NCS000336_Permit (Issuance)_20120427

-----'-STORM WATE R-DIVISION CODING_SHEET'__ �
PERMIT NO.
NCSGoOS36
DOC TYPE
ZrFINAL PERMIT
❑ MONITORING INFO
❑ APPLICATION
❑ COMPLIANCE
❑ OTHER
DOC DATE
❑
YYYYMM DD

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April 27, 2012
Robert Clark
Facility Manager
UFP Elizabeth City, LLC
141 Knobbs Creek Drive
Elizabeth, NC 27909
Subject: Permit No. NCS000336
UFP Elizabeth City, LLC
Formerly UFP Atlantic Division, LLC
Pasquotank County
Dear Mr. Clark:
Division personnel have reviewed and approved your request to change your name under the
individual permit, received on November 29, 2012.
Please find enclosed the revised permit cover page. The terms and conditions contained in the permit
remain unchanged and in full effect.
If you have any questions, please contact the Stormwater Permitting Unit at 919-807-6300.
Sincerely,
for Chuck Wakild
cc: Washington Regional Office
Stormwater Permitting Unit
Wetlands and Stormwater Branch
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone: 91M07-6300l FAX: [phone] Customer Service: 1-877-623.6.748
Internet: www.ncwaterqualit .org
An Equal Opportunity 1 Affirmative Action Employer
One
North Carolina
Naturally

STATE OF NORTH CAROL.INA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
PERMIT
TO DISCHARGE STORMWATER UNDER THE
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,
UFP Elizabeth City, LLC
is hereby authorized to discharge stormwater from a facility located at
UFP Elizabeth City, LLC
141 Knobbs Creek Dr.
Elizabeth City
Pasquotank County
to receiving waters designated as Knobbs Creek, a class C stream; Sw stream in the Pasquotank River
Basin in accordance with the discharge limitations, monitoring requirements, and other conditions set
forth in Parts I, 11, III, IV, V and VI hereof.
This permit shall become effective April 27, 2012.
This permit and the authorization to discharge shall expire at midnight on April 30, 2014.
Signed this day April 27, 2012.
Chuck Wakild, Director
Division of Water Quality
By Authority of the Environmental Management Commission

Beverly Eaves Perdue, Governor
Dee Freeman, Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
Division of Water Quality
I. Please enter the permit number for which the change is requested.
NPDES Permit (or) Certificate of Coverage
N S Q 1 0 1 0 1 3 13 j 6 1 1 N' G
II. Permit status prior to requested change.
a. Permit issued to (company name): UFP Atlantic Division, LLC
b. Person legally responsible for permit: Robert W. Lees T
First MI Last
President
Title
2801 East Beltline NE
Permit Holder Mailing Address
Grand Rapids MI 49525
City State Zip
616 364-6161 616 364-5558
Phone Fax
c. Facility name (discharge): UFP Atlantic Division, LLC - Elizabeth City
d. Facility address: 141 Knobbs Creek Dr.
Address
Elizabeth City NC 27909
City State Zip
e. Facility contact person: Robert Clark 252-338-2821
First / MI / Last Phone
III. Please provide the following for the requested change (revised permit).
a. Request for change is a result of: ® Change in ownership of the facility
❑ Name change of the facility or owner
If other please explain:
b. Permit issued to (company name):
_ _ UFP Elizabeth City, LLC
c. Person legally responsible for permit:
Robert
Clark
First MI
Last
Manager
Title
141 Knobbs Creek Dr.
Permit Holder Mailing Address
Elizabeth Ci NC
27909
City State
Zip
252-338-2821 rclark u i.corn
Phone E-mail Address
d. Facility name (discharge):
_ UFP Elizabeth City, LLC
e. Facility address:
141 Knobbs Creek Dr.
Address
Elizabeth City NC
27909
City State
Zip
f. Facility contact person:
Robert
Clark
First MI
Last
252 338-2821 rclark u
i.com
Phone E-mail Address
Revised 812008

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: _Kelley A Spence
First MI Last
Reuulatory Compliance Specialist
Title
2801 E. Beltline Ave. NE
Mailing Address
Grand Rapids MI 49525
City state zip
_(616) 364-6161 [e-mail]
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 RETURNED UNPROCESSED IF ITEMS
ARE INCOMPLETE OR MISSING:
❑ 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 must 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):
1, Robert W._Lees, as President of UFP Atlantic Division, LLC, 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 returned as incomplete.
LSn�RifT �� LP/S
Robert W Loos (Nov 21. 2011)
Nov 21, 2011
Signature Date
APPLICANT CERTIFICATION
I, Robert Clark as Manager of UFP Elizabeth City, LLC, 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 returned as incomplete.
Robert Clark (Nov 21, zo117 Nov 21, 2011
Signature
Date
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

I
m
Universal Forest Products; Inc,
November 21, 2011
North Carolina Division of Water Quality
Surface Water Protection Section
1617 Mail Service Center
Raleigh, North Carolina 27699
RE: NPDES Permit Name/Ownership Change Form- Name Change
UFP Elizabeth City, LLC
NPDES Permit: NCS000336
Dear Sir or Madam:
Due to corporate restructuring, the permit information for the above referenced facility
has changed. The company name on record for the Permit should be UFP Elizabeth City,
LLC (EIN 45-2530406). Please find the enclosed Surface Water Protection Section,
Permit Name/Ownership Change Form reflecting this change. If you should have any
questions please do not hesitate to contact me Kelley Spence at 616.365.1522 or
k sp en-c e(a,,u fp i . com .
Sincerely,
bMWV-::--4�
Barbara J. Peters
Legal Compliance Assistant
enclosure
�D
NOV 29 2011
�D AWDS�AR
Corporate Headquarters
2801 E. Beltline NE Grand Rapids, MI 49525 Tel: [phone] Fax: [phone] www.ufpi.com