NCG180061_COMPLETE FILE - HISTORICAL_20160222

STORMWATER DIVISION CODING SHEET
RESCISSIONS
PERMIT NO.
IVC C,/
DOC TYPE
❑COMPLETE FILE -HISTORICAL
DATE OF -
RESCISSION
❑ o�� � U� a�
YYYYMMDD

Alexander, Laura
From: Farabee, Chris<[e-mail]>
Sent: Monday, February 22, 2016 10:44 AM
To: Alexander, Laura
Cc: Duncan, Kathy
Subject: HHG plant 10 stromwater permit
Attachments: LV10 SW 02022015 permit rescission.pdf
Follow Up Flag: Follow up
Flag Status: Completed
Laura —The permit for Plant 10 was rescinded on February 2, 2015. See attached letter.
Chris Farabee
Environmental Engineer Fleritage Home Group
1925 Eastchester Drive High Point, NC 27262
336.476.2250 office1336.391.2579 cell 1 336.474.8880 fax I [e-mail]
From: Duncan, Kathy
Sent: Monday, February 22, 2016 10:39 AM
To: Farabee, Chris
Subject: FW: Permit Payment
Kathy .Duncan
A/P Auebior
1=Ierilage .1-lome Groin LLC
Kal-by. corn
1925 Faslchesler Drive
.High Poinl, NC 27265
336-476-23 1 6
From: Alexander, Laura [maiIto: laura.alexander ncdenr. ov]
Sent: Monday, February 22, 2016 10:01 AM
To: Duncan, Kathy
Subject: Permit Payment
Good Morning,
Please see attached. Our full address is as follows:
NCDEQ— Division of Energy, Mineral and Land Resources

Attn: Stormwater Billing
1612 Mail Service Center
Raleigh, NC 27699-1612
Also, can you give me a permit # for Plant #10?
Thank you,
Laura Alexander
Administrative Assistant
Stormwater Permitting Program
North Carolina Division of Energy. Mineral and Land Resources
North Carolina Department of Environmental Quality
919 807 6368 Office
919 807 6494 Fax
]aura. alexander(c7ncdenr.gov
512 North Salisbury Street
1612 Mail Service Center
Raleigh, North Carolina 27699
Nothing Compares—._
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.

� �.G rau D.
UNCASHED CHECK(s) Notification Over 90 Days
Dear NCDENR-Div. of Energy, Mineral & Land Resources
a—l�o
1 rEd 0 4 2016
You are receiving this letter because our company issued check number 711105
Dated 09/30/2014 in the amount of 1� 00.00 to you and as of 1/29/2016 has never cleared our
account.
If the check was not received and the payment is not a duplicate or invalid payment to your
company and you want to request a replacement at this time, please sign and return this letter to
our office by 2/12/2016
If we do not hear from you by 2/12/2016, the funds to cover this check will be transferred to the
appropriate state's Unclaimed Property Division and a claim for the money will need to be made
directly with their office.
The check references the following invoice payments: Annual Fee for Stormwater Permit for
Plant #10
I would like to request a replacement check for the above -referenced fund.
Signature:
Address: I j ram. r 5e4—✓1'I A[ D Jv G Date I
The Payment Received Is Duplicate or Invalid
Please return this letter to:
Heritage Home Group LLC
1925 Eastchester Drive
High Point, NC 27265
n}m [phone]
CJld Attention: Kathy Duncan
OR
Email reply to: kathy.duncan(&heritagehome.com
I.v

