NCG050449_Application_20200415

JELD-E�VN
March 25, 2020
Ms. Suzanne McCoy
DEMLR — Stormwater Program
Dept. of Environment Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
RE: Notice of Intent & NEC Rescission
JELD-WEN, Inc. d.b.a., JELD-WEN
North Wilkesboro NC — NCGNE0372
Dear Ms. McCoy:
is}}4 3 ���' '' F� •� h.n
DENR-LAND QUALITY
STORFAWATER PERibIITTIN(-'
JELD-WEN, Inc, respectfully submits the enclosed Notice of Intent for coverage under General Stormwater Permit
NCG050000 and rescission request for No Exposure Certification for our exterior door manufacturing facility
located at 205 Lanes Dr, North Wilkesboro.
If you have questions or require additional information regarding this application, please contact me 336-479-1925.
Sincerely,
JELD-WEN, Inc.
'41t"O-in
Aaron Brite
Regional Environmental Manager
Enclosure: NOI NCG050000, Rescission request form, Location Map, Check
JELD-WEN, inc. 2645 Silver Crescent Drive, Charlotte, NC 28273 USA www.jeld-wen.com

I)fil JELo � VEN

KC7- Division of Energy, Mineral & Land Resources
Land Quality Section/Stormwater Permitting Program
National Pollutant Discharge Elimination System
Environmental
Quality RESCISSION REQUEST FORM
FOR AGENCY USE ONLY
Date Received
Year
Month
Day
Please fill out and return this form if you no longer need to maintain your NPDES stormwater permit.
1) Enter the permit number to which this request applies:
Individual Permit (or) Certificate of Coverage
N I C I S N C I G IN E O 3 7 2
2) Owner/Facility Information: * Final correspondence will be mailed to the address noted below
Owner/Facility NameJELD-WEN Inc
Facility Contact
Street Address
City
County
Telephone No.
Jeff Mang, Plant Manager
205 Lanes Dr
North Wilkesboro
Wilkes
336 838-0292
State NC
E-mail Address
Fax:
ZIP Code 28659
[e-mail]
3) Reason for rescission request (This is required information. Attach separate sheet if necessary):
❑ Facility closed or is closing on . All industrial activities have ceased such that no discharges of
stormwater are contaminated by exposure to industrial activities or materials.
❑ Facility sold to on . If the facility will continue operations under the new owner it
may be more appropriate to request an ownership change to reissue to permit to the new owner.
✓❑ Other: Facility applying for coverage under NCGO5000
4) Certification:
I, as an authorized representative, hereby request rescission of coverage under the NPDES Stormwater Permit for the
subject facility. I am familiar with the information contained in this request and to the best of my knowledge and belief
such information is,t�e, complete and accurate.
Signature
Jeff Mang V
Print or type name of person signing above
Please return this completed rescission request form to:
Date 3 1 rh,�v
Plant Manager
Title
DEMLR - Stormwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Revised 2018Jan10

Division of Energy, Mineral and Land Resources
Land Quality Section
National Pollutant Discharge Elimination System
Environmental
Quality NCG050000
NOTICE OF INTENT
FOR AGENCY USE ONLY
Date Received
Year
Month
Da
Certificate of coverage
Check #
Amount
Permit signed to
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG050000:
STORMWATER DISCHARGES associated with activities classified as:
SIC' 23 Apparel and Other Finished Products Made from Fabrics and Similar Materials
SIC* 265 Paperboard Containers and Boxes
SIC' 267 Converted Paper and Paperboard Products
SIC' 27 Printing, Publishing and Allied Industries
SIC' 30 Rubber and Miscellaneous Products (except as specified below)
SIC' 31 Leather and Leather Products (except as specified below)
SIC* 39 Miscellaneous Manufacturing Industries
SIC* N/A Like activities deemed by DEMLR to be similar in the process and/or the exposure of raw
materials, products, by-products, or waste materials
The following activities are specifically excluded from coverage under this General Permit:
SIC* 301 Tires and Inner Tubes
SIC" 311 Leather Tanning and Finishing
* Standard Industrial Classification Code
(Please print or type)
1) Mailing address of owner/operator (address to which all permit correspondence will be mailed):
Name JELD-WEN Inc
Street Address 205 Lanes Dr
City North Wilkesboro State NC ZIP Code 28659
Telephone No. 336 838-0292 Fax:
E-mail Address
2) Location of facility producing discharge:
Facility Name JELD-WEN Exterior Doors
Facility Contact Jeff Mang, Plant Manager
Contact E-mail [e-mail]
Street Address 205 Lanes Dr
City North Wilkesboro State NC ZIP Code 28659
County Wilkes
Telephone No. 336 838-0292 Fax:
3) Physical Location Information:
Please provide a narrative description of how to get to the facility (use street names, state road numbers, and
distance and direction from a roadway intersection). Turn onto Lanes drive from LibertyChurch/River Road.
Facility is at the end of Lanes Drive.
(A copy of a county map or USGS quad sheet with facility clearly located on the map is required with this application)
4) Latitude 6* 11' 23.9" N Longitude 81* 05' 13.9" W (degrees, minutes, seconds)
Page 1 of 4
SWU-220-071408 Last Revised 6/24/14

