NCG210288_Request for Dormant Status_20210622

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June 22, 2021
Boise Cascade
Roxboro EWP
CERTIFIED MAIL / RETURN RECEIPT REQUEST
7019 0700 00015967 2233
Thad Valentine
Senior Environmental Specialist
Division of Energy, Mineral and Land Resources
NC Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
Re: Roxboro Engineered Wood Products
NPDES Permit: NCG210000
Roxboro, Person County, NC
DEENR`LAND QUALITY
STORMWATER PERMITTING
Roxboro Engineered Wood Products
i000 North Park Drive
Roxboro, NC 27573
Telephone [phone]
Fax [phone]
This letter is sent asking for Dormant Status at the Boise Cascade Roxboro facility located at 1000 North Park Drive in
Roxboro, NC 27573. The washdown area has been locked out and signage has been applied that says that the area is not to
be used. Shamrock Environmental Corporation removed the drums located in the washdown area from the facility, a copy
of their waste disposal manifest is attached. If additional information is required, please contact Brian Van Gelder at (803)
385-4957.
Sincerely,
Scott Kreps
Southern Region Manager
Boise Cascade Wood Products

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NONHAZARDOUS 1. Generator ID Number
2. Page I o1
3. Emergency Response Phone
4. Manifest Document Number
WASTE MANIFEST
5. Generator's Name and Mailin Addles Generator's Site Address (d different
than mauing address)
Generator's Phone:
6. Transporter 1 Company Name
U.S. EPA ID Number
SHAMROCK ENVIRONMENTAL CORPORATION
N.C.0.0.0.0.9.4.2.1.4.4
7. Transporter 2 Company Name
U.S. EPA ID Number
8. Designated FaaTly Name and Site Address
U.S. EPA 10 Number
SHAMROCK ENVIRONMENTAL CORPORATION
6106 CORPORATE PARK OR., BROWNS SUMMIT, NC 27214
(336)-375-1989
Facility's Phone:
N . C . 0.0.0.0.9.4.2.1
.4.4
HAM 9. Waste Shipping Name and Description
10. Containers
11. Total
12. Unit
Approval Codes
No.
Type
Ouanliy
WUvol.
1.
R
W
W 2.
C1
3. ,, <tJU
yN ya OFJ
4.
13. Special Handling Instructions and Additional Information
Power Una Trailer k
Job e
14. GENERATOR'S CERTIFICATION: I certify the materials described above on this manifest are not subject to federal regulations for r ePorlln9 proper disposal of Hazardous Wast,
Gerterelo's/OflelorsPrirlted/1-ypedName Signature
Month Oay
-.r 15. Invinabonal Shipments
G. amport ro U.S. ❑Export from U.S. Port
- "
of entrylexit:
t Trans rterSi nature for Eieorfson ):
Dateleavin U.S.:
16. TransporterAcknow/edgment of Receipt of Materials
Transporter I Printed Typed Name
S gnature
Month Day Year
Transporter 2 Pdnted?yped Name
Signature
Month Day Year
17. Discrepancy
17a. Discrepancy Indication Space
❑ Quantity ❑ Type ❑
Residue
❑ Partial Rejection
El Full Rejection
17b. ARemale Facifi Man test Reference Number
ty (or Generator)
U.S. EPA ID Number
Fac,lity's Phone:
17c. Signature of Anemate Facihy (or Generator)
Month Day Year
9.2 9.3
9�Desjgnated
9.4
1Owneror Operator. Certification of recept of materials covered by the manifest except as noted in Item 17a
If Printed/Typed Name Signature
�
Month Day Year
i
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' GENERATOR'S/SHIPPPD-c rn _T ..•