—*Tqw�
9CMENK
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Mr, David Stout
Heritage Home Group, LLC
815 Visionary Sheet
Lenoir, NC 28645
Dear Mr. Stout:
Donald R. van der Vaart
Secretary
February 2, 2015
Subject: Rescission of NI'DES Stormwater Permit
Certificate of Coverage Number NCG 180061
Catawba County
On November 26, 2014 the Division of Energy, Mineral and Land Resources received your request to
rescind your coverage under Certificate of Coverage Number NCG180061. In accordance with your request,
Certificate of Coverage Number NCG 180061 is rescinded effective immediately.
Operating a treatment facility, discharging wastewater or discharging specific types of stormwater to waters
of the State without valid coverage under an NPDES permit is against federal and state laws and could result
in fines. if something changes and your facility would again require stormwater or wastewater discharge
permit coverage, you should notify this office immediately. We will be happy to -assist you in assuring the
proper permit coverage.
If the facility is in the process of being sold, you will be performing a public service if you would inform the
new or prospective owners of their potential need for NPDES permit coverage.
If you have questions about this matter, please contact us at 919-707-9200, or the Stonnwater staff in our
Mooresville Regional Office [phone].
Sincerely,
for Tracy E. Davis, PE, CPM, Director
Division of Energy, Mineral and Land Resources
cc: Mooresville Regional Office
Stormwater Permitting Program
Central Files - w/attachments
Division of Energy, Mineral, and Land Resources
Energy Section • Geological Survey Section • Land Quality Section
1612 Mail Service Center, Raleigh, North Carolina 27699-1612.919-707-92001 FAX: [phone]
512 North Salisbury Street, Raleigh, North Carolina 27604 • Internet: hitp:I/portal.ncdenr,org/webllr!
An Equal Opportunity I Affirmative Action Employer - 50% Recycled 110% Post Consumer Paper

NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Mr. David Stout
Heritage Home Group, LLC
815 Visionary Street
Lenoir, NC 28645
Dear Mr. Stout:
Donald R. van der Vaart
Secretary
February 2, 2015
Subject: Rescission of NPDES Stormwater Permit
Certificate of Coverage Number NCG 180061
Catawba County
On November 26, 2014 the Division of Energy, Mineral and Land Resources received your request to
rescind your coverage under Certificate of Coverage Number NCG 180061. In accordance with your request,
Certificate of Coverage Number NCG 180061 is rescinded effective immediately.
Operating a treatment facility, discharging wastewater or discharging specific types of stornwatcr to waters
of the State without valid coverage under an NPDES permit is against federal and state laws and could result
in fines. If something changes and your facility would again require stormwater or wastewater discharge
permit coverage, you should notify this office immediately. We will be happy to assist you in assuring the
proper permit coverage.
If the facility is in the process of being sold, you will be performing a public service if you would inform the
new or prospective owners of their potential need for NPDES permit coverage.
If you have questions about this matter, please contact us at 919-707-9200, or the Stormwater staff in our
Mooresville Regional Office [phone].
Sincerely,
ORIGINALKEN PICKLE
Bl
SIGNED
for Tracy E. Davis, PE, CPM, Director
Division of Energy, Mineral and Land Resources
cc: Xooresville Regional Office
ormwater Permitting Program
Central Files - w/attachments
Division of Energy, Mineral, and Land Resources
Energy Section • Geological Survey Section • Land Quality Section
1612 Mail Service Center, Raleigh, North Carolina 27699-1612 - 919-707-92001 FAX: [phone]
512 North Salisbury Street, Raleigh, North Carolina 27604 • Internet: http:llportal.ncdenr.orglweb/Ir/
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper

H451
Heritage Home Group
November 14, 2-014
North Carolina Department of Environment and Natural Resources
Division of Energy, Mineral, and Land Resources
Stormwater Permitting
Attention: Ms. Bethany Georgoulias
217 West Jones St.
Raleigh, NC 27603
RE: Heritage Home Group, LLC
Lane Venture Plant 10
205 Workman St, Conover NC, Catawba County
Stormwater General Permit No. NCG180000
COC NCG180061
Permit Recession Request
Dear Ms. Georgoulias:
David Stout
Director of Environmental Compliance
815 Visionary St,
Lenoir, NC 28645
828-759-8510 Tel
828-406-6079 Cell Phone
828-438-2623 Fax
Email address:
[e-mail]
RECEIVED
NOV 2 6 2014
DENR-LAND QUALITY
STQRMWATER PERMITTING
I am writing this letter to notify you that our Lane Venture Plant located at 205 Workman St.,
Conover NC, has been permanently closed and is for sale. 1 would like to request that
Stormwater General Permit No. NCGI80000, COC NCG180061, be terminated.
If you need further information or have questions, please contact me.
Sincerely,
Heritage Home Group
David Stout
I certify, under penalty of law, that this document and all attachments were prepared under my
direction or supervision in accordance with a system designed to assure that qualified personnel
properly gather and evaluate the information submitted. Based on my inquiry of the person or
persons who manage the system, or those persons directly responsible for gathering the
information, the information submitted is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations.
Davy hittington, Vice resident of Compliance and Logistics, Heritage Home Group LLC
r-,2y�y
{Sign re & date}

