NCGNE0007_COMPLETE FILE - HISTORICAL_20090225

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCGNE
DOC TYPE
HISTORICAL FILE
DOC DATE
❑ �n[� i7ad'S
YYYYMMDD

RC:,No G%posure NCGNE0523-11ratt Industries4S
Subject: Re: No Exposure NCGNE0523-Pratt Industries
From: Marcia Allocco <[e-mail]>
Date: Wed, 25 Feb 2009 16:52:32 -0500
To: Sarah Young <Sarah.Young a ncmai].net>
Hi Sarah,
Thanks for forwarding the'info on Pratt Industries. I'II talk with Mike and see what he saw that was different
than what I saw.
Sounds good on rescinding NCGNE0007 for Duke.
Thanks,
Marcia
Sarah Young wrote:
per my voieemail
Sarah M. Young
Wetlands and Stormwater Branch 1617 Mail Service Center
Raleigh, NC 27699-1617
Phone: [phone]
Fax: [phone]
Email: sarah.young a,nctnail.net
Web site: http:Hh2o.enr.state.nc.us/ws/home.htm
**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.**
Marcia Allocco wrote:
Sarah,
I had visited the Pratt facility last year and told them they should get No Exposure. I told Samar
this and I am unsure if someone went to the facility in between my visit and our recent visits but I
don't think this No Exposure should have been denied.
Can you let me know what Samar had sent you regarding this facility?
Thanks,
Marcia
Marcia Allocco, MS - marcia.Allocco(a7,ncmail.net
Environmental Chemist
North Carolina Department of Environment & Natural Resources
Division of Water Quality - Surface Water Protection Group
t of 2
2/26/2009 9:1 1 AM

R:: No Exposure NC6NE0523-Pratt Industries
Mooresville Regional Office
610 East Center Ave., Suite 301
Mooresville, NC 28115
Ph: [phone] Fax: [phone]
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.
Marcia Allocco, MS - marcia.Alloccoencmail.net
Environmental Chemist
North Carolina Department of Environment & Natural Resources
Division of Water Quality - Surface Water Protection Group
Mooresville Regional Of -ice
610 East Center Ave., Suite 301
Mooresville, NC 28115
Ph: [phone] Fax: [phone]
E-mail correspondence to and from this address may be subject to the
North Carolina Public Records Law and may he disclosed to third parties.
2 of 2 2/26/2009 9:1 1 AM

r 1'.
F'Al A rF
`0�4 RpG Michael F. Easley
Governor
Cq 7 William G. Ross Jr„ Secretary
North Carolina Department of Environment and Natural Resources
0 Alan W. Klimek, P.E. Director
Division of Water Quality
July 1, 2003
John Estridge, P.E.
Duke Energy Corporation
526 South Church Street
Charlotte, North Carolina 28201-1006
Subject: No Exposure Certification
Aviation -Charlotte Operations
DWQ Tracking no.` NCGNE0007
Mecklenburg County
Dear Mr. Estridge:
The Division has reviewed your submittal of the No Exposure Certification for Exclusion
from NPDES Storm Water Permitting form, which we received October 18, 2002. Based
on our review, the Division has determined that the facility qualifies for the conditional no
exposure exclusion provided for under 40 CER 126.22(g) which is incorporated by reference
in North Carolina regulations.
Please note that by our acceptance of your no exposure certification, you are obligated to
maintain no exposure conditions at your facility. If conditions change such that your facility
can no longer qualify for a no exposure exclusion, you are obligated to immediately obtain
NPDES permit coverage for your stormwater discharge. Otherwise, the discharge becomes
subject to enforcement as an un-permitted discharge.
Your conditional no exposure exclusion expires in five years. At that time you must re-
certify with the Division, or obtain NPDES permit coverage for any stormwater discharges
from your facility.
Your certification of no exposure does not affect your facility's legal requirements to obtain
environmental permits that may be required under other federal, state, or local regulations
or ordinances.
If you have any questions or need further information, please contact Ken Pickle at (919)
733-5083 ext. 584, or at ken. [e-mail].
Sincerely,
Alan W. Klimek, P.E.
cc: Mooresville Regional Office
' DWQ Central Files
SGPU Files
�A
NCDENR
Customer Service Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 [phone]
1 800 623-7748

