NCG210202_COMPLETE FILE - HISTORICAL_20181113

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v
DOC TYPE
LY HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ au D i I I -�
YYYYM M D D

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V a O (P y y
DOC TYPE
'HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ pro) q 0
YYYYMMDD

Division of Encray, Mineral, and Land Resources I FOR AGENcy USE ONLY I
Land Quality Section / Stormwater program Dare Recened
- % veal I1%c DayJ
I i —lJ
Nall0m11 POHLItam Discharge Elimination Svsicm (NI)DES)
Lam •.,soutCos PERMIT OWNER AFFILIATION DESIGNATION FORM
Lund Resources
IN i:.LHMr6,;d OlID I17Y (Individual Legally Responsible for Permit)
Use this form if there has been:
NO CHANGE in facility ownership or facility name, but the individual
who is legally responsible for the permit has changed.
If the name of the facility has changed, or if the ownership of the facility has changed,
do NOT use this form. Instead, you must fill out a Name -Ownership Change Form
and submit the completed form with all required docume�i�0nEIVEn
What does "legally responsible individual' mean?
NOV 13 20;"
I he person is ether. DENR-LAND
• the responsible corporate officer (for a corporation); STORMWATERPcRALITY
• the principle executive officer or ranking elected official (for a nunticipality, state, federal orwIT1fr public
agency);
• the general partner or proprietor (for a partnership or sole proprietorship);
• or, the duly authorized representative of one of the above.
1) Enter the permit number for which this change in Legally Responsible Individual ("Owner Affiliation")
applies:
Individual Permit
Nr *�C % EFFF-1
2) Facility Information:
Facility name:
Company/Owner Organization:
Facility address: V .
(or) Certificate of Coverage
�2_1_1 2lo Z
C 4.414 prom W urtjc:S
Al f tS 'f4 / St1 K i H
/ Address
L I—i—t/✓67o NC o1�S'f(o
City State rip
To find the current legally responsible person associated with your permit, go to this website:
http://deg.nc.gov/about/divisions/encrpy-mineral-land-resources/energy-mineral-land-permits/stormvvster-program
and run the Permit Contact Summary Report.
3) OLD OWNER AFFILIATION that should be removed:
Previous legally responsible individual: t:i(-QrSTO0fe°f' A- M 1 LLEIo,
First 1\1I krst
4) NEW OWNER AFFILIATION (legally responsible for the permit):
Person legally responsible for this penno:
j'd1 f=Rk C MooRL/gG
First Nil bast
SW U-OWNE RAFF IL-23Ma rch2017
Face I ol2

NPDES Stormwater Permit OWNER AFFILATION DESIGNATION Form
(if no Facility Name/Ownership Change)
Thic
I' o sr ctS 5/01 Sb wrr<-f
Mailing Address
Ll/-<1NGTn/ n/G 27s:4
City Stare rip
(9/o) H3 -.S7/3 jMooivn(dcka>"�tsrlh6�N+S
Telephone F� mail AddressJ her
(4I,o ) 01 /`I - 0Q'1 6
F x Number
5) Reason for,this change:
"!t�� ��• Employee or management change
A resulCof: ❑ Inappropriate or incorrect designation before
Outer
/f other please explain:
The certification below must be completed and signed by the permit holder.
PERMITTEE CERTIFICATION:
I, U—Ejp /rlaaai.✓� ; attest that this application for this change in Owner Affiliation
(person legally responsible for the permit) has been reviewed and is accurate and complete to the best of my
knowledge. I understand that if all required parts of this form are not completed, this change may not be
processed.
nature
PLEASE SEND THE, COMPLETED FORM TO:
Division of Energy, Mineral; and Land Resources
Stormwater program
1612-Mail Service Center
Raleigh, North Carolina 27699-1612
Date
For more information or staff contacts, please call [phone] or visit the website at:
htti): //deg. nc.gov/about/divisions/energy-mineral-land-resources/stormwater
Paec 2 of 2
SWU-OWNE RAFFIL-23Ma r2017

t ^Ape NJl
CH` A M PPI OWN''MANUFACTURED BEAUTIFULLY"
August 4, 2017
Division Of Energy, Mineral and Land Resources (DEMLR)
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, N.C. 27699-1612
Subject: Owner Affiliation Designation form
Certificate of Coverage NCG210202
Attached is an Owner Affiliation Designation form from:
Champion Homes
Champion Home Builders, Inc.
4055 US 401 South
Lillington, N.C. 27540
RECEIVED
HUG 08 2011
DENR-LAND QUALITY
STORMWATER PERMITTING
If this form is insufficient in any way, Please call me at [phone] or write to me at the address
listed below. Thank you.
Sincerely,
Rober ergusson
Safety and Training Manager
Champion Homes, Lillington
4055 US 401 South
Lillington, NC 27546

