NCG040209_COMPLETE FILE - HISTORICAL_19941026

Uo/ �, � G�t--v
STORMWATER DIVISION CODING SHEET
RESCISSIONS
PERMIT NO.
1 Y U`;�
DOC TYPE
COMPLETE FILE - HISTORICAL
DATE OF
RESCISSION
❑ I G yl q ) u a
YYYYMMDD

State of North Carolina •
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
Mr. Leon W. Perry
Perry Builders Outlet, Inc.
Post Office Box 589
Henderson, NC 27536
Dear Mr. Perry:
LJ
A4
E)EHNR
October 26, 1994
Subject: NPDES Stormwater Permit
Perry Builders Outlet, Inc.
COC NCG040209
COC NCG040210
Vance County
On May 27th and June 3rd of this year, the Division of Environmental Management issued NPDES
Stormwater Certificates of Coverage (COC's) under General Permit NCG040000 to the subject facilities.
The General Permit does not cover facilities primarily engaged in Wood Preserving, Standard Industrial
Classification (SIC) 2491. We understand that the two subject sites are engaged in wood preserving
activities.
An individual NPDES Stormwater Permit for each facility will be prepared pending submittal of
Form 2F (enclosed), excluding the sampling information. Descriptive answers to the questions in these
forms will provide the needed ongoing and historical preserving processes that have occurred on site.
The application materials should be submitted by November 30, 1994. If materials are not
submitted, permits shall be prepared for issuance without the benefit of the site specific information and
the certificates of coverage under the general permit revoked for each site. Your assistance in providing
the information will result in development of permits that reflect actual site conditions.
Your application fees (two @ $400.00 each) will be applied to new individual permits, and
therefore, additional applications fees need not be submitted. If you have any questions concerning this
matter, please contact Steve Ulmer at 919 / 733-5083.
Sincerely,
cc: Raleigh Regional Office
Enclosure
iriesO62ward, Jr., P.E.
Regional Offices
Asheville Fayetteville Mooresville Raleigh Washington Wilmington Winston-Salem
704/251-6208 919/486-1541 704/663-1699 919/733-2314 919/946-6481 919/395-3900 919/896-7007
Pollution Prevention Pays
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone]
An Equal Opportunity Affirmative Action Employer

•
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FORM
wcc«cy
1. EPA I.D. NUMBER
c®/� GENERAL INFORMATION
p
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F
ce«cwwL rncno«h«sus
GENERAL
Nn fef:n
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1. EPA I.D. NUMBER
it in low dwipmted apes. Reyww the infmn-
anion camully: R any of n Is irconen, opal
thm,wh it am ant. tW coma dab in tW
Ill. FACILITY NAME
appopeb fill—in arw below. At.. it any M
the pheprinted drta a abeem fore . W dw
IIit* of 1a 1a0ef space, lbw ft NRwtnadow
V. AGILITY
MAILIN ADDREss P EASE PLACE LABEL IN THIS SPACE
d'^'I101Ib a0pe"I• plaaw papyde h lo Ow
plapar fill—in weehl Wow. If 1M label e
comprte and oorroct. Y. heed not cOnvii
Ibma I. 111, V. and VI (e[npr V68 which
muar m cwnp/ebd nPandlew). Complab all
Hems R alp ball hill Opal poNdad. Ratter W
FACILITY
Vt'LOCATION
hlatlVClpm'for drtalled hall dea.14V
tium wd fW ma failed authorlaat)um unM
which dale dab a collaicbd.
41. POLLUTANT CHARACTERISfIIS
INSTRUCTIONS: Complete A through J to determiM whathr You mad m Submit MY permit epplicstion forms to the EPA If you sh wer'Yei to any
You must submit the form and Me supplemental form leNd in theparenthem
following the Question Mark '%' in the box in the ;hind column
gllasticnL
ff the supplemental form is ff"SOM If you amtller "no to adI question, You (lead net eubme Dry of theta fp You m" elbwp'no' it Your ectivity
is excluded fmm permil rpuimmants; m Section C of the Ilan U, am Sea also, Section D of the iMructions f W defpdtiom of bald—fwd berm&
secant pu[rno«s
_
aPcaFtc ouceaowe
y
B. Doesa will the facility Wdwr exbtlng apnpowd/
A. It me facility • phMidy owwed tentwnt web
a colvdnbd btbrl fpdknp opanomt a
X(FORM
which rawh. in • diacherga to wpaa of few U.S.?locltde
811 it
2A1
r
� W MeweP —W FOR 2M
h l n a ace, nil rc cmrem v new fact
to wren Of tha U.S. .1Wr than thole di cibaid in
X
s s• pm ny o -
M A a 8 aWwj which will spun la a 6idwrp to
X
A., ebow7 IFORM2CI
wqywsQ!t&i*USi?jFQRM7D)
F. Op you a will You ilhj•ct at the facility InduatliM a
E. put or wild the facility Irpt, aloe, Or dwpnw of
X
rtat .Cnw effluent bac eloalhe lowilaymet eintuln eon•
X
haaMdou wprp7(FORM 2)
timing, within om rlwbr JINN p tW will We.
and arround aohucu �rthMkilq wslar' (FORM dI
h•
o you or w, You Infect at t la act ny any
N. Do You a .All you Ildact ifthe tsOhY MYldl for all!
water or otmr fluid. which are bmulht W tW aunt—
till prooaaw such p miNng at Sulfa by the Fratctn
X
in connection with ccnwwitioml oil a Iwtural twl pr>
X
pm solution mining W mhnwall, in tint cafnbtle
duction, Injacl tluil l -W fix enhanced aalnwrY of
tlon call fowl full, a rr0oyery of 8eonrorl energy?
oil p futhim ali, a inject Build, Ill nuala of liquid
(FORM /1
ha
h roorbom7 (FORM a)
w
, t n ace, ny a tbt•onwY saute
one of the 28 Inchni rail cltparies fished M the in
NOT om Ow 28 iMumiM lasaiporNt feted in tlw
X
nructions and which will Potentially with 100 tors
X
Ysvhactiaru am which will w wPotentially ok 250 tom
of and' aia pollubra rqulrtW moss the Clean
W ynf of are sic polimill aalutrtW under the
Clain Air Act ad mry aff act a W located in en
par Yaw
Air Act and may rfNct a be looted In en atiall tleln
auinifa t.? (FOAM 51
PIA? (FORM 5)
IIL NAME Of FACILITY
I
style PtRRI MfILDERS OUTLET
INC.
t
IV. FACILITY CONTACT
....... T1TLa flail fiver. A lift')
a. [nowt Iowa seder • np.l
ON W PERRY
91 49 9171
V. FACILITY MAILING ADDRESS
•. srltee♦ ow P.o. aox
3, P0BOX5 9
a. urn ow roww
csrwr o•re cop[
y ' HENDERSON r
11k 7536
Vt. FACILITY LOCATION
w. srwc[r, wourc No. ow oTNcw s..cv¢ I... rill..
s MOBILE ROAD
a. COVNVyN Y(
VANCE
c. chrY ow Towle
srwr
c. zR coo.
if kojuaiLl
s
HENDERSON
NC
27536
1
EPA Form 31610-1 (Aar. 1020)
PAGE 1

W e
V11. SIC CODES (4�1;1.`in orwr a/pdedry)
.ecowo
l
4 1
/1-cf" WOOD PRESERVING 7
urllY)
c. rwua o. rovwry
nPra7Y) hPrcityl
7
f
Vill. OPERATOR INFORMATION
wya
Htlw na-a llaad In
I. V N I -A awo
ewwrt
g
LEON W PERRY]
YES ONO
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e.arwrVS Or o.aw.TOw(En ter dle aPProenzrc 4rtr•Mro dig alvwTr bo::q"OMri", tPMfrl
o..wowx (ann coo a_MERnal
ALPUBLIC r.d¢rrlanfird,,allsyc)
hnnfYl
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9
49
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S : STATE O -OTHER (rare t)
A
P PRIVATE
C Rwe.T Ow ..0..0.
X 5
r. crrr ow To.rw G.arwT w. xIr coot
IX. INOIAN LAND
I. IM naNliw looted on Indun Rnd.t
g
HENDERSON
NC
2 53
1 O YES K3NO
X. EXISTING ENVIRONMENTAL PERMITS
w. wrocs (Dacharty to Swfacr Waft)
o. no (A& En ov from Pro,o<L Sovnrrl
9 P
9 IN
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0. V IC((lndr•jrVlNd J.*K of l.W)
GOTwew hP.'v,')
"PeniY)
9
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c wcww (HaraNau. WLnvl
C arwal. (.P.*l
9 R 9
%I. MA►
Attach to this application a topographic map of the area extending to at least one mile beyond property bounderim The map must show
the outline of the facility, the location of each of its existing and proposed intake and discharge structures, each of its hazardous wane
treatment, storage, or disposal facilities, and each well where it injects fluids underground. Include all springs, riven and other surface
water bodies in the map area. See instructions far precise requimmemj.
XIL NATURE OF BIAINESS (ero. W. a bdrf description
WOOD PRESERVING
XI11. CERTIFICATION !rw ir.rwctiwnl
l certify under penalty of law that l have personalty examined and an, familiar with the information submitted in this goplkation and all
sttac hmenn and that, based on my inquiry of those persons immediately mWonsible for obtaining the information contained in the
application, l believe that the information is Hue, accurate and complete. / am aware that there art, significant penalties for submitting
false information, including Me possibility of fine and imprism nerrL
wig[. ornuwl ni[[(rypr o•Pnnq
.. acwwrowc (� cowT[z�cw[o
LeoN LJ• PIP/
]I 11-,24
..OMMENTS FOR OFFICIAL IISE ONLY
C
EPA For- 3511F1 (Rw. 10601 Ras
PAGE 2
. v.:. .n..I... nI r.... ml o!o« : Ives • 11.

Ak
EP1.11Rb Number (copy from item I of Form 1)
mrn QR91 1 snLn
FISppmved. OMB No. 2040-0086
Approval expires 5-31-92
Form
2F
NPOEs
United States Environmental Protection Agency
Washington, DC 20460
,� Application for Permit To Discharge Stormwater
®®EP Discharges Associated with Industrial Activity
Paperwork Reduction Act NoOce
Public reporting burden for this application is estimated to average 28.6 hours per application, including time for reviewing instructions.
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send
comments regarding the burden estimate, any other aspect of this collection of information, or suggestions for improving ;his grin, including
suggestions which may increase or reduce this burden to: Chief, Information Policy Branch, PM-223. U.S. Environmental Protection Agency,
401 M St.. SW, Washington. DC 20460. or Director. Office of Information and Regulatory Affairs, Office of Management and Budget,
Washington. DC 20503.
I. Outfa11 Location
For each ou'all. list the latitude and longitude of its location to the nearest 15 seconds and the name of the receiving water.
A. Oudall Number
flis') -= I G. Latitude
C. Longitude
D. Receiving Water
(name)
001 1 360 1
18' i
32"
8°
'
" I
SANDY CREEK
002 ! 360
18'
35" I
78°
1 24' 1
04"
SANDY CREEK
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II. Imorovemenls
A. Are you now required by any Federal, Slate, or local authority to meet any implementation schedule for the construction, voerading or
operation of wastewater treatment equipment or practices or any other environmental programs which may affect the discharges
described in this application? This includes, but is not limited to, permit conditions, administrative or enfcrcemen: orders. enforcement
compliance schedule letters. stipulations, court orders, and grant or loan conditions.
1. Identification of Conditions,
Agreements, Etc.
2. Affected Outfalls
4. Final
Comaiance Date
3. Brief Description of Project a. rec. I b. prof.
number
source of discharge
NONE
I N/A
N/A
N/A
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B. You may attach additional sheets describing any additional water pollution (or other environmental projects which may affect your
discharges) you now have under way or which you plan. Indicate whether each program is now under way or planned. and indicate your
actual or planned schedules lor'construclion.
III. Site Drainage Ma
Attach a site map showing topography (or indicating the outline of drainage areas served by the outfall(s) covered in the applfcatien it a
topographic map is unavailable) depicting the facility including: each of its intake and discharge structures: the drainage area of each storm
water outtall: paved areas and buildings within the drainage area of each storm water outfall, each known past or present areas used for
outdoor storage or disposal of significant materials. each existing structural control measure to reduce pollutants in storm wa:e, runoff.
materials loading ano access areas, areas where pesticides. herbicides, soil conditioners and fertilizers are applied; each c: :s hazardous
waste treatment. storage or disposal units (including each area not required to have a RCRA permit which is used for acc•_mula:...g hazardous
waste under 40 CFR 262.34); each well where fluids from the facility are injected underground; springs. and other surface �a!er boozes which
receive storm water ciscnarges from the facili N.
EPA Form 3510-2F (11-90) Page t of 3°"""v° "" •aye
2F-1

Ah
A. For each oudall, provide an estimate of the area (include units) of impervious surfaces (including paved areas and building rocfs) drained
to the oudall, and an estimate of the total surface area drained by the oudall.
Oudall I
Area of Impervious Surface
Total Area Drained
Oudall
Area of Impervious Surface
Total Area Drav,ec
.Number
(pldvide unit�l
(provide units)_
Number
M,dre unirs1lto
vin'!-
001
152756 SF
I 169,729 SF
002
311:629 SF
311,629 SF
G. Provide a narrative description of significant materials that are currently or in the past three years nave been treated, siorec or aIsccsec
a manner to allow exposure to storm water: method of treatment, storage, or disposal: past and present materials management ::a:::ces
employed. in :he last three years. to minimize contact by these materials with storm water rune": materials loading and access areas, anz
the location. manner, and Ireeuency in whirh pesticides, herbicides, soil conditioners, and fenilizerz are applied.
Preserved lumber is stored outside before shipping
Unpreserved lumber is stored outside before shipping
t
C. For each oudall, provide the location and a cescription of existing structural and nonstructural control measures to recuce pcl:v:ap:s :n
storm water ruho:': and a description of the treatment the storm water receives, including the schedule and type of maintenance ::: cchscl
n m. rP ln• m +a r n : im • i n li I w i ^h
Oudall List C' . '.. "
-
m Tr
n --
001
None
002
None
V. Nonstormwater Dischar es
A. I eerily uncer penalty of law that the oudall(s) covered by this application have been tested or evaluatec :or t'e presence C:
nonstormwaler discharges, and that afl nonstormwater discharges from these oudall(s) are identified in either an accompanying Fcrm 2C
r Form 2c a^ Iica'i o for the ityda'l.
Name and O"icial Tale (r pe or prier)
Signature
Date Sicced
Li. per. II1 J P
(XON y
B. Provice a cescr.puon of Ine memco used, the date of any testing, and the onsite drainage points that were directly observed cuonc a test
N/A
VI. Significant Leaks or Spills
Provide existing iplwmation regarcino the history of significant leaks or spills of toxic or hazardous pollutants at the facility in the :as: ^ree
years. including :he approximate date and location of the spill or leak, and the type and amount of material released.
None in the last 3 years.
EPA Form 3510-2F (11.90) Page 20l 3 Continue on Page 3
2F-2

item/ of Form r)
Continued from Page 2 1 NCD98211504
VII Dig har4
A.B.C, d D: See instructions before proceeding. Complete one set of tables for each curtail. Annotate the ou11411 number in the space provided.
Tables VII-A, VII-B, and VII-C are included on separate sheets numbered VII.1 and 10II.2.
E: Potential discharges not covered by analysis - Is any pollutant listed in Table 2F-2 a substance or a component of a substance which you
currently use or manufacture as an intermediate or final product or byproduct?
Yes (list all such pollutants below) No (o fo $ecrion IX)
ToXiCity JQ5tjOgD t
Do you have any knowledge or reason to believe that any biological test for acute or chronic toxicity has been made on any of your discharges or
on a receiving water in relation to your discharge within the last 3 years?
Yes (list all such pollutants below/ No too to Section lx)
IX. ConlEact Analysis InfocmaliQ
Were any of the analyses reported in hem V performed by a contract laboratory or consulting firm?
Yes (lisr the name, address, and telephone number or, and pollutants No (go fo Section �
'rrnbelow)
A. Name B. Address
C. Area Code &Phone No.
D. Pollutants?,nalvzed
1 certify under penalty of law that this document and all attachments were prepared under my direcrion or
supervision in accordance with a system designed to assure that qualified personnel properly garner and evaluate
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 submitted is, to the best of my knowledge and
belief, true, accurate, and complete. 1 am aware that there are Significant penalties for submitting false information,
including the possibility of fine and imprisonment for knowing violations.
A. Name 8 Official Title (type orprin!)
B. Area Code and Phone No.
PPre-v• P•
919-492-9171
Leon w- Ll�
C. Signature
D. Date Signet
D.
Page 3 of 3
EPA Form 3510.21F (11-90)
oc I

E'r4 umber (copy Irpm r;em r of Pone r)
NCD982115040
rQAppmved. OMB No. 209: --0 r
APpmval expues 5-31.92
VII. Discharge Information (Cononued from oa e 3 of Form 2F
Part A - you must provide the results of at least one analysis for every pollutant in this table. Complete one table for each cu:!au. See
instructions lot additional details.
Pollutant I
and
CAS Number
(it availabre)
Maximum Values
(include units)
Average Values
(include units)
Number
of
Sources of Pollutants
Grab Sample
Taken During
First 30
Minutes
Flow -weighted
Composite
Grab Sample
Taken During
First 30'
Minutes
Storm
Flow.weighted I Events
Composite Sampled
Oil and Grease
Biological Oxygen
Demand (BOOS)
Chemical Oxygen
Cemand (COD)
i I I
1
OMIT
Total Suspended
Solids (TSS)
i
Total Kieldahl
Nitro en
Nitrate plus
Ntl1ne Nitrogen
i
Total
PhoSbhorvS
pry Minimum :.Maximum Minimum Maximum
Part B - List each pollutant ;hat is I,mnec in an emuent gwdeene wMcn the faulty is Su D)ec::0 cr any pollutant listec in me lacivty s NPC^
permit lot its process wastewater (if the facility is operating under an existing NPDES permit) Complete one table to each cu::a;l
C.. In. m tor cs,l, n
I Maximum Values
Pollutant (include unirs)
Average Values I Num.bet
I (include units) I of
Sources cl Pcllu:an:s
and Grab Sample
CAS Number I Taken During
First 30
(it avadaole) , Minutes
Grab Sample
Flow-weign:ed I Takeo Dunng
First 30
Composite Minutes
I Flow -weighted
Composite
I Storm
I Events
Sampled
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EPA Form 3510-2F (11.90) Page Vn.t - Continue pit =e: r.se

AhL
n
COntlnuac Rom in. rren,
Part C - List each pollutant shown in Tables 2F- , 2F-3, and 2F-4 that you know or have reason to believe is present. See the mstructions for
additional details and requirements. Complete one table for each outfall.
Pollutant
and
CAS Number
(if available)
Maximum Values
(include units)
Average Values
(include units)
Number
of
Storm
Events
Sampled
Sources of Pollutants
Grab Sample
Taken During
First 30
Minutes
Flow -weighted
Composite
Grab Sample
Taken During
First 30
Minutes
Flow -weighted
Composite
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Part D - Provide data for the storm eventfs which resulted in the maximum values for the flow weighted composite sample.
t.
Date of
Storm
Event
2.
Duration
of Storm
(in minutes) I
3.
Total rainfall
during storm event
in inches)
4.
Number of hours between
beginning of storm mess.
uretl and end of previous
measurable rain event
5.
Maximum floe rate
during rain event
(gallons/minute or
specify units
6.
Total flow from
I rain event
- (gallons or
soeci units)
7. I
Season
e
samplas
takenw
8.
Form of
Precipitation
(rainfall,
snowmelt)
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9. Provide a description of the method of flow measurement or estimate.
EPA Form 3510-2F (11-90) Page Vil-2
2F-5

1tate of North Carolina
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
Mr. Leon W. Perry III
Perry Builders Outlet, Inc.
P.O. Box 589
Henderson, NC 27536
Dear Mr. Perry:
EL
[DFEE HNR
June 3, 1994
RECEIVED
JUN U 7 1994
DEHNR-RAL RO
Subject: General Permit No. NCG040000
Perry Builders Outlet, Inc.
COC NCG040210
Vance County
In accordance with your application for discharge permit received on March 29, 1994, 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
December 6, 1983.
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 Environmental Management. The Division of Environmental Management 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 Environmental Management 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 Steve Ulmer at telephone number 919/733-
5083.
Sincerely, g ned By
Original Si
Coleen H.
A. Preston Howard, Jr., P. E.
cc: Ra el igh.Regional Office
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
STORMWATER DISCHARGES
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,
Perry Builders Outlet, Inc.
is hereby authorized to discharge stormwater from a facility located at
Perry Builders Outlet, Inc. - Raleigh Road Plant
Raleigh Road South / US Highway 64 Business
Henderson
Vance County
to receiving waters designated as Martin Creek in the Roanoke 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. NCGO40000 as attached.
This Certificate of Coverage shall become effective June 3, 1994.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day June 3, 1994.
Original 8frr�
Coleen H
A. Preston Howard, Jr., P.E., Director
Division of Environmental Management
By Authority of the Environmental Management Commission

1 7' 30"
TC L LD
1 MILE
7000 FEET
KILOMETER
12
BEQUEST
-015oo0 N.
—cloiomca SUAVE+. peso+. vaciwi._3-36°15'
734 • „�.a�o. 73500on,.E °ss 78°22'30„
ROAD CLASSIFICATION
Primary highway, Light -duty road, hard or ioF
T
hard surface ................. improved surface_...
Secondary highway,
hard surface ...._....... Unimproved road..._._______--
Interstate Route U. S. Route State Route
...... ... .. .... ... ... ... N3615=0.78225/75. ..:_
1970
PHOTOREVISED 1982
DMA 5356 IV SW -SERIES Va42
NC'

State of North Carolina
-­y--Department=of-E-nvironFr
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
May 27, 1994
Mr. Leon W. Perry
Perry Builders Outlet, Inc.
P.O. Box 589
Henderson, NC 27536
........r..f
[DEHN11
Subject: General Permit No. NCG040000
Perry Builders Outlet, Inc.
COC NCG040209
Vance County
Dear Mr. Perry:
In accordance with your application for discharge permit received on March 29, 1994, 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 .l and the
Memorandum of Agreement between North Carolina and the US Environmental Protection agency dated
December 6, 1983.
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 Environmental Management. The Division of Environmental Management 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 Environmental Management 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 Steve Ulmer at telephone number 919/733-
5083.
Sincerely, rod BY
origin
af St'SuVlins
Coleen H.
A. Preston Howard, Jr., P. E.
cc: Raleigh Regional Office
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50%recycled/ 10%post-consumer paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
GENERAL PERMIT NO,NCG040000
CERTIFICATE OF COVERAGE►1 NCG040209
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,
Perry Builders Outlet, Inc.
is hereby authorized to discharge stormwater from a facility located at
Perry Builders Outlet, Inc. - Mobile Plant
Cedar Street
Henderson
Vance County
to receiving waters designated as Rowland Pond/Sandy Creek in the Tar -Pamlico 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. NCGO40000 as attached.
This Certificate of Coverage shall become effective May 27, 1994.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day May 27, 1994.
Ori&final S•,�Sudins
coleen N.
A. Preston Howard, Jr., P.E., Director
Division of Environmental Management
By Authority of the Environmental Management Commission

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Ulmk/—
CX4 13(i"1 400D0 it
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
NOTICE OF INTENT REQUESTING COVERAGE UNDER
GENERAL PERMIT NO. NCG040000
STORMWATER DISCHARGES associated with activities classified as Timber Products (Standard
Industrial Classification Code (SIC 24)).
Complete this Notice of Intent (NO1) and mail to the following address
North Carolina Division of Environmental Management
Water Quality Section, NPDES Group,
P.O. Box 29535
Raleigh, North Carolina, 27626-0535
The NO1 must be accompanied with a general permit filing fee of 5400.00. The check should be
made out to the North Carolina Department of Environment, Health, and Natural Resources.
THIS SECTION TO BE COMPLETED BY ALL INDUSTRIAL ACTIVITIES:
Name: Perry Builders Outlet, Inc.
Address: P. 0. Box 589
City:
Henderson
State:
NC
Zip: 27536 Phone:( 919 t 49 -9171
Name: Perry Builders Outlet Inc - Mobile Plant
Address: Cedar Street
City:
County:
Henderson
Vance
State: NC Zip: 27536
Phone L 919 492-9171
N01 04 Page 1

0 . !
Physical Location Information:
(Street address, state road number, distance and direction from roadway intersection, and
attach a copy of a county map or USGS quad with the location of the facility marked on the map.)
adjoining Nicholas Street less than 1/10 mile north of Skenes Ave (State
Road 1145)
[Agency use only: Lattitude
Longitude 1
STANDARD INDUSTRIAL CLASSIFICATION (SIC CODE): 2491(for activity for which the
facility is primarily engaged)
DESCRIPTION OF INDUSTRIAL ACTIVITY/PRODUCTS MANUFACTURED AT THIS FACILITY:
CCA treatment of lumber
This is an 2L_ existing facility or a _ proposed facility.
If proposed, date operation is to begin
Stormwater discharges to a drainage ditch alongside Skenes Ave.
(name of receiving water or, if to a separate storm sewer system, name of the separate storm
sewer system)
A. Does this facility have any NPDES Permits? _yes L_no If yes, NPDES No,
B. Are vehicle maintenance activities occurring on site? _ yes x no
C. Does this facility employ any best management practices for stormwater control? 1-yes _no
D. Number of stormwater discharge points? 2
E. Is this facility a Hazardous Waste Treatment, Storage, or Disposal facility? —yesx • no
F. Is this facility a Small Ouantitiy Generator (less than 1000 kg. of hazardous waste generated
per calendar month) of Hazardous Waste? X yes _no
Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated
per calendar month) of Hazardous Waste? _yes: no
N0I 04 Page 2

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.
1 certify that I am familiar with the Information contained in the application and that to the best
of my knowledge and belief such information is true, complete, and accurate.
1 certify that I am familiar with the information contained in the application and that to the best of my
knowledge and belief such information Is true, complete, and accurate.
March 25, 1994
signature
Leon W. Perry III
name of person signing above (printed or typed) title
date
Vice —President
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 Article 21 or regulations of the
Environmental Management Commission implementing that Article, or who falsifies, tampers
with or knowingly renders Inaccurate any recording or monitoring device or method required to
be operated or maintained under Article 21 or regulations of the Environmental Management
Commission implementing that Article, shall be guilty of a misdemeanor punishable by a fine m
not to exceed $10,000, or by Imprisonment not to exceed six months, or by both. (18 U.S.C. o
Section 1001 provides a punishment by a fine of not more than $10,000 or imprisonment nob,
more than 5 years, or both, for similar offense.) c
W mm�
�D D
NOI 04 Page 3

1
V
SCALE
1.000. 0 1,000' 2,000- 3.000- 4,000- 5,000-
SOURCE: U.S. GEOLOGICAL SURVEY MAP
HENDERSON. N.C., PHOTOREVISED 1982
FIGURE 1
SITE LOCATION MAP
ENVIRONMENT & PERRY BUILDERS, INC.
INFRASTRUCTURE MOBILE ROAD PLANT
VANCE COUNTY, N.C.
PROJECT NUMBER: 32335.000
CADFILE: 32490-2. DATE PLOTTED: 11-17-94