NCG210434_COMPLETE FILE - HISTORICAL_20150326

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v C& a I o Li,jy
DOC TYPE
C2' HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑
YYYYMMDD

Central Files: APS _ SWP
312512015
L �
Permit Number NCG210434
Program Category
NPDES SW
Permit Type
Timber Products Stormwater Discharge COC
Primary Reviewer
rick.riddle v
Coastal SWRule
Permitted Flow
Facility
f Permit Tracking Slip
RECEIVED
MAR 26 201n
CENTRAL FILES
DWR SECTION
Status Project Type
In review New Project
Version Permit Classification
COC
Permit Contact Affiliation
Facility Name
Major/Minor Region
Kepley -Frank Hardwood Company, Inc. Y
Minor Winston-Salem
Location Address
County
3979 Old Linwood Rd
Davidson
Facility Contact Affiliation
Linwood NC 27299 Jimmy Kepley '
975 Conrad Hill Mine Rd
Owner Lexington NC 27292
Owner Name Owner Typo
Kepley -Frank Hardwood Co Inc Non -Government
Owner Affiliation
Jimmy Kepley
975 Conrad Hill Mine Rd
Dates/Events Lexington NC 27292
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
2I2I2015
Regulated Activities Requested /Received Events
RO staff report received 3124/15
RO staff report requested 2111115
Outfail 1
Waterbody Name Streamindex Number Current Class Subbasin
Swearing Creek 12-113 C 03-07-07
V
W

NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Mr. Jimmy Kepley
Kepley -Frank Hardwood Co., Inc.
975 Conrad Hill Mine Road
Lexington, North Carolina 27292
Dear Mr. Jimmy Kepley:
Donald R. van der Vaart
Secretary
March 25, 2015
Subject: General Permit No. NCG210000
Kepley -Frank Hardwood Co, Inc.
COC No. NCG210434
Davidson County
In accordance with your application for a discharge permit received on February 02, 2015, 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). The Certificate of Coverage
number NCG180039 was previously rescinded for this facility per your request.
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. The Division of Water Quality may require
modification or revocation and reissuance of the certificate of coverage. This permit does not affect the
legal requirements to obtain other permits which may be required by the Division of Water Quality or
permits required by the Division of Land Resources, Coastal Area Management Act or any other federal
or local governmental permit that may be required.
If you have any questions conceming this permit, please contact Richard Riddle, Stormwater
Engineer at telephone number [phone].
Sincerely,
4't')
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
Division of Energy, Mineral and Land Resources
1612 Mail Service Center, Raleigh, NC 27699-1612 • Phone: [phone] • Fax: [phone]
Location: 512 N. Salisbury Street, Raleigh, NC 27604 • http://portal.ncdenr.org/webllr!
An Equal Opportunity/Affirmative Action Employer- 50% Recycled 110% Post Consumer 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. NCG210434
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,
Jimmy Kepley
is hereby authorized to discharge stormwater and from a facility located at
Kepley -Frank Hardwood Co., Inc.
3979 Old Linwood Road
Linwood
Davidson County
to receiving waters designated as Swearing 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 1, II, III, and IV of General Permit No. NCG210000 as attached.
This certificate of coverage shall become effective March 25, 2015.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day March 25, 2015.
for Tracy E. Davis, P.E., Director
Division of Energy, Mineral, and Land Resources
By the Authority of the Environmental Management Commission

&o' . 711 �, !,• / �; , Cam_
10
Kepley -Frank Hardwood Co., Inc.
r� u - ti �• DJ 41 -'i A.
IA
NCG210434
N
W E
S
Map Scale 1:24,000
Kepley -Frank Hardwood Co., Inc.
Latitude: 351 45' 48.07" N
Longitude: 801 18' 31.8" W
County: Davidson
Receiving Stream: Swearing Creek
Stream Class: C
Index Number: 12-113 (Yadkin Pee -Dee River Basin)
IF
1
IN
Facility Location