NCDENR
Division of Energy, Mineral and Land Resources
Land Quality Section / Stormwater Permitting Program
National,,Polhitant Dischargc,Elimination System (NPDES)
PERMIT OWNER AFFILIATION DESIGNATION FORM
(Individual Legally Responsible for Permit)
` Use'this`form if there has been:
q-, II 1 11
Y I
ENCY USE ONLate
ReceivedMonth
P
"Day
NO CHANGE' in •facilityjownership. or• facility name, but the individual
who is legally responsible for the permit has changed.
If the name of the facility has changed, or if the ownership of the facility has changed,
do NOT use this form. Instead, you must fill out a Name -Ownership Change Form
and submit the completed form with all required documentation.
What does "legally responsible individual' mean?
The person is either:
• the responsible corporate officer (for a corporation); CCt�++r� �� ��F
• the principle executive officer or ranking elected official (for a municipality, state, red e��C%916r�tlbttC�
agency); AUG 8 2� 1�
• the general partner or proprietor (for a partnership or sole proprietorship);
• or, the duly authorized representative of one of the above. DENR•LAND QUALITY
gTORMWATER PERMITTING
1) Enter the permit number for which this change in Legally Responsible Individual ("Owner Affiliation').
applies:
Individual Permit
N C S
2) Facility Information:
(or) Certificate of, Coy ,
Facility name: GaAM� aOMC5
Company/OwnerOrganizatioh: AMPLO N11�. uILDEQSINC.
Facility address: D55 US O
Address
LlttlN16mo /QC. 75Y0 /
City State 'Lip
To find the current legally responsible person associated with your permit, go to this website:
littp://portal.iicdenr.orWweb/Ir/sw-permit-contacts and run the Permit Contact Summary Report.
3) OLD OWNER AFFILIATION that should be removed:
Previous legally responsible individual: :(-(,� S. J WKVP
First Mt Last
4) NEW OWNER AFFILIATION (legally responsible for the permit):
Person legally responsible for this permit:
C�11z)s A 6�ILLIEQ
First Mn Last
SW U-OW NERAFFIL-25J u1y2014
Page I of

NPDES Stormwater Permit OWNER AFFILATION DESIGNATION Form
(if no Facility Name/Ownership Change)
(,�Eeac. MaNar�
Title
Lioss usliol SoLrrA
�1aAdiling ress
Lt LLjt3LnTr> �C- z-7s (i&
City State Zip
CM'dle ZP 41A►nP10 ;joM63. cowl
Telephone E-mail Address
3rc>) Siy - 04y10
Fax Number
5) Reason for this change:
A result of: k Employee or management change
❑ Inappropriate or incorrect designation before
❑ Other
If other please explain:
The certification below must be completed and signed by the permit holder.
PERMITTEE CERTIFICATION:
I, n 4RlI5 [A ILLE12— , attest that this application for this change in Owner Affiliation
(person legally responsible for the permit) has been reviewed and is accurate and complete to the best of my
knowledge. 1 understand that if all required parts of this form are not completed, this change may not be
processed.
Signature' �`• Date
PLEASE SEND THE COMPLETED FORM TO:
Division of Energy, Mineral and Land Resources
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
'more;
,. pit?
F61 more information�o,r staff contacts, please call 919-707-9220 or visit the website at:
hap://aortal.ncdcnr.orUwcb/Ir/storinwater
Page 2 of 2
SW U-OWNERAFFI L-25JUIy2014

�r
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Energy, Mineral, and Land Resources
Land Quality Section
Tracy E. Davis, PE, CPM Pat McCrory, Governor
Director John E. Skvarla, III, Secretary
Champion Home Builders Inc.
Attn: John Soukup
PO Box1389
L i l l i ngton, NC 27546
Aug. 12, 2013
Subject: NPDES Stormwater Permit Coverage Renewal
COC #NCG210202
Dear Permittee:
In response to your renewal application for continued coverage under Stormwater General Permit
NCG210000, the Division of Energy, Mineral and Land Resources (DEMLR) is forwarding herewith the
reissued Certificate of Coverage and stonnwater General Permit. This permit is reissued pursuant to the
requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement between
the state of North Carolina and the U.S. Environmental Protection Agency, dated October 15, 2007 (or as
Subsequently amended.) The following information is included with your permit package:
• A new Certificate of Coverage
• A copy of the stormwater General Permit
• A copy of a Technical Bulletin for the General Permit
• Copies of the Discharge Monitoring Report (DMR) Form
• Copies of the Annual Discharge Monitoring Report Form (if applicable)
• Copies of the Qualitative Monitoring Report Form
The General Permit authorizes discharges of stormwater only, and it specifies your obligations with
respect to stormwater discharge controls, management, monitoring and record keeping. Please review the
new permit to familiarize yourself with all changes in the reissued permit. Significant changes to the
General Permit are outlined in the attached Technical Bulletin.
Your coverage under the General Permit is transferable only through the specific action of DEMLR.
This permit does not affect the legal requirements to obtain other permits which may be required by the
N.C. Department of Environment and Natural Resources, nor does it relieve the permittee from
responsibility for compliance with any other applicable federal, state, or local law, rule, standard.
ordinance, order, judgment or decree.
If you have any questions regarding this permit package please contact the DEMLR Stormwater
Permitting Program at 919-807-6300.
Sincerely.
for Tracy E. Davis, P.E., C.P.M.
cc: Stormwater Permitting Files
1612 Mail Service Center, Raleigh, North Carolina 27699-1612 • Telephone [phone] / FAX: [phone]
512 North Salisbury Street, Raleigh, North Carolina 27604 • Internet: http://portal,ncdenr.org/web/Ir/land-quality
An Equal Opportunity 1 Affirmative Action Employer- 50% Recycled 110% Post Consumer Paper

