NCG180253_COMPLETE FILE - HISTORICAL_20190520

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT N0.
/v C&
DOC TYPE
HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ oS aIi d S,)�o
YYYYMMDD

' t.r..r•
Division of Energy,. Mineral, and Land Resources
j . Land Quality Section 1 Stormwater Program
National Pollutant Discharge Elimination System (NPDES)
Energy, Mineral PERMIT OWNER AFFILIATION DESIGNATION FORM
Land Resources
VIVIROPIMEWAL auAL11Y (individual Legally Responsible for Permit)
Use this form If there has been:
FOR AGENCY USE ONLY
[rate Received
Year
Month
Da
NO CHANGE in facility. ownership or facility name, but the individual
who is legally responsible for the permit has changed.
If the name of the facility has changed, or If the ownership of the facility has changed,
do NOT use this form. Instead, you must fill out a Name -Ownership Change Form
and submit the completed form with all required documentation.
What does "legally responsible individual' mean?
The person is either.
• the responsible corporate officer (for a corporation);
• the principle executive officer or ranking elected official (for a municipality, state, federal or other public
agency);
• the general partner or proprietor (for a partnership or sole proprietorship);
• or, the duly authorized representative of one of the above.
1) Enter the permit number for which this change in Legally Responsible Individual ("Owner Affiliation")
applies:
Individual Permit (or) Certificate of Coverage
N I C I SI I N I C I t3 1 8 10 12 15 3
2) Facility Information:
Facility name: American Woodmark Corporation
Company/Owner Organization: AWC
Facility address: 838 Lincoln County Parkway
Address
Lincolnton NC 28092
City State Zip
To find the current legally responsible person associated with your permit, go to this website:
ht :I/de .nc: ov/about/divisions/cner -mineral-land-resources/ener -mineral-land- ermits/stor nwater- ro iv
am
and run the Permit Contact Summary Report.
3), OLD OWNER AFFILIATION that should be removed:
Previous legally responsible individual: Doug Burns
First Mi Last
A) NEW OWNER AFFILIATION (legally responsible for the permit):
Person legally responsible for this permit:
Anthony Holifield
First MI Last
Paget o f 2
SW U-0WNERAFFIL-23March2017

NPDES Stormwater Permit OWNER AFFILATION DESIGNATION Form
(if no Facility NamelOwnership Change)
,S) Reason for this change:
A result of.
If other- please explain:
Director of Operations
Title
838 Lincoln County Parkway
Mailing Address
Uncotnton NC 28092
City State Zip
(828 )a28_ 1962
Telephone E-mail Address
Fax Number
0 Employee or management change
❑ Inappropriate or incorrect designation before
❑ Other
The certification below must be completed and signed by the permlt,holder.
PERMITTEE CERTIFICATION:
1, Anthony Moli#ield , attest that this application for this change in Owner Affiliation
(person legally responsible for the pernut) has been reviewed and is accurate and complete to the best of my
knowledge. i understand that if all required parts of this form are not completed, this change may not be
processed.
Signature Date
PLEASE SEND THE COMPLETED FORM TO:
DEMLR - Stormwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
For, more information or staff contacts, please call [phone] or visit the website
at: htt://de .nc. ov/about/divisions/ener -mineral-land-resources/stormwater
Page 2 of 2
SW U-oWNERAFFIL23Mar2017

Central Files: APS _ SVVP _
11/1612016
Permit Number NCG180253
Permit Tracking Slip
Program Category
Status Project Type
NPDES SW
In review New Project
Permll Type
Version Permit Classification
Furniture and Fixtures Stormwater Discharge COC
COC
Primary Reviewer
Contact Affiliation
}ulie.ventaloro
� �� �
I � ��il
Coastal SWRule
NOV 2 S 2016
Permitted Flow
CENTRAL FILES
DWR SECTION
Facility
Facility Name
Major/Minor Region
RSI Home Products
Minor Fayetteville
Location Address
County
200 Development Or
Richmond
Facility Contact Affiliation
Hamlet NC 28345
Doug Burns
838 Lincoln County Hwy
Owner
Lincoinfon NC 28082
Owner Name
Owner Type
Rai Home Products Inc
Non-Govemment
Owner Affiliation
Doug Bums
838 Lincoln County Hwy
Dates/Events Lincolnton NC 28092
Scheduled
Orig Issue App Received Draft Initiated Issuance
Public Notice
t
Exp
1011212018
i eip
'V
t'ff
rb
flc�� `f
Regulated Activities
Requested /Received Events/Received Events
Wood kitchen cabinets manufacture
RO staff report requested
10/25/16
RID staff report received
W10116
Outfal I 001
Waterbody Name Streamindex Number Current Class Subbaain
Marks Creek (Boyle Lake, City Lake, Everetis Lake) 13-45-(2) C 03.07.16

