NCG210515_Application_20240715

C r vtf4 w4e, NC6 C ; U 311
RECEIVED
FOR AGENCY USE ONLY JUN 13 M4
NCG210 5 k 6
Assigned to: R cad k
ARO FRO MRO RRO WARO WIRO SRO
Division of Energy, Mineral, and Land Resources Land Quality Section
National Pollutant Discharge Elimination System
NCG210000 Notice of Intent
This General Permit covers STORMWATER DISCHARGES associated with activities under the following Standard
Industrial Classifications: SIC 24[Timber Products, including Wood Chip Mills—except as specified below]and 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 2434[Wood Kitchen Cabinets],SIC 2491[Wood Preserving],and SIC 2411 [Logging]. You con find
information on the DEMLR Stormwater Program atdeq.nc.gov/SW.
Directions: Print or type all entries on this application. Send the original,signed application with all required
items listed in Item(6)below to: NCDEMLR Stormwater Program,1612 MSC, Raleigh,NC 27699-1612. The
submission of this application does not guarantee coverage under the General Permit. Prior to coverage under
this General Permit a site inspection will be conducted.
1. Owner/Operator(to whom all permit correspondence will be mailed):
Name of legal organizational entity: Legally responsible person as signed In Item(7)below:
Unilin Flooring NC,LLC Jennifer Teague
Street address: City: State: Zip Code:
550 Cloniger Dr Thomasville NC 27360
Telephone number: Email address:
(336)3134231 jennifer [e-mail]
Type of Ownership:
Government
❑County ❑Federal ❑Municipal ❑State
Non-government
El Business(if ownership is business,a copy of NCSOS report must be included with this application)
❑Individual
2. Industrial Facility(facility being permitted):
Facility name: Facility environmental contact:
Unilin Flooring-Thomasville Plant Jennifer Teague
Street address: City: State: Zip Code:
550 Cloniger Or Thomasville NC 27360
Parcel Identification Number(PIN): County:
Davidson
Telephone number: Email address:
336-313-4000 [e-mail]
4-digit SIC code: Facility is: Date operation is to begin or began:
W 1 ❑New ❑Proposed El Existing
Latitude of entrance: Longitude of entrance:
35.867068 -80.052067
Brief description of the types of Industrial activities and products manufactured at this facility:
Manufacture of laminate flooring which includes Impregnating paper that is then pressed with MDF board and then cut and milled into planks.
This facility will produce Wood Pellets: ❑Yes ElNo
If the Stormwater discharges to a municipal separate storm sewer system(MS4),name the operator of the MS4:
El NIA
Page 1 of 5

3. Consultant(if applicable):
Name of consultant: Consulting firm:
t
Street address: City: State: Zip Code:
Telephone number: Email address:
i
4. Outfall(s)At least one outfall is required to be eligible for coverage.
3-4 digit identifier: Name of receiving water: Classification: —This water is impaired.
001 1 Hamby Creek Class C O This watershed has a TMDL.
Latitude of outfall: Longitude of outfall:
35.863823 -80.055131
Brief description of the industrial activities that drain to this outfall:
General wood manufacturing,hazardous waste accumulation,boiler room,vehicle maintenance,parking lot
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? El Yes ❑No
If yes,how many gallons of new motor oil are used each month when averaged over the calendar year?
>55 gallons i
3-4 digit identifier: Name of receiving water: Classification: ❑This water Is impaired.
002 Hamby Creek Class C O This watershed has a TMDL
Latitude of outfall: Longitude of outfall:
35.860926 -80.054334
Brief description of the industrial activities that drain to this outfall:
Wood dust collection,chemical receiving and storage,warehousing,Impregnation
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? ❑Yes ❑� No
If yes,how many gallons of new motor oil are used each month when averaged over the calendar year?
3-4 digit identifier: Name of receiving water: Classification: ❑This water is impaired.
003 1 Little Uwharrie River WS-III ❑This watershed has a TMDL.
Latitude of outfall: Longitude of outfall:
35.863971 -80.047893
Brief description of the industrial activities that drain to this outfall:
Wood dust collection from sawing and milling,warehousing
Do Vehicle Maintenance Activities occur In the drainage area of this outfall? ❑Yes M No
If yes,how many gallons of new motor oil are used each month when averaged over the calendar year?
3.4 digit identifier: Name of receiving water: Classification: ❑This water Is impaired.
❑This watershed has a TMDL.
Latitude of outfall: Longitude of outfall:
Brief description of the industrial activities that drain to this outfall:
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? 0 Yes El No
If yes,how many gallons of new motor oil are used each month when averaged over the calendar year?
All outfalls must be listed and at least one outfall is required.Additional outfalls may be added in the section
"Additional Outfalis"found on the last page of this NOL
Page 2 of 5