RECEIVED
FE8 0,02015
DENR-LAAID
STORMW.'* Rp RMIt NG
December 2014
NCDENR
Division of Energy, Mineral, and Land Resources
Land Quality Section
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Subject: Notice of Intent
Application for Coverage Under NPDES General Stormwater Permit NCG210000
And Rescission of Permit 180039
Kepley -Frank Hardwood Co.
3979 Old Linwood Road
Lexington, Davidson County, North Carolina
Dear Gentlemen:
On behalf of Kepley -Frank Hardwood Co, Inc., Blue Ridge Geological Services, Inc. (Blue Ridge)
prepared the attached application for coverage under NPDES General Pert -nit #NCG210000 to discharge
storm water associated with industrial activities at the subject site (Figures 1 and 2). A check for S100
for the new application fee is attached. We request that the current NPDES permit (#180039) be
rescinded since furniture manufacturing operations are not performed at the site. A rescission form is
attached.
Please contact the undersigned at 336.431-5454 if you have any questions concerning this application or you
need additional information.
Sincerely,
Jeffrey L. Gerlock, L.G.
NC Licensed Geologist #1 141
Cc: Mr. Jim Kepley
Attachments — Application, Figures, Check, Rescission Request Form
306 Eden Terrace, Suite C, Archdale, NC 27263 * Phone/Fax: [phone]

Division of Energy, Mineral and Land Resources
Apr/ Stormwater Permitting Program
National Pollutant Discharge Elimination System
NC®ENR
9px CI NA DC+ 7we w NCLi21i/Da1.1
[vnM,`.r�H TwoKQL Rcso�nccs
NOTICE OF INTENT
FOR AGENCY USE ONLY
Date Received
Year
Month
Dav
Certificate orcovera ge
zt
Check
A Gant
Pemut rigs ed to
-160a I
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 PertAjt,.r,(�EIVFn
• Wood Kitchen Cabinets (SIC 2434) ��
• Wood Preserving (SIC 2491) FEB 02 2015
• Logging (SIC 2411)
* Standard Industrial Classification Code DENR-LAND QUALITYSTORMWATER PERMITTING
(Please print or type)
1) Mailing address of ownerloperator (address to which official permit correspondence will be mailed):
Name Keplev-Frank Hardwood Co. Inc'
Owner Contact (a person) Mr. Jimmy Kepley
Street Address 975 Conrad Hill Mine Road
City Lexington State NC ZIP Code 27292
Telephone No. 336-746-5419 _ Fax: [phone]
E-mail Address ikepley�a keple}�frank.com
2) Location of facility producing discharge:
Facility Name Kepley -Frank Hardwood Co, Inc.
Facility Contact (a person) Mr. Jimmy Kepley '
Contact E-mail jkepley�keeleyfrank.com_
Street Address 3979 Old Linwood Road
City Linwood State NC ZIP Code 27299
County Davidson
Telephone No. 336-746-5419 Fax: [phone]
3) Permit Contact
Permit Contact (a person) Mr. Rangy Allen
Contact E-mail rallen(@kepleyfrank.com
Contact phone number 336-746-5419
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). Interstate 85. Take exit 88 (Linwood / Hwy 47). South on
Harqrave Road for 0.7 miles, mercies with Old Linwood Road. Site on left after 0.8 mi
(A copy of a my map or USGS fec
sheet with facility clearly located on the �nap is required to be submitted with this application)
ego
5 Latitude 5 deg, 9 min, N Longitude -80 deg, 1100 min, 0 sec W (degrees, minutes, seconds)
�7 �1 Page 1 of 4
SwU-23"80113 /� t I� �1 � Last revised 7/2/14

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: 2421
8) Provide a brief narrative description of the types of industrial activities and products manufactured at
this facility: Wood is brought to the site from Kepley Lexington facility and dried in dry, kilns_ and stored in the
onsite storage shed and yard. Wood waste is brought to the site and feeds the boilers which provide heat for
the kilns. Storage in warehouses. Maintenance in shop and garage. Oils stored in _shed.
9) Discharge points 1 Receiving waters:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? Four
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? Swearing Creek
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?
❑ No
X Yes
If yes, list the permit numbers for all current water quality permits for this facility: NCG180039 which we are
rescinding
12) Does this facility have any Non -Discharge permits (ex: recycle permits)?
X No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
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, stores materials on
concrete, keep lids on containers, clean up spills immediately, retention pond
14) Does this facility have a stormwater Pollution Prevention Plan?
❑ No
X Yes
If yes, when was it implemented?2012
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.)
X No ❑ Yes
Page 2 of 4
SW U-236-0801 13 Last revised 712114