PDuke
ower.
A D-k, 6-,v G P-.7
October 15, 2002
Mr. Bradley Bennett
Stormwater and General Permits Unit
NC Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27699-1617
Subject: Duke Energy — Charlotte Aviation Hanger
Storm Water No Exposure Certification Form
Dear Mr. Bennett:
Duke Power
526 South Church Srreer
P.O. Box 1006
Charlotte, NC 28201-1006
Attached please find EPA Form 3510-11, No Exposure Certification for NPDES Storm
Water Permitting. This certification is being provided for Duke Energy's Charlotte
Aviation Hanger which conduct activities characterized by SIC Code 4581 and 4522.
These SIC codes require the facility to obtain a storm water NPDES permit for the
industrial activity or to submit the attached No Exposure Certification Form. This facility
has been evaluated and determined not to have any exposure to stormwater that
requires a storm water NPDES permit.
Should you have any questions concerning this letter, please give me a call at 704-382-
3293.
Sincerely,
John Estridge, P.E.
EHS Compliance Services
cc: Brian Hennessey — City of Charlotte
OCT $ 2002
pENR - Vd„TER QUALITY
palm SOURCE BRANCH
6113 CI eorji,a [phone] - 418P L4� w&gip PngeC -SS//ICI i�

MPO
r�ul�.sJ I r ac IE'6j',.-�

WGWE000 ]
United States Environmental Protection Agency Farm Approved
9 Y OMB No.2040-0211
NPDES Washington, DC 20460
FORM 4310"EPANO EXPOSURE CERTIFICATION for Exclusion from
351 D-11
NPDES Storm Water Permitting
Submission of this No Exposure Certification constitutes notice that the entity identified in Section A does not require permit authorization for its storm water
discharges associated with industrial activity in the State identified in Section B under EPA's Storm Water Multi -Sector General Permit due to the existence
of a condition of no exposure.
A condition of no exposure exists at an industrial facility when all industrial materials and activities are protected by a storm resistant shelter to prevent
exposure to rain, snow, snowmelt, and/or runoff. Industrial materials or activities include, but are not limited to, material handling equipment or activities,
industrial machinery, raw materials, intermediate products, by-products, final products, or waste products. Material handling activities include the storage,
loading and unloading, transportation, or conveyance of any raw material, intermediate product, final product or waste product. A storm resistant shelter is
not required for the following industrial materials and activities:
- drums, barrels, tanks, and similar containers that are tightly sealed, provided those containers are not deteriorated and do not leak. "Sealed"
means banded or otherwise secured and without operational taps or valves;
- adequately maintained vehicles used in material handling; and
- final products, other than products that would be mobilized in storm water discharges (e.g., rock salt).
A No Exposure Certification must be provided for each facility qualifying for the no exposure exclusion. In addition, the exclusion from NPDES permitting is
available on a facility -wide basis only, not for individual outfalis. If any industrial activities or materials are or will be exposed to precipitation, the facility is
not eligible for the no exposure exclusion.
By signing and submitting this No Exposure Certification form, the entity in Section A is certifying that a condition of no exposure exists at its facility or site,
and is obligated to comply with the terms and conditions of 40 CFR 122.26(g).
ALL INFORMATION MUST BE PROVIDED ON THIS FORM.
Detailed instructions for completing this form and obtaining the no exposure exclusion are provided on pages 3 and 4.
A. Facility Operator Information
1. Name: ID l U I k I el_ I 'y el r, g ly I I C I CI rl g rl al tth 11 l C1 5L_I_I_1 i i 1 1 2. Phone: 17 10 i 41 31 81 31219 13 I
3. Mailing Address: a. Street: 1 S I 0 I U I tI hl/ IC I h I u I ri cl ' 7 I S I t I rl el el iI I I I I I I I I I- I I I
b. City. IC I h I a I rl 11 U tl tl e I I I I I I I I I I I I I I c. State: LLB d. Zip Code: 1 2181 21 al ll —1 110 1 01 61
B. Facility/Site Location Information
1.FacilityName: IAIVa 1 tli join l-ICIhlalr11 o,t,tlel l0 p,e,r,a, !,o,UI51 1
2. a. Street Address: 1416, 21 0 F i r s tj IF 11 1 i I g I h I t' p I r I i v e
b. City: ICI hi a1 11 11 Oi t1 tl el I I I I �t I I I �I I I I I I 1 c. County: I Ml e I c l k1 11 a In I b., u I rl g
d. State: �� e. Zip Code: 12 1 81 21 01 81 - 15 17 1710
3. Is the facility located on Indian Lands? Yes ❑ No Ej
4, Is this a Federal facility? Yes ❑ No !�
5. a. Latitude: 131 51 - I112 1 L--5l-1J" N b. Longitude: 10 LLJ 16J ,J " w
6. a. Was the facility or site previously covered under an NPDES storm water permit? Yes ❑ No ❑X
b. If yes, enter NPDES permit number:
7. SICIActivity Codes: Primary: 41 15 # 81 -� Secondary (it applicable): 41 15 1 2 1 2
8. Total size of site associated with industrial activity: 3.3 ____ acres
9. a. Have you paved or roofed over a formerly exposed, pervious area in order to qualify for the no exposure exclusion? Yes ❑ No L ]
b. If yes, please indicate approximately how much area was paved or roofed over. Completing this question does not -disqualify -you for the
exclusion. However, your permitting authority may use this information in considering whether storm water isrges front you,sitep
an adverse impact on water quality, in which case you could be required to obtain permit coverage. f}
Less than one acre ❑ One to five acres ❑ More than five acres ❑
ll � nrT 1 Q
EPA Form 3510-11 (10-99)
Page Vof 4
V�j�TER QUALITY
PUNTSUURCEBRAticli