NCGO50000 N.O.I.
5) This NPDES Permit Application applies to which of the following:
❑ New or Proposed Facility Date operation is to begin
0 Existing
6) Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: 3 0 8 3
7) Provide a brief narrative description of the types of industrial activities and products manufactured at
this facility: Facility produces molded fiberglass door facings and assembles exterior doors from the facings,
wood frame components, poyurethane foam, and glass window inserts
8) Discharge points:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property?
List discharge points (outfalls) that convey discharge from the site (both on -site and off -site) and location
coordinates. Attach additional sheets if necessary, or note that this information is specified on the site plan.
Stormwater Outfall No. 1
Latitude (degrees/minutes/seconds): 360 11' 27.38" N
Longitude (degrees/minutes/seconds): 810 05' 10.4" W
Stormwater Outfall No. 2
Latitude (degrees/minutes/seconds): 360 11' 22.8
N
Longitude (degrees/minutes/seconds): 810 05' 19.5"
W
Stormwater Outfall No. 3
Latitude (degrees/minutes/seconds): 360 11' 21.6"
N
Longitude (degrees/minutes/seconds): 810 5' 6.5"
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds):
N
Longitude (degrees/minutes/seconds):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds):
N
Longitude (degrees/minutes/seconds):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds):
N
Longitude (degrees/minutes/seconds):
W
Page 2 of 4
SWU-220-071408 Last Revised 6/24/14

NCGO50000 N.O.I.
Stormwater Outfall No.
Latitude (degrees/minutes/seconds):
Longitude (degrees/minutes/seconds):
9) Receiving waters:
N
W
What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater
discharges end up in? Yadkin River
If the site stormwater discharges to a separate storm sewer system, name the operator of the separate storm
sewer system (e.g. City of Raleigh municipal storm sewer).
10) Does this facility have any other NPDES permits?
❑ No
Yes
If yes, list the permit numbers for all current NPDES permits for this facility: NCGNE0372
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
0 No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
12) Does this facility employ any best management practices for stormwater control?
❑ No
0 Yes
If yes, please briefly describe: All raw materials stored outside. Loose waste contained in compactors to include
dust collector waste. Only clean good condition pallets stored outside. Weekly outside housekeeping with quarterly
stormwater inspections. No idustrial processes occur outside. All wastes contained in appropriate containers.
13) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No
11 Yes
If yes, when was it implemented? April 2020
14) Are vehicle maintenance activities occurring at this facility?
11 No ❑ Yes
15) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
0 No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
IN No ❑ Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
11 No ❑ Yes
d) If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste:
Page 3 of 4
SWU-220-071408 Last Revised 6/24/14

NCG050000 N.O.I.
How is material stored: _
Where is material stored:
How many disposal shipments per year:
Name of transport / disposal vendor: _
Vendor address:
16) Certification:
North Carolina General Statute 143-215.6 b (i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan, or other
document filed or required to be maintained under this Article or a rule implementing this Article; or who knowingly makes a false
statement of a material fact in a rulemaking proceeding or contested case under this Article; or who falsifies, tampers with, or knowingly
renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
[Environmental Management] Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine not to
exceed ten thousand dollars ($10,000).
I hereby request coverage under the referenced General Permit. I understand that coverage under this permit
will constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an
individual permit.
I certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing: Jeff
Title: Plant Manager
l0Zd
(Dat Signe )
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to NCDEQ.
Page 4 of 4
SWU-220-071408 Last Revised 6/24/14

NCGO50000 N.O.I.
Final Checklist
This application will be returned as incomplete unless all of the following items have been included:
❑ Check for $100 made payable to NCDEQ
❑ This completed application and all supporting documents
❑ Copy of county map or USGS quad sheet with location of facility clearly marked on map and nearby waters
Mail the entire package to:
DEMLR - Stormwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Note
The submission of this document does not guarantee the issuance of an NPDES permit.
For questions, please contact the DEMLR Central Office or Regional Office for your area.
DEMLR Regional Office Contact Information:
Asheville Office ......
[phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
[phone]
Washington Office ...(252)
946-6481
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........(919)
807-6300
Page 5 of 4
SWU-220-071408 Last Revised 6/24/14