Energy, Mineral
and Land Resources
ENVIRONMENTAL QUALITY
November 16, 2016
Mr. Doug Burns
RSI Home Products, Inc.
838 Lincoln County Highway
Lincolnton, NC 28092
PAT MCCRORY
' Governor
DONALD R. VAN DER VAART
Secretary
TRACY DAVIS
Dtreclor
Subject: General Permit No. NCG 180000
RSI Home Products
COC No. NCG180253
Richmond County
Dear Mr. Burns:
In accordance with your application for a discharge permit received on October 12, 2016, we are
forwarding herewith the subject certificate of coverage (COC) 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 upon approval of the
Division of Energy, Mineral and Land Resources. The Division of Energy, Mineral and Land
Resources may require modification or revocation and reissuance of the certificate of coverage.
This permit does not affect the legal requirements to obtain other permits which may be required by
the Division of Energy, Mineral and Land Resources, the Coastal Area Management Act, or any other
federal or local government permit that may be required.
If you have any questions concerning this permit, please contact Julie Ventaloro at telephone number
[phone] or by email iulie.ventaloro(@,ncdenr.gov.
Sincerely,
for Tracy E. is, P.E., CPM, Director
Division of Energy, Mineral and Land Resources
cc: Fayetteville Regional Office, Mike Lawyer
Central Files
Stormwater Permitting Program Files
State of North Carolina I E nvironmental Quality I Energy, Mineral and Land Resources
1612 Mail Service Center 1 512 North Salisbury Street I Raleigh, NC 27699-1612
919 707 9200 T

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
GENERAL PERMIT NO. NCG180000
CERTIFICATE OF COVERAGE No. NCG180253
STORMWA'CER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINA,rION 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,
RSI Home Products, Inc.
is hereby authorized to discharge stormwater from a facility located at
RSI Home Products
200,Development Drive
Hamlet
Richmond County
to receiving waters designated as Marks Creek, a class C water in the Yadkin River Basin, in
accordance with the effluent limitations, monitoring requirements, and other conditions set forth
in Parts 1, II, III, and IV of General Permit No. NCG180000 as attached.
This certificate of coverage shall become effective November 16, 2016.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day November 16, 2016.
for Tracy E. DaV1S�.1?., CPM
Director, Division of Energy, Mineral and Land Resources
By the Authority of the Environmental Management Commission

• r `• �.. ✓. _ _ • _' • , — . 1 jti l del 1' rii1E�
• ,. f M 'ram-,-• sy 1 % / � �./% ��1- ���' - � "r? � �. �[ ,1
P
4 1 s 1 • o
11 �fiA
h9•
n
lea
Ih I n � •
a
NCG 180253
N
W E
S
Map Scale 1: 24, 000
Gaso n
RSI Home Products T""k u
1/
!l
s y
�W.�
i � V
sMWAY
V
� �
1/
�
♦ 4
�� 1
.• 6��
r
Mir
/yf�y^'f 'N/: �,i1 ,�s •'1�
'i
�frf�
IG
9
J[�J
ff
T
b
• j �II� ti5
{
•ri.1. Spy ,Y';4
I
M' ;
.�
11 �
RSI Home Products, Inc.
RSI Home Products
Latitude: 34' 51' 24" N
Longitude, 790 42` 50" W
County: Richmond
Receiving Stream: Marks Creek
Index No: 13-45-(2)
Stream Class: C
Sub -basin: 03-0746 (Yadkin River Basin)
Facility Location