Certificate of Coverage
http://portal.ncdenr.org/web/1 r/ncg21-erenewal
STXfE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAND NATURAL RESOURCES
DIVISION OI' WATER QUALITY
GENERAL PERMIT No. NCG210000
CERTIFICATE OF COVERAGE No. NCG210202
STORM WATER
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,
Champion Home Builders Inc
is hereby authorized to discharge stormwater from a facility located at
Champion I -tome Builders Inc
4055 US 401 S
Lillington
Harnett County
to receiving waters designated as Upper Little River, class C water(s) in the Cape Fear River Basin(s) in
accordance with the stormwater pollution management requirements, monitoring and reporting
requirements, and other conditions set forth in Parts I, II. III and IV of General Permit No. NCG210000 as
attached.
This certificate ofcoverage shall become ef}ective August I, 2013.
This Certificate of Coverage shall remain effective for the duration of the General Permit.
Signed this day August I, 2013.
fbr Thomas A.Reeder, Acting Director
Division of Water Quality
By Authority of the Environmental Management Commission
I of 1 8/ 19/2013 10:43 AM

Georgoulias, Bethany
From: [e-mail]
Sent: Friday, August 09, 2013 3:05 PM
To: SVC DENR.stormwater
Subject: Confirmation for Renewal of DWQ Stormwater NPDES General Permit
** Do not reply to this e-mail as it is from an unmonitored mailbox. **
Thanks for renewing your permit using our on-line option. No further action is necessary. The new General
Permit is available for printing from our website at http://portal.ncdenr.or€'/web/Ir/stormwatcr .
If you have questions, please contact Bethany Georgoulias at betham,.georaoulias a,ncdenr.gov phone (919)
807-6372 or Bradley Bennett at bradlcy.bcnnctta,ncdenr.gov phone [phone]. If you forgot to print your
Certificate of Coverage you can resubmit the data and print another copy.
This COC is issued pursuant to the requirements of North Carolina General Statute 143-215.1 and the
memorandum of Agreement between the state of North Carolina and the U.S. Environmental Protection
Agency, dated October 15. 2007 (or as subsequently amended.)
The General Permit authorizes discharges of stormwater and specifies your obligations for discharge controls,
management, monitoring, reporting, and record keeping. Please review the new permit to familiarize yourself
with all of the changes. Parts III and IV contain the Standard Conditions, including Compliance and Liability,
Reporting, Monitoring and Records requirements; Operation and Maintenance obligations; and Definitions.
Your facility has six months from receipt of the COC to update its Stormwater Pollution Prevention Plan
(SPPP) to comply with changes in SPPP requirements. Other changes are effective immediately. Please note
that Tier 3 Actions (if applicable) are triggered by four benchmark exceedances beginning on the effective
date of the renewal permit and do not count prior exceedances. Please visit our website above to review the
new General Permit carefully.
Please note that the Stormwater Permitting Unit is in the process of moving to the Division of Energy, Mineral,
and Land Resources (DEMLR). Your coverage under the General Permit is transferable only through the
specific action of DWQ and/or DEMLR. This permit does not affect the legal requirements to obtain other
permits which may be required by DENR, nor does it relieve the permittee from responsibility for compliance
with any other applicable federal, state, or local law, rule, standard, ordinance, order, judgment, or decree.
CONFIRMATION DETAILS
PemitNumbei•: • tt+ ^ NCG21D202,'
Expiration Date: 7/31/2018
Organi2atibn-Name: ,Champion Home Builders Inc,,.,
Facility Name: Champion Home Builders Inc
AdminRegion: Jfayetteville
Countv Name: 1-larnett
Receivine Stream Name: Urver Little River
Basin: Cape Fear
facility; Address: .; ,:., 4g,055�US „4,01 S
23

Facilitv Citv: Lillineton
Facilitv Zip: 27546
First Name: John
Middle Name:
Last Name: Soukun
Work Phone Number: [phone]
(Email:
nger�ncd'ehr:"� � i
24

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG210000
CERTIFICATE OF COVERAGE No. NCG210202
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,
Champion Home Builders Inc.
is hereby authorized to discharge stormwater from a facility located at:
Champion Home Builders Inc
4055 US 401 South
Lillington
Harnett County
to receiving waters designated as Upper Little River, a class WS-IV waterbody in the Cape Fear River
Basin in accordance with the effluent limitations, monitoring requirements, and other conditions set forth
in Parts.l, ll, III, IV, V and VI of General Permit No. NCG210000 as attached.
This certificate of coverage shall become effective July 16, 2010.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this 161h day of July, 2010.
ORIGINAL SIGNED SY
BRADLEY RENNETT
for Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

