NCG040210_COMPLETE FILE - HISTORICAL_19941026

Uu/ in G C�L"
STORM_ WATER DIVISION CODING SHEET
RESCISSIONS
PERMIT NO.
DOC TYPE
COMPLETE FILE - HISTORICAL
DATE OF
RESCISSION
❑ I _I r `7 i U a (O
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:
L]
A- J
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
Storm water 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
fors 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,
Jriesoaward, Jr., P.E.
cc: Raleigh Regional Office
Enclosure
Regional Offices
Asheville Fayeiteville 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 Pa vs
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone]
An Equal Opportunity Affirmative Action Employer

Pleare or.m or lVM'n rM unsnaaM •real only lion Apww•C OMB No. 2WO 6 Apw01110p1$ 731 IS
hill— a rp•cM ran Nrrt type, r.
s
U.a.s«unwoNM[wuLrworecTlo«ACE«cv
FORM
LEpq LD. NUMBER
C GENERAL INFORMATION
ronnofiNned RmnO Proyrwn
1 0/LDA
F D
OCMEwA............
GENERAL ,Reed nhr "Lenity Imnv<Iiom"
Mfow we.mna.l
Ii . preprinrd I.MI KM been pwiEW. affix
I. EPA I.D. NUMBER I
it to the dwi weo rpaa. Rewt•w IlM Inform
.Ilan arelully: R any of n 4 inrsr.ecL aoo
Mrpgh 4 Into enw IN corr.ct Us. In Thal
III. FACILITY NAME
ap,h,,Sa a fil"n .nr below. Also. It any of
tN sprinted drul I. sb.em (ON .na'n ON
left of ON Naaf apse fiftyfiftyVas NfonNtlan
ACI LITY
Y' MAtL1N ADDREss P EASE PLACE LABEL IN THIS SPACE
tltat NovlO aaaasrf• deaas below. If Ie n N the
Into ann(a/.ne 11 the label 4
mmo s You need ,tot-8
Ill.
aean,s
"ita
1. V. ha •vlifar
L III, V. Ind VI Vela.
om
hh, d np.Nlmv Comp4Y MI
moat N c
NWI Na bean Provided. m
dams tl labal
FACILITY
YI.
dwaeter
dM U deW1.d llerll d.vtf>
LOCATION
awe N
tip« and M IM lean awlalcatbm under
and for
wwltich this tow 4 collernd.
11. POLLUTANT CHARACTERISTICS
INSTRUCTIONS: Complete A through J to determine whether you Nod m wbmh any pllmit application forms to tM EPA It you aNwer'ytl'to any
fubmit this lam and the supplemental farm, Idnd In the
pusothew following the quadoa Mark "X' in the box in the third column
Quamju,L you must
if the mpplamental farm fa finagiv i. 11 You amwea anon to ash pueraim, you nwd not submit My of these forma You may wwer'no- it your activity
is excluded from pemit Mquir, oh ntr, a Sactian C of the hgauctian Sea after Ssbm 0 o1 the imbucboN for defimtiom of bold -Iced tams.
f•[CIFIC 0Y[eT1O«F
•
r
V[CIPIC OY[fTIOMf
a.
r
8. Dan a will this f dish, "WW rotin, apnpcand/
A Is m4 ficil' • Y awwrd Vaatllwt Iswlq
X
Include a FzwawMtr W AIt6,a1 feateeg OpredYl a
X
:Mich rMuh I. a d4rhre. m wreaf of err U.L?
e p atic a * product" feaBNy, wnidt rewlta in a
(FORM 2A)
&xNPr m wetws of tha USI (FORM 281
I I s I •a nv K EUIrw it v new u m
10 .elane of the U.S. other than thcr a deviled in
X.
. a• M o
N A a B Abowl) wwldtll will rauh In a A m
X
A1, .00.? (FORM 2
ON, U 7 fFQflM7Ol
F. Do you a will yw inject at this reality IndUrN44 a
E. Oars a wi11 this failhr oast. Ron. a dimu.a or
X
Thin .oW eHhwm belotalN lowvmat Itresan Ise'
X
h.a." waas2(FORM 21
Yining• an dw well b
wnd:h=,Zwo'(FORMa)re,
undarpwith
G. o I.. o, w� you .nett aI t n .O "any
H. Do You a will YOU Meet ifthis facility 8uide Map►
at",••
.Man or atr fluids wnidt eve INoegsu ht M the r/w
dal pronefew wall m mining at wlfa by the Frwel
X
in connaaion with "IentiCNl pit a Ntunl eM go-
X
a— solution min'wg Be minanb. In dta carbon
duction, iniM fluids used ip anhertad nrawfry of
flan of fatal fuel. a noway of geoUrnlW eteyy2
Oil a Ntunl W. a inject fluids fa atpap of liquid
(FORM O
N
�•
h ronrbom7lFORM aI
w
a t n acI nr • RMMw•wY .plea a
a nY • wbM apwea
NOT IN 28 irduWal aYgarlM Ib.ed N tit
oN of the 28 indavial ategpies linad in IN in-
d which will polantielly it 100 tons
anem
X
awe of
4salatione and which will POW Wry anttit 250 tone
X
nrvnions
of awe .ir pollutant regulated undo the
pan year of ewe a« pollucant ng WW under the Chan
per year
Clean Air Act and may sINr a be located in on
At, Act and may aI abelocatedNanatak-
atYinEllarlt area? (FORM 51
.? WORM 51
IIL NAME OF FACILITY
1M.. P R ILDERS OUTLET
INC.
IV. FACILITY CONTACT
A. M AM... Y.TLC 1.1 tint, A filUl
s. rn0«c fana <eJ< A «e.l
2
ON W PERRY
91
49 9171
V. FACILITY MAILING ADDRESS
A. srw ECT ow r.o. Ioa
3, P 0 BOX 589
A. urY ow rOWN
<srwT O•z:•COOE
4 - HENDERSON
NC 7536
VI FACILITY LOCATION
A. STwc ET. ROUTE NO. On OTHER SPECIFIC IDENTIFIER
s MOBILE ROAD
I. COUNTY M
VANCE
c. urY ow Tow«
.ITAT
over coot
6 HENDERSON
NC
27536
1
EPA Form 3510P1 1Rew. 10410)
PAGE 1