NPDES NO EXPOSURE CERTIFICATION for Exclusion from Form Approved
FORM OMB OMB No. 2040-0211
3510-11 NPDES Storm Water Permitting
C. Exposure Checklist
Are any of the following materials or activities exposed to precipitation, now or in the foreseeable future?
(Please check either "Yes" or "No" in the appropriate box.) If you answer"Yes" to any of these questions
(1) through (11), you are not eligible for the no exposure exclusion.
Yes
No
1. Using, storing or cleaning industrial machinery or equipment, and areas where residuals from using, storing
X❑
or cleaning industrial machinery or equipment remain and are exposed to storm water
2. Materials or residuals on the ground or in storm water inlets from spillslleaks
3. Materials or products from past industrial activity
X❑
4. Material handling equipment (except adequately maintained vehicles)
❑
Q
5. Materials or products during loading/unloading or transporting activities
❑
El
6. Materials or products stored outdoors (except final products intended for outside use [e.g., new cars] where
Q
exposure to storm water does not result in the discharge of pollutants)
7. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, and similar containers ZI
8. Materials or products handled/stored on roads or railways owned or maintained by the discharger ❑ ZI
9. Waste material (except waste in covered, non -leaking containers [e.g.. dumpsters]) 0
10, Application or disposal of process wastewater (unless otherwise permitted)
11. Particulate matter or visible deposits of residuals from roof stacks and/or vents not otherwise regulated
(i.e., under an air quality control permit) and evident in the storm water outflow
D. Certification Statement
I certify under penalty of law that I have read and understand the eligibility requirements for claiming a condition of "no exposure" and obtaining an
exclusion from NPDES storm water permitting.
I certify under penalty of law that there are no discharges of storm water contaminated by exposure to industrial activities or materials from the industrial
facility or site identified in this document (except as allowed under 40 CFR 122.26(g)(2)).
I understand that I am obligated to submit a no exposure certification form once every five years to the NPDES permitting authority and, if requested, to
the operator of the local municipal separate storm sewer system (MS4) into which the facility discharges (where applicable). I understand that I must
allow the NPDES permitting authority, or MS4 operator where the discharge is into the local MS4, to perform inspections to confirm the condition of no
exposure and to make such inspection reports publicly available upon request. I understand that I must obtain coverage under an NPDES permit prior
to any point source discharge of storm water from the facility.
Additionally, 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 gathered and evaluated 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 fine and imprisonment for knowing violations.
Print Name: I l l DI DI a 1 l 1 dl 1 111 I S I t 1 e le l l le I I I l I I I I 1 1 1 1 1 11 1 1 1 1
Print Title: I V i I Ce Pre I s ident I ICo I rporate R.e IS,ource Is
Signature:-_
- �/� v-- ------ ---------------
Date: 111diliql0i
OCT 1 8 2002
EPA Form 3510-11 (10-99) D,F�i� }f - WATER 011ALI Y Page 2 of 4
p," 1T SOUK CE 0f;AFlGN