Via FedEx Standard Overp&h t
September 28, 2016
Division of Energy, Mineral, and
Land Resources
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Attn: Stormwater Permitting Program
Re: Notice of intent for -Coverage
Under General Permit NCG180000
RSI Home Products
200 Development Drive
Hamlet, North Carolina
H&H Project No. RSI-001
Dear Sir or Madam
RECEIVED
uu 112 2016
DENR-LAND QUALITY
STORMWATER PERMITTING
R9I Home Products, Inc. (RSI) is providing the attached Notice of Intent for National Pollution
Discharge Elimination System (NPDES) coverage under General Permit NCG1800000 for RSI's
new wood components/wood cabinet manufacturing facility located at 200 Development Drive in
Hamlet, North Carolina.
If you have any questions, or require additional information, please don't hesitate to contact us.
Sincerely,
RSI Home Products, Inc.
ohn Raney R
Director of Manufacturing
Enclosures
C.NUsctsVbwn3YpppDalAVAxaPM mwffi%Vmd(n*Tcmporary Internet tdciTo%em.Oullwk%1 BFINM6DA1No1 Cover Lrumdoc

Division of Energy, Mineral, and Land Resources
Land Quality Section
RCDENRNational Pollutant Discharge Elimination System
N,M H (.4R 1l [X'/pTMFYT OP
FHYirkomm ? Aw NauRN, Rr50JRGpa
NCG180000
NOTICE OF INTENT
FOR AGENCY 115E ONLY
Date Received
Year
Manih
Da
Certific to f Cave
e
Cn
ermit Assi d to
re)
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG 180000:
STORMWATER DISCHARGES associated with activities classified as: RECEIVED
SIC' 25 Furniture and Fixtures, and SIC 2434 Wood Kitchen Cabinets, UC f 12 2016
And, Like activities deemed by DEMLR to be similar in the process, or the exposurog�EYND CDAUTy
materials, products, by-products, or waste materials. STaRMWATER FE18iyl€TfING
` Standard Industrial Classification Code
(Please print or type)
1) Mailing address of owner/operator (address to which official permit correspondence will be mailed):
Name
Street Address
City
Telephone No.
E-mail address
Doug Burns - - _Y,� �towu pmc6cts� --rn G
838 Lincoln Countv Highwav
Lincolnton State NC ZIP Code 28092
828-428-5130 Fax:
dburns@rsihomeproducts,com
2) Location of facility producing discharge:
Facility Name
Facility Contact
Street Address
City
County
Telephone No.
RS1 Home Products
Doug Burns
200 Development Drive
Hamlet State NC ZIP Code 28345
Richmond
828-428-5130
3) Physical Location Information:
Fax:
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 exit 319 from I-74 and turn north onto NC-38N.
From NC-38N, turn left onto Freeman mill road. The site will be on the left after 0.7 miles.
(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 34°51'24.1" N
Longitude 79°42'50.1"W I (degrees, minutes, seconds) 30SIOU70
5) This NPDES Permit Application applies to which of the following :
fif New or Proposed Facility
❑ Existing
6) Standard Industrial Classification:
Date operation is to begin October 1, 2016
qq . 70 7/;�3
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: 2 4 3 4
7) Provide a brief narrative description of the types of Industrial activities and products manufactured at
this facility: Cabinet manufacturing „
Page 1 of 4
SWU-233-82814 Last revised 8/28/14

' NCG180000 N.O.I.
8) Discharge points I Receiving waters:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property?
There are two stormwater outfalls in the southern portion of the site where stormwater will discharge (see attached site plan
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? Marks Creek - Class C water
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). Stormwater discharges to NC DOT drainaged
US
10} Does this facility have any other water quality permits? ditches along Highway 74 to the south of thesite
6d No
❑ Yes
If yes, list the permit numbers for all current water quality permits for this facility:
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
Rf 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
1T Yes
If yes, please briefly describe: please see attachment for this response
13) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No
fK Yes
If yes, when was it implemented? October 1. 2016
14) Are vehicle maintenance activities occurring at this facility?
V No ❑ Yes
15) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
VT No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
it No ❑ Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
RT No ❑ Yes
Page 2 of 4
SWU-233-82814 Last revised 8128/14

