NCG050413_COMPLETE FILE - HISTORICAL_20131125

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V L& OSO `'I m
DOC TYPE
�HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑
YYYYMMDD

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Energy, Mineral, and Land Resources
Land Quality Section
Tracy E. Davis, PE, CPM
Director
November 25, 2013
Mr. Bill Dotson
Leggett & Platt Components Co., Inc.
178 Orbit Rd.
Statesville, NC 28677
Pat McCrory, Governor
John E.' Skvarla, AI, Secretary
©- D4-�
gyp ; - 2013
Qrf�r.
Subject: General Permit No. NCG050000
Sackner NC Facility
COC NCGO50413
Iredell County
Dear Mr. Dotson:
in accordance with your application for a discharge permit received on November 7, 2013,
we are forwarding herewith the subject certificate of coverage to discharge under the subject state -
NPDES general permit. This permit is issued pursuant to the requirements of North Carolina General
Statute 143-215.1 and the Memorandum of Agreement between North Carolina and the US
Environmental Protection Agency dated October 15, 2007 (or as subsequently amended).
Please take notice that this certificate of coverage is not transferable except after notice to
the Division of Energy Mineral & Land Resources (DEMLR). If the facility changes ownership or is
closed, DEMLR may require modification, revocation., or reissuance of the certificate of coverage.
Per the requirements of the Catawba Riparian Buffer Rule, all stormwater drainage to
stream buffers, from portions of this site that have been constructed after June 30, 2001, must be
discharged through a correctly designed level spreader or another device that meets diffuse flow
requirements per 15A NCAC 213.0243. Diffuse flow requirements are described in Chapter 8 of the
North Carolina Stormwater BMP Manual, available at
http:.Zlportal.ncdenr.org./web/wg/`­wslsu/bmp-manual.
This permit does not affect the owners legal obligation to obtain other permits which may be
required by DEMLR, or permits required any other federal, state, or local governmental authorities.
If you have any questions concerning this permit, please contact Larry Wade PE at telephone
number [phone]
;ry,�L
for Tracy E. Davis, P.E.
cc: Mooresville Regional Office
Central Files
Stormwater Permitting Unit Files
1612 Mail Service Center, Raleigh, North Carolina 27699-1612 • Telephone [phone] FAX: [phone]
512 North Salisbury Street, Raleigh, North Carolina 27604 - Internet: htt :// iftal.ncdenr.or Mebgr,land ualit
An Equal Opportunity 1 Affirmative Action Employer - 50% Recycled 110% Post Consumer Paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
GENERAL PERMIT NO, NCGO50000
CERTIFICATE OF COVERAGE No. N0050413
STORMWATER DISCHARGES
NA1101�OLLUTANT_DISCHARGE ELIMINATION SYSTEM
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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,
Leggett & Platt Components Company, Inc.
is hereby authorized to discharge stormwater from a facility located at
Sackner NC
178 Orbit Road
Statesville
Iredell County
to receiving waters designated as Back Creek, a class C water in the Catawba River Basin, in
accordance with the effluent limitations, monitoring requirements, and other conditions
set forth in Parts 1,11, I[], IV, V, and VI of General Permit No. NCG050000 as attached.
This certificate of coverage shall become effective November 25, 2013.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day November 25, 2013.
W)�
for Tracy E. Davis, P.E., Director
Division of Energy, Mineral, and Land Resources
By the Authority of the Environmental Management Commission

NCGO50413
Map Scale 1:24,000
Leggett & Platt Components Co... Inc.
Sackner NC
Latitude: 350 46' 25.22" N
Longitude: -801 59' 28.27" W
County: Iredell
Receiving Stream: Back Creek
Stream Class: C
Sub -basin: 03-07-06 (Catawba River Basin)
Facility Location

