: General Permit No. NCG210000
Pallet Express; Inc.
COC No. NCG210438
Randolph County
In accordance with your revised application for a discharge permit received on October 12,
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],
Sincerely,
ORIGINAL SIGNED �1
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 Center, Raleigh, North Carolina 27699-1601
Phone: [phone] Intemet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Acton 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. NCG210000
CERTIFICATE OF COVERAGE No. NCG210438
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,
Pallet Express, Inc.
is hereby authorized to discharge stormwater from a facility located at
Pallet Express, Inc.
6306 Old 421 Road
Liberty, Randolph County
to receiving waters designated as an unnamed tributary to South Prong of Stinking Quarter Creek, a Class WS-V, B,
NSW waterbody, Cape Fear River Basin; in accordance with the effluent limitations, monitoring requirements, and
other conditions set forth in Parts 1, II, III, IV, V and VI of General Permit No. NCG210000, 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 W
KEN PICKLE
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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Surface Water Flow Direction
Site Location(office) - Latitude - 35 degrees 53 minutes 11 seconds North
Longitude - 79 deg 34 min 54 sec West
Receiving Waters - South Prong of Stinking Quarter Creek.
This creek is listed as impaired on the State 303(d) list (fish tissue mercury)
REF.: USGS Kirnesvilie, NC Quadrangle Dated 1970
photorevised 1982

October 7, 2015
NCDENR
Division of Energy, Mineral, and Land Resources
Land Quality Section
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
DENR-LAND QUALITY
STOR t ATER pERN11;TING
Subject: Notice of Intent
Application for Coverage Under NPDES General Stormwater Permit NCG210000
Pallet Express
6306 Old 421 Road, Liberty, North Carolina
Dear Gentlemen:
On behalf of Pallet Express, Inc., Blue Ridge Geological Services, Inc. (Blue Ridge) prepared the
attached application for coverage under NPDES General Permit #NCG210000 to discharge storm water
associated with industrial activities at the subject site (Figures 1 and 2). A check for $100 for the new
application fee is attached.
Please contact the undersigned at 336431-5454 if you have any questions concerning this application or you
need additional information.
Sincerely,
Jeffrey L. Gerlock, L.G.
NC Licensed Geologist # 1141
Cc: Mr. Louis Barber, Pallet Express
Attachments — Application, Figures, Check
306 Eden Terrace, Suite C, Archdale, NC 27263 * Phone/Fax: [phone]

PALLET EXPRESS INC. errs 071
6306 OLD 421 RD. FiRST CMZENS GMK
P.O. BOX 1998
LIBERTY, NC 27298
PH: 336-622-2266
*ONE HUNDRED AND XX 1 100
DATE AMOUNT
10/8I2015 ****� *�`****100.00*
I
TO THE NC DEPT ENVIR $ NAT RESOURCES -
' ORDER DIVISION OF AIR QUALITY
OF 1641 MAIL SERVICE CENTER& AA
RALEIGM NC 27699-1641 .c am
AUTHORIZED SIGNATURE

Diuguid, Bill
From:
Gantt, Matt
Sent:
Friday, November 20, 2015 8:43 AM
To:
Diuguid, Bill
Cc:
White, Glen
Subject:
RE: NCG210438 Pallet Express Inc Liberty Randolph County NOI Oct 12 2015
NCG030666 US Chemical Facility (1806 River Street)
NCG030665 US Chemical 1605 (Industrial Drive)
Mr. Duiguid
I went to the US Chemical sites yesterday. I didn't realize there were two different facility permits but Industrial Drive is
just off River Street. They have assembly and shipping facilities. OK to issue permits.
Glen White
Environmental Specialist
NCDENR Winston-Salem Regional Office
Division of Energy, Minerals & Land Resources
450 Hanes Mill Rd — Suite 300
Winston-Salem, NC 27105
glen. [e-mail]
[phone]
From: Diuguid, Bill
Sent: Friday, November 20, 2015 8:18 AM
To: Gantt, Matt <[e-mail]>
Subject: NCG210438 Pallet Express Inc Liberty Randolph County N01 Oct 12 2015
Matt Gantt, Winston-Salem Regional Office:
Please review the attached NOI application with the objective of responding to me with a recommendation to issue the
permit. I recognize that you may not visit each new permittee during this NOI review, but it affords you the opportunity
to log the permit into your regional database and add the facility to a future monitoring and compliance visit
schedule. Therefore, your recommendation now to issue the permit serves as your acknowledgement that (1) the
facility is located in your region, (2) that there are no current complaints outstanding about the facility that have not
been dealt with, and (3) that the facility may ultimately be inspected by the regional staff. I've also attached a scanned
copy of the NOI and a location map for your review.
COC # Facility Location City/County
NCG210438 Pallet Express, Inc. 6306 Old 421 Road Liberty/Randolph County
If you need any more info, give me a call. If you could send me a recommendation to issue the permit by 12/20/2015,
I'd appreciate it, so I can issue their COC. I cannot issue the permit until the respective regional office reviews and
comments back to me with a recommendation to issue the permit.
Thanks.
Bill
Bill Diuguid

