NCG180163_COMPLETE FILE - HISTORICAL_20140910

STORMWATER DIVISION CODING SHEET
RESCISSIONS
PERMIT NO.
��G / �o l(a 3 I
DOC TYPE
❑ COMPLETE FILE - HISTORICAL
DATE OF
RESCISSION
❑1 �l D
YYYYMMDD

WDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Mr. Chris Farabee
Heritage Home Group LLC
Thomasville Furniture
401 East Main Street
"Thomasville, NC 27360
Dear Mr. Farabee:
John E. Skvarla, III
Secretary
September 10, 2014
Subject: Rescission of NPDES Stormwater Permit
Certificate of Coverage Number NCG 180163
Thomasville Location
Davidson County
On September 4, 2014 the Division of Energy, Mineral and Land Resources received your request to rescind
your coverage under Certificate of Coverage Number NCG 180163. In accordance with your request,
Certificate of Coverage Number NCG 180163 is rescinded effective immediately.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 Stormwater staff in our
Winston-Salem Regional Office at 336-771-5000.
Sincerely,
ORIGINAL SIGNED BY
BETHANY GEORGOU! IAS
for Tracy E. Davis, PE, CPM, Director
Division of Energy, Mineral and Land Resources
cc: WSRO -- Aana Taylor -Smith
Stormwater Permitting Program
Central Files - w/attachments
Deborah Reese, DEMLR Budget — Please waive fees
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://portal.ncdenr,org/web/Ir/
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Division of Energy, Mineral & Land Resources
Land Quality Section/Stormwater Permitting Program
s�
NCDENRNational Pollutant Discharge Elimination System
Np Cu 0— O�.C—Or
EmnnoNktNr mo NR RC3 mc[
RESCISSION REQUEST FORM
FOR AGENCY USE ONLY
Date Received
Year
Month
Day
RECTIVED
[+CD rt A 70H
Please fill out and return this form if you no longer need to maintain your NPDES stormwater per -LAND QUALITY
STORMWATER PERMITTING
1) Enter the permit number to which this request applies:
Individual Permit (or) Certificate of Coverage
N I C I S I I I I I I I N I C I G I I g o 1 (0 3
2) Owner/FacilityInform{ac�tion: "Final correspondence will bemailed to�the address noted below `
Owner/Facility Name i'1t'.f'� ' a4e _HDme— Gfooe,LLC 1 toy+o"&sy *I (e, -ufn �TVYe, Tt`d
Facility Contact
Street Address
City
County
Telephone No.
3) Reason for rescission request (This is rrei uired information. Attach separate sheet if necessary):
Facility closed or is closing on'I I' All industrial activities have ceased such that no discharges of
stormwater are contaminated by exposure to industrial activities or materials.
G -lV M
ec'4al
!� W-- , Can
❑ Facility sold to C==7­0 on = . If the facility will continue operations under the new owner it
may be more appropriate to request an ownership change to reissue to permit to the new owner.
❑ Other:
4) Certification:
I, as an authorized representative, hereby request rescission of coverage under the NPDES Stormwater Permit for the
subject facility. I am familiar with the information contained in this request and to the best of my knowledge and belief
such information is true, complete and accurate.
9
Signature Cel
, 4 No a-- Date
j f � / o
Y AIPSA-Z7 I JACp r
Print or type name of person signing above Title
Please return this completed rescission request form to: NPDES Permit Coverage Rescission
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
1612 Mail Service Center, Raleigh, North Carolina 27699-1612
Phone: [phone] FAX: [phone]
An Equal Opportunity 1 Affirmative Action Employer I
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111 ��

•
'NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES II II II I I I II I I II II III I I I I I II
INVOICE * 2 0 1 4 P R 0 0 7 2 6 8
Annual Permit Fee Open
This annual fee is required by the North Carolina Administrative Code. it covers the administrative costs associated with
your permit. It is required of any person holding a permit for any time during the annual fee period, regardless of the facility's
operating status. Failure to pay the fee by the due date will subject the permit to revocation. Operating without a valid
permit is a violation and is subject to a $10,000 per day fine. If the permit is revoked and you later decide a permit is
needed, you must reapply, with the understanding the permit request may be denied due to changes in environmental,
regulatory, or modeling conditions.
Invoice Number. 2014PR007268
Permit Number: NCGlBO163
Davidson County
Thomasville Furniture Ind. - C&M
Chris Farabee
Heritage Home Group LLC
PO Box 339
Thomasville, NC 27361-0339
Annual Fee Period: 2014-09-01 to 2015-08-31
Invoice Date: 08/07/2014
Due Date: 09/06/2014
Annual Fee'. $100.00
Notes:
1. You may pay either by checklmoney order OR by electronic payment.
2. If payment is by check/money order, please remit payment to:
NCDENR - Division of Energy, Mineral and Land Resources
Attn: Stormwater Billing
1612 Mail Service Center
Raleigh, NC 27699.1612
3. It payment is electronic, see http:/l grtrtal,ncdenr.o[g/web/wq/hQt-topics/epayment for additional details. See
http:llportal.ncdenr.org/weblwolepayment to pay electronically. Only eCheck transactions are allowed at this time. Credit card
transactions are not accepted.
4. Please include your Permit Number and Invoice Number on all correspondence.
5. A $25.00 processing fee will be charged for returned checks in accordance with North Carolina General Statute 25-3-512.
6. Non -Payment of this fee by the payment due date will initiate the permit revocation process.
7. Should you have any questions regarding this invoice, please contact the Annual Administering and Compliance Fee
Coordinator at 919-707-9220.
(Return This Portion With Check)
ANNUAL_ PERMIT INVOICE
Invoice Number: 2014PR007268
Permit Number: NCO180163
Davidson County
Thomasville Furniture Ind. - C&M
Chris Farabee
Heritage Home Group LLC
PO Box 339
Thomasville, NC 27361-0339
II I I III I IIII I I II II III III I I II
* 2 0 1 4 P R 0 0 7 2 6 8
Open
Annual Fee Period: 2014-09-01 to 2015-08.31
Invoice Date: 8/7/2014
Due Date: 916/2014
Annual Fee: $100.00
Check Number:

i Iexander, Laura
From:
Taylor -Smith, Aana
Sent:
Tuesday, September 09, 2014 9:22 AM
To:
Alexander, Laura
Cc:
Gantt, Matt
Subject:
RE: NCG180163
Attachments:
Rescission request for NCG180243
Hi Laura,
I have just returned from the NCG180163 and NCG180243 sites. Both are shut down and permits can be rescinded.
Thanks!
Aana
Aana Taylor -Smith
Land Quality Section
Division of Energy, Mineral, and Land Resources
NC DENR Winston-Salem Regional Office
Phone: [phone]
Fax [phone]
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Low and may be disclosed to
third parties.
From: Alexander, Laura
Sent: Monday, September 08, 2014 2:39 PM
To: Taylor -Smith, Aana
Subject: NCG 180163
Aa na,
Here is another rescission request from Thomasville Furniture — Heritage Home Group.
Thank you!
Laura Alexander
i

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
.fames B. Hunt, Jr.,'Governor
Wayne McDevitt, Secretary
Kerr T. Stevens, Director
August 27, 1999
ROCHELLE CHISOM
THOMASVILLE FURNITURE IND. PLANT C , M
POST OFFICE BOX 339
THOMASVILLE, NC 27361
Pear Permittee:
A947iL)�i
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
Subject: Reissue - NPDES Stormwater Permit
Thomasville Furniture Ind. Plant C , M
COC Number NCG180163
Davidson County
In response to your renewal application for continued coverage under general permit NCG180000, 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 Aisha Lau of the Central Office Stormwater
and General Permits Unit at [phone], ext. 578
Sincerely,
for Kerr T. Stevens
Director, Division of Water Quality
cc: Central Files
Winston-Salem Regional Office
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] FAX [phone]
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STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG180000
CERTIFICATE OF COVERAGE No. NCG180163
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,
THOMASVILLE FURNITURE IND.
is hereby authorized to discharge stormwater from a facility located at
THOMASVILLE FURNITURE 1ND.
405 E MAIN STREET
THOMASVILLE
DAVIDSON COUNTY
to receiving waters designated as North Hamby Creek in the Yadkin - Pee Dee River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts 1, I1, 111,
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

State 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 16, 1995
Rochelle Chisom
Thomasville Furniture Plt C,M
401 E Main Street
Thomasville, NC 27361
IL
I DEHNR
Subject: General Permit No. NCG 180000
Thomasville Furniture Plt C,M
COC NCG180163
Davidson County
Dear Rochelle Chisom :
In accordance with your application for discharge permit received on April 6, 1995, 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
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 MS. AISHA LAU at telephone number
919/733-5083.
Sincerely, Original Signed gy
Col"n H. Sullins
A. Preston Howard, Jr. P.E.
cc: Winston-Salem Regional Office
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
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STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
GENERAL PERMIT NO. NCG180000
CERTIFICATE OF COVERAGE No. NCG180163
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,
Thomasville Furniture Industries, Inc.
is hereby authorized to discharge stormwater from a facility located at
Thomasville Furniture Industries, Inc. Plant C and Plant M
405 E. Main Street
Thomasville
Davidson County
to receiving waters designated as North Hamby Creek in the Yadkin -Pee Dee 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. NCG 180000 as attached.
This Certificate of Coverage shall become effective June 16, 1995.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this clay June 16, 1995.
06pinal Si91"ed 0y
CAleen �j.• Sollins
A. Preston Howard, Jr., P.E., Director
Division of Environmental Management
By Authority of the Environmental Management Commission

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582 51 •.583 1 �FA 117 GROVE 1.5 Mi. 584 (FA lR GROVE) 585 186 1 2 30" ^
4955 , SE
SCALE 1:24 000
# I 0 1 MILE
MN 1000 0 100, 2000 30W 4000 5000 5000 7000 FEET
ON
1 5 0 I a<ILOMETER
6-
l07 MILS a•33' CONTOUR INTERVAL 10 FEET
10 MILS nrnr,nw,e, ­—.1 .-1. : _.,. ... --

FACILITY Thomasville Furniture Industries, Inc. Plant C, Plant M
COUNTY Davidson
NPDES NCG180163
MAP#
D18NE
DSN FLOW
NA
SUB BASIN
03-07-07
LATTITUDE
350 53' 03"
LONGITUDE
800 04' 29"
RCVNG. STREAM
North Hamby Creek
STREAM CLASS
C
DSCHRG. CLASS
Stormwater
EXP. DATE
8/31/99