i map://ken.pickle%40dwq.denr.nemail.net @ cros.ncmail. net:143/fetc...
`r
Subject: Re: Duke Energy - Charlotte Aviation Hanger
From: Michael Parker <[e-mail]>
Date: Mon, 16 Jun 2003 08:06:04 -0400
To: Ken Pickle <[e-mail]>
Ken,
I don't really see a problem with allowing the No Exposure Exemption for
this facility. Duke i typically pretty good about correctly identifying
site specific characte is tics at their facilities so I don't have a problem
if they feel that this site meets our No Expopsure criteria. I'm planning
to accompany Meck. Co. n an NPDES inspection of the airport soon anyway so
I can run by there and Make sure that the site meets our criteria.
Michael
Ken Pickle wrote:
Hi Mike,
Duke Energy sent us (SG ) a completed No Exposure Certification for
Exclusion from NPDES Sto m Water Permitting form in October of 2002.
They've called asking a out it, and Bradley has pulled their form out
of a stack of about 40 f these for me to "expedite". I'll drop you.a
copy of it today.
As I understand it, they' e going to build a new hanger (or, maybe by
now it's already built) w ere they will be conducting activities
described by SIC codes 458 (Airports) and 4522 (Air transportation).,
It's on 3.3 acres at 4620 First Flight Drive (Charlotte Douglas
Airport?).
We want your input on whether or not you have concerns about me issuing
a no exposure acknowledgement letter for this facility. If you can
respond in the next couple of days, great. If you want to wait on
responding until you receive the copy of the form that I'll send you
today, that's ok too.
In the meantime, I'm going to call Georgina Franklin with Duke and tell
her that we're expediting the review of their submittal.
Thanks,
Ken
Michael Parker - [e-mail]
Environmental Engineer II
North Carolina Dept. of Environment & Natural Resources
Division of Water Quality
919 N. Main Street
Mooresville, NC 28115
Ph: 704.663.1699 Fax: [phone]
Michael Parker <[e-mail]>
Environmental Engineer II
NC DENR -Mooresville
Division of Water Quality
1 of 1 6/ 16/2003 8:20 AM

2,2
A lu-rC - q- 92

o�0F w a rE9Q�
r
July 1, 2003
John Estridge, P.E.
Duke Energy Corporation
526 South Church Street
Charlotte, North Carolina 28201-1006
Dear Mr. Estridge:
Michael F. Easley
Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
R F f "Y FED
JUL 0 7 2003
Subject: No Exposure Certificatt0 SECTION
Aviation -Charlotte Operations
DWQ Tracking no. NCGNE0007
Mecklenburg County
The Division has reviewed your submittal of the No Exposure Certification for Exclusion
from NPDES Storm Water Permitting form, which we received October 18, 2002. Based
on our review, the Division has determined that the facility qualifies for the conditional no
exposure exclusion provided for under 40 CFR 126.22(g) which is incorporated by reference
in Borth Carolina regulations.
Please note that by our acceptance of your no exposure certification, you are obligated to
maintain no exposure conditions at your facility. If conditions change such that your facility
can no longer qualify for a no exposure exclusion, you are obligated to immediately obtain
NPDES permit coverage for your stormwater discharge. Otherwise, the discharge becomes
subject to enforcement as an un-permitted discharge.
Your conditional no exposure exclusion expires in five years. At that time you must re-
certify with the Division, or obtain NPDES permit coverage for any stormwater discharges
from your facility.
Your certification of no exposure does not affect your facility's legal requirements to obtain
environmental permits that may be required under other federal, state, or local regulations
or ordinances.
If you have any questions or need further information, please contact Ken Pickle at (919)
733-5083 ext. 584, or at [e-mail].
Since rely,
Alan W. Klimek, P.E.
cc: ,Mooresville-RegionalOffice
DWQ Central Files
SGPU Files
NCDENR
Customer Service Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 [phone]
1 800 623-7748