KNAJELIMEN.
�`
March 25, 2020
Ms. Suzanne McCoy
DEMLR — Stormwater Program
Dept. of Environment Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
RE: Notice of Intent & NEC Rescission
JELD-WEN, Inc. d.b.a., JELD-WEN
North Wilkesboro NC—NCGNE0372
Dear Ms. McCoy:
JELD-WEN, Inc, respectfully submits the enclosed Notice of Intent for coverage under General Stormwater Permit
NCG050000 and rescission request for No Exposure Certification for our exterior door manufacturing facility
located at 205 Lanes Dr, North Wilkesboro.
If you have questions or require additional information regarding this application, please contact me 336-479-1925.
Sincerely,
JELD-WEN, Inc.
Aaron Brite
Regional Environmental Manager
Enclosure: NOI NCG050000, Rescission request form, Location Map, Check
JELD-WEN, inc. 2645 Silver Crescent Drive, Charlotte, NC 28273 USA www.jeld-wen.com

FAI JELBroVEN.

Division of Energy, Mineral & Land Resources
Land Quality Section/Stormwater Permitting Program
National Pollutant Discharge Elimination System
Environmental
Quality RESCISSION REQUEST FORM
FOR AGENCY USE ONLY
Date Received
Year
Month
Day
Please fill out and return this form if you no longer need to maintain your NPDES stormwater permit.
1) Enter the permit number to which this request applies:
Individual Permit (or) Certificate of Coverage
N I c I s Nv I C I G N E 0 3 7 2
2) Owner/Facility Information: * Final correspondence will be mailed to the address noted below
Owner/Facility NameJELD-WEN Inc
Facility Contact
Street Address
City
County
Telephone No.
Jeff Mang, Plant Manager
205 Lanes Dr
North Wilkesboro
Wilkes
336 838-0292
State NC
E-mail Address
Fax:
ZIP Code 28659
[e-mail]
3) Reason for rescission request (This is required information. Attach separate sheet if necessary):
❑ Facility closed or is closing on . All industrial activities have ceased such that no discharges of
stormwater are contaminated by exposure to industrial activities or materials.
❑ Facility sold to on . If the facility will continue operations under the new owner it
may be more appropriate to request an ownership change to reissue to permit to the new owner.
✓❑ Other: Facility applying for coverage under NCG05000
4) Certification:
I, as an authorized representative, hereby request rescission of coverage under the NPDES Stormwater Permit for the
subject facility. I am familiar with the information contained in this request and to the best of my knowledge and belief
such information is true, complete and accurate.
Signature
Jeff Man
Print or type name of person signing above
Please return this completed rescission request form to:
Date 3/04,TD
Plant Manager
Title
DEMLR - Stormwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Revised 2018Jan10

Division of Energy, Mineral and Land Resources
Land Quality Section
National Pollutant Discharge Elimination System
Envirvnmen tut
Quality NCG050000
NOTICE OF INTENT
FOR AGENCY USE ONLY
Date Received
Year
Month
Da
Certificate of Coverage
N HA
I
Check #
Amount
Permit Assigned to
National Pollutant Discharge Elimination System application for coverage under General Permit
NCGO50000:
STORMWATER DISCHARGES associated with activities classified as:
SIC' 23 Apparel and Other Finished Products Made from Fabrics and Similar Materials
SIC' 265 Paperboard Containers and Boxes
SIC' 267 Converted Paper and Paperboard Products
SIC' 27 Printing, Publishing and Allied Industries
SIC' 30 Rubber and Miscellaneous Products (except as specified below)
SIC' 31 Leather and Leather Products (except as specified below)
SIC" 39 Miscellaneous Manufacturing Industries
SIC* N/A Like activities deemed by DEMLR to be similar in the process and/or the exposure of raw
materials, products, by-products, or waste materials
The following activities are specifically excluded from coverage under this General Permit:
SIC" 301 Tires and Inner Tubes
SIC' 311 Leather Tanning and Finishing
Standard Industrial Classification Code
(Please print or type)
1) Mailing address of owner/operator (address to which all permit correspondence will be mailed):
Name JELD-WEN Inc
Street Address 205 Lanes Dr
City North Wilkesboro State NC ZIP Code 28659
Telephone No. 336 838-0292 Fax:
E-mail Address
2) Location of facility producing discharge:
Facility Name JELD-WEN Exterior Doors
Facility Contact Jeff Mang, Plant Manager
Contact E-mail [e-mail]
Street Address 205 Lanes Dr
City North Wilkesboro State NC ZIP Code 28659
County Wilkes
Telephone No. 336 838-0292 Fax:
3) Physical Location Information:
Please provide a narrative description of how to get to the facility (use street names, state road numbers, and
distance and direction from a roadway intersection). Turn onto Lanes drive from LibertyChurch/River Road.
Facilitv is at the end of Lanes Drive.
(A copy of a county map or USGS quad sheet with facility clearly located on the map is required with this application)
4) Latitude 6° 11' 23.9" N Longitude 81 ° 05' 13.9" W (degrees, minutes, seconds)
Page 1 of 4
SWU-220-071408 Last Revised 6/24/14