NCG210000 N.O.I.
16) Are vehicle maintenance activities occurring at this facility?
X No ❑ 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).
hereby request coverage under the referenced General Permit. I understand that coverage under this permit
will constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an
individual permit.
certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing: t&z-s /4,44�a---Y ,m
Title:,/ -*Fs
(Signature of
/2 - /d •2a i}!
(Date Signed)
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to:
NCDENR
Page 3 of 4
SWU-236-080113 Last revised 7I2I14

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Site Location - Latitude - 35 degrees 49 minutes 41.9 seconds North
Longitude - 90 deg 10 min 20.8 sec West
Receiving -Water s - Swearing Creek. This creek in this area is not listed as impaired on the State 303(d) list.
Surface Water Flow Direction
Topographic Map
Kepley -Prank Hardwood Co.
3979 Old Linwood Road
REF.; USGS Linwood, NC Quadrangle Dated 1950 Linwood, North Carolina
photorevised 1994, from MSR Website Dec 2014 1 Figure 1

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LCLI_md:
lm�€r�iuua.a�rcas: 4alfall.d...... PQiul.4f.Uischargc-Lai itu*Ungiltdsc
1 - Pad -mounted transformer
Drainage Area OF-1 = 85% OF-1 35 deg 54' 58.61" N! 79 deg 59'56.76" Ni'
2 - Gasoline and diesel ASTs (concrete con twin nlen t) Drainage Area OF-2 = 90% OF-2 35 deg 54' 57.89" N/ 80 deg 00'01.48" W
3 -Oil Storage Shed Drainage Area OF-3 = 80 % OF-3 35 deg 54' 58.03" NI80 deg 00'07.38" W
4 - ,Maintenance Building Drainage Area OF-4 - 100% OF-4 35 deg 55' 7" N/80 deg 00'00" W
5 - Former Paint / Hazardous Waste Storage Area - erAp
6 - Four Fromer Paint ASTs (eniph' / not in use) RF,F.; 2004 Aerial photograph from Davidson County GIS
7 - Pad -mounted transfonners, compressors, trash compactor Prepared by Blue Ridge Geological Services
8 - Boilers (treatment chemicals, oil)
9 - 15,000-gal 95 Fuel oil AST (concrete containment) - empty J �'
10 - Diesel AST in Fire Shed
11 - l;quipmcnt with oil reservoirs
12 - Pole -mounted transformer
Stormwater catch basin
Site Drainage Map
\, Direction of Surface Water Flow (dashed lines = underground water flow) Kepley -Frank Hardwood Co.
�l Stormwater outfall location 3979 Old Linwood Road
Linwood, North Carolina
OF-3 Doc 2014 Figure 2

ATR
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Mr. Jimmy Kepley
Kepley -Frank Hardwood Co., Inc.
975 Conrad Hill Mine Road
Lexington, North Carolina 27292
Dear Mr. Jimmy Kepley:
Donald R. van der Vaart
Secretary
March 25, 2015
Subject: General Permit No. NCG210000
Kepley -Frank Hardwood Co, Inc.
COC No. NCG210434
Davidson County
In accordance with your application for a discharge permit received on February 02, 2015, 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). The Certificate of Coverage
number NCG 180039 was previously rescinded for this facility per your request.
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. The Division of Water Quality may require
modification or revocation and reissuance of the certificate of coverage. This permit does not affect the
legal requirements to obtain other permits which may be required by the Division of Water Quality or
permits required by the Division of Land Resources, Coastal Area Management Act or any other federal
or local governmental permit that may be required.
If you have any questions concerning this permit, please contact Richard Riddle, Stormwater
Engineer at telephone number [phone].
Sincere ORIGINAL SIGNED W
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
Division of Energy, Mineral and Land Resources
1612 Mail Service Center, Raleigh, NC 27699-1612 • Phone: [phone] • Fax: [phone]
Location: 512 N. Salisbury Street, Raleigh, NC 27604 • http://portal.ncdenr.orolwebA
An Equal Opportunity/Affirmative Action Employer— 50% Recycled 110% Post Consumer Paper