S. Other Facility Conditions(check all that apply and explain accordingly):
❑This facility has other NPDES permits.
If checked,list the permit numbers for all current NPDES permits:
❑This facility has Non-Discharge permits(e.g.recycle permit).
If checked,list the permit numbers for all current Non-Discharge permits:
i
El This facility uses best management practices or structural stormwater control measures.
If checked,briefly describe the practices/measures and show on site diagram:
The facility has five stormwater ponds. Monthly housekeeping PMs and cleanup of dock areas and dust collectors. J
p This facility has a Stormwater Pollution Prevention Plan(SWPPP).
If checked,please list the date the SWPPP was implemented:
2/26/2013
❑This facility stores hazardous waste in the 100-year floodplain. I
If checked,describe how the area is protected from flooding:
❑This facility is a(mark all that apply) {
O Hazardous Waste Generation Facility
❑ Hazardous Waste Treatment Facility
❑ Hazardous Waste Storage Facility
❑ Hazardous Waste Disposal Facility, ,
t
If checked,indicate:
Kilograms of waste generated each month: Type(s)of waste:
155 Cyclohexane,Xylene,Isopropanol,Petroleum Distillates,MEK
How material is stored: Where material is stored:
Stored inside a small plasticstorage Wlding viith secondary containment provided. Inside boiler room and In satellite accumulation areas long each Milling line.
Number of waste shipments peryear: Name of transport/disposal vendor:
6-7 HazMal Environmental Services,LLC
Transport/disposal vendor EPA ID: Vendor address:
NCD048461370 221 Dalton Ave.Charlotte,NC 28206
❑This facility is located on a Brownfield orSuperfund site
If checked,briefly describe the site conditions
6. Required Items(Application will be returned unless all of the following items have been Included):
VI Check for$100 made payable to NCDEQ
❑Copy of most recent Annual Report to the NC Secretary of State(if applicable)
El This completed application and any supporting documentation
O A site diagram showing,at a minimum,existing and proposed:
a) outline of drainage areas
b) surface waters
c) stormwater management structures
d) location of stormwater outfalls corresponding to the drainage areas
e) runoff conveyance features —
f) areas where materials are stored
g) Impervious areas
It) site property lines
El copy of county map or USGS quad sheet with the location of the facility clearly marked
Page 3 of 5

7. Applicant Certification:
North Carolina General Statute 143-215.68(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...shall be guilty of a Class 2 misdemeanor which may include a fine not
to exceed ten thousand dollars($10,000).
Under penalty of law,1 certify that:
0 1 am the person responsible for the permitted industrial activity,for satisfying the requirements of this permit,and for any
civil or criminal penalties incurred due to violations of this permit.
O The information submitted in this NO]is,to the best of my knowledge and belief,true,accurate,and complete based on
my inquiry of the person or persons who manage the system,or those persons directly responsible for gathering the
information.
O 1 will abide by all conditions of the NCG210000 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.
O I hereby request coverage under the NCG210000 General Permit.
Printed Name of Applicant: Yassmin Desoky
Title: VP Hardwood&Laminate Operations
CI
„igna to of Applicant) cs (Date Signed)
Mail the entire package to: DEMLR—Stormwater Program
Department of Environmental Quality
1612 Mail Service Center
Raleigh,NC 27699-1612
Page 4 of 5

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