,. •:•
NC®ENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
John S. Soukup
Champion Home Builders Inc...
4055 US 401 South
Lillington, NC 27546
Dear Mr. Soukup:
Division of Water Quality
Coleen.H. Sullins
Director
July 16, 2010
Dee Freeman
Secretary
Subject: NPDES Stormwater Permit
Name/Ownership Change and Permit Renewal
Champion Home Builders Inc, formally
Champion Home Builders Co.
CDC Number NCG210202
Harnett County
On July 1, 2010 we received your request for Name/Ownership Change for the above referenced facility. Our
records indicated that this facility's permit was expired. We have used your request to not only change the
name/owner, but also to renew your permit coverage. The Division of Water Quality (DWQ) is forwarding
herewith the reissued stormwater General Permit. This permit is reissued pursuant to the requirements of North
Carolina General Statute 143-215.1 and the Memorandum of Agreement between the state of North Carolina and
the U.S. Environmental Protection Agency, dated October 15, 2007 (or as subsequently amended). This permit
has changed substantially from the previous version, please review the permit and other attached materials to
assure compliance with all permit conditions.
Your coverage under the General Permit is transferable only through the specific action of DWQ.
This permit does not affect the legal requirements to obtain other permits which may be required by DENR, nor
does it relieve the permittee from responsibility for compliance with any other applicable federal, state, or local
law, rule, standard, ordinance, order, judgment, or decree.
If you have any.questions regarding this permit package please contact me at [phone] or
bradley. ben [e-mail].
Sincerely,
ORIGINAL SIGNED BY
BRADLEY BENNETT
for Coleen H. Sullins
cc: DWQ Central Files
Stormwater Permitting Unit Files
Fayetteville Regional Office
Wetlands and Stormwater Branch
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604 One Phone: [phone] FAX: 91 M07-64941 Customer Service: 1-877-623-6748 NOrt.L.r t Carol t na
Internet: w .ncwaterquality.org a {um / y
An Equal Opportunity l AlfirmativeAction Employer (/ ylI ` L!((�

VJAT
13cvei ly Eaves l'ciduc. Clovcrnoi
Mal
v; / r Dee Freeman, Secretary
>_ ti North Carolina Department of Fnvironmcnt and Nanavl Resources
O'• �
COIeCa 11. Sullins, Dlreemr
Division or Wnlcr Quality
SURFACE WATER PROTECTION SECTION
PERMIT NAME/OWNERSHIP CHANGE FORM
Please enter the permit number' for which the change is requested.
NPDE-SPermit(or) Certificate ofCoverage
N I C I S 10 1 1 1 N I C I G .�- v Z
Permit status [ rior to requested change. �
a- PCI'ntll issued to (company name): luti�lbyV bnN e ::& �US C D
b. Pcison legally responsible for pennit: --jDt{-,3 5- K;tQ
First MI Last
661,' ERAL hl-N AiC
'Title
LJOW btS CI61 &)LLW
Permit Molder Mailing Address
State zip
(916 413-5713 (9i0) "S-soe7
Phone Fax
c. Facility name(dischargc): QPAA+ea00 Attic &tL;DC0; Co
d. Facility address: '/a» Os q0 / �au ni
Address
LIupt.,6,-S >lu 6C ;27ay�
City State 'Lip
e. Facility contact person: JO)fN S - SO(AW ( O ) 873 —S7/3
First / MI / Last Phoac
111. ['lease provide the following for the requested change (revised permit).
a. Request for change is a result oC Change in ownership of the facility
❑ Name change of the facility or owner
// other please esplrrin:
b. Permit issued to (company name):
c. Person legally responsible for permit:
JuL f 9010
ENR - WATER QU
W & &Cinch
d. Facility name ((Iischarge):
C. Facility address:
1'. Facility contact person:
66-�J&Zkc- klj2.�a G e(z
Title Pennit Holder M2ihm, Address
1 /I �IL �-7S Ll ill
City State Zip
R3- 57/3
Phone//tt ! B-mar Address
CNf}MYION cZS -50C-
Ups,5- QS yo, SawN —
II Addrel:}s
�I��I✓t�"7�n � �i54(c
city State 'Lip
First MI Last
( Ito > 09 3 - 5713 _IS4 p�J C"�im .cvr 1
Phone -:-mad A(N(ress Q
Revised 812008

0
r

PERMIT NAME/OWNERSHIP CHANGE FORM
Page 2 of 2
IV. Permit contact information (if different from the person legally responsible for the permit)
Permit contact: SA M
Fast N11 1-9st
Tide
y� LLS t/01
Mailing Ads i
less
k, c C/ (f,
�eilty State zip
(�lI0) 693-5713 �so,Lkeoglc�n:mrnVa�.Vim
Phone E-mail Address
V.
Will the permitted facility continue to conduct the same industrial activities conducted prior
to this ownership or name change?
Yes
❑ No (please explain)
VI. Required Items: THIS APPLICATION WILL BE RI?TURNED UNPROCESSED IF ITEMS
ARE INCOMPLETE OR iMISSING:
This completed application is required for both name change and/or ownership change
requests.
Legal documentation of the transfer of ownership (such as relevant pages of a contract deed,
or a bill of sale) is required for an ownership change request. Articles of incorporation are
not sufficient for an ownership change.
.......................................................................................................................
The certifications below nuist be completed and signed by both the permit holder prior to the change, and
the new applicant in the case of an ownership change request. For a name change request, the signed
Applicant's Certification is sufficient.
PERMITTEE CERTIFICATION (Permit holder prior to ownership change):
I, �&, attest that this application for a name/ownership change has been reviewed and is accurate and
complete to the best of my knowledge. I understand that if all required parts of this application are not
completed and that if all required supporting information is not included, this application package will be
reuuned as incomplete.
a � , 1, V � /—
Signawre
APPL,ICA C11,11,11,111,11CAIflolt
('AS/o
Date
I,1SS , attest that this application fora name/ownership change has been reviewed and is accurate and
complete to the best of my knowledge. I understand that if all required parts of this application are not
completed and that if all required supporting information is not included, this application package will be
returned as incomplete.
Signature 64te
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Division of Water Quality
Surface Water Protection Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Revised 712008