NCGI80000 N.O.I.
d) If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste: Waste paint, clean -tip solvents (non -halogenated), equipment lubrication oils, water -based gitte
How is material stored:
Where is material stored: In designated, indoor storage area that is inspected weeldy
How many disposal shipments per year: At least two times per year
Name of transport / disposal vendor: e r ry (Disposal)
Vendor address: —Disposal address:_1220 Valley Di, Attalla, AL
16) Certification: . U.S. Waste Industries 4420 ]efferies Hwy P.O. Box 2326 Walterboro, SC
North Carolina General Statute 143-215.6 b (1) 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 Article 21 or regulations of the Environmental
Management Commission Implementing that Article, or who falsifies, tampers with or knowingly rendors Inaccurate
any recording or monitoring device or method required to be operated or maintained under Article 21 or regulations of
the Environmental Management Commission Implementing that Article, shall be guilty of a misdemeanor punishable
by a fine not to exceed $10,000, or by Imprisonment not to exceed six months, or by both. (10 U.S.C. Section 1001
provides a punishment by a fine of not more than $10,000 or Imprisonment not more than 5 years, or both, for a similar
offense.)
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:�`-� w
Title: 0 w"-. &- X--
of
(Date Sign j
must be accomparfled 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.
Please do not ask us to hold an Incomplete application In anticipation of a check under separate cover.
Ell" —Check for $100 made payable to NCDENR
L�Thls completed application, signed by the owner/operator, and all supporting documents
17�Copy of county map or USGS quad sheet with the location of the facility clearly marked on the map
Mall the entire package to:
Stormwater Permitting Program
Division of Energy, Mineral, and Land Resources
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Please note: The submtpslon of this document does not guarantee the Issuance of an NPDES permit.
Page 3 of 4
SWU-233-62814 Last revised 8/28/14

�-• � �� _) �i 1 Itj `--' ,.- _ram � r `/� �" - �l
New�T0�wn
EDWARDS SMILET
T��
-8r l '4
E7t W DR 1
77.
jil
r.f %-; ' � •5`T
®yp
74
\�a a�=
✓- ti. Aar �. �4— w .�"�- � ;A /� yRo�
,1,. %`
IN
�.I�-'"
350 YSON OR
APPROXIMATE
N 0 2000 4000
SCALE IN FEET
U.S.G.S. QUADRANGLE MAP
GHIO, NORTH CAROLINA 2016
QUADRANGLE
7.5 MINUTE SERIES (TOPOGRAPHIC)

Response to item #12
A Stormwater Pollution Prevention Plan (SWPPP) is being proposed for the facility, and
will include the following best management practices (BMPs) to be implemented at the
facility:
1) Housekeeping — The facility will be maintained in a clean and organized fashion.
Chemicals will be stored indoors when possible and on containment pallets.
Chemicals stored on -site will be inventoried and each container will be properly
labeled.
2) Preventative Maintenance -- Stormwater conveyance systems including building
gutters, downspouts, and stormwater catchment basins, will be routinely inspected
and maintained as needed to maintain proper stormwater control.
3) Inspections — Facility inspections will be conducted on a monthly basis to identify
and remove potential sources of impact to stormwater.
4) Spill Prevention and Response — A spill prevention and response plan will be
incorporated into the facility SWPPP. In the event of a release, the response plan
will detail procedures to contain the release and to minimize exposure to
stormwater.
5) Sediment and Erosion Control — A sediment and erosion control plan will be
drafted for use during building construction and/or renovation activities to
minimize soil and sediment runoff to stormwater.
6) Management of Runoff — Runoff patterns will be inspected to identify potential
off -site sources of impacts to stormwater. If off -site sources are identified, the
facility will be contacted to correct the issue.
7) Employee Training — A Stormwater Pollution Prevention Team will be created
and its members will be trained in the safe handling and storage of materials and
chemicals stored on -site. The team will also be trained to properly respond to
spills or releases, should they occur.
8) Recordkeeping and Reporting — Incidents involving the spill or release of
petroleum or potentially hazardous materials will be documented. Additionally,
facility inspection activities, maintenance activities, and spill response activities
will be documented. Documents will be maintained on-sitc for a minimum of one
year following expiration of the permit.
RSI Home Products
Notice of Intent
September 2016
Page 1 of 1