0- •
VII. SIC CODES (a-d%ah, in ender of Prladryl
wfT •. EEcowo
4 1
I'P, Y/ WOOD PRESERVING
P ryY)
E. TN.wO D.. wTN
!+➢rnfy/ nPrrUY/
i
1
Vill: OPERATOR INFORMATION
wue
bdw nun. llma In
ItEm V I I I -A
Ala
)
s
LEON W PERRY
}}��ewrr
4JYE S ONO
e.frwrVf or orawwTow(En nor Nr aaamariErE lrrtrraro du anrwrr Aor:U"'Odlrr", +ardfY�l
o. PNONe (anP redr A nwl
AL - LI (.M"Iftanfrdna(o.rtesr/
(PrrIfY)
9
49
1 1
S - STATE O - OTHER J~y)
A
P - PRIVATE
f, sTwear ow P.o. sox
X5
•In.
e. eve ow mow e.sTAT x11 EooE
11X. INDIAN LAND
Ir E E facility Iolated Ise irE,4. Hndl7
e
HENDERSON
NC
1 2 53
O YES S3NO
.:
X EXISTING ENVIRONMENTAL PERMITS
o. M. (A& Emla . fh n, fr poaed S..,
9 P
A. woof (Di Aar,.,. S—f. W.Url
9
N
•a•mc(UwderPPlord/wirelioe
ofFiwMsl
aorwfw(,x I
IsarW/1
9
U
g
C. wC.A (Nasudaur Mlxr+l
eon.. (1Prci/y/
(rprelryl
9 R 9
xl. MAP
Attach to this application a topographic map of the area eaten ing to at least one mile beyond property bounnderieu. The map must show
the outline of the facility, the location of each of its existing and proposed intake end discharge structures, each of its hazardous waste
treatment, storage, a dispoul facilities, and each well where it injects fluids underground. Include all springs, riven and other surface
water bodies in the map area. See instructions for precise requirements.
XIL NATURE OF BUSINESS (,.erodea brief daA'rVden
WOOD PRESERVING
x I1L CERTIFICATION (.,InMVEd.l
1 certify under penalty of law that 1 have personally erarrinedand am familiar with the infomu rias submitted in this application and all
attachments and that, based on my inquiry of those penorss immediately responsible for obtaining the information contained in the
application, 1 believe that the information is true, accurate and compI l am aware that there are significant penaltia for submitting
false information, irncluding the possibiliry of fine and imprisonment
Le�E A Oi FICIAL TITLE /rY➢r 0/➢can!/
Y. FICMwTVwC
C. OATC SIONCD
Q Pi t.t.! r -PP fy lj! tl
z l • �1C.
.,OMMENTS FOR OFFICIAL USE ONLY
C
EPA Fa- 3510.1 (Rw. I"01 Aw ,rE
PAGE 2
a 1.:. ln., rnvnl rnn��H otl.,e IeR na 'r. q:Hl