Champion Home Builders, Co.
755 West Big Beaver Road
Suite 1000
IT, NC 48084
248.614.8215
248.2.73.4268
49areh 16. 2010
Re: Change of Ownership for Champion Lorne Builders Co,; Redman Horne.. , Inc.;
W"estern llonre,c Corp.; New rD-a Buffiling Systems, Inc,; Norilr American
Hon -sing Corp.; Highland .?Uanulacturing Coniparq,, LLC; crud lfomes gf'Alerit,
Inc.
Dear Sir or Nladame:
On March 19, 2011 Champion }Monte Builders Co. (and its affiliated entities listed
above) will be Sold to a new entity (Champion Home Builders_ I ic.). We do not
anticipate that there will be any change in our business or operations. However, the
company names for all of the above mains acturing cntitus will change to Champion
Home Builders, Inc. We understand that some states may require Champion Hume
Builders, Inc. to register to do business (due to the change of ownership). In some cases,
a strue tnay ask for proof that the prior company relinquishes its existing permits to allow
the transfer.
therefore, please allow this Sur to serve as notice that Champion [Tome Builders Co.
(and the entities listed above) will hereby relinquish any rights to state licenses and
penis to the extent tho state gnuns a new license or permit to the owner of the company
(Cltantpiou I -lone Builder;. Inc.).
Sincerely,
RogerK. Scholten
Vice President oi'Champ'ion )tome. Builders Co., Rodman 1-Bonus, Q4 Western Homes
Corp.; New Era Building Systems, btr..; North American Housing Corp.. Highland
\4-RuUfacturigg, Company, L.LC; acid 1-10111cs of Nterit, Inc.

B
C201008200446
Defaware PAGE 1
Tie Tirst State
I, JEFFREY W. BULLOCK, SECRETARY OF STATE OF THE STATE OF
DELAWARE, DO HEREBY CERTIFY "CHAMPION HOME BUILDERS, INC." IS
DULY INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE AND IS
IN GOOD STANDING AND HAS A LEGAL CORPORATE EXISTENCE SO FAR AS
THE RECORDS OF THIS OFFICE SHOW, AS OF THE NINETEENTH DAY OF
MARCH, A.D. 2010.
AND I DO HEREBY FURTHER CERTIFY THAT THE FRANCHISE TAXES
HAVE NOT BEEN ASSESSED TO DATE.
4779790 8300
100300157
You may verify nia esrtificato on.i"e
ac eorp. d�l�rare. gov/autnwr. aG[ai
Jelfmy W. Bullock, 5ecmww a! State
AUTHEN7 C TION: 7881822
DATE: 03-19-10
Cei4ilicitiotdJ C2010f18200446-1 Reference# C01008200446- Page. 6 of 6

NORTH CAROLINA
r_ Department of The Secretary of State
To all whom these presents shall come, Greetings:
1, Elaine F. Marshall, Secretary of State of the State of North Carolina, do hereby certify
the following and hereto attached to be a true copy of
APPLICATION FOR CERTIFICATE OF AUTHORITY
OF
CHAMPION HOME BUILDERS, INC.
the original of which was filed in this office on the 23rd day of March, 2010.
iN WITNESS WHEREOF, I have hereunto set
my hand and affixed my official seal at the City
of Raleigh, this 23rd day of March, 2010.
Certifcationtt C201008200446-1 Referencek C201008200446-1 Page: I of
Verify this certificate online at www.secretary_state. ne. us/verification
Secretary of State

C201008200446
SOSID: 1141619
Date Filed: 3/23/2010 3:22:00 PM
Elaine F. Marshall
North Carolina Secretary of Stale
C2010082011446
State of North Carolina
Department of the Secretary of State
APPLICATION FOR CERTIFICATE OF AUTHORITY
Pursuant to §55-15-03 of the General Statutes of North Carolina, the undersigned corporation hereby applies for a Certificate of
Authority to transact business in the State of North Carolina, and for that purpose submits the following:
1. The name of the corporation is Champion Home Builders, Inc. ; and if the corporate name is
unavailable for use in the State of North Carolina, the name the corporation wishes to use is:
2. The state or country under whose laws the corporation was organized is: Delaware
3. The date of incorporation was 1-21-10 ; its period of duration is: perpetual
4. Principal office information: (Select either -a or 6) .
a. © The corporation has a principal once.
The street address and county of the principal office of the corporation is:
Number and Street 755 West Big Beaver Rd., Suite 1000
City, State, Zip Code Troy, MI 48084 CountyOakland
The mailing address, ydifferent from the street address, of the principal office of the corporation is:
b. ❑ The corporation does not have a principal office.
5. The street address and county of the registered office in the Slate of North Carolina is:
Number and Street 150 Fayetteville Street, Box 1011
City, State, Zip Code Raleigh North Carolina 27601 County Wake
6. The mailing address, if sl&reni from the sheet address, of the registered office in the State of North Carolina is:
7. The name of the registered agent in the State of North Carolina is: C T Corporation System
8. The names, titles, and usual business addresses of the current officers of the corporation are (attach if necessary):
Name Title Business Address
See attached
9. Attached is a Certificate of Existence (or document of similar import) duly authenticated by the Secretary of State or other
official having custody of corporate records in the state or country of incorporation. The Certificate of Existence must b¢
an orfalnal and less than six months ofd.
CORPORATIONS DIVISION
(Revised January, 2002)
NMI. I Wna00f CTSy Wls
P. 0. BOX 29622
RALMOH, NC 27626-0622
(Form B-09)
Cerlinearion# C201008200446-1 Reference# C2010118200446- Pngc 2 uf6

