NCG180202_COMPLETE FILE - HISTORICAL_20140613

STORMWATER DIVISION CODING SHEET
RESCISSIONS
PERMIT NO.
DOC TYPE
❑COMPLETE FILE -HISTORICAL
DATE OF
RESCISSION
❑ L-61 7 0 G /-?
YYYYMMDD

LPIWA
A7L*WA
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Scott Lesnet
The Hon Company
408 E. Second St
Muscatine, IA 52761
Dear Mr. Lesnet:
John E. Skvarla, III
Secretary
June 13, 2014
Subject: Rescission of NPDES Stormwater Permit
Certificate of Coverage Number NCG 180202
HNI Corporation/The Hon Company
Franklin County
On June 9, 2014, the Division of Energy, Mineral and Land Resources received your request to rescind your
coverage under Certificate of Coverage Number NCG 180202. In accordance with your request, Certificate
of Coverage Number NCG 180202 is rescinded effective immediately.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 Julie Ventaloro at 919-807-6370, or the Stormwater
staff in our Raleigh Regional Office at 919-791-4200.
Sincerely,
for Tracy E. avis, PE, CPM, Director
Division of Energy, Mineral and Land Resources
cc: Raleigh Regional Office — D. Parnell
96i mwater 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:l/portal.ncdenr.or iwebllr!
An Equal opportunity 1 Affirmative Action Employer — 50% Recycled 110%o Post Consumer Paper

i
pop_
A r
NCDENR
NpeTN CA-0—A DEMRTMMl OF
Division of Energy, Mineral & Land Resources
Land Quality Section/Stormwater Permitting Program
National Pollutant Discharge Elimination System
RESCISSION REQUEST FORM
FOR AGENCY USE ONLY
Date Received
Year
Month
Day
Please fill out and return this form if you no longer need to maintain your NPDES stormwater permit.
1) Enter the permit number to which this request applies:
Individual Permit (or) Certificate of Coverage
N I C ,6(D20 I Z I N I C I G
6e
2) Owner/Facility Information: "Final correspondence will be mailed to the address noted below
Owner/Facility NamE
Facility Contact
Street Address
City
County
Telephone No.
3) Reason for rescission request (This is required information. Attach separate sheet if necessary):
Z&D9
Facility closed or is closing on F&, i . All industrial activities have ceased such that no discharges of
stormwater are contamin-atted by exposure to industrial activities or materials.
❑ Facility sold to rJ§ IV4,PC. P 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.
Signature
GAR\4 CA R_L, 0 r\J
Print or type name of person signing above
Date � (Z 1
0j (Ip ✓F'1�0(�n 1
Title
Please return this completed rescission request form to: NPDES Permit Coverage Rescission
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1W
1612 Mail Service Center, Raleigh, North Carolina 27699-1612
Phone: [phone] FAX: [phone]
R@9ae�
F-JUN 0 9 20I4
An Equal Opportunity 1 Affirmative Action Employer

Ventaloro, Julie
From: Parnell, David
Sent: Friday, June 06, 2014 9:57 AM
To: Ventaloro, Julie
Subject: RE: Palziv Group in Louisburg and rescission request
Follow Up Flag: Follow up
Flag Status: Flagged
Julie,
I wanted to follow up. So much going on this week.
Please rescind the permit for NCG180202 HNI Corporation.
Palziv does require a new stormwater permit, depending on their SIC code.
Thanks,
Dave
From: Ventaloro, Julie
Sent: Friday, May 30, 2014 4:10 PM
To: Parnell, David
Subject: FW: Palziv Group in Louisburg and rescission request
Dave,
I was just talking with Mike Johnson with Palziv Group. He said you had visited their site. Did you recommend a
particular general permit for them?
Thanks,
Julie
From: Ventaloro, Julie
Sent: Tuesday, May 20, 2014 11:55 AM
To: Parnell, David
Subject: Palziv Group. in Louisburg and rescission request
Hi Dave,
Can you help me determine if the Palziv Group facility located in Louisburg needs to be covered under an industrial
stormwater permit?
It came up because I got a call from the HNI Corporation regarding their NCG180202 permit. They told me they are no
longer operating at that facility and that it was sold a while ago to a new company. I am sending them a rescission
request form. The representative with HNI wanted to know if they should transfer the permit to the new owner rather
than rescind their permit. I told him I'd check on it, but I'm doubtful that the new owners of the facility, Palziv Group,
would qualify for an NCG18 since they manufacture polyethylene foams, not furniture.
Please let me know what.you think as far as if the Palziv Group needs an industrial stormwater permit, and if so, which
one. You may also consider this a request for your recommendation on the rescission of NCG180202 HNI Corporation.
The facility address is 7966 NC Hwy 56, Louisburg. Main number of Palziv Group is 919-497-0010.

Thanks for your help!
Julie Ventaloro
Stornlwater Permitting, Program
NC Division of Fnergy, Mineral, and Land Resources
1612 Mail Service Center, Raleigh, NC 27699-1612,
Phone: (gig) 807-6370 Fav [phone]
Website: httl2://watersupRlywatershed.nc.gov
E-mail correspondence to and from this address rrxry be subject to the North Carolina Public Records Law and may be disclosed to third
parties.