A RMA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Energy, Mineral, and Land Resources
Land Quality Section
Tracy E. Davis, PE, CPM
Director
November 25, 2013
Mr. Bill Dotson
Leggett & Platt Components Co., Inc.
178 Orbit Rd.
Statesville, NC 28677
Pat McCrory, Governor
John E. Skvarla, Ili, Secretary
Subject: General Permit No. NCG050000
Sackner NC Facility
COC NCG050413
Iredell County
Dear Mr. Dotson:
In accordance with your application for a discharge permit received on November 7, 2013,
we are forwarding herewith the subject certificate of coverage to discharge under the subject state -
NPDES general permit. This permit is issued pursuant to the requirements of North Carolina General
Statute 143-2.15)A and the Memorandum of Agreement between North Carolina and the LIS
Environmental Protection Agency dated October 15, 2007 (or as subsequently amended).
Please take notice that this certificate of coverage is not transferable except after notice to
the Division of Energy Mineral & Land Resources (DEMLR). If the facility changes ownership or is
closed, DEMLR may require modification, revocation, or reissuance of the certificate of coverage.
Per the requirements of the Catawba Riparian Buffer Rule, all stormwater drainage to
stream buffers, from portions of this site that have been constructed after June 30, 2001, must be
discharged through a correctly designed level spreader or another device that meets diffuse flow
requirements per 15A NCAC 213.0243. Diffuse flow requirements are described in Chapter 8 of the
North Carolina Stormwater BMP Manual, available at
hU://I)ortal.ncdenr.org/web/wq/ws/sulbmp-manual.
This permit does not affect the owners legal obligation to obtain other permits which may be
required by DEMLR, or permits required any other federal, state, or local governmental authorities.
If you have any questions concerning this permit, please contact Larry Wade PE at telephone
number [phone]
;ry,�L
for Tracy E. Davis, P.E.
cc: Mooresville Regional Office
Central Files
Stormwater Permitting Unit Files
1612 Mail Service Center, Raleigh, North Carolina 27699-1612 • Telephone [phone] / FAX: [phone]
512 North Salisbury Street, Raleigh, North Carolina 27604 • Internet: htt :I/ rrtal.ncdenr.gr /webPrAand ualit
An Equal Opportunity 1 Affirmative Action Employer - 50% Recycled L 10% Post Consumer Paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
GENERAL PERMIT NO. NCG050000
CERTIFICATE OF COVERAGE No. NCGO50413
STORMWATER DISCHARGES
NATI—OHAL POLLUTANT T DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-21S.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,
Leggett & Platt Components Company, Inc.
is hereby authorized to discharge stormwater from a facility located at
Sackner NC
178 Orbit Road
Statesville
Iredell County
to receiving waters designated as Back Creek, a class C water in the Catawba River Basin, in
accordance with the effluent limitations, monitoring requirements, and other conditions
set forth in Parts 1, 11, II1, IV, V, and VI of General Permit No. NCG050000 as attached.
This certificate of coverage shall become effective November 25, 2013.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day November 25, 2013.
for Tracy E. Davis, P.E., Director
Division of Energy, Mineral, and Land Resources
By the Authority of the Environmental Management Commission

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Bou-ghazale, Samar
From: Wade, Larry
Sent: Thursday, November 14, 2013 11:28 AM
To: Bou-ghazale, Samar
Subject: NCG050413 Leggett & Platt
Attachments: NCG050413 NOI.pdf
Hello Samar,
Find attached the NOI for the subject existing facility. Please review and let me know if you have any concerns for
issuing the stormwater permit.
If a response is not received within 15 days from this email, we will proceed with issuing the permit contingent upon our
review.
Thanks,
Larry W. Wade PE Telephone: [phone]
Fax: [phone]
Stormwater Permitting Program
North Carolina Department of Environment & Natural Resources
Division of Energy Mineral and Land Resources
1612 Mail Service
9425
Raleigh, NC 27699-1612
Physical Address - 512 N. Salisbury St. Room
Raleigh, NC 27604
************************This isa' government E-mail address****************************
*********E-mails sent and received from this address can be disclosed to third parties************