V. I - �� /
Duke
®Power,
A D-k, E-V C-p -y
October 15, 2002
NC DEFT. OF t�Ei1T
AND NATURAL REM IRCES
PF
JUN 2 3 2003
Mr. Bradley Bennett
Stormwater and General Permits Unit
NC Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27699-1617
Subject: Duke Energy — Charlotte Aviation Hanger
Storm Water No Exposure Certification Form
Dear Mr. Bennett:
Duke Power
526 South Church Street
P.O. Box 1006
Charlotte, NC 28201-1006
Attached please find EPA Form 3510-11, No Exposure Certification for NPDES Storm
Water Permitting. This certification is being provided for Duke Energy's Charlotte
Aviation Hanger which conduct activities characterized by SIC Code 4581 and 4522.
These SIC codes require the facility to obtain a storm water NPDES permit for the
industrial activity or to submit the attached No Exposure Certification Form. This facility
has been evaluated and determined not to have any exposure to stormwater that
requires a storm water NPDES permit.
Should you have any questions concerning this letter, please give me a call at 704-382-
3293.
Sincerely,
J-�- �b7dj--Jz-
John Estridge, P.E.
EHS Compliance Services
cc: Brian Hennessey — City of Charlotte
OCT 18 2002

Dukc s
ha e��-Su re.
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' lCGtiEa009
United States Environmental Protection Agency Form Approved
9 Y OMB No. 2040-0211
NPDES , ��� Washington, UC 20460
FORM �►
351 t]-11 NO EXPOSURE CERTIFICATION for Exclusion from
NPDES Storm Water Permitting
Submission of this No Exposure Certification constitutes notice that the entity identified in Section A does not require permit authorization for its storm water
discharges associated with industrial activity in the State identified in Section B under EPA's Storm Water Multi -Sector General Permit due to the existence
of a condition of no exposure.
A condition of no exposure exists at an industrial facility when all industrial materials and activities are protected by a storm resistant shelter to prevent
exposure to rain, snow, snowmelt, and/or runoff. Industrial materials or activities include, but are not limited to, material handling equipment or activities,
industrial machinery, raw materials, intermediate products, by-products, final products, or waste products. Material handling activities include the storage,
loading and unloading, transportation, or conveyance of any raw material, intermediate product, final product or waste product. A storm resistant shelter is
not required for the following industrial materials and activities:
- drums, barrels, tanks, and similar containers that are tightly sealed, provided those containers are not deteriorated and do not leak. 'Sealed"
means banded or otherwise secured and without operational taps or valves;
- adequately maintained vehicles used in material handling; and
- final products, other than products that would be mobilized in storm water discharges (e.g., rock sail).
A No Exposure Certification must be provided for each facility qualifying for the no exposure exclusion. In addition, the exclusion from NPDES permitting is
available on a facility -wide basis only, not for individual outfalls. If any industrial activities or materials are or will be exposed to precipitation, the facility is
not eligible for the no exposure exclusion.
By signing and submitting this No Exposure Certification form, the entity in Section A is certifying that a condition of no exposure exists at its facility or site,
and is obligated to comply with the terms and conditions of 40 CFR 122.26(g).
ALL INFORMATION MUST BE PROVIDED ON THIS FORM
Detailed Instructions for completing this form and obtaining the no exposure exclusion are provided on pages 3 and 4.
A. Facility Operator Information
1. Name: ID 1U 1 k el I q _ael—il gly I I �1 fll rl q t1 al tL� 1 Ol nl 1 t i I I 1 1 2. Phone: I� !� 14I 31 �I � 31219 13 I
3. Mailing Address: a. street: IS 101 U 1 t1 by IC t h I u I rl C! h I S I t I r I et e1 }l I I I I I I I I 1� 1 1 I 1
b. City: IC 1 h JL_rl 11 q t( tl e1 I I I 1 1_ l I 1 I i _l I 1 c. State: IJ d. Zip Code: 1 218 121 01 11-- 1 110 101 6i
B. Facility/Site Location information
1. Facility Name: LAl Vt i31 i1t1i f oID t - 1 C1 Il1a 1r 11 10 I tl tl el-I0_t-j Lrl d1 tl 1 1 01 ill S I
2. a. Street Address: 14, 61 21 01 1F I i I r I S I tI IF II 11 1 g I h1 tl ID I r! i I V1 e,l... I I I I I I I__Lj
b. city: 1C I h1 al n 1t DI tl tt e1 1 1 1 1 1 1 1 1 1 1 1 1 I I c. county: M e C k j e n b u r g
d. State: �CJ ' e. Zip Code: 12 1 81 21 01 `Q1 -15 1 7 1 % 1 a l
3. Is the facility located on Indian lands? Yes ❑ No
4. Is this a Federal facility? Yes ❑ No FTJ
u
5. a. Latitude: ICJ C LL? f 15111 " N b. Longitude: 1018, J 5,6 1 IJJ w
6. a. Was the facility or site previously covered under an NPDES storm water permit? Yes ❑ No ❑X
b. If yes, enter NPDES permit number;
7. SIC/Activity Codes: Primary: 41 1 51_§_Llj Secondary (if applicable): 4� 15 1 21 2
B. Total size of site associated with industrial activity: ____ 3. 3 ____ acres
9. a. Have you paved or roofed over a formerly exposed, pervious area in order to qualify for the no exposure exclusion?
b. If yes, please indicate approximately how much area was paved or roofed over. Completing this question does
exclusion. However, your permitting authority may use this information in considering whether storm water rll�)
an adverse impact on water quality, in which case you could be required to obtain permit coverage.
Less than one acre ElOne to five acres ❑ More than five acres ❑
EPA Form 3510-11 (10-99)
Yes❑ No
sliscpalify-you for.the- rn a sure
Ids from yo,�site re it y�he v i
Page 1'of 4