M
�`� • Division of Energy, Mineral & Land Resources
Land Quality Section/Stormwater Permitting Program
NCDENRNational Pollutant Discharge Elimination System
NORTw GROLINA D�TMEH OF
�HVIRONNl.NT Aim Nwlu — PESn. +c[.
RESCISSION REQUEST FORM
FOR AGENCY USE ONLY
Date Received
Year Month
Day
Please fill out and return this form if you no longer need to maintain your NPDES stormwater permit.
1) Enter the permit number to which this request applies:
Individual Permit (or) Certificate of Coverage
N C N C G
2) Owner/Facility Information: * Final correspondence will be mailed to the address noted below
Owner/Facility Nam(
Facility Contact
Street Address
City
County
Telephone No.
3) Reason for rescission request (This is required information. Attach separate sheet if necessary):
Facility closed or is closing on Q i ?60
All
z :- industrial activities have ceased such that no discharges of
66W
stormwater are contaminated by exposure to industrial activities or materials.
❑ Facility sold to on G� - . 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.
Signature
&AR\' CA 2.(.�0 N
Print or type name of person signing above
Please return this completed rescission request forth to:
Date p + 2 C 10
V1,('P +i V'p1' J t'' 1
Title
NPDES Permit Coverage Rescission
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1tp
1612 Mail Service Center, Raleigh, North Carolina 27699-1612
Phone: [phone] FAX: [phone]
An Equal Opportunity 1 Affirmative Action Empioyer
JUN 0 9 2014
D . Nft - VV. Al EF QIJALU17Y l

Lesnet, Scott (HNI Corp)
From: Ventaloro, Julie [e-mail]
Sent: Tuesday, May 20, 2014 11:16 AM
To: Lesnet, Scott (HNI Corp)
Subject: NC Stormwater permit rescission request form
Attachments: NPDES-Rescission-Form-20140127-DEMLR-SW.doc
Mr. Lesnet,
I appreciate your patience as I've tried to track down the permit rescission request form you submitted for stormwater
permit #NCG1$0202. This is a permit issued to HNI Corporation for The HON Company facility at 7966 NC Hwy 56,
27549, Louisburg, NC. Unfortunately, I wasn't able to find the form you submitted. I apologize for the inconvenience,
but would you please complete the attached rescission request form and mail it to the address shown below? You can
put it to my attention to be sure it gets to me.
Also, you had inquired as to whether the new owner of the facility in Louisburg would prefer to have the permit
transferred to them rather than rescinding it and starting from scratch with a new permit. The new owner, Palziv Group,
is involved in manufacturing of polyethylene foams and would not qualify for coverage under the NCG18 permit, which
is for furniture manufacture. So I think the most appropriate action here is for you to re -submit the rescission request.
I'll send you an email as confirmation once I receive the rescission request from you.
Thank you,
Julie Ventaloro
Stormwater Permitting Program
NC Division of Energy, Mineral, and ],and Resources
1612 Mail Service Center, Raleigh, INC 27699-1612
Phone: [phone] fax: [phone]
Website: http:l/watersuppl watershed.nc. ov
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Low ❑nd may be disclosed to third
parties.

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
LARRY G. GRAY
THE HON COMPANY/ DIV. INDUSTRIES
7966 NC 56 HWY
LOUISBURG, NC 27549
A ILF??FA
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL (RESOURCES
Subject: Reissue - NPDES Stormwater Permit
The Hon Company/ Div. Industries
COC Number NCG 180202
Franklin County
Dt!;ir Perrnittee.
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 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
Raleigh Regional Office
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone]B3 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. NCG180202
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,
THE HON COMPANY/ DIV. INDUSTRIES
is hereby authorized to discharge stormwater from a facility located at
THE HON COMPANY/ DIV, INDUSTRIES
7966 NC 56 HWY
LOUISBURG
FRANKLIN COUNTY
to receiving waters designated as a UT of Wolfpen Branch in the Tar - Pamlico River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts 1, I1, III,
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.
��a-e xi
for Kerr T. Stevens, Director T
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
April 19, 1996
James Higgins
Hon Company
414 E Third Street
Muscatine, IO 52761
Oft
IDEHNF�
Subject: General Permit No. NCG 180000
Hon Company
COC NCG 180202
Franklin County
Dear James Higgins:
In accordance with your application for discharge permit received on December 4, 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 MR. BILL MILLS at telephone number
9191733-5083.
Sincerely, OgGiMSiGNEDBY
BRADLEY BENNETT
A. Preston Howard, Jr. P.E.
cc: Raleigh Regional Office
EPA
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

J
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
GENERAL PERMIT NO. NCG180000
CERTIFICATE OF COVERAGE NO. NCGL80202
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,
HON Industries
is hereby authorized to discharge stormwater from a facility located at
The HON Company
Hwy 56 West
Louisburg
Franklin County
to receiving waters designated as an unnamed tributary to Wolfpen Creek in the Tar - Pamlico River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I,11, III
and IV of General Permit No. NCG 180000 as attached.
This Certificate of Coverage shall become effective April 19, 1996,
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day April 19, 1996.
0 t'j Cj%'' �l. S1GW20 BY
BRAULEY BENNETT
A. Preston Howard, Jr., P.E., Director
Division of Environmental Management
By Authority of the Environmental Management Commission

kk
Iz
\ in LINE
`rFq Armory ��'
Bp • / • a ��
Drive-in s/ I
Theatre
� BM Water `� .�� � d(3� � ��4 J •� �f,.
co
54 •Tar)k p > f A
364
er
-�! • ABM.
41
N
315
•^_ �� �{c/i � � ,; i� � 1.1 � ' �\• �_,�I� ram— � - ,� �. ,� �,
lT=­
fj.
23
Res
' • I l' \ / � r � it -- - .� _

FACILITY
COUNTY
NPDES
p #
FLOW
S I N 0 3-0 3 - 0 1
�DE 3
-2 o
STREAM A-o
CLASS J, rort tz l�x
Ey,pj %jdi?0,N DATE