f.
Energy, Mineral
and Land Resources
ENVIRONMENTAL MAUTY
November 16, 2016
Mr. Doug Burns
RSI Home Products, Inc.
838 Lincoln County Highway
Lincolnton, NC 28092
PAT MCCRORY
Governor
DONALD R. VAN DER VAART
secrelRty
TRACY DAVIS
I)ircclnr
Subject: General Permit No. NCG180000
RSI Home Products
COC No. NCGIS0253
Richmond County
NOV 2 9 2016
Dear Mr, Burns:
E �
In accordance with your application for a discharge -permit received on October 12, 2016, we are
forwarding herewith the subject certificate of coverage (COC) 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 upon approval of the
Division of Energy, Mineral and Land Resources, The Division of Energy, Mineral and Land
Resources may require modification or revocation and reissuance of the certificate of coverage.
This permit does not affect the legal requirements to obtain other permits which may be required by
the Division of Energy, Mineral and Land Resources, the Coastal Area Management Act, or any other
federal or local government permit that may be required,
If you have any questions concerning this permit, please contact Julie Ventaloro at telephone number
[phone] or by email julie.ventaloroaa•nedenr.gov.
Sincerely,
ORIGINAL SIGNED BY
BETHANY GEORGOULIAS
for Tracy E. Davis, P.E., CPM, Director
Division of Energy, Mineral and Land Resources
cc: Fayetteville Regional Office, Mike Lawyer
Central Files
Stormwater Permitting Program Files
State of North Carolina I Environmental Quality I Energy, Mineral and Land Resources
1612 Mail Service Center 1 512 North Salisbury Street I Raleigh, NC 27699-1612
919 707 9200 T

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
GENERAL PERMIT NO. NCG180000
CERTIFICATE OF COVERAGE No. NCG1.80253
STORMWATER DISCHARGES
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,
RSI Home Products, Inc.
is hereby authorized to discharge stormwater from a facility located at
RSI Home Products
200 Development Drive
Hamlet
Richmond County
to receiving waters designated as Marks Creek, a class C water in the Yadkin River Basin, in
accordance with the effluent limitations, monitoring requirements, and other conditions set forth
in Parts 1, I1, 111, and IV of General Permit No. NCG180000 as attached.
This certificate of coverage shall become effective November 16, 2016.
'Phis Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day November 16, 2016.
ORIGINAL SIGNED BY
BETHANY GEORGOULIAS
for Tracy E. Davis, P.E., CPM
Director, Division of Energy, Mineral and Land Resources
By the Authority of the Environmental Management Commission

i a� pf • \. ..,ice". i � -r �� I •'' ,�iil�
• • • yr -� (`� � �. r..� � !��/J r ,r r p • • A � � l �y � � .J
.fti ` ^ 1? iaa. 4 � � � , ■, .,,i.. ` � f'" � /... �;�, I � � � I� r I fr `~
,, r p� � " �.- � ✓ �, �r""�rlJy ``J V , ��b s� _� 5 'i �W
r ` ! � .iEl'r'','�� �- �I♦1 �� � �.1 1 •Y�(.aM1 •J I � 'w, r�,11 �.../
`
TM
• '� �,r � Gaso n �T,
4Y ` 1
1 Tenkf t
RSI Home Products
Of, d., 4 Mq N } --
0
•'i -.,. ...� ..�' >9 ° 9, �� mot• /'
��y lia -ti ii !320
r ♦t� C `. ) _. kq u 41 _ P d I
�`�ecaaa ` j�j{yj r .,•`=ak' '�nar ,,`0 9
` �c t U /f � ' 10G ,-..,�:a i s � epw 'f^�^`+7 `•d}s • ece�arc+xL ,^
Vp � i r,� ' H UUf \lam JI wJ � xa�4J /Ri � i • � •P�
d. i 4 � ram.• " �f y � 6.
VVV fi I 9 d t O Y.� ,� S� y E -•!v.' a� Q
10
on
fl i 4 r• 11 �' .,�. J ••aa C� i..
NCG 180253
N
W E
S
Map Scale 1; 24, 000
RSI Home Products, Inc.
RSI Home Products
Latitude: 34' 51' 24" N
Longitude: 791 42' 50" W
County: Richmond
Receiving Stream: Marks Creek
Index No; 13-45-(2)
Stream Class; C.
Sub -basin, 03-07-16 (Yadkin River Basin)
Facility Location