RECE/VED
DENR.WJD r
STQRn4W47ER P�UMJTTIy !G
December 2014
NCDENR
Division of Energy, Mineral, and Land Resources
Land Quality Section
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Subject: Notice of Intent
Application for Coverage Under NPDES General Stormwater Permit NCG210000
And Rescission of Permit 180039
Kepley -Frank Hardwood Co.
3979 Old Linwood Road
Lexington, Davidson County, North Carolina
Dear Gentlemen:
On behalf of Kepley -Frank Hardwood Co, 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. We request that the current NPDES permit (# 180039) be
rescinded since furniture manufacturing operations are not performed at the site. A rescission form is
attached.
Please contact the undersigned at 336-431-5454 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. Jim Kepley
Attachments — Application, Figures, Check, Rescission Request Form
306 Eden Terrace, Suite C, Archdale, NC 27263 * Phone/Fax: [phone]

w
Division of Energy, Mineral and Land Resources
Stormwater Permitting Program
it
National Pollutant Discharge Elimination System
NCDENR
Rmc �W"x
F�+wnanneNr .wo NRVAPL RE-MlRcf7 NCG210000
NOTICE OF INTENT
FOR AGENCY USE ONLY
Date Received
Year
Month
Da
Certificate of Covera e
NICIG12 1
Check
A unt
PermitAss1kned to
I
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 Pere [''[[ tCRvFn
• Wood Kitchen Cabinets (SIC 2434)
Wood Preserving (SIC 2491) � B � f-
• Logging (SIC 2411)
" 13
Standard Industrial Classification Code DENR-LAi #D QUALITY
STORMWATER PERMITTING
print or type)
1) Mailing address of ownerioperator (address to which official permit correspondence will be mailed):
Name Keolev-Frank Hardwood Co. Inc"
Owner Contact (a person) Mr. Jimmy Kepley
Street Address 975 Conrad Hill Mine Road
City Lexington State NC ZIP Code 27292
Telephone No. 336-746-5419 _ Fax: [phone]
E-mail Address ikepley(d-)ke0eyfrank.com
2) Location of facility producing discharge:
Facility !Jame Kepley -Frank Hardwood Co Inc.
Facility Contact (a person) Mr. Jimmy Kepley'
Contact E-mail [e-mail]
Street Address 3979 Old Linwood Road
City Linwood State NC ZIP Code 27299
County Davidson
Telephone No. 336-746-5419 Fax: [phone]
3) Permit Contact
Permit Contact (a person). Mr. Randy Allen
Contact E-mail rallenCa)kepleyfrank.com
Contact phone number 336-746-5419
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). Interstate 85. Take exit 88 (Linwood / Hwy 47). South on
Hargrave Road for 0.7 miles merges with Old Linwood Road. Site on left after 0.8 mi
(A copy of a c`oounty map or USGS d sheet with facility clearly loj�e ors the�rtap is re uIred to be submitted with this application)
5) Latitude 3brdea, Fnin, 42 sec N Longitude-eg, 100 min.�0 sec W (degrees, minutes, seconds)
SW t1-236-080113
�-" Page 1 of 4
Last revised 712114

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: 2421
8) Provide a brief narrative description of the types of industrial activities and products manufactured at
this facility: Wood is brought to the site from Kepley Lexington facility and dried in dry_kilns and stored in the
onsite storage shed and yard. -Wood waste is brought to the site and feeds the boilers which provide heat for
the kilns. Storage in warehouses. Maintenance in shop and garage. Oils. stored in shed.
9) Discharge points 1 Receiving waters:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? Four
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? Swearing Creek
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?
❑ No
X Yes
If yes, list the permit numbers for all current water quality permits for this facility: NCG180039 which we are
rescinding
12) Does this facility have any Non -Discharge permits (ex: recycle permits)?
X No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
13) Does this facility employ any hest management practices for stormwater control?
❑ No
X Yes
If yes, please briefly describe: Good housekeeping, store materials inside when possible,_ stores materials on
concrete. keep lids on containers, clean up spills immediately, retention pond
14) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No
X Yes
If yes, when was it implemented?2012
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.)
X No ❑ Yes
Page 2 of 4
5WU-236-080113 Last revised V2114

NCG210000 N.O.I.
16) Are vehicle maintenance activities occurring at this facility?
X No ❑ 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:
Now 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 l 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:.�y��,��pLEr
Title: ta" F T
/Z - /o •za �yl
(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
5WU-236-080113 Last revised 7/2114