Alexander, Laura
From: Bou-ghazale, Samar
Sent: Friday, January 30, 2015 2:29 PM
To: Georgoulias, Bethany; Khan, Zahid; Stout, David
Cc: Bennett, Bradley; Alexander, Laura
Subject: RE: NPDES General Permit NCG180000 Renewal Instructions
Follow Up Flag: Follow up
Flag Status: Flagged
Hi Laura,
The waste container has been removed from the site. We recommend that permit # NCG180061 be rescinded as
requested.
Inspection report is in Bims.
Please let me know if you have any questions.
Thanks,
Samar
From: Georgoulias, Bethany
Sent: Monday, January 05, 2015 1:26 PM
To: Bou-ghazale, Samar; Khan, Zahid; Stout, David
Cc: Bennett, Bradley; Alexander, Laura
Subject: RE: NPDES General Permit NCG180000 Renewal Instructions
Samar,
Our office will hold the rescission request until the MRO is ready to re -inspect and confirm the issue has been
resolved. No need for David to reapply, just coordinate with you all. Please close the loop with Laura when it concludes.
Thanks,
Bethany
13elham (ceorgolllias, F,nvii"fIN111enful l lW lleel-
NC:DI-,NIt 1 Division of I"nergy, Mineral. and Land Resources
Storrnwatcr Permitting, Program
1612 Mail Scrvice Center, Raleigh. NC 27699-1612
512 N. Salisbury Street. Raleigh. NC 27604
919 / 807-6372 (phone);.919 / 807-6494 (fat)
Website: http://portal.iicdenr.ori,,/web/Ir/siormwatcr
1s'-rnad Corra.5pnadencv to and fr•orn This atldrt ss mci.v he mdycu to the A'orlh Carob o Public Rccordy lain card nuii, be disckoecei rn rhirdparries
From: Bou-ghazale, Samar
Sent: Monday, January 05, 2015 10:31 AM
To: Khan, Zahid; Georgoulias, Bethany; Stout, David
Cc: Bennett, Bradley; Alexander, Laura
Subject: RE: NPDES General Permit NCG180000 Renewal Instructions
i

Hi Bethany,
Below is a copy of the inspection that was posted in Bims on 12/12/2014.
"The permittee has requested that the permit be rescinded. Based on an inspection dated 12/11/2014, It was noted that
rusted dumpster filled with metals is still on the property. In a conversation with the applicant Mr. David Stout, it was
conveyed to us that he was planning to empty the dumpster but he didn't expect us to inspect the facility that quickly.
He informed us that he will re -apply when the facility is ready to be inspected."
I called Mr. Stout This morning and left a message -with my information.
Thanks,
Samar
From: Khan, Zahid
Sent: Monday, January 05, 2015 9:51 AM
To: Georgoulias, Bethany; Stout, David
Cc: Bennett, Bradley; Alexander, Laura; Bou-ghazale, Samar
Subject: RE: NPDES General Permit NCG180000 Renewal Instructions
Bethany,
Samar inspected this site and will follow-up on this e-mail. Thanks
Zahid
From: Georgoulias, Bethany
Sent: Monday, January 05, 2015 9:40 AM
To: Stout, David
Cc: Bennett, Bradley; Alexander, Laura; Khan, Zahid; Bou-ghazale, Samar
Subject: RE: NPDES General Permit NCG180000 Renewal Instructions
Hi David,
I'll be glad to get in touch with someone in MRO about this. I have copied the Supervisor there, as well as one other
staff member. I am also copying Laura Alexander who coordinates the rescission requests in our office.
Zahid, could you please find out which inspector needs to follow up on this? Details are highlighted below.
Thanks,
Bethany
13elhaio, Geot-goulitis, F_rrvii-onmenitrl Engineer-
NCI.)ENR / Division of } nergy, Mineral, and Land Resources
Storrnwater Permitting Program
1612 Mail Service Center, Raleigh, NC 27699-1612
512 N. Salisbury Street, Raleigh, NC 27604
919 1807-6372 (phone); 919 / 807-6494 (fax)
Wehsite: Ittt :/1 ortal.ncdcnr.or_q/wch/lr/stor•mwater
F,-mad currespondence 10 um{Ji•nm lhi.S addr4'.aS IFOY N sv6ycel to the Yorfh Carolina Public Records law and inuY he Awlased to third papfies.
From: Stout, David[maiIto: David. Stout(&heritagehome.com7
Sent: Wednesday, December 31, 2014 2:06 PM
To: Georgoulias, Bethany

