NCG050190_COMPLETE FILE - HISTORICAL_20121206

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v
DOC TYPE
HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ � b I G� �
YYYYMMDD

HICKORYSPRINGS
MANUFACTURING COMPANY
December 6, 2012 VIA CERTIFIED MAIL
Mr. Robert Krebs
NCDENR — Division of Water Quality
Iredell County Government Center South
610 East Center Avenue, Suite 301
Mooresville, NC 28115
RECEIVED
DIVISION OF WATER QUALITY
DEC 10 2012
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MOORESVILLE REGIONAL OFFICE
RE: Hickory Springs Manufacturing Company (Conover Complex)
Storm Water.Permit-No, NCG050000
COC No.6CG0501 go
Dear Mr. Krebs:
The purpose of this letter is to renew the existing storm water permit held by Hickory
Springs Manufacturing Company at 1115 Farrington Street Conover, NC.
Forms included in this request:
Notice of Intent (application and supporting documents)
USGS Quad Sheet
Check for $100.00 to NCDENR
If you have any questions concerning this matter, please feel free to contact Stephen
Aldridge at [phone], Ext. 4811.
Sincerely,
Stephen M. Aldridge
Environmental Compliance Coordinator

LIMA
• Division of Water Quality / Water Quality Section
NCDENR National Pollutant Discharge Elimination System
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NCGO50000
NOTICE OF INTENT
I Date Received I
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG050000:
STORMWATER DISCHARGES associated with activities classified as:
SIC 23
SIC 265
SIC 267
SIC 27
SIC" 30
SIC 31
SIC 39
SIC" NIA
Apparel and Other Finished Products Made from Fabrics and Similar
Paperboard Containers and Boxes
Converted Paper and Paperboard Products
Printing, Publishing and Allied Industries
Rubber and Miscellaneous Products (except as specified below)
Leather and Leather Products (except as specified below)
Miscellaneous Manufacturing Industries
DENR - WATER QUALITY
We lands S rwaty- Branch
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 ownerloperator (address to which all permit correspondence will be mailed):
Name Hickory Springs Manufacturing Company
Street Address 235 2"d Avenue NW
City Hickory StateNC ZIP Code 28601
Telephone No. 828-328-2201 Fax:
E-mail Address [e-mail]
2) Location of facility producing discharge:
Facility Name
Facility Contact
Contact E-mail
Street Address
City
County
Telephone No.
Hickory Springs — Conover Complex
Stephen M. Aldridge
[e-mail]
1115 Farrington Street
Conover
Catawba
828-328-2201, Ext. 4811 Fax:
State NC ZIP Code 28613
3) 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). Use Exit 130 off 1-40 and proceed North and West on
US 70A. Turn left at light onto Workman Street. Turn left onto Farrington Street. Proceed down hill on
Farrington Street and to the facility entrance at the facility security guard building.
(A copy of a county map or USGS quad sheet with facility dearly located on the map is required with this application)
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NCG050000 N.O.I.
4) Latitude 35° 43' 01.97" N Longitude 81° 14' 30.93" w (degrees, minutes, seconds)
5) This NPDES Permit Application applies to which of the following:
❑ New or Proposed Facility
0 Existing
6) Standard Industrial Classification:
Date operation is to begin
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: 3086
Provide a brief narrative description of the types of industrial activities and products manufactured at
this facility: A variety of products are manufactured at the Conover Complex, including flexible
polyurethane foam products for the bedding and furniture industries, wire products used for the a
wide range of markets in the cable industry, and extruded polyethylene foam products for packaging,
insulation, bedding, furniture, and recreational products
7) Discharge points:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? 06
8) 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? Cline Creek, Catawba River Drainage Basin
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 facility have any other NPDES permits?
❑ No
0 Yes
if yes, list the permit numbers for all current NPDES permits for this facility: IUP# 101 HS
10) Does this facility have any Non -Discharge permits (ex: recycle permits)?
0 No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
11) Does this facility employ any best management practices for stormwater control?
❑ No
0 Yes
If yes, please briefly describe: Good Housekeeping: Facility outdoor areas are kept clean and free of debris, overhead
doors are kept closed during rain events, and significant materials are stored indoors or within outdoor secondary
containment. Preventive Maintenance: Berms, including secondary containment structures and drains maintained and
inspected on a monthly basis, equipment operated according to manufacturer's recommendations. Spill Prevention and
Response: Accumulated rainwater with secondary containment areas is visually inspected for the presence of an oil sheen
before discharge, leaks of petroleum products are immediately cleaned up, and implementation of the facility's SPCC
Plan.
12) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No
0 Yes
If yes, when was it implemented? The SWPPP was first implemented in the early 1990's (est. 1993)
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NCG050000 N.O.I.
13) Are vehicle maintenance activities occurring at this facility?
❑ No 91 Yes
14) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
© No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
© No ❑ Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
91 No ❑ Yes
d) Ifyou 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 address:
15) 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: !Bobby W. Bush
Title:enjlor Vice�PresideA Foam & Environmental Technology
(Signature of
(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
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NCG050000 N.O.l.
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
El This completed application and all supporting documents
© Copy of county map or USGS quad sheet with location of facility clearly marked on map and nearby waters
Mail the entire package to:
Stormwater and General Permits Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Note
The submission of this document does not guarantee the Issuance of an NPDES permit.
For questions, please contact the D WQ Central Office or Regional Office for your area.
DWQ Regional Office Contact Information:
Asheville Office ......
(828) 2964500
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
[phone]
Washington Office ...
[phone]
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........
[phone]
Page 4 of 4
SWU-220-071408 Last Revised 7/14/2008

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Figure 1 - General Location Map
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