NCGNE0466_COMPLETE FILE - HISTORICAL_20090220

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCGNE
90C TYPE
HISTORICAL FILE
DOC DATE
❑ C� CO0-0
YYYYMMDD

M�
MCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality �
Beverly Eaves Perdue Coleen H. Sullins -� V��s
tFrr�eman
Governor director E ''� ecretary ,►
February 20, 2009 FEB 2 4 2008
Mr. Joe Hudson
City of Statesville �t, r t �,
PO Box 1111 D"U-Surface trryid,ter prc.10c;�' `l
Statesville, NC 28677
Subject: Denial of No -Exposure Certification NCGNE0466
41h Creek WVVrp
693 Bell Farm Rd., Statesville, NC 28677
Iredell County
Dear Mr. Hudson:
The Division has reviewed your submittal of the No Exposure Certification for Exclusion from NPDES Stormwater
Permitting form, which we received on October 25, 2007. The Division is unable to concur with your certification of no
exposure.
Based on an inspection of your facility, Mooresville Regional Office staff found that materials on your site either are
exposed, or have the potential to be exposed. DWQ cannot grant your requested exemption from permit coverage
when materials are exposed or have the potential to be exposed. Please continue to operate under the General Permit
NCG110000.
If you have any questions or need further information, please contact Robert Patterson at [phone], or through
email at [e-mail].
for
cc: Mooresville Regional Office -Michael Parker
Stormwater Permitting Unit Files
NCG110112 Permit File
Sincerely,
W-L"" fal I&
Coleen H. Sullins
Wetlands and Stormwater Branch One
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 North Caroli na
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone: [phone] FAX: 9IM07-64941 Customer Service: 1-877-623-6748 ;Vaturallff
intemet: www.ncwaterqualit .org
An Faual 0wortunily l Affirmative Action Employer

NCDENR
North Carolina Department of Environment and Nat 1 e ources
Division of Water Qualify '71 r
Beverly Eaves Perdue Coleen H. Sullins r DeelFreerr�n
_ �._�.: L i k rt
Governor Director SeCretar ;
Mr. Andy Smith
City of Statesville 4In Creek WWTP
PO Box 1111
Statesville, NC 28677
Dear Mr. Smith'
February 16, 2009 FES 2 4 7"n8
QWQ-Surf;ArG� Xflon
Subject: Denial of No -Exposure Certification NCGNE0511
4'h Creek WWTP
693 Bell Farm Rd, Statesville, NC
Iredell County
The Division has reviewed your submittal of the No Exposure Certification for Exclusion from NPDES Stormwater
Permitting form, which we received on September 13, 2007. The Division is unable to concur with your certification of
no exposure.
Based on an inspection of your facility, Mooresville Regional Office staff found that materials on your site either are
exposed, or have the potential to be exposed. DWQ cannot grant your requested exemption from permit coverage
when materials are exposed or have the potential to be exposed. Please continue to operate under the General Permit
NCG110000.
If you have any questions or need further information, please contact Brian Lowther at [phone], or through email
at [e-mail].
Sincerely,
�e�ze_ 41�7Q�
for Coleen H. Sullins
cc: Mooresville Regional Office
Stormwater Permitting Unit Files
Wetlands and Stormwater Branch
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone: [phone] FAX [phone] Cuslomer Service: 1-877.623-6748
Internet: www.rrcwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer
NCG110112 Permitting file
No rthCarol.ina.

50
�-k I

Permit
I
Facility
Number
Name - Facility
Address
Facility City
NCGNEC236
Green Fiber -
Green Fiber
1007 Amble Dr
Charlotte
N C National
NCGNE0376
Guard - NC Nat
Gd- Belmont
300 N 6th St
Belmont
N C National
NCGNE0389
Guard - NC Nat
Gd- Gastonia
2100 Robinwo
Gastonia
City of
NCGNE0511
Statesville -
Fourth Creek
WWTP
fi93 Bell Farm FStatesville
Hd Supply - H❑
NCGNE0468
Supply
Piumbing/HVAC
MG 0910
1942 Airport Rd
Monroe
The Pepsi
Bottling Group
NCGNE0472
Inc - The Pepsi
Bottling Group,
Inc.
5047 Hwy 24-27,Midland
City of
I NCGNE0466
No -(Dee
No-(J
Creek WWTP 1693 Bell Farm F,Statesville NO-WQ
Jack B Kelley
Inc. Jack B.
NCGNE0467 Kelley - 10
Terminal
16108 Old Mt Ho
Charlotte
Land O'Lakes -
Land O'Lakes
NCGNE0476
Purina Feeds,
LLC
173 McNess Rd
Statesville
NO -(Wes Bell)
City of Gastonia
NCGNE0480
- Long Creek
WWTP
3000 Long Cree
Dallas
NO -(Wes Bell)
City of Gastonia
NCGNE0461
- Crowders
Creek WWTP
5642 $ York Rd Gastonia
No -(Wes Bell)

Memo
Datoc W712007
To: Storrnwater Permitting Unit
cc Res
Fmm Andy Snft
RE Attachment C
To whom it may concern.
f����odc�fl
SSEP 13 2007
QE - WAfER QUI Ll
wet>ar�ds a Stormweter ,
Upon re-evaluating the Fourth Creek VWVI'P, I am respectfully asking and applying for
the "No Exposure Certification". I received the Certificate of Coverage for this facility on
August 22, 2007. After getting some of the requested infiormatioon together I realized that
everything that we have regarding chemicals and routine operations is under roof.
If you need more information, please contact me.