Cc: Bennett, Bradley
Subject: RE: NPDES General Permit NCG180000 Renewal Instructions
Bethany — I got a call from someone from the Mooresville Regional Office who claimed to have done a site visit
regarding the attached Stormwater Permit recession request. He denied the request because there was a 40 yard trash
dumpster on -site with trash in it. I was on the road and requested an email so I could get his contact information. He
said that he would send the email but I never got one and have not gotten anything in writing as to the status of Lane
Venture Plant No. 10. Currently there is "no one on -site", the all manufacturing operations are permanently terminated,
and normally the gate is closed. The trash dumpster will be emptied when the plant clean -out is completed, but that
has been put on hold for a month or so. Could you send me something in writing regarding the Status of the
Stormwater Permit recession request regarding bane V_entur_e Plant 10, at 205 Workman St._, Conover NC 28613,
NCG180000, COC NCG18006T. My contact information is: — —
David Stout
Director of Environmental Compliance
Heritage Home Group
Phone: [phone]
Thank you for assistance you can give.
From: Georgoulias, Bethany{rnailto:[e-mail]]
Sent: Thursday, September 18, 2014 9:08 AM
To: Stout, David
Cc: Bennett, Bradley
Subject: RE: NPDES General Permit NCG180000 Renewal Instructions
Hi David,
I'm looking into NCG180241. That permit is no longer active and was not eligible for renewal when we set up our
system. I see there was a rescission request back in 2012, but the regional office did not approve it. Billing stopped
after that, and it became inactive, I'm not sure what happened, but I'll get back to you on this one. I take it the
company still requires permit coverage for that facility?
I apologize for the confusion over NCG180061. A renewal notice with a PIN was not supposed to go out to you, but it
did anyway. That permit has outstanding fees (Invoice No. 2014PR007245 of $100.00 was due on September 6,
2014). Please make sure this fee is paid as soon as possible, and the COC you have printed will remain valid.
There is also an outstanding fee of $100 (Invoice No. 2014PR007269) for NCG180169. Please pay this fee as soon as
possible, and we can forward renewal instructions with a PIN to you.
Important. The person who can work with you on fee payments is Deborah Reese in NC DEMLR. She can be reached at
[e-mail] or919-707-9220.
I will call you later this morning to talk about the changes you said you needed to make on the COCs you called
about. I'll also share any updates I have on the Drexel Plant 7 at Longview.
Regards,
Bethany
Beihanj, (;eorgorrliac, Environmerrral l?ngilreer
NCI)ENR / Division oCl nergy, Mineral, and Land Resources
Slonnnwaler Permilling Program
1612 Mail Service Center. Raleigh, NC 27699-1612
3