NPDES
FORM
3510-if
A ®n
`vOE�A NO EXPOSURE CERTIFICATION for Exclusion from
NPDES Storm Water Permitting
Form Approved
OMB No. 2040 4211
C. Exposure Checklist
Are any of the following materials or activities exposed to precipitation, now or in the foreseeable future?
(Please check either'Yes" or "No" in the appropriate box.) If you answer"Yes" to any of these questions
(1) through (11), you are not eligible for the no exposure exclusion.
Yes
No
1. Using, storing or cleaning industrial machinery or equipment, and areas where residuals from using, storing
X�
or cleaning industrial machinery or equipment remain and are exposed to storm water
2. Materials or residuals on the ground or in storm water inlets from spillslleaks
XQ
3. Materials or products from past industrial activity
F1
4. Material handling equipment (except adequately maintained vehicles)
XX
S. Materials or products during loadinglunloading or transporting activities
O
6. Materials or products stored outdoors (except final products intended for outside use [e.g., new cars] where
exposure to storm water does not result in the discharge of pollutants)
7. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, and similar containers
❑
X❑
8. Materials or products handled/stored on roads or railways owned or maintained by the discharger
X❑
9. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters])
❑
X❑
10. Application or disposal of process wastewater (unless otherwise permitted)
11. Particulate matter or visible deposits of residuals from roof stacks and/or vents not otherwise regulated
(i.e., under an air quality control permit) and evident in the storm water outflow
O. Certification Statement
I certify under penalty of law that I have read and understand the eligibility requirements for claiming a condition of "no exposure" and obtaining an
exclusion from NPDES storm water permitting.
I certify under penalty of law that there are no discharges of storm water contaminated by exposure to industrial activities or materials from the industrial
facility or site identified in this document (except as allowed under 40 CFR 122.26(g)(2)).
I understand that I am obligated to submit a no exposure certification form once every five years to the NPDES permitting authority and, if requested, to
the operator of the local municipal separate storm sewer system (MS4) into which the facility discharges (where applicable). I understand that I must
allow the NPDES permitting authority, or MS4 operator where the discharge is into the local MS4, to perform inspections to confirm the condition of no
exposure and to make such inspection reports publicly available upon request. I understand that I must obtain coverage under an NPDES permit prior
to any point source discharge of storm water from the facility.
Additionally, 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 gathered and evaluated 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 fine and imprisonment for knowing violations.
Print Name: [ pl �l DI a l l dl _].l i S l t l ele le I 11 I t 1 1 I l l I I I I I I l t l
Print Title: IV, i I c e I IP 1 r I el sl il d 1 el n t I IC lo I rl p ol rl alt let. R le I sl o u r c e I s
Signature: <_
Date: I0 y o
Ill/'`}
f i :1L:
i
i
EPA Form 3510-11 (10-99)
Page 2 of 4