NCG050000 N.O.I.
5) This NPDES Permit Application applies to which of the following :
❑ New or Proposed Facility Date operation is to begin
M Existing
6) Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: 3 0 8 3
7) Provide a brief narrative description of the types of industrial activities and products manufactured at
this facility: Facility produces molded fiberglass door facings and assembles exterior doors from the facings,
wood frame components, poyurethane foam, and glass window inserts
8) Discharge points:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property?
List discharge points (outfalls) that convey discharge from the site (both on -site and off -site) and location
coordinates. Attach additional sheets if necessary, or note that this information is specified on the site plan.
Stormwater Outfall No. 1
Latitude (degrees/minutes/seconds): 360 11' 27.38" N
Longitude (degrees/minutes/seconds): 810 05' 10.4" W
Stormwater Outfall No. 2
Latitude (degrees/minutes/seconds): 360 11' 22.8
N
Longitude (degrees/minutes/seconds): 810 05' 19.5"
W
Stormwater Outfall No. 3
Latitude (degrees/minutes/seconds): 360 11' 21.6"
N
Longitude (degrees/minutes/seconds): 810 5' 6.5"
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds):
N
Longitude (degrees/minutes/seconds):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds):
N
Longitude (degrees/minutes/seconds):
W
Stormwater Outfall No.
Latitude (degrees/minutes/seconds):
N
Longitude (degrees/minutes/seconds):
W
Page 2of4
SWU-220-071408 Last Revised 6/24/14

NCGO50000 N.O.I.
Stormwater Outfall No.
Latitude (degrees/minutes/seconds): N
Longitude (degrees/minutes/seconds):
9) Receiving waters:
►n]
What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater
discharges end up in? Yadkin River
If the site stormwater discharges to a separate storm sewer system, name the operator of the separate storm
sewer system (e.g. City of Raleigh municipal storm sewer).
10) Does this facility have any other NPDES permits?
❑ No
M Yes
If yes, list the permit numbers for all current NPDES permits for this facility: NCGNE0372
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
M No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
12) Does this facility employ any best management practices for stormwater control?
❑ No
Yes
If yes, please briefly describe: All raw materials stored outside. Loose waste contained in compactors to include
dust collector waste. Only clean good condition pallets stored outside. Weekly outside housekeeping with quarterly
stormwater inspections. No idustrial processes occur outside. All wastes contained in appropriate containers.
13) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No
0 Yes
If yes, when was it implemented? April 2020
14) Are vehicle maintenance activities occurring at this facility?
M No ❑ Yes
15) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
11 No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
M No ❑ Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
0 No ❑ Yes
d) If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste:
Page 3 of 4
SWU-220-071408 Last Revised 6/24/14

NCG050000 N.O.I.
How is material stored: _
Where is material stored:
How many disposal shipments per year:
Name of transport / disposal vendor: _
Vendor address:
16) Certification:
North Carolina General Statute 143-215.6 b (i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan, or other
document filed or required to be maintained under this Article or a rule implementing this Article; or who knowingly makes a false
statement of a material fact in a rulemaking proceeding or contested case under this Article; or who falsifies, tampers with, or knowingly
renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
[Environmental Management] Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine not to
exceed ten thousand dollars ($10,000).
I hereby request coverage under the referenced General Permit. I understand that coverage under this permit
will constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an
individual permit.
I certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing: Jeff Ma
Title: Plant Manager
(Signature
(Date Signed)
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to NCDEQ.
Page 4 of 4
SWU-220-071408 Last Revised 6/24/14

NCG050000 N.O.I.
Final Checklist
This application will be returned as incomplete unless all of the following items have been included:
❑ Check for $100 made payable to NCDEQ
❑ This completed application and all supporting documents
❑ Copy of county map or USGS quad sheet with location of facility clearly marked on map and nearby waters
Mail the entire package to:
DEMLR - Stormwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Note
The submission of this document does not guarantee the issuance of an NPDES permit.
For questions, please contact the DEMLR Central Office or Regional Office for your area.
DEMLR Regional Office Contact Information:
Asheville Office ...... [phone]
Fayetteville Office
... [phone]
Mooresville Office
... [phone]
Raleigh Office ........
[phone]
Washington Office
...[phone]
Wilmington Office
... [phone]
Winston-Salem ......
[phone]
Central Office .........(919)
807-6300
Page 5 of 4
SWU-220-071408 Last Revised 6/24/14