12 N. Salisbury Stree(, Raleigh, NC 27604
919 / 807-6 372 (phone): 919 / 807-6494 {tax)
Website: litip://porta1.ticdenr•.or2/tiveb/It,/storiiiwater
Is-rnud correspondence io amyl, o m this adelress mar he suhlect !o the +forth C'andinu Public Records lam and men, he disclosed 1u third parties.
From: Stout, David [ma !Ito: David. [e-mail]]
Sent: Wednesday, September 17, 2014 3:14 PM
To: Georgoulias, Bethany
Subject: RE: NPDES General Permit NCG180000 Renewal Instructions
got the COC for NCG180061, but did not for NCG180169. I also did not get the one for NCG 180241, which is our Drexel
Plant 7 @ Longview. It may have overdue fees also, as our Accounts Payable department is running behind. I will talk to
you tomorrow. Thank you.
From: Georgoulias, Bethany [mailto:Bethany.georgouliaso, ncdenr.gov�
Sent: Wednesday, September 17, 2014 3:07 PM
To: Stout, David
Subject: RE: NPDES General Permit NCG180000 Renewal Instructions
Ni David,
I got your voice mail message today and will get back to you at my first opportunity tomorrow morning (I'm headed out
for the day shortly). We can talk about what changes need to be made.
I did want to let you know that there were two permits of yours that we did not e-mail out with PINS for because there
are overdue fees owed on them. They are COC numbers:
NCG180061, and
NCG180169
To resolve these, you'll need to contact Deborah Reese ([e-mail] or at 919-707-9220) about it. Once
these fees are paid, we can send you information to renew those permits on-line as well.
Thanks, and I'll speak with you tomorrow.
Bethany
Belhon`v Creorgoulios, Envrrortntenlal fi.-n sneer
NCDENR / Division of Energy. Mineral, and Land Resources
Storr'nwater Permitting Program
1612 Mail Service Center, Raleigh, NC 27699-1612
512 N. Salisbury Street, Raleigh, NC: 27604
9 19 / 807-6372 (phone); 919 / 807-6494 (tax)
Website: hitp:/IportaLncdenr.or.Le u;eb/Ir/stornlwat(:r
E-mail corres'punder7ce to and, j om this address m<q' he sub)va to the North Carolina Public Records Irnr and mm, Lc disc&rsed io third parries.
From: Georgoulias, Bethany
Sent: Friday, September 12, 2014 11:06 AM
To: '[e-mail]'
Subject: NPDES General Permit NCG180000 Renewal Instructions

bear Permit Contact:
NC DENR's Stormwater Permitting Program has reissued NPDES Stormwater General Permit NCG180000 (Furniture and
Fixtures), which became effective September 1, 2014. Your Certificate of Coverage (COC) is ready for renewal and
download from our website. Please follow the instructions below and be sure to print your new COC for your records.
1. Go to the following URL link: http://go.ncdenr.gov/sw-erenewal
2. Enter your COC Permit Number and unique PIN:
Permit Number: NCG180071
Unique PIN number: 99802
3. Scroll Down and update the e-mail address information if necessary for a renewal confirmation. These fields are
pre -filled with information we have on file about the Owner (including the e-mail, if we had one). **However, if the
confirmation should be e-mailed to someone else instead of to the e-mail in that box, PLEASE REVISE THAT E-
MAIL.** You are unable to change the information in the other fields. Please contact us if something is incorrect.
4. Click "SUBMIT." A confirmation screen should follow.
5. On this screen, click the button "DISPLAY CONFIRMATION DETAILS." Clicking this button will automatically generate
an e-mail to the address you provided on the previous screen. It will also send you to a screen that will display details of
your renewal.
6. IMPORTANT: THIS IS WHERE YOU PRINT YOUR COC. On this screen, you must print a copy of the Certificate of
Coverage for your facility by clicking on "Print COC." It is your responsibility to generate this COC for your own records —
we do not generate a duplicate copy centrally during this process.
By following these steps, you will have a record of continued coverage under the new general permit, as of September
1, 2014. Please visit our website at http://portal.ncdenr.org/web/Ir/stormwater/2014-gps to download a copy of the
General Permit, monitoring forms, and technical bulletin.
Thank you for taking the opportunity to renew your permit on-line. We appreciate the chance to better serve you and
hope you find the process beneficial. If you have any questions, please contact:
Bethany Georgoulias, E-mail: [e-mail] Telephone: [phone], or
Bradley Bennett, E-mail: brad [e-mail] Telephone: [phone], or
Bridget Munger, E-mail: [e-mail] Telephone: [phone],
Bethany Georgoulias, Environmental Engineer
NCDENR I DEMLR I Stormwater Permitting
1612 Mail Service Center, Raleigh, NC 27699-1617
512 N. Salisbury St, Raleigh, NC 27604
Phone: [phone]
Fax: [phone]
Website: http://portal.ncdenr.org/web/Ir/stormwater
E-mail correspondence to and from this address may be subject to the North Carolina Public
Records Law and may be disclosed to third parties.