NPDES rs Instructions for the NO EXPOSURE CERTIFICATION for Form Approved
FORM -,EPA OMB No. 0211
3510-11 Exclusion from NPDES Storm Water Permitting
Who May Fite a No Exposure Certification Section B. Facility/Site Location Information
Federal law at 40 CFR Part 122.26 prohibits point source discharges of
storm water associated wish industrial activity to waters of the U.S. without
a National Pollutant Discharge Elimination System (NPDES) permit. However,
NPDES permit coverage is not required for discharges of storm water
associated with industrial activities identified at 40 CFR 122.26(b)(14)(i)-
ft) and (xi) if the discharger can certify that a condition of 'no exposure"
exists at the industrial facility or silo.
Storm water discharges from construction activities identified in 40 CFR
122.26(b)(14)(x) and (b)(15) are not eligible for the no exposure exclusion.
Obtaining and Maintaining the No Exposure Exclusion
This form is used to certify that a condition of no exposure exists at the
industrial facility or site described herein. This certification is only applicable
in jurisdictions where EPA is the NPDES permitting authority and must be
re -submitted at least once every five years.
The industrial facility operator must maintain a condition of no exposure at
its facility or site in order for the no exposure exclusion to remain applicable.
If conditions change resulting in the exposure of materials and activities to
storm water, the facility operator must obtain coverage under an NPDES
storm water permit immediately.
Where to file the No Exposure Certification Form
Mail the completed no exposure certification form to:
Storm Water No Exposure Certification (4203)
USEPA
401 M Street, SW
Washington, D.C. 20460
Completing the Form
You must type or print, using uppercase letters, in appropriate areas only.
Enter only one character per space (i.e., between the marks). Abbreviate
if necessary to stay within the number of characters allowed for each item.
Use one space for breaks between words. One form must be completed
for each facility or site for which you are seeking to certify a condition of no
exposure. Additional guidance on completing this form can be accessed
through EPA's web site at www.epa.gov/owm/sw. Please make sure you
have addressed all applicable questions and have made a photocopy for
your records before sending the completed form to the above address.
Section A. Facility Operator Information
1. Provide the legal name of the person, firm, public organization, or any
other entity that operates the facility or site described in this certification.
The name of the operator may or may not be the same as the name of
the facility. The operator is the legal entity that controls the facility's
operation, rather than the plant or site manager.
2. Provide the telephone number of the facility operator.
3. Provide the mailing address of the operator (P.O. Box numbers may be
used). Include the city, state, and zip code. All correspondence will
be sent to this address.
inn? s l
1. Enter the official or legal name of the facility or site.
2. Enter the complete street address (if no street address exists, provide
a geographic description [e.g., Intersection of Routes 9 and 55]), city,
county, state, and zip code. Do not use a P.O. Box number.
3. Indicate whether the facility is located on Indian Lands.
4. Indicate whether the industrial facility is operated by a deparlment or
agency of the Federal Government (see also Section 313 of the Clean
Water Act).
5. Enter the latitude and longitude of the approximate center of the facility
or site in degrees/minutes/seconds. Latitude and longitude can
be obtained from United States Geological Survey (USGS) quadrangle
or topographic maps, by calling 1-(888) ASK-USGS, or by accessing
EPA's web site at http://www.epa.gov/owm/swlndustry/index.him and
selecting Latitude and Longitude Finders under the Resources/Permit
section.
Latitude and longitude for a facility in decimal form must be converted
to degrees ('), minutes ('), and seconds (') for proper entry on
the certification form. To convert decimal latitude or longitude to
degrees/minutes/seconds, follow the steps in the following example.
Example: Convert decimal latitude 45.1234567 to degrees (1), minutes
('), and seconds (").
a) The numbers to the left of the decimal point are the degrees: 45°.
b) To obtain minutes, multiply the first four numbers to the right of the
decimal point by 0,006: 1234 x 0.006 = 7.404.
c) The numbers to the left of the decimal point in the result obtained
in (b) are the minutes: 7'.
d) To obtain seconds, multiply the remaining three numbers to the
right of the decimal from the result obtained in (b) by 0.06:
404 x 0,06 = 24.24. Since the numbers to the right of the decimal
point are not used, the result is 24'.
e) The conversion for 45.1234567 = 451 7' 24".
6. Indicate whether the facility was previously covered under an NPDES
storm water permit. It so, include the permit number.
7. Enter the 4-digit SIC code which identifies the facility's primary activity,
and second 4-digit SIC code ideriff tying the facility's secondary activity,
it applicable. SIC codes can be obtained from the Standard Industrial
Classification Manual, 1987.
8. Enter the total size of the site associated with industrial activity in acres.
Acreage may be determined by dividing square footage by 43,560, as
demonstrated in the following example.
Example: Convert 54,450 ft2 to acres
Divide 54,450 ft2 by 43,560 square feet per acre:
54,450 ft2 + 43,560 ft2/acre = 1.25 acres.
9. Check "Yes' or'No" as appropriate to indicate whether you have paved
or roofed over a formerly exposed, pervious area (i.e., lawn, meadow,
dirt or gravel road/parking lot) in order to qualify for no exposure. If yes,
also indicate approximately how much area was paved or roofed over
and is now impervious area.
EPA Form 3510-11 (10-99) Page 3 of 4