Stormwater Permitting Program
Land Quality Section
Division of Energy, Mineral and Land Resources I NCDEQ
1612 Mail Service Center (Mail)
512 N. Salisbury St, Raleigh, NC 27604 1 9th Floor (Location & Parcels)
Raleigh North Carolina 27699-1612
Phone: [phone] Fax: [phone]
Website: http:[/portal.ncdenr.orglweb/w /wslsu
ti
Nothing Compares
f�
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties

Division of Energy, Mineral and Land Resources
�;.8; Stormwater Permitting Program
�a
National Pollutant Discharge Elimination System
NCDENR
Na C 0, D[PaAnyENTOF NCG210000
F_RQ E- -D Ncun- Resouneee
NOTICE OF INTENT
FOR AGENCY UTF ONLY
Date Received
Year I
Month
Day
201s5
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CertificateofCovera
e
N 1'
Check
A ount
Perrnit Assi ned to
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National Pollutant Discharge Elimination System application for coverage under General Permit
NCG210000:
For STORMWATER DISCHARGES associated with activities classified as:
SIC 24 Timber Products (except as specified below), including Wood Chip Mills;
And, Like activities deemed by DEMLR 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:
• Wood Kitchen Cabinets (SIC 2434) C
• Wood Preserving (SIC 2491)� ` `��
• Logging (SIC 2411) J ll/ nrr 12
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Standard Industrial Classification Code y 0 DEN11-LAND QUALITY
(Please print or type) — ! r v �$rOf�MwprEP
PERMITTING
1) Mailing address of owner/operator (address to which official permit correspondence will be mailed):
Name Pallet Express, Inc
Owner Contact (a person) Ms. Lynn Bell
Street Address 6306 Old 421 Road
City Liberty
Telephone No,
E-mail Address Ibell((Dpalletexpress.com
2) Location of facility producing discharge:
State NC ZIP Code 27298 _
336-622-2266 Fax:[phone]
Facility Name Pallet Express, Inc. 'T S F'K r Roles we A m it
Facility Contact (a person) Ms. Lynn Bell
Contact E-mail Ibellgpalletexpress.com
Street Address 6306 Old 421 Road
City Liberty State NC ZIP Code 27298
County Randolph
Telephone No. 336-622-2266 Fax: [phone]
3) Permit Contact
Permit Contact (a person) Mr. Mark Shropshire
Contact E-mail mshropshire(a)palletexpress.com
Contact phone number 336-622-2266 X 309
4) Physical Location Information:
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). Highway 421 South from Greensboro. Exit onto Highway
62. East on Hwy 62 / Liberty Road (road turns into Old 421 Road) for about five miles. Site is on the left.
(A copy of a county map or USGS quad sheet with facility clearly located on the map is required to be submitted with this application)
5) Latitude 35 deg 53 min 11 sec N Longitude -79 deg 34 min 54 sec W (degrees, minutes, seconds)
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NCG210000 N.O.I.
6) This NPDES Permit Application applies to which of the following :
❑ New or Proposed Facility Date operation is to begin
✓ ❑ Existing
7) Standard Industrial Classification (SIC):
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: 2448
8) Provide a brief narrative description of the types of industrial activities and products manufactured at
this facility: Pallets are brought to the facility, disassembled, and repaired/refurbished and resold 1 recycled.
Wooden pallets that cannot be repaired and other wood brought to the site are ground into mulch, colored,
and then shipped offsite to be used as landscape material. Distribution trucks are serviced 1 maintained inside
a truck shop building.
9) Discharge points 1 Receiving waters:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? Two
10) Receiving waters:
What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater
discharges end up in? South Prong of Stinking Quarter Creek _C-AL r F_A-R O 3 — (it.= G3 (7 B j
us_v�
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),
11) Does this facility have any other water quality permits?
X❑ No
❑ Yes
If yes, list the permit numbers for all current water quality permits for this facility:
12) Does this facility have any Non -Discharge permits (ex: recycle permits)?
X No
❑ Yes
If yes, list the perinit numbers for all current Non -Discharge permits for this facility:
13) Does this facility employ any best management practices for stormwater control?
❑ No
X Yes
If yes, please briefly describe: Good housekeeping, store materials inside when possible, store materials on
concrete, keep lids on containers, clean up spills immediately
14) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No
X Yes
If yes, when was it implemented?2015
15) Does this facility have exposed accumulations of sawdust, bark, mulch, wood chips, or similar size
woody material on -site for longer than seven (7) days? (Exposed directly to rainfall or to run-on from
other areas of the facility.)
❑ No X ❑ Yes
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91 ' t
NCG210000 N.O.I.
16) Are vehicle maintenance activities occurring at this facility?
❑ No x ❑ Yes
17) 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) 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:
18) 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.
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: Lvi ja
Title: V 0 1
(Signa7rfre of
I I.
(Date Signed)
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to:
NCDENR
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SWU-236-080113 Last revised 712114