J ,
_7006 DIII &O 0010a, qc�, ),S
qV5-c, Y--<.
NCDEMM
Nortm r..ouN. OErwrNCNr or
E.NVIRONNCRT N.p NA7VRAL RESOURCE$
Division of Energy, Mineral and Land Resources
Land Quality Section 1 Stormwater Permitting Program
National Pollutant Discharge Elimination System (NPDES)
PERMIT OWNER AFFILIATION DESIGNATION FORM
(Individual Legally Responsible for Permit)
FOR AGENCY USE ONLY
Date Received
Year Month
Da
RECEIVED
SEP 2 5 1014
Use this form if there has been: DENR-LAND Q JALITY
NO CHANGE in facility ownership or facility name, but the individu�l WADER P RMITf!
who is legally responsible for the permit has changed.
If the name of the facility has changed, or if the ownershio 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 Kermit number for which this change in Legally Responsible Individual ("Owner Affiliation")
applies:
Individual Permit
N I C S
2) Facility Information.
Facility name:
Company/Owner Organization:
Facility address:
{or% Certificate of Coverage
N I C I G I I U {Q
L a-ne. VQAA -(-e, P L ao+ 10
C� 0
MOn
Address
Goln)�(e,)r N C
City State Zip
`lb find the current legally responsible person associated with your pernnit, go to this website:
littp://poi-tal.iiedeiir.or webhr/sw-permit-contacts and run the Permit Contact Summary Report.
3) OLD OWNED AFFILIATION that should be removed:
Previous legally responsible individual: &e r e, F3 u-
First MI Last
4) NEW OWNER AFFILIATION (legally responsible for the permit):
Person legally responsible for this permit: DaV y �, n C,
First MI Last j-
rage 1 of 2
S W U-OWN ERAFF I L-25J uly2014

F
NP®ES Stormwwater Permit OWNER AFFILATION DESIGNATION (Form
(if no Facility Narnelownership Change)
Title
Mailin4 Address
_ f\f C dMol+5-
city State Zip
-75 _.4-700 Jayn,win-4ir% t�v) �
'i'eIeplloue E-mail Address J L0 Fax NUinber
5) Reason for this change:
A result of: /En-iployce or management change
❑ Inappropriate or incorrect designation before
❑ Other
If other please explain:
The certification below must be completed and signed by the permit holder.
PERIVIITTEE CERTIFICATION:
I, _ D&Vu attest that this application for this change in Owner Affiliation
(person legally responsible or the permit) has been reviewed and is accurate and complete to the best of my
knowledge. I understand that if all rewired Darts of this form are not completed, this cliange may not be
processed.
Sig tune Date
PLEASE SEND THE COMPLETED FORM TO:
Division ofEnergy, Mineral and Land Resources
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
For more information or staff contacts, please call 9I9-707-9220 or visit the website at:
litti):Hportal.iicdeiir.orgZweb/h-/storinNvater
Page 2 of 2
S W U-OVVN ERAFR 1 L-25J u1y2014