�.t
70((7S
I• —±� +�i SN �.f/r'"• ..� _ ./ ; rki: t i!' �i fiZA
01
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V.
14
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Site Location - Latitude - 35 degrees 49 minutes 41.9 seconds North
Longitude - 80 deg 10 min 20.8 scc West
Receiving- Waters - Swearing Creek. This creek in this area is not listed as impaired on the State 303(d) list.
Surface Water Flow Direction
Topographic Map
Kepley -Frank Hardwood Co.
3979 Old Linwood Road
REF.: USGS Linwood, NC Quadrangle Dated 1950 Linwood, North Carolina
photorevised 1994, from MSR Website Dec 2014 Figure 1

OF-
r Manufacturing, *;!
N Building
(not in A. r y
.Finishing � ww_
Building
Warehouse. .
-4
-3
OF
Scale: 1 in - 91311 fl: Llti�
Lven d
Ia11tsCYigvS.9[ea5: QuIlaR.0 ...... P4iat.sf.U6rhargcIalit ull aaagiltltlg:
1 - Pad -mounted transformer
Drainage Area OF-1 = 85% 017-1 35 deg 54' 58.61"NI79 deg 59'56.76" W
2 -Gasoline and diesel ASTs (concrete containment) Drainage Area 017-2 = 90% OF-2 35 deg 54' 57.89" NI go deg 00'01.48" W
3 - Oil Storage Shed Drainage Area OF-3 = 80% OF-3 35 deg 54' 58.03" N/ 80 deg 00'07.38" W
4 - Maintenance Building Drainage Area OF-4 = 100% OF-4 35 deg 55' 7" NI80 deg 00'00" W
5 - Former Paint / Hazardous Waste Storage Area - e
6 - Four Fromer Paint ASTs (emph' / not in use) REF.: 2004 Aerial photograph from Davidson County GIS
7 - Pad -mounted transformers, compressors, trash compactor Prepared by Blue Ridge Geological Services
8 - Boilers (treatment chemicals, oil)
9 - 15,000-gal ##5 Fuel oil AST (concrete containment) - empty ! 4
10 - Diesel AST in Fire Shed f"
11 - Equipment with oil resetwoirs
12 - Pole -mounted transformer
® 5tormwater catch basin Site Drainage Map
\, Direction of Surface Water Flow (dashed lines = underground water flow) Kepley -Frank Hardwood Co.
'tl Stormwater outfall location 3979 Old Linwood Road
OF-3 Linwood, [North Carolina
❑ec 2014 1 Figure 2

f' 4
A
• . Division of Energy, Mineral & Land Resources
�� hand Quality Section/Stormwater Permitting Program
49W.P9=N.0 IL
MCDENRNational Pollutant Discharge Elimination System
N H Gnat+,. Ocr wr, or
E���«cam use Hew. ReyouMe[n
RESCISSION REQUEST FORM
FOR AGENCY USE ONLY
Date Received
Year
Month
Day
Please fill out and return this form if you no longer need to maintain your NPDES stormwater permit.
1) Enter the permit number to which this request applies:
Individual Permit (or) Certificate of Coverage
N C ,.5 N I C •G. / 8D 6) ,j
2) Owner/Facility Information: ' Flnal corresponden will be mailed to the address noted be! w OD
LL C — oWac,,-
,
Owner/Facility Name-�`Dt > L±n+�,� _fix OD
r 3979 0/ Lr'.,wuv. �oa Lrn cvocc�
Facility Contact e_
Street Address
City IVIJ State N+✓ ZIPCade -27 2
County Is on E-mail Address KC c C' . co,
Telephone No. 33�2 t- 5-/ Fax:
3) Reason for rescission request (This is required information. Attach separate sheet if necessary):
Facility closed or is closing onf'i All industrial activities have ceased such that no discharges of
stormwater are contaminated by exposure to i dus lal activities or materials.
(� Facility sold to � wU L - on ff' 7% 3 If the facility will continue operations under the new owner it
may be more appropriate to request an ownership change/ - .
to reissue to permit i th new owner. /
kher:
Lt� wv k/1 l�t �ry � - "4 d_J Sdd /% M Z. W'k '4 � All
�,v�Y ✓1 ,i yk f %C
n A/, 'A,,-, 44- tir e
4) Certification:
I, as an authorized representative, hereby request rescission of coverage under the NPDES Stormwater Permit for the
subject facility.- I am familiar with the information contained in this request and to the best of my knowledge and belief
such information is true, complete and accurate.
Sig
Date' 14., 0e/51
Print or type name of person signing above Title
Please return this completed rescission request form to: NPDES Permit Coverage Rescission
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
1612 Mail Service Center, Raleigh, North Carolina 27699-1612
Phone: [phone] FAX: [phone]
An Equal Opportunity k Affirmative Action Employer