46
NCI
Division of Water Quality / Water- Quality *etion
National Poflutant. Discharge Elimination System
NCG050006?
NOTICE OF INTENT
National Pollutant Discharge Elimination System application,foi coverageunder Genera! Permit
NCG050000:
STORMWATER DISCHARGES associated .-.with activities.classiliied as:`
SIC 23 Apparel and Other Finished .Products Made -from Fabrics and Similar Materials
SIC 265 Paperboard Containers and Boxes
L
SIC 26T Converted Paper and Paperboard Products
SIC 27 Printing, Publishing and. Allied Industries
§IC Rubber and Miscellaneous. Products (except as'specified below)
SIC' 31. Leather and Leather.Products. (except -as specified below)
SIC 3W Miscellaneous Manufacturing Industries
SIC" WA Like activities deemed by DWQ 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. Gen oral Permit:
SICK 301 Tires,and Inner Tubes
SIC. 311 Leather Tanning and Finishing.
Standard Industrial Classlticatlon Code,
(Please print or type)
1) Mailing address of ownedoperator (address to which all permit cor"g2ndence will be mailed):
Name Leggett & Platt Components Comoany, In(;,,.
Street Address 178 Orbit Road
City Statesville ....State NC IP-Code 8677_
1 Telephone No. 704-873-1086 Fax: [phone]
E-mail Address bill.dotsonAIegaett.Com-.
I
2) .Location of facility, producing discharge.
Tetept�ie IMto Faxµ 7f34�872=6�93'1�-
�3) l.Physlil I:Looatio_ n letotinationi
Pose 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). From 1�40 take exit 144 for Old Mountain Road. Turn
(A copy of a county map or USGS quad sheet with facility dearly located on the map is required with this app9cation)
Page!1 of 4
SWU-220-071408 r East Revised 7/1412008

a,
NCGO50000 N.O.I.
4) Latitude 360 46' 25.2221 " Longitude -800 59' 28,2714" (degrees, minutes, seconds)
5) This 10151tS'Pecnnit-Application applies to which of the following :
❑ New or Proposed Facility Date operation is to begin
X Existing
6) Standard Industrial Classification:
Ptovide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: 2 3 9 9 ;
Providees _A brief narrative description of the typof industrial active ies and products manufactured at
this faciUly: Facility manul=actures-braided welt .cord - UFAC -and non-UEAC. Also manufactured are
7.) Discharge points:
How many discharge points (ditches;,pipes, channels, etc.) convey stormwater from the property? 2
t
8) Receiving waters:
VVhat is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater
discharges end up in? Catawba 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). NA
9) Dies this facility have,any other NPDES permits.?
X No
f
❑ Yes
If yes,.Iist the permit numbers for all current NPDES permits for this facility:
10):Does this facility have any Non -Discharge permits (ex:. recycle permits)?
X No
❑ Yes
If yes, list -the permit numbers for all current Ikon -Discharge permits for this WRY:
11) Does this facllity'ernptoy any hest management practices for storrnwater control?
❑ No
X Yes
If yes, please.brietiy describe: Wooden pallets are the only materialsstored outdoors.
12) Does this facility have a-StormwatOr Pollution Prevention Plan?
X .No
❑ Yes
It yes, when was;if implemented?
13) Are vehicle maintenance activities occurring at this facility
X No ❑ Yes
Page 2 of 4
SWU-220-071408 Last Revised 7/14/2008

NCGu0000 EN.O.I..
14) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
X No ❑ Yes
b), Is. this facility a Small Quantity Generator (less than 1000,;kg. of, hazardous waste generated per month) of
hazardous,waste?
❑X No ❑ Yes
c) Is this facility a large Quantity Generator (1000 kg
hazardous waste?
❑ X No ❑ Yes
or more of hazardous waste generated per month) of
d) If you answered yes to questions b, or c., please provide the following information:
.Type(s) of waste. -
How is material shored:.. -
_t
Where is materiai stored::-- --- - -
How many disposal shipments pacyear:
Name of transport 1 disposal vendor-
Vendor address:" —
15CedWiication:.:
North Carolina:Genera{ Statute-143-215.6 b (i).provides that:
.Any person wtio 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 knowingty makes,a false
statement of a material fact in a rulemaking proceeding of contested case under this Article; or who falsifies, tampers with, or knowingly
rendeis Inaccurate any recordliig or monitoring device or method required to be operated or maintained under this Article or rules of the
[Environmental lfianagemert] 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 discharges) 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: 01 ;') I;G;.; 0• 111),-60,V
Title: ' •�(34iof [a !*.
of Applicant)
la fzt/1
(Date Signed)
-Notice:of=Intent must be accompame' d,by a check -or money order for $100.00,made payable to NCDENR.
SWU-220-071408
page 3 of 4
Last Revised •7l1412008