E Number (copy from ttem I of Form 1)
,..,i., mrnoa9114r1/.n
Spproved. OMB No. 2040-0086
Approval expires 5-31-92
Ica>v yn.n.,.
Form
2F
NPDES
rr-.•••..-_.. _.._____. __ _.__-_______
United States Environmental Protection Agency
Washington, DC 20460
Application for Permit To Discharge Stormwater
WEP Dischar es Associated with Industrial Activit
Paperwork Reduction Act Notice
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 regarCing the burden estimate, any other aspect of this collection of information, or suggestions for improving :his form, including
suggestions which may increase or reduce this burden to: Chief, Information Polity Branch, PM-223, U.S. Environmental Protection Agency,
401 M St., SW. Wasnington, DC 20460. or Director, Office of Information and Regulatory Affairs. Office of Management and Budget.
Washington, DC 20503.
I. Outfall Location
For each oudalllist the latitude and longitude of its location to the nearest 15 seconds and the name of the receivin water.
A. Oudall Number
flsr) -:. I B. Latitude
C. Lonoitude
D. Receiving Water
(name)
001 1 360 1
18' l
2"
7 8°
"
SANDY CREEK
002 1 360
18'
35"
1 78°
24'
04"
SANDY CREEK
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H.Improvements
A. Are you now required by any Federal. State, or local authority to meet any implementation schedule for the construction, uperading 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 enforcement oreers, enfcrcement
compliance schedule letters. stipulations, court orders, and grant or loan conditions.
1. Identification of Conditions,
Aereements, Etc.
2. Affected Outfalls
4. Final
Compliance Date
3. Brief Description of Project a. rec. b. prof.
number
source of discharge
NONE
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 for construction. _
Ill. Site Draina a Ma
Attach a site map showing topography (or indicating the outline of drainage areas served by the outfall(s) covered in the appGeatien if a
topographic map is unavailable) depicting the facility including: each of its intake and discharge structures; the dramaee area of each storm
water outtall: paved areas and buildings within the drainage area of each storm water outtall, 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, :unolt.
materials loading arc access areas, areas where pesticides, herbicides, soil conditioners and fertilizers are applied: each et :s hazardous
waste treatment. storage or disposal units (including each area not required to have a RCRA permit which is used lot accumwancg hazardous
waste under 40 CFR 262.34); each well where fluids from the facility are injected underground: springs, and other surface waief bodies •which
receive storm water disLgames from the facility.
EPA Form 3510.2F (11-90) Page 1 or 4 y` -
2F-.1