Ventaloro, Julie
From:
Lawyer, Mike
Sent:
Thursday, November 10, 2016 4:56 PM
To:
Ventaloro, Julie
Cc:
LaBounty, Tim L
Subject:
RE: Review Request NCG180253 RSI Home Products
Follow'Up Flag:
Follow up
Flag Status:
Flagged
Julie,
Sorry for the delay on this. I have been inspecting this project for compliance with their approved erosion control plan
and was planning to inform them about the need to obtain coverage under an industrial stormwater permit once
construction was completed. Glad to see that they went ahead and applied for coverage without me having to tell them.
Unless you need additional or specific information about the facility, please proceed with issuance of permit coverage.
Thanks,
Mike
Michael Lawyer, CPSWQ
Environmental Program Consultant
Division of Energy, Mineral and Land Resources
North Carolina Department of Environmental Quality
910 433-3394 office
[e-mail]
225 Green Street, Suite 714
Fayetteville, NC 28301
f"-"'Nothing Compares.,.,,,
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
From: Ventaloro, Julie
Sent: Tuesday, October 25, 201612:53 PM
To: LaBounty, Tim L <[e-mail]>
Cc: Lawyer, Mike <[e-mail]>
Subject: Review Request NCG180253 RSI Home Products
Tim and Mike,
We've received an NOI for a new wood cabinet manufacturing facility in your region:
NCG180253 RSI Home Products in Richmond County. This site discharges stormwater at 2 points to Marks Creek (Class
C). The NOI states that the stormwater discharges to NC DOT ditches along US Hwy 74. The NOI is attached.
Please let me know within 30 days if the Fayetteville Regional Office has any concerns about issuing this COC.

Thanks!
Julie Ventaloro
Stormwater Permitting Program
NC Division of Energy, Mineral, and Land Resources
1612 Mail Service Center, Raleigh, NC 27699-1612
Phone: [phone] Fax: [phone]
Website: http:l/watersuppllywatershed.nc.c�ov
K
, "Nothing Compares-.,.-,
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.

Via FedEx Standard_ Overnight
September 28, 2016
Division of Energy, Mineral, and
Land Resources
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Attn: Stormwater Permitting Program
Re: Notice of Intent for Coverage
Under General Permit NCO180000
RSI Home Products'
200 Development Drive
Hamlet, North Carolina
H&H Project No. RSI-001
Dear Sir or Madam
RECEIVED
UU f 12 2016
DENR.LAND QUALIV
STORMWATER PERMITTING
A81 Home Products, Inc. (RSI) is providing the attached Notice of Intent for National Pollution
Discharge Elimination System (NPDES) coverage under General Permit NCG1800000 for RSI's
new wood components/wood cabinet manufacturing facility located at 200 Development Drive in
Hamlet, North Carolina.
If you have any questions, or require additional information, please don't hesitate to contact us.
Sincerely,
RSI Home Products, Inc.
ohn Raney H
Director of Manufacturing
Enclosures
C IUce[sW6ivnslAppbadVacaMIluo�o[R1YfndomlTempamp Intam FkAComwd.0QPok11BHW4WM01 Cover Lcnv.&c

STORMWATER DISCHARGES associated with activities classified as:
SIC 25 Furniture and Fixtures, and SIC 2434 Wood Kitchen Cabinets,
j&�a
Division of Energy, Mineral, and Land Resources
` Land Quality Section
NCDENRNational Pollutant Discharge Elimination System
14, RH GAO� Dcrw. EW pr
Fmv"wr."Apm Nxruw kmomc►s NCGI80000
NOTICE OF INTENT
FOR AGENCY USE ONLY
Date Received
Year
Month
Do
CenificateAfCovemie
Ch
ermit Assi d to
tvh ry
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG180000: RECEIVED
OCT 12 2016
And, Like activities deemed by DEMLR to be similar in the process, or the exposur;OENv(N.Q QUALIT`t
materials, products, by-products, or waste materials. STORM�lATERPERMFTTING
Standard Industrial Classification Code
(Please print or type)
1) Mailing address of owner/operator (address to which official permit correspondence will be mailed):
Name Doug Burns Ul- �tawu 606C
Street Address
City
Telephone No.
E-mail address
Lincolnton State NC ZIP Code 28092
828-428-5130 Fax:
[e-mail]
2) Location of facility producing discharge:
Facility Name RSI Home Products
Facility Contact Doug Burns
Street Address 200 Development Drive
City Hamlet State NC ZIP Code 28345
County Richmond
Telephone No. 828-428-5130 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 exit 319 from 1-74 and turn north onto NC-38N.
From NC-38N, turn left onto Freeman mill road. The site will be on the left after 0.7 miles.
(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 34"51'24.1"N
Longitude 79°42'50.1"W (degrees, minutes, seconds) 3051600
5) This NPDES Permit Application applies to which of the following :
2f New or Proposed Facility
❑ Existing
6) Standard Industrial Classification:
Date operation is to begin October 1, 2016
.7q, r7o 7ID-3
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: 2 4 3 4
7) Provide a brief narrative description of the types of Industrial activities and products manufactured at
this facility: Cabinet manufacturing
Page 1 of 4
SWU-233-82814 Last revised 8/28/14