NCG050000 N.O.I.
E,na1 Checklist ,
This application will he returned as incomplete unless all of the following items have been included:
❑ Check, for- $100 made payable to NMEN R
This completed application and:all supporting documents
D Copy of county map or USGS quad sheet with location of facility clearly marked on map and nearby waters
M. Wl the entire. package to:
Stormwater and General Permits Unit
Division of Water Quality
1617_Mail Service Center
Raleigh, North Carolina 27699-1617
Note
The submission of this document does not guarantee the issuance of an NPDES permit.
For questions, please contact the DWQ Central Office or Regional Office for pour area.
DWO Regional Qf
igg ContaLt jnformatigni
Asheville Office ......
(828),2964500
Fayetteville Office ...
[phone]
Mooresville Office.
[phone]
Raleigh Office ........
[phone]
Washington Office ...(252)
946-6481 Am
Wilmington Office ...
[phone]
Winston-Salem _ _ _ _..
[phone]
Central Office .._._.._.(919)
807-6300
M
0
Page 4 of 4
SVVU-220-071408 last Revised 7/14/2008

9
0

FINVA
� R Division of Water Quality / Water Quality Section
NCDENRNational Pollutant Discharge Elimination System
� CW
EwRo 0�� ..
NCG050000
NOTICE OF INTENT
FOR AGENCY USE tII Y
Date Ve
Yeaz I Month
I Day
Certificate of coverap
NICIG10 D
a I Am wt
a 14100
Pffmil Amigaed to
a
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 266 Paperboard Containers and Boxes
SIC 267 Converted Paper and Paperboard Products
w
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* NIA Like activities deemed by DWQ 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
w Standard industrial Classification Code
(Please print or type)
1) Mailing address of ownerloperator (address to which all permit correspondence will be mailed/:
Name Leggett & Platt Components Com�anys Inc
Street Address 178 Orbit Road
City Statesville State NC ZIP Code 28677
Telephone No. 704_-873-1086 Fax: [phone]
E-mail Address bill.dotson(Meggett.com
2) Location of facility producing discharge:
Facility Name Sackner NC
Facility Contact Bill Dotson D
Contact E-mail bill.dotsonaletxtxettcom �L
Street Address 178 Orbit Road
City Statesville State NC ZIP Code 28677
County Iredell
Telephone No. 704-873-1086 Fax: [phone]„_
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). From 1-40 take exit 144 for Old Mountain Road. Turn
south on Old Mountain Road drive .1 miles and then turn east onto Orbit Road. The facility is located .3 miles
down on the south side of the road.
(A copy of a colony map or USGS quad sheet with facility dearly located an the map is required with this application)
Page 1 of 4
SWU-220-071408 Last Remised 7/14/2008