�� Division of Water Quality / Surface Water Protection
National Pollutant Discharge Elimination System
NCDENR
Reso°rscrs " PERMIT NAME/OWNERSHIP CHANGE FORM
E�r+a+MeKr "o NRurUL
FOR AGENCY USE ONLY
Date Received
Year
Month
Day
I. I'lease enter the permit number for which the change is requested.
MIMES Permit (or) Certificate of Coverage
N Cl G I 11118 1 0 1 0 1 0 1 0 N ,( ;G 111 8 0 0 6 1
H. Permit status RLjiE to requested change.
a. Permit issued to (company name): Furniture Brands International
b. Person legally responsible for permit: Clyde D Whittington
First M 1 Last
Vice 1'resident of Lo istics &, Compliance
Title
825 Visionary Street
I'ennit Holder Mailing Address
Lenoir NC 28645
Cit}, State "Lip
[phone] NA
Phone Fax
c. Facility name (discharge): Lane Venture Plant 10
d. Facility address: 205 Workman St.
Address
Conover NC 28613
City Slate Zip
e. Facility contact person: David Stout [phone]
First I MI 1 Last 11110ne
II[. Please provide the following for the requested change (revised permit).
a. Request for change is a result of X Change in ownership of the facility
Name change of the facility or owner
If other please exlVain:
b. Permit issued to (company naive):
c. Person legally responsible for permit:
d. Facility name (discharge):
e. Facility address:
f. Facility contact person:
Heritage Home Group, LLC
Gene
BUMS
First
M 1 Last
Chief Financial
Officer, Lane Venture
Title
205 Workman St.
Permit Holder Mailing Address
Conover
NC 28613
City
State Zip
[phone]
eene.builis a,heritagehome.eom
Phone
E—mail Address
Lane Venture Plant 10
205 Workman Street
Address
Conover
NC 28613
City
Stale Zip
David
E Stout
First
MI Last
[phone]
david.stout a,heritagehome.com
Phone
L-mail Address
Revised 2012Apr23

NPDES 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: David E Stout
First Ml Last
Director of Environmental Compliance
"Title
815 Visionary Street
Mailing Address
Lenoir NC 28645
City State Zip
828 759-8510 david.stout a herita ,,ehorne.coin
Phone E-mail Address
V. Will the permitted facility continue to conduct the same industrial activities conducted prior
to this ownership or name change?
X Yes
❑ No (please explain)
VI Required Items: THIS APPLICATION WILL 13E RETURNED UNPROCESSED IF ITEMS
ARE INCOMPLETE OR MISSING:
X '['his completed application is required 1-or both name change and/or ownership change
requests.
X 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, Clyde D. Whittington, 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.
&Ixw 3 -Y1 Y
Signature Date
APPLICANT CERTIFICATION
1, Gene Huliis, 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.
4 " J_s1/�,
l�
Signature Date
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Division of Water Quality
Surface Water Protection Section
1617 Mail Set -vice Center
Raleigh, North Carolina 27699-1617
Revised 7/2008

Fu rn itu reBrands
David Stout
Manager Environmental Compliance Policy
January 5, 2010
Mr. Robert Patterson, PE
NCDI-NR/DWQ/Stormwater Permitting
1617 Mail Service Center
Raleigh, NC 27604
RE: Stormwater Permits
Laneventure Plant 414, COC180087
Laneventure Plant 410, COC180061
Catawba County
Contact Change request
Dear Robert,
Furniture Brands International
One Broyhill Park
Lenoir, NC 28633
828-758-3374 Tel
828-221-5448 cell
828-758-3110 Fax
dstoutgfurniturebrands.com
RECOVER
JAN 8 Z010
own \J\i <�-
This letter is written in response to today's phone conversation between the two of us. Thank
you again for yourhelp in sending me copies of the Stormwater Permits for the two Laneventure
Plants, No.14 and No.10. Also I would like to request that your records be changed to show me
as the facility contact for permitting and Milling for the two Laneventure facilities referenced
above.
My contact information is:
David Stout
Furniture Brands International, Inc.
One Broyhill Park
Lenoir, NC 28633
Phone [phone]
Fax [phone]
Email [e-mail]
If you have questions or need further information, please contact me.
Sincerely,
David Stout