As
nr,..o
A. For each outtall, provide an estimate of the area (include units) of impervious surfaces (including paved areas and building fools) arainea
to the outfall, and an estimate of the total surface area drained by trio outiall.
Oudall
Area of Impervious Surface
Total Area Drained
Oudall
Area of Impervious Surface
Total Ajea Dramec
tJ mbC(
(provide unirs)
(provide units)
N,i her
vi ni
(onovide nr',,
001
152,756 SF
169,729 SF
002 I
311,629 SF
311,629 SF
B. Provide a narrative description of significant materials that are currently or in the past three years nave been treated, stored or disposed :n
a manner to allow exposure to storm water: method of treatment, storage, or disposal: past znd present materials management p:ac:ces
employed, in :he last three years, to minimize contact by these materials with storm water rune':; materials loading and access areas. anp
the location, manner, and frecuency in whirh pesticides, herbicides, soil conditioners• and fertilizers are applies.
Preserved lumber is stored outside before shipping
Unpreserved lumber is stored outside before shipping
i
C. For each ousall, provide me location and a description of existing structural and nonstructural control measures to reduce pC;:u:ap:s :n
storm water tuna':; and a description of the treatment the storm water receives, including the schedule and type of maintenance I]: con:fcl
and treillmen; m =� r n in e disposal gf anylid or fluid wastes Other than by disclnilCe-
Outfall
List Cpdes :
I --
m r.
Ttflifirrent Tz-
t
001
None
002
None
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V. Nonstormwater Dischar es
A. I cerdy under penalty of law :hat the ousall(s) covered by this application have been tees ^d or evaluateo for me presence ^
nonvormwater discharges• and that all nonstormwater discharges from these oudall(s) are identified in either an accompanying Fcrm 2C
r F :m 2c^ li a•i o for the CU'.Ir
name and Qnicial Tale (type or print)
Signapure
�'
Date Sic❑ed
I 1-a �-/ - 9 �-/
(�o� U1 • P� r•y Ill J �
d-��.-• r� U-T.
B. Provide a description of the me:nco used, the date of any testing• and the onsite drainage points !hat were directly observed cuor.^ ate-:
N/A
VI. Significant Leaks or Spills
Provide existing information regarcing lne history of significant leaks or spills of toxic or hazardous pollutants at the facility in the :as::-•e!
years, inclutling :he approximate ❑ate and location of the spill or leak, and the type and amount of ma:erial released.
None in the last 3 years.
EPA Form 3510-2F (11.90) Page 2 0l 3 Continue on Paoe 3
2F-2

EPANumber (copy from hem I of Form 1)
NCD982115040
uontlnued from Page 2
VII niq�hnroejnfQrmation
A,B,C, ti 0: See instructions before proceeding. Complete one set of tables for each ourall. Annotate the curtail number in the space provided.
Tables V16A, VII.B, and VII-C are included on separate sheets numbered VII-1 and VII-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 to Section IX)
Toxicityt 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 cr
on a receiving water in relation to your discharge mihin the last 3 years?
Yes (list all such pollutants below) No too to Section IX)
IX ronl[acl Analysis InformaliQ
Were any of the analyses reported in hem V performed by a contract laboratory or consulting firm?
Yes (list the name, address, and telephone number of, and pollutants No (go to Section X)
- 5rm below)
A. Name B. Address
C. Area Code 8 Phone No.
D. Pollutants Analyzed
f certify under penalty of law that this document and all attachments were prepared under my direction, or
supervision in accordance with a system designed to assure that qualified personnel properly gather 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 or print)
B. Area Code and Phone No.
PP�� v. P.
919-492-9171
Lech W-
C. Signatures
D. Date Signed Q u
- oaq- / 1
EPA Form 3510.2F (11-90) Page 3of3
nr n

EPA umoer (copy from I:em r o/ Form r)
NCD 82115040
OAPPmved. OMB No. 204400a6
Approval exams 5- i1.92
VII. Discharge Information (Continued from oa e 3 of Form 2F
Part A- you must provide the results of at least one analysis for every pollutant in tics table. Complete one table for eacn cudall, See
instructions for additional details.
Pollutant
and
CAS Number
(i/dvdildblel
Maximum Values
(include units)
Average Values
(include units)
Number
of
Sources of Pollutan:s
Grab Sample
Taken During
Frst JO
Minutes
Flow-waF htetl
g
Gpmposlte
Grab $ample
Taken Cling
First "
Minutes
Storm
Flow -weighted Events
Composite Samolee
OII and Grease
Biological Oxygen
Demand IBCO51
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Chemical Oxygen
Demand (COD)
I I I
OMIT
Total Suspended
Solids ITSSI
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t
Total Kieldahl
Nitrogen
Nitrate plus
Name Nitrogen
I
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Total
Phosphorus
I
PH M.mmum Ma,,m.um Minimum Maxvmum
Pan 6 - List eacn pollutant inat is mmiteo in an effluent guideline wnicn me facedy is suolec: to cr any pollutant fisted in :me laumy s r;PCES
permit for its process wastewater (if the facility is operating under an existing NPOES permit) Complete one taote For eacn ou•: an
in. in I Tnngl
'
Maximum Values
Pollutant (include unilil I
Average Values
(include units)
i Number
i of
I
Sources cl Ppllu:an:;
and Grab Sample
CAS Number I Taken During
Flip ?0
(i/dvaJab/e) i Minutes
Grab $ample
I Flow.weignied Taken rt 30 ng
Composite Minutes
I SICIM
Flow -weighted Events
Composite Sample d
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EPA Form 3510-2F (11-90) rage vn-t - i-onunue v- -e:r. se