C201008200446
--- - —
APPLICATION FOR CERTIFICATE OF AUTHORITY
Page 2
10. If the corporation is required to use a fictitious name in order to transact business in this State, a copy of the resolution of its
board of directors, certified by its secretary, adopting the fictitious name is attached.
11. This application will be effective upon filing, unless a delayed date and/or time is specified:
This is the 19 day of A'1are11 , 2010
Champion Home Builders, Ine
Name of Corporation
ez ( �o Q��
Signature
Jenny Kim, Assistant Secretary
Type or Print Name and Title
NOTES:
f. Filing fee is $250. This document must be filed with the Secretary of State.
CORPORATIONS DIVISION P. 0. BOX 29622
(Revised January, 2002)
N021 - INnaM CT 3,... NJW
RALEIOH, NC 27626-0622
(Form B-09)
Cerlificall ..A C2O008200446-1 ltefm'mmeH C201008200446- Page: 3 of 6

NORTH CAROLINA
Attachment to Application for Certificate of Authority
Champion Home Builders, Inc.
List of Offic urs
William
Griffiths
President and CEO
755 West Big Beaver Rd.
Suite 1000
Troy, MI 48084
PhyllisKnight
_
Executive VP, CFO and Treasurer
755 West Big Beaver Rd.
Suite 1000
Troy, MI 48084
Rog
Scholtm _
Serum VP, General Counsel and Secretary
755 West Big Beaver Rd,
Suitt 1000
Troy, MI 48084
Ri
d Hevelhorst
Vice President and Controller
755 West Big Beaver Rd,
Suite 1000
Troy, MI 48084
Lauri
VanRaemdonck
Vice President, Finance
755 West Big Beaver Rd,
Suite I0o0
Troy, MI 48084
W"
Starner
Vice President, Product F_ guleenng
755 West Big Beaver Rd,
Suite 1000
Troy, MI 48084
John
ledhill
Vice President, Industrial Engineering
755 West Big Beaver Rd.
Suite 1000
Troy, W 48084
Willi;'Tackett
Vice President, Purchasing
755 West Big Beaver Rd.
Suite 1000
Troy, MI 48084
Louis
Ventura
Chief Information Officer
755 West Big Beaver Rd -
Suite 1000
Troy, MI 48084
w

lii
111
1�
111
1 :1:
111
111
VA
A

ATF
9oWilliam
Michael F. Easley, Governor
G. Ross Jr., Secretary
G
North Carolina Department of Environment and Natural Resources
Y
r
Alan W. Klimek, P.E. Director
Division of Water Quality
April 28, 2003
John Soukup
Champion Home Builders Co - Hwy 401 South
PO Box 1389
Lillington, NC 27546
Subject: NPDES Stormwater Permit Renewal
Champion Home Builders Cc - Hwy 401 South
COC Number NCG210202
Harnett County
Dear Permittee:
In response to your renewal application for continued coverage under general permit NCG210000, the
Division of Water Quality (DWQ) is forwarding herewith the reissued stormwater general permit. This
permit is reissued pursuant to the requirements of North Carolina General Statute 143-215.1 and the
Memorandum of Agreement between the state of North Carolina and the U.S. Environmental Protection
Agency, dated December 6, 1983.
The following information is included with your permit package:
• A new Certificate of Coverage
• A copy of General Stormwater Permit NCG210000
• A copy of the Analytical Monitoring Form (DMR)
• A copy of the Qualitativel Monitoring Form
• A copy of a Technical Bulletin for the general permit
Your coverage under this general permit is not transferable except after notice to DWQ. The Division
may require modification or revocation and reissuance of the Certificate of Coverage. This permit does
not affect the legal requirements to obtain other permits which may be required by the Department of
Environment and Natural Resources, or relieve the permittee from responsibility for compliance with any
other applicable federal, state, or local law, rule, standard, ordinance, order, judgment, or decree.
If you have any questions regarding this permit package please contact Bill Mills of the Central Office
Stormwater and General Permits Unit at [phone], ext. 548.
cc: Central Files
Stormwater & General Permits Unit Files
Fayetteville Regional Office
N. C. Division of Water Quality 1617 Mail Service Center
Sincerely,
Bradley Bennett, Supervisor
Stormwater and General Permits Unit
`AL
NCDENR
Raleigh, NC 27699-1617 [phone] Customer Service
1 800 623-7748