,,NCG180000 N.0.1.
8) Discharge points 1 Receiving waters:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property?
There are two stormwater ouifalls in the southern portion of the site where stormwater will discharge (see attached site plan
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? Marks Creek - Class C water
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). Stormwater discharges to NC DOT drainaged
10) Does this facility have any.other water quality permits? ditches along US Highway 74 to the south of the
site
V No
❑ Yes
If yes, list the permit numbers for all current water quality permits for this facility:
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
9 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
ST Yes
If yes, please briefly describe: please see attachment for this response
13) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No
if Yes
If yes, when was it implemented? October 1. 2016 _
14) Are vehicle maintenance activities occurring at this facility?
Rf No ❑ Yes
15) Hazardous Waste:
a) ,Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
it No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
q No ❑ Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
ig No ❑ Yes
Page 2 of 4
SWU-233-82814 Last revised 8/28/14

NCG180000 N.O.I.
d) If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste: Waste paint, clean -tip solvents (non -halogenated), equipment lubrication oils, water -based glue
How is material stored: In clearly labeled, wastc-compatible containers
Where is material stored: In designated, indoor storage area that is inspected weekly
How many disposal shipments per year: At least two times per year
Name of transport 1 disposal vendor: ry (Disposal)
Vendor address: Disposal address:1220 Valley D11, Attalla, AL
16) Certification: U.S. Waste Industries 4420 )efferies Hwy P.O. Box 2326 Walterboro, SC
North Carolina General Statute 143-215.6 b (1) provides that:
Any person who knawingly.makes any false statement, representation, or certification in any application, record,
report, plan or other document filed or required to be maintained under Article 21 or regulations of the Environmental
Management Commission implementing that Article, or who falsifies, tampers wilh or knowingly renders inaccurate
any recording or monitoring device or method required to be operated or maintained under Article 21 or regulations of
the Environmental Management Commission Implementing that Article, shall be guilty of a misdemeanor punishable
by a fine not to exceed $10,000, or by Imprisonment not to exceed six months, or by both. (18 U.S.C. Section 1001
provides a punishment by a fine of not more than $10.000 or Imprisonment not more than 5 years, or both, for a similar
offense.)
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 in 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:. lt'
Title: 0 eve ., -,F AkA-,-
of
DataSi bn d
l p J
Notict_p(lntent must be accompariled by a check or money order for $100.00 made payable to:
NCDENR.
Final Checklist -
This.application will be returned as incompl$te unless all of the following Items have been Included.
Please do not ask us to hold an Incomplete application In anticipation of a check under separate cover.
Check for $100 made payable to NCDENR
Er" -This completed application, signed by the owner/operator, and all supporting documents
Copy of county map or USGS quad sheet with the location of the facility clearly marked on the map
Mail the entire package to:
Stormwater Permitting Program
Division of Energy, Mineral, and Land Resources
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Please rote: The submisslon of this document does not jouaranLee the tssuancs of an AMES permit.
Page 3 of 4
SWU-233-62814 Last revised 8/28114

I
�J . �'+ �~�,�f�e� _ _ _� -- •��.'~ it.` \ �. _!„�.yl}� r_-"r ..✓�/,JJJ� /+''.7JJ/�I��� ���\� ! �
,�' �iV !•. +l I If ,' _ �� BRYSON CR _ 110
5 _�-
APPROXIMATE
N 0 2000 4000
SCALE IN FEET
U.S.G.S. QUADRANGLE MAP
GHIO, NORTH CAROLINA 2016
QUADRANGLE
7.5 MINUTE SERIES (TOPOGRAPHIC)
TITLE
SITE LOCATION MAP
PROJECT PROPOSED RSI HOME PRODUCTS FACILITY
200 DEVELOPMENT DR
HAMLET, NORTH CAROLINA
hart � h i c km a n Char South oryvn Carolina
282 3
Charlotte, North Carolina 287A3
704-586-0007 (p) 704-586.0373 {fj
SMARTER ENVIRONMENTAL SOLUTIONS
DATE: 7-20-2016 REVISION NO: 0
JOB NO: RSI-001 FIGURE: 1