NCGO50000 N.O.I.
4) Latitude 35046' 25.2221" Longitude -80059' 28.2714" (degrees, minutes, seconds)
n5) This NPDES Permit Application applies to which of the following:
❑ New or Proposed Facility
X Existing
6) Standard Industrial Classification:
Date operation is to begin
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: 2 3 9 9
Provide a brief narrative description of the types of industrial activities and products manufactured at
this facility: Facility,manufactures braided welt cord — UFAC and non-UFAC. Also manufactured are
extruded plastic covered wire, poly rod, and foam welt.
7) Discharge points:
How many discharge points (ditches, pipes, channels, etc_) convey stormwater from the property? 2
8) 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? Catawba Rlver
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). NA
Vj Does this facility have any other NPDES permits?
X No
❑ Yes
If yes, list the permit numbers for all current NPDES permits for this facility:
10) Does this facility have any Non -Discharge permits (ex: recycle permits)?
X No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:.
`11)-Does this facility employ any best management practices for stormwater control?
❑ No
X Yes
If yes, please briefly describe: Wooden pallets are the only materials stored outdoors,
tqy Does this facility have a Stormwater Pollution Prevention Plan?
X No
❑Yes.
if yes, when was it implemented?
13) Are vehicle maintenance activities occurring at this facility?
X No ❑ Yes
Page 2 of 4
Sv+ru-22M71408 Last Revised 7l14nOO8

NCG050000 N.O.I.
14) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
X No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
❑X No ❑ Yes
c) Is this facility a large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
❑X No ❑ Yes
d) If you answered yes to questions b. or c_, please provide the follo%ring information:
Type(s) of waste:
How is material stored:
Where is material stored:
How many disposal shipments per year.
Name of transport 1 disposal vendor
Vendor address:
15) 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 fad 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: { I GM J 0+f o"r
Title: _ C e-✓eo,,, ( M,,,14ya -
ILA
(Signature of Applicant)
1 a ILI
(Date Signed)
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to NCDENR.
Page 3 of 4
SWU-220-0714M Last Revised 7/142008

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 NCDENR
❑ 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:
Stormwater and General Permits Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Note
The submission of this document does not guarantee the issuance of an NPDES permit.
For questions, please contact the DWQ Central Office or Regional Ofce for your area.
DWQ Regional Office Contact Information:
Asheville Office ...... [phone]
Fayetteville Office ...
1910) 433-3300
Mooresville Office ...
[phone]
Raleigh Office ........
[phone]
Washington Office...
(252) 946- 481
Wilmington Office _..
[phone]
Winston-Salem ......
[phone]
Central Office .........(919)
807-6300
Page 4 of 4
SWU-220-071408 Last Revised 7/14/2008

Cep® � ucoerouTEn
[phone]
42
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igb- DETACH AT PERFORATION AND RETAIN FOR YOUR RECORDS' 06748360
CHECK NUMBER
CHREQ105013
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SR 0548 J WILLIAMS
NOTICE OF INTENT
FEE
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100.00
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POSTLNG GUESTMS • CALL 417-
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VERIFY THE AUTHENTICITY OF THIS MULTI -TONE SECURITY DOCUMEN"L ® THE[ FACE OF THIS DOCUMENT HAS A BLUE AND GREEN BACKGROUND
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/� JPMORGAN CHASE BANK N. 50 937 648360
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CHECK NO.
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NET AMOUNT
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THIS IS A POSITIVE PAY CHECK
VOID'AFTER 180 DAYS

Wade, Larry
From: Bou-ghazale, Samar
Sent: Monday, November 25, 2013 8:24 AM
To: Wade, Larry
Subject: RE: NCGO50413 Leggett & Platt
Good Morning Larry,
We offer no objections for the issuance of the subject permit.
Good Day[
Samar
From: Wade, Larry
Sent: Thursday, November 14, 2013 11:28 AM
To: Bou-ghazale, Samar
Subject: NCG050413 Leggett & Platt
Hello Samar,
Find attached the N01 for the subject existing facility. Please review and let me know if you have any concerns for
issuing the stormwater permit.
If a response is not received within 15 days from this email, we will proceed with issuing the permit contingent upon our
review.
Thanks,
Larry W. Wade PE Telephone: [phone]
Fax: [phone]
Stormwater Permitting Program
North Carolina Department of Environment & Natural Resources
Division of Energy Mineral and Land Resources
1612 Mail Service Physical Address - 512 N. Salisbury St. Room
942S
Raleigh, NC 27699-1612
Raleigh, NC 27604
is a government E-mail address****************************
*********E-mails sent and received from this address can be disclosed to third parties************
1