,/sy
Division of Water Quality / Surface Water Protection
NCDENR National Pollutant Discharge Elimination System
Hic , C „ Dawwpm�� NO EXPOSURE CERTIFICATION for Exclusion
Enwawrt µoHAnm�`�ou� NCGNE0000
NO EXPOSURE CERTIFICATION
National Pollutant Discharge Elimination System application for exclusion from
based on NO EXPOSURE:
FOR AGENCY USE ONLY
Dale Received
Year
I Month
Day
eam of cove-9c
l
/a�-(4! � �j �4i
S61PISOZ.
Aftw PPrn7i ,
Submission of this No Exposure Certirication constitutes notice that your facility does not required
authorization for its stormwater discharges associated with industrial activity in the State of North _'
Carolina because it qualifies for a no exposure exclusion. A condition of no exposure at an industrial
facility means all Industrial materials and activities are protected by a storm resistant shelter (with some
exceptions) 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 with locked or non -operational taps or valves;
adequately maintained vehicles used in material handling; and final products, other than products that
would be mobilized in stormwater discharges (e.g., rock salt).
A No Exposure Certiflication must be provided for each facilitv 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, you certify that a condition of no exposure exists at this facility or site and are
obligated to comply with the terms and conditions of 40 CFR 122.26(g).
You are required to reapply for the No Exposure Exclusion once every five 5 ears.
For questions, please contact the DWQ Regional Office for your area. (See page 5)
(Please print or type)
1) Mailing address of o�wn"[
erloperator (address to which all certification correspondence will be mailed):
Name f , 4V WF��t SU\�\,E• 1-1" cw—eK WwTe
Street Address
City
Telephone No.
2) Location of facility producing discharge:
r, f�
Facility Name q CreK
Facility Contact
(%--1'>0A
Street Address
k93 dom';k"
City
S4101,il
County
EI
Telephone No.
$�$
State a(- ZIP Code T1
Fax:
State KL ZIP Code
Fax: 717 7 S-
Page 1 of 5
SWU-NE-060607 Last revised 06/06/07

NCGNE0000 No Exposure Certification
3) Physical location information:
Please provide a narrative description of how to get to the facility (use strgjet names, state road numbers, and
distance and direction from a roadway intersection). Sep, AAy\�, i
(A copy of a map with the facility clearly located on it should be included with the certification application.)
4) Is the facility located on Native American Lands? ❑ Yes l�o
5) Is this a Federal facility? ❑ Yes O No
6) Latitude?.S' G 36I Longitude 80 q11 (deg, min, sec)
7) This NPDES Permit Application applies to which of the following:
❑ New or Proposed Facility Date operation is to begin
Existing Date operation began
8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes B'IQo
If yes, what is the NPDES Permit Number?
9) Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: Oa— 6— a
10) Provide a brief description of the types of industrial activities and products produced at this facility:
S l S a W UY — O. S a� Cb� C.�.
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
❑ No
eroYes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
Exposure Checklists (12. - 14.)
12) Are any of the following materials or activities exposed to precipitation, now or in the foreseeable
future? (Please check either "Yes" or "No.") If you answer "Yes" to any of these items, you are not
eligible for the no exposure exclusion.
a. Using, storing, or cleaning industrial machinery or equipment, and areas where
residuals from using, storing or cleaning industrial machinery or equipment remain
and are exposed to stormwater
b. Materials or residuals on the ground or in stormwater inlets from spills/leaks
c. Materials or products from past industrial activity
d. Material handling equipment (except adequately maintained vehicles)
e. Materials or products during loading/unloading or transporting activities
f. Materials or products stored outdoors (except final products intended for outside
use [e.g., new cars] where exposure to stormwater does not result in the discharge
of pollutants)
Page 2 of 5
SWU-NE-060607
❑ Yes
Ir No
❑ Yes
2-lqo-
❑ Yes
U-Na`
© Yes
❑ Yes
2-lCo
❑ Yes
Last revised
06/06/07

NCGNE0000 No Exposure Certification
g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks,
❑ Yes
2'No
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by
❑ Yes
211
the discharger
i. Waste material (except waste in covered, non -leaking containers (e.g., dumpsters])
❑ Yes
21q-0
j. Application or disposal of process wastewater (unless otherwise permitted)
❑ Yes
8'No
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not
❑ Yes
01�0-
otherwise regulated (