A
Response to item #12
A Stormwater Pollution Prevention Plan (SWPPP) is being proposed for the facility, and
will include the following best management practices (BMPs) to be implemented at the
facility:
1) Housekeeping — The facility will be maintained in a clean and organized fashion.
Chemicals will be stored indoors when possible and on containment pallets.
Chemicals stored on -site will be inventoried and each container will be properly
labeled.
2) Preventative Maintenance — Stormwater conveyance systems including building
gutters, downspouts, and stormwater catchment basins, will be routinely inspected
and maintained as needed to maintain proper stormwater control.
3) Inspections — Facility inspections will be conducted on a monthly basis to identify
and remove potential sources of impact to stormwater.
4) Spill Prevention and Response — A spill prevention and response plan will be
incorporated into the facility SWPPP. In the event of a release, the response plan
will detail procedures to contain the release and to minimize exposure to
stormwater.
5) Sediment and Erosion Control — A sediment and erosion control plan will be
drafted for use during building construction and/or renovation activities to
minimize soil and sediment runoff to stormwater.
6) Management of Runoff — Runoff patteYns will be inspected to identify potential
off -site sources of impacts to stormwater. If off -site sources are identified, the
facility will be contacted to correct the issue.
7) Employee Training — A Stormwater Pollution Prevention Team will be created
and its members will be trained in the safe handling and storage of materials and
chemicajs stored on -site. The team will also be trained to properly respond to
spills or releases, should they occur.
8) Recordkeeping and Reporting — Incidents involving the spill or release of
petroleum or potentially hazardous materials will be documented. Additionally,
facility inspection activities, maintenance activities, and spill response activities
will be documented. Documents will be maintained on -site for a minimum of one
year following expiration of the permit.
RSI Home Products
Notice of Intent
September 2016
Page Iof1

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
GENERAL PERMIT NO. NCG180000
CERTIFICATE OF COVERAGE No. NCG180253
STORMWATER DISCHARGES
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,
RSI Home Products, Inc.
is hereby authorized to discharge stormwater from a facility located at
RSI Home Products
200 Development Drive
Hamlet
Richmond County
to receiving waters designated as Marks Creek, a class C water in the Yadkin River Basin, in
accordance with the effluent limitations, monitoring requirements, and other conditions set forth
in Parts I, II, III, and IV of General Permit No. NCG180000 as attached.
This certificate of coverage shall become effective November 16, 2016.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day November 16, 2016.
ORIGINAL SIGNED BY
BETHANY GEORGOLILIAS
for Tracy E. Davis, P.E., CPM
Director, Division of Energy, Mineral and Land Resources
By the Authority of the Environmental Management Commission

a9
� o+ • �.f ° � �' r \ �,OMa °a1; •• •r_� '.. - ° v •, fi-c� �,� i �S1 i 4�e' I• �[T1�8
ti o v, � f l2 ° g a� ��' � � �.'"�� � ` 9 %w. � �i�� "°._� �,.� % �`: � � ]J] � •% r 4 f ' I '� -
Il f
C � 4 �J V.�Qq j•;� ��i-��� asp �4,` { b ` ,
RSI Home Productsa Tank nr '
r f
19
j L r,
1
�XU
�, , `.a� •' 4 � � A�4f�r� zl.�;;F;s<+��� �1 ^� 3.11 �� � Q �
°'m'j�an >n�>r 'p•�- j?s i ��W..it• � r'.` '� n�R G.. � a ,"�''15 .. �,a�. 9� ,. yql.' �°4.
Ji
if
41.
*;d h ' T e • r ,�("�_ - N, �' 4,
. �.�r��`: w.R �Wj 115�..I' 7' - y4,§•;i .'� /f •~� ! f , }
NCG180253
N
W E
S
Map Scale 1, 24, AV
RSI Home Products, Inc.
RSI Home Products
Latitude: 340 51' 24" N
Longitude: 791 42' 50" W
County: Richmond
Receiving Stream: Marks Creek
Index No: 13-45-(2)
Stream Class: C
Sub -basin: 03-07-16 (Yadkin River Basin)
Facility Location