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG210000
CERTIFICATE OF COVERAGE No. NCG210202
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,
Champion Home Builders Cc
is hereby authorized to discharge stormwater from a facility located at
Champion Home Builders Co - Hwy 401 South
Hwy 401 South
Lillington
Harnett County
to receiving waters designated as the Upper Little River, a class WS-IV stream, in the Cape
Fear River Basin in accordance with the effluent limitations, monitoring requirements, and other
conditions set forth in Parts I, II, III, IV, V, and VI of General Permit No. NCG210000 as
attached.
This certificate of coverage shall become effective May 1, 2003.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day April 28, 2003.
for Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross Jr., Secretary
Alan W. Klimek, P.E. Director
10/24/2002
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
CHAMPION HOME BUILDERS CO - HWY 401 SOUTH
PO BOX 1389
LILLINGTON, NC 27546
Dear Permittee:
1�
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
Subject: NOTICE OF VIOLATION
FAILURE TO SUBMIT RENEWAL APPLICATION
CHAMPION HOME BUILDERS CO - HWY 401 SOUTH
NCG210000
COC NUMBER NCG210202
HARNETT COUNTY
This letter is to inform you that, as of the date of this letter, the Division of Water Quality has not received a
renewal request for the subject permit certificate of coverage. This is a violation of NCGS § 143.215.1 (c)(1) which
states "All applications shall be filed with the commission at least 180 days in advance of the date on which it is
desired to commence the discharge of wastes or the date on which an existing permit expires, as the case may be".
Any permittee that has not requested renewal at least 180 days prior to expiration or permittee that does not have a
permit after the expiration and has not requested renewal at least 180 days prior to expiration, will be subjected to
enforcement procedures as provided in NCGS § 143-215.6 and 33 USC 1251 et. seq.
In order to prevent continued, escalated action, including the assessment of civil penalties you must submit a
completed permit coverage renewal application to the attention of the "Stormwater and General Permits Unit" at
the letterhead address within ten (10) days of your receipt of this letter (renewal application enclosed). If the
subject discharge has been terminated, please complete the enclosed rescission request form. A valid reason for
requesting rescission is required, incomplete forms will be returned and you will still be subject to possible
escalated action. Mailing instructions for submitting rescission request are listed on the bottom of the form. You
will be notified when the rescission process has been completed.
Thank you for your prompt attention to this situation. If you have any questions regarding this matter, please
contact Bill Mills of the central office Stormwater and General Permits Unit at 919-733-5083, ext. 548.
Sincerely,
for Alan W. Klimek, P.E.
Director, Division of Water Quality
cc: Stormwater and General Permits Unit Files
Central Files
Fayetteville Regional Office
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E., Director
Division of Water Quality
September 4, 2002
JOHN SOUKUP
CHAMPION I-IOMl3 BUILDERS CO - HWY 401 SOUTH
PO BON 1389
LILLINGTON, NC 29546
Subject: NPDES Slormwatcr Permit Coverage Renewal
Champion IIonic Builders Cu - Hwy 401 South
COC Number ncg210202
Iin[net( County
Dee' Pcirinucc:
Your L'tcility is Currently covered for stornlwuter discharge under General Permit NCG210000. This pennit expires
on March 11. 2003. The Division suds is currently in the process of rewriting this pernlit and is sehCduled to havC
the pernlit reissued by early spring of 2003, Once the Permit is reissued, your f rcility would be eligible lit
continued covcnrgc under the reissued permit.
In order 10 assure your continued covCrage under the galetal permit, you nmsl apply 10 the Division of Water . .
QUulily (DWQ) [or rmlcwal of your permit covcrugc. To make this rcmo%vsl.Druccss %V;; arcinlltnring you ill
adv:ulce that your permil covcragc will he expiring. Er1CIO5ed you will find a Permit Coverage Renewal
Application Nunn. The nppliculion must he completed and returned by October 2, 2002 in order to assure
continued covcrugc under the general pernlit. Due to Si budget constraints, letters continuing our receipt of
the completed applicalion will not be sent.
FailurC In rcqucst renewal within the time period specified, cony result in a civil aSSCSSnlpnt nl al Icust $250.00.
Larger Pemdtics may he assessc(I (Iepending on the delinquency of the request. Discharge nl stint ler from your
ktciliry without covcragc un(Icr a valid stoi nlwatcr NPDES permit would constitute ❑ viohuiun of NCGS 143-215. 1
and could result in assessnlenls of civil penalties of up to $10,000 per day.
Please note that recent fe(lurel legislation has uxten(Ied the "no exposure exclusion" (o all operators of inrlustri:d
Iacilitics in any of the I I categories of "slornr water discharges associated with industrial activity," (excCpl
construction activities). If you Ieel your I,rcility can eel lify a condilion of "no exposure", i.e. the facility industrial
ntatcrinls and operations arc not exposed to stonuwater, you cu apply tin' the no egxsure Cclusion. Pon additional
information contact the Central (A [ice Stormwater Staff member listed below or check the Stormwatcr & Gcnei A
Pernli(s Unit Web Site at http://112o.enr.suuc.ne.us/su/sturnlwatur.huul
If the subject stunnwater discharge to waters of the state has been to-nninuted, please conlplete the enclosed
Rescission Request Form. Mailing instructions arc IISICd on (he bottom ol' the Joint. You will be notilled when the
rescission process has been completed.
11 you have any questions rcg:u'ding the permit renewal procedures please contact Ricky Revels of the Ftuyctleville
Regional Ofllce ❑( 910-480-1541 un Bill Mills of the Central OlJice Stool Unit at [phone], exi. 548
Sincerely.
Bradley 13enncu. Supervisor
Shunlwatcr: nd General Per Unit
cc: Central Piles
Slormwatcr and General PCI'iniis Unit Files
Fuvencvillc Regional Officc
e - m
Wil
N. C. Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 [phone] Customer Service
1- 800-623-7748

