NCG070216_NOI Application_20180531

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QDivision
of Energy, Mineral and Land Resources
Year Month Da
Land Quality Section
NCDENR
NORTH
National Pollutant Discharge Elimination System
CAROLINA DEPARTMENT OF
ENVIRONMEM AND NATURAL RESOURCES
NCG070000
NOTICE OF INTENT
FOR AGENCY USE ONLY
Date Received
Year Month Da
Certificate of Coverage
N
Check #
Amount
Permit Assigned to
National Pollutant Discharge Elimination System application for coverage under General Pernkk ! j�,/
NCG070000: ll�� L"1)
STORMWATER DISCHARGES associated with activities classified as: MAI V 31 .1
4018
SIC* 32 Stone, Clay, Glass, and Concrete Products (except as specified below) S.r ©�'�AN
SIC* N/A Like activities deemed by DEMLR to be similar in the process and/or the expos re MA4, pQRA//?Y
materials, products, by-products, or waste materials NG
The following activities are specifically excluded from coverage under this General Permit:
SIC+ 3273 Ready -Mixed Concrete
* Standard Industrial Classification Code
(Please print or type)
1) Mailing address of owner/operator (address to which all permit correspondence will be mailed):
Name Ply Gem Speciality Products, LLC (dba: Canyon Stone)
Street Address 409 Northbrook Dr.
City Younqsville State NC ZIP Code 27596
Telephone No. 919 562-5005 Fax: [phone]
E-mail Address
2) Location of facility producing discharge:
%.01f781g1,--78 cIg3pgg
Facility Name Ply Gem Speciality Products, LLC (dba: Canyon Stone)
Facility Contact Randal (Randy) Carter
Contact E-mail rcarte r@canyonstone. corn
Street Address 409 Northbrook Dr.
City Younosville State NC ZIP Code 27596
County Franklin
Telephone No. 919 451-4686 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). Take Highway 1 (Capital Blvd.) from Wake Forest. Turn R on
Bert Wilson Rd. After 1/8th mile turn R on Northbrook Dr. Canyon Stone is at the end of the Northbrook Dr,
(A copy of a county map or USGS quad sheet with facility clearly located on the map is required to be submitted with this application)
4) Latitude 36d, 2', 52.4076" N Longitude 70d. 28' 59.5128 W (degrees, minutes, seconds)
5) This NPDES Permit Application applies to which of the following :
❑ New or Proposed Facility
® Existing
Date operation is to begin 01/2013
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NCG070000 N.O.I.
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 2 7 2
7) Provide a brief narrative description of the types of industrial activities and products manufactured at
this facility: The facility mixes aggregrate (rock), sand and Portland cement to manufacture a Stone Veneer product for the
housing industry.
8) Discharge points / Receiving waters:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? 3
9) Receiving waters:
What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater
discharges end up in? stormwater flows through a wooded area into unnamed ditches eventually reaching Brandy Creek
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). N/A
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:
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
® 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: BMP's are described in the SWPPP. BMP's include housekeeping, inspections,
Spill prevention and response employee training SWPPP Team outside storage procedures and recorkeeping
and reportinq
13) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No
® Yes
If yes, when was it implemented? April, 2018
14) Are vehicle maintenance activities occurring at this facility?
® No ❑ Yes
15) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
® No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
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NCG070000 N.O.I.
® No ❑ Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
® No ❑ Yes
d) If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste.-
How
aste: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: Randal Carter
Title: Plant Manaaer - .e
(Signature of Applicant)
(Date Signed)
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to NCDENR
Final Checklist
This application will be returned as incomplete unless all of the following items have been included:
® Check for $100 made payable to NCDENR
® This completed application and all supporting documents
IN Copy of county map or USGS quad sheet with location of facility clearly marked on map
Mail the entire package to:
Stormwater and General Permits Unit Program
Division of Energy, Mineral and Land Resources
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
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NCG070000 N.O.I.
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 .........
[phone]
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SWU-222-071408 Last Revised 6/24/14

Map
Satellite
O

1) Indicates storage of finished product — Stone veneer
2) Indicates 2 40 Yard open top containers used for disposal of plant non -hazardous waste
3) Indicates Wash out pits (Gar-bro's)
4) Indicates Silo (Portland Cement)
5) Indicates 20 -yard closed top container used for disposal of plant non -hazardous waste
6) Trailers — Storage of Old Equipment
7) Parking Lots
8) Receiving docks
9) 20 -yard closed top container — Disposal of Plant non -hazardous waste
10) Outfall #1— Parking lot
11) Outfall #2 — Wash out pits and west outside storage area
12) Outfall #3 — North and West side outside storage areas.
Red lines show direction of flow to each outfall

Ply Gem Specialty Products dba: as Canyon Stone is located at 409 Northbrook Dr. Youngsville, NC 27596
Latitude and Longitude are marked on the map.

" Ply Gem-
BUtL CiYG PRt1G,V:'S
VOUNGSVILLE, NC OPERATION
NPDES STORMWATER PERMIT
MAY 15, 2018
Stormwater and General Permits Unit Program
Division of Energy, Mineral and Land Resources
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Permit Application:
To Whom It May Concern:
Rece/vEo
MAY 312016
DFNR-CAAlD
STORMWA�ER ERM�MNG
Canyon Stone, which was an induvial owed business, was recently purchased by Ply Gem Industries.
During a regulatory review by Ply Gem Associates it was discovered that Canyon Stone had not
submitted a Notice of Intent to be covered under the North Carolina NDPES General Permit for
Stormwater.
The site manufactures Stone Veneer Products for housing. The primary components of the finished
product are aggregate (rock) and Portland cement. As such, the business is subject to be covered by
Permit # NCG070000 for Stone, Clay, Glass, & Concrete Products.
The site has developed and is in the process of implementing a written Stormwater Pollution Plan as
required by the General Permit.
Included with this cover letter are
• A completed Notice of Intent: Application for coverage under General Permit NCG070000:
• A map with the location of facility clearly marked
• A check for $100.00
If you have questions or comments please call or email the people listed below.
Randy Carter
Plant Manager
Ply Gem Industries, Inc. — Stone Division
409 Northbrook Dr.-
Youngsville, NC 27596
p: 919.562.5005 c: 919.451-4686
e-mail: [e-mail]
Regards
Terry Bass
Ply Gem Siding Group
Safety Manager
Terry Bass
Corporate Safety Manager
Ply Gem Siding Group
2600 Grand Blvd — Suite 900,
Kansas City, MO 64108
p: 816-426-8464 1 c: 816-536-9605
e-mail: [e-mail]