Riddle, Rick L
From: Riddle, Rick L
Sent: Wednesday, February 11, 2015 1:47 PM
To: Gantt, Matt
Subject: NCG210434 Kepley -Frank Hardwood Co, Inc. and Rescission of NCG180039
Attachments: NCG210434 NOI Feb 11 15.pdf
Matt Gantt:
Please review the attached NOI application and after your review respond to me with any recommendations for
issuance of the permit. As you may know, the original facility, Linwood Furniture and permit #NCG180039, was closed
and the current owner/operator (Kepley -Frank Hardwood Co.) has previously requested a rescission request of
NCG180039. 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 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
NCG210434 Kepley -Frank Hardwood Co, Inc. 975 Conrad Hill Mine Rd Lexington/Davidson
If you need any more info, give me a call. If you could send me a recommendation to issue the permit by 03/11/2015,
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,
Richard Riddle
Rirluird 1.. Riddlc.11
Slormwater Engineer Phone: [phone]
NC Division of Energy, Mineral and Land Resources Fax: [phone]
1612 Mail Service Center Email: rick. rid dle(a)ncdenr.gov
Raleigh, NC 27699-1612 Web: http://portal.ncdenr.org/web/Ir/stormwater
Email correspondence to and from this address may be subject to public records taws

KEF EY-FRANK HARDWOOD CO., INC.
WHOLESALE & RETAIL LUMBER
121614
12/16/14 100.00
127199
100.00
19
ilvri� „
� ! T T 111•I G
1/30/13 127199 NCDENR if � C ^� � � $100.00 C.
IiCiWPLEY-FRANK HARDWOOD CO.JNC.
�.. WHOl ESALE'&'RETAIL LUMBER -.
r. -PH. 336-746-5419
975 CONRAD HILL MINE RD.
- Y '
LEXINGTON, NC 27292
Memo:
rOne .::Hundred ;and 00/100 Dollars
T04THE NCDENR
ORDER - Stormwater Permitting Program
1612 .Mail Service Center
,NC - 27699-1612
127199
127199
` NORTH CAROLINA
66-112-531
DATE AMOUNT m
m
Jan 30, 2015 ******$100.00
m
d
KEPLEY-FRANK HARDWOOD CO., INC.
1-
01- AUTHORIZED SIGNA7110

NCG210000 N.O.I.
Final Checklist
This application will be returned as incomplete unless all of the following items have been included:
❑ Check for $100 made payable to NC DENR
0 This completed application and all supporting documents
❑ Copy of county map or USGS quad sheet with location of facility clearly marked on map
Mail the entire package to:
Stormwater Permitting Program
Division of Energy, Mineral, and Land Resources
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Note
The submission of this document does not guarantee the issuance of an NPDES permit.
For questions, please contact the DFMLR Central Office or Regional Office for your area.
To visit our website, go to httpJ/portal.ncdenr.org/weblir/stormwater
DEMLR Re ional Office Contact Information:
Asheville Office ......
[phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
[phone]
Washington Office ...(252)
946-6481
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........
[phone]
Page 4 of 4
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a
�U 4
�4
NCG210434
N
W E
S
Map Scale 1:24,000
r r Kepley -Frank Hardwood Co., Inc. '
U �
9W
A
Kepley -Frank Hardwood Co., Inc.
Latitude: 350 45' 48.07" N
Longitude: 800 18' 31.8" W
County: Davidson
Receiving Stream: Swearing Creek
Stream Class: C
Index Number: 12-113 (Yadkin Pee -Dee River Basin)
Facility Location

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. NCG210434
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,
Jimmy Kepley
is hereby authorized to discharge stormwater and from a facility located at
Kepley -Frank Hardwood Co., Inc.
3979 Old Linwood Road
Linwood
Davidson County
to receiving waters designated as Swearing 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, II, III, and IV of General Permit No. NCG210000 as attached.
This certificate of coverage shall become effective March 25, 2015.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day March 25, 2015.
ORIGINAL B1
EN piCKLE
for Tracy E. Davis, P.E., Director
Division of Energy, Mineral, and Land Resources
'By the Authority of the Environmental Management Commission