NPDES �,, Instructions for the NO EXPOSURE CERTIFICATION for Form Approved
FORM �.ryEp� OMB No. 2040-0211
3510-11 Exclusion from NPDES Storm Water Permitting
Section C. Exposure Checklist
Check 'Yes" or "No"as appropriate to describe the exposure conditions at
your facility. If you answer "Yes" to ANY of the questions (1) through (11)
in this section, a potential for exposure exists at your site and you cannot
certify to a condition of no exposure. You must obtain (or already have)
coverage under an NPDES storm water permit. After obtaining permit
coverage, you can institute modifications to eliminate the potential for a
discharge of storm water exposed to industrial activity, and then certify to
a condition of no exposure.
Section D. Certification Statement
Federal statutes provide for severe penalties for submitting false information
on this application form. Federal regulations require this application to be
signed as tollows:
For a corporation: by a responsible corporate officer, which means:
(i) president, secretary, treasurer, or vice-president of the corporation
in charge of a principal business function, or any other person
who performs similar policy or decision making functions for the
corporation, or
(H) the manager of one or more manufacturing, production, or
operating facilities, provided the manager is authorized to make
management decisions which govern the operation of the
regulated facility including having the explicit or implicit duty of
making major capital investment recommendations, and initiating
and directing other comprehensive measures to assure long
term environmental compliance with environmental laws and
regulations; the manager can ensure that the necessary systems
are established or actions taken to gather complete and accurate
information for permit application requirements; and where
authority to sign documents has been assigned or delegated to
the manager in accordance with corporate procedures;
For a partnership or sole proprietorship: by a general partner or the
proprietor; or
For a municipal, State, Federal, or other public facility: by either a
principal executive or ranking elected official.
Paperwork Reduction Act Notice
Public reporting burden for this certification is estimated to average 1.0 hour
per certification, including time for reviewing instructions, searching existing
data sources, gathering and maintaining the data needed, and completing
and reviewing the collection of information. Burden means the total time,
effort, or financial resources expended by persons to generate, maintain,
retain, or disclose to provide information to or for a Federal agency. This
includes the time needed to review instructions; develop, acquire, install,
and utilize technology and systems for the purposes of collecting, validating,
and verifying information, processing and maintaining information, and
disclosing and providing information; adjust the existing ways to comply with
any previously applicable instructions and requirements; train personnel to
be able to respond to a collection of information; search data sources;
complete and review the collection of information; and transmit or otherwise
disclose the information. An agency may not conduct or sponsor, and a
person is not required to respond to, a collection of information unless it
displays a currently valid OMB control number. Send comments regarding
the burden estimate, any other aspect of the collection of information, or
suggestions for improving this form, including any suggestions which may
increase or reduce this burden to: Director, OPPE Regulatory Information
Division (2137), USEPA, 401 M Street, SW, Washington, D.C. 20460.
Include the OMB control number of this form on any correspondence. Do
not send the completed No Exposure Certification form to this address.
EPA Form 3510-11 (10-99) Page 4 of 4