if
a
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
May 1, 1998
LLOYD BLACK
CHAMPION HOME BLDRS-TITAN HOME
2701 UNIVERSITY DRIVE
AUBURN HILLS, MI 48003
Subject: Reissued Stormwater General Permit for
Certificate of Coverage No. NCG210202
Harnett County
Dear Permittee:
I' ",
LT. A
ID E N R
In response to your renewal application for continued coverage under the General Permit
NCGO40000, the Division of Water Quality (DWQ) is forwarding herewith the General Permit
NCG210000 which is a new General Permit to cover most of the Timber Products Industry. You
have now been given coverage under NCG210000 and your coverage under NCGO40000 is hereby
terminated. 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.
The following information is included with your permit package:
■ A copy of the stormwater general permit NCG210000.
■ A new Certificate of Coverage under general permit NCG210000.
■ A Stormwater Pollution Prevention Plan Certification Form. This form certifies that you have
developed and implemented the Stormwater Pollution Prevention Plan (SPPP) required in your
permit (both NCGO40000 and NCG210000). This form must be completed and returned to the
Division within 30 days of receipt of this letter. DO NOT send the SPPP with the signed form.
■ Five copies of Analytical Monitoring forms.
■ Five copies of Qualitative Monitoring forms.
■ A copy of a Technical Bulletin on the stormwater program which outlines program components
and addresses frequently asked questions.
Your certificate of coverage is not transferable except after notice to DWQ. 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
DWQ or permits required by the Division of Land Resources, Division of Air Quality, Coastal Area
Management Act or any other Federal or Local governmental permits that may be required.
If you have any questions concerning this permit or other attached documents, please contact the
Stormwater and General Permits Unit at telephone number [phone].
Sincerely, /
for A. Preston Howard, Jr., P. E.
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 AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG210000
CERTIFICATE OF COVERAGE NO. NCG210202
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,
CHAMPION HOME BLDRS-TITAN HOME
is herby authorized to discharge stormwater from a facility located at:
PO BOX 1389, HWY 401 SOUTH
LILLINGTON, NC
HARNETT COUNTY
to receiving waters designated as Upper Little River in the Cape Fear River Basin
in accordance with the -effluent limitations, monitoring requirements and other conditions set forth in Parts 1,
B, III and IV of General Permit No. NCG210000 as attached.
This Certificate of Coverage shall become effective May 1, 1998.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day May 1,1998
for A Preston Howard, Jr., P.E., Director
Division of Water Quality
By Authorization of the Environmental Management Commission

81ate 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. Phil Cummings
Champion Home Builders Co.
2701 University Dr.
Auburn Hills, MI 48003
Dear Mr. Cummings:
IT A
C)EHNR
May 20, 1994
Subject: General Permit No. NCG040000
Champion Home Builders Co.
COC NCG040202
Harnett County
In accordance with your application for discharge permit received on March 25, 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 Mr. Bill Mills at telephone number 919/733-
5083.
Sincerely,
Original Signed By
C leen H. Sullins
A. reston Howard, Jr., P. E.
cc: Fayetteville 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,
Champion Home Builders Co.
is hereby authorized to discharge stormwater from a facility located at
Titan Homes Division
US Highway 401 South
Lillington
Harnett County
to receiving waters designated as Upper Little River in the Cape Fear 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 20, 1994.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day May 20, 1994.
Original Signed c y
Coleen H. Sullita
A. Preston Howard, Jr., P.E., Director
Division of Environmental Management
By Authority of the Environmental Management Commission

2
Peik
c�
�Y
r\
�/ e
IIIIr
pe.F
at- (1
jJ�•
�•
qt
J
-
f
.t
Cq�Ja rave
nl
4 M
,o
M �.�.
l 9 1
rY
�•/i o, 1 IGr
oed
ParQ-\27
'
x
••
aZk
"
6fiJ •
9711Q
`
•I ✓.l
4vl
alG`rove'
I
�•' V `
-77• }I A� le
l`t� /
�S i4 cl
FL
h
•
T
��
��_
�. 6
� •lJ �
Sre
fin
2 Q�f � el�
i .OI
on , u
j II
/II
� ti 8 , �
�•1:'Lf�
_ o
kf • ; "1 f
� r ,
\\•\
-
iH+•
t
fi
ee i[
fi0n5avrj
�:
.
.f',
1 J
I�.
•\:
210
66 —
'i
II
�:
"9¢°
98
'�- 99
. 00
01
02
5
q
Sul.
x
�4
till
tip:-
5e
•Sand and
ravel Pit
;
.•'
Ir
�``�"--
,
r_e
A
IF
9
avel
.If
Or
0
��'
a
�'
J
j-�,•
�/!�
EL RlV
R PITS
o
(
•�
J/ �r.
—�,
i
� •�
4
li
McLean
�
yI
18
17
16
15
Co.
14
13
20'
12

FACILITY,
COUNTY''
NPDES
MAP #
C-l-i-tL—n^Flc` 40m,
OA-a-N E-rr-
0 0 2 0 7-
2-,3
nem .FLOW
SUB EASIN
D 1-6
LATTiTUDE Zo 5 o
LONGhUDE
RECEIVING STREAM
STREAM CLASS
DISCHARGE CLASS
-1
EXPIRATION DATE
L3PF->Crz L-11TLE V-IVEr--
W 5 - S�
5-rc)"WATE R
Do - 31- 9-4