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
Kerr T. Stevens, Director
August 27, 1999
MIKE SMITH
LANE COMPANY- LANE VENTURE PLT 10 PLT 10
P.O. BOX 151
ALTAVISTA, VA 24517
Dear Permittee:
WA
9� 1 •
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
Subject: Reissue - NPDES Stormwater Permit
Lane Company-Laneventure Plt 10 Pit 10
COC Number NCG 180061
Catawba County
In response to your renewal application for continued coverage under general permit NCGI80000, the Division of
Water Quality (DWQ) is forwarding herewith the reissued Stormwater general permit. This permit is reissued
pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement
between the state of North Carolina and the U.S. Environmental Protection Agency, dated December 6, 1983,
The following information is included with your permit package:
* A copy of general stormwater permit NCG180000
* A Stormwater Pollution Prevention Plan (SPPP) Certification Form. Completion of this form is required to
certify that you have developed and implemented the SPPP as per the conditions of the permit. This form
must be completed and returned to the Division within 30 days of receipt of this letter.
DO NOT SEND the SPPP with the signed form.
* Five copies of the Analytical Monitoring form and five copies of the Qualitative Monitoring form
* A copy of a Technical Bulletin on the Stormwater program which outlines program components and
addresses frequently asked questions
* A corrected Certificate of Coverage if you indicated a name change on the Renewal Application
Your coverage under this general permit is not transferable except after notice to DWQ. The Division 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 DENR or relieve the permittee from responsibility
for compliance with any other applicable federal, state, or local law rule, standard, ordinance, order, judgment, or
decree.
if you have any questions regarding this permit package please contact Bill Mills of the Central Office Stormwater
and General Permits Unit at [phone], ext. 548
Sincerely,
for Kerr T. Stevens
Director, Division of Water Quality
cc: Central Files
Mooresville Regional Office
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG180000
CERTIFICATE OF COVERAGE No. NCG180061
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,
LANE COMPANY -LANEVENTURE PLT 10
is hereby authorized to discharge stormwater from a facility located at
LANE COMPANY-LANEVENTURE PLT 10
205 WORKMAN STREET
CONOVER
CATAWBA COUNTY
to receiving waters designated as Cline Creek in the Catawba River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts 1, II, 1I1,
IV, V, and VI of General Permit No. NCG180000 as attached.
This certificate of coverage shall become effective August 27, 1999.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day August 27, 1999.
for Kerr T. Stevens, Director
Division of Water Quality
By Authority of the Environmental Management Commission

jtate of North Carolina
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
June 9, 1995
James Hall
Lane Company
P.O. Box 151
Altavista, VA 24517
Subject: General Permit No. NCG 180000
Lane Company
COC NCG 180061
Catawba County
Dear James Hall:
In accordance with your application for discharge permit received on March 23, 1995, we are
• forwarding-herewith-_the•subjectcertificate of:coverage to -discharge -under-_the ;subject-state`--NPDES-general _.
T 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
December 6, 1983.
If any parts, measurement frequencies or sampling requirements contained in this permit are
unacceptable to you, you have the right to request an individual permit by submitting an individual permit
application. Unless such demand is made, this certificate of coverage shall be final and binding.
Please take notice that this certificate of coverage is not transferable except after notice to the Division
of Environmental Management. The Division of Environmental Management 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 Environmental Management or permits required by the Division of Land Resources, Coastal
Area Management Act or any other Federal or Local governmental permit that may be required.
If you have any question concerning this permit, please contact MR. BILL MILLS at telephone number
919/733-5083.
Sincerely,
Original Si nedi RV
Coleen H. SWIM!;
A. Preston Howard, Jr. P.E.
cc: Mooresville Regional Office
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
GENERAL PERMIT NO. NCG180000
CERTIFICATE OF COVERAGE NO. NCG180061
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,
Lane Company
is hereby authorized to discharge stormwater from a facility located at
Lane Upholstery Plant #10
205 Workman Street
Conover
Catawba County
to receiving waters designated as Cline Creek in the Catawba River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts 1, 11, 111
and IV of General Permit No. NCG180000 as attached.
This Certificate of Coverage shall become effective June 9, 1995.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day June 9, 1995.
i�riginal i ,rt c� [•Y
col4t•:n N. S��liit�s
A. Preston Howard, Jr., P.E., Director
Division of Environmental Management
By Authority of the Environmental Management Commission

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