rill
ConnnVee From in. rreni
Part C - List each pollutant shown in Tables 2F-2, 2F-3. and 2174 that you know or have reason to believe is present. See the instructions for
additional details and requirements. Complete one table for each outlall.
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 events which resulted in the maximum values for the flow weiohted composite sample.
1.
Date of
Storm
Event
2.
Duration
of Storm
(in minures) I
3.
Total rainfall
during storm eventsample
in inches)
4.
Number of hours between
beginning of storm meas-
and end of previous
measurable rain event
5.
Maximum floe rate
during rain eventent
(gallons/minute orcr
s ci unNs
from
70,ta,',
units)
7. I
Season
wasuretl
taken
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

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 III
Perry Builders Outlet, Inc.
P.O. Box 589
Henderson, NC 27536
Dear Mr. Perry:
A LTO.WYWA
IT 0
Al 1 8 0 0 ffbl I AN,
E:)FEE HNR
June 3, 1994
RECEIVED
JUN U 7 199,
DEHHR•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, Signed 5v
Original Sig
Coleen H.
A. Preston Howard, Jr., P. E.
cc: ighRegionalO eff,
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 Pans 1, 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 8ieri_a
Coleen H
A. Preston Howard, Jr., P.E., Director
Division of Environmental Management
By Authority of the Environmental Management Commission

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7EQUEST
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[J 25 5V� DMA 5356 IV SW —SERIES V842

State of North Carolina
Division of Environment al.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 • i _�
�As
E) E H N IR
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 .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
origtriat Signed BY
coleen H. Sullins
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 NO, 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 Oudet, 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.
Original SivSuHins
Coleen K
A. Preston Howard, Jr., P.E., Director
Division of Environmental Management
By Authority of the Environmental Management Commission

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NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
NOTICE OF INTENT REQUESTING COVERAGE UNDER
GENERAL PERMIT NO. NCG040000
STORMWATER DISCHARGES associated with activities casslfied as Timber Products (Standard
Industrial Classification Code (SIC 24)).
Complete this Notice of Intent (NOI) and mail to the following address
North Carolina Division of Environmental Management
Water Ouality Section, NPDES Group,
P.O. Box 29535
Raleigh, North Carolina, 27626-0535
The NOI must be accompanied with a general permit filing fee of $400.00. The check should be
made out to the North Carolina Department of Environment, Health, and Natural Resources. Z
THIS SECTION TO BE COMPLETED BY ALL INDUSTRIAL ACTIVITIES: >v
Facllity Owner/Operator Information:
Name: Perry Builders Outlet, Inc.
Address: P. 0. Box 589
City:
Henderson
State:
NC
Zip: 27536 Phone:( 919 ) 492-9171
Facility Location Information:
Name: Perry Builders Outlet Inc. - Mobile Plant
Address: Cedar Street
Cm, Henderson State: NC Zip: 27536
County- Vance phone ( 919 1 492-9171
NOI 04 Page 1

Physical Location Information:
(Street address, state road number, distance and direction from roadway intersection, &a
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 i
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 Z_ 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 ono 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? x 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 Quantitiy Generator (less than 1000 kg. of hazardous waste generated
per calendar month) of Hazardous Waste? des _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

0- O
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 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 143-215.6B (1) 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.) 0
W m
NOI 04
Page 3

4
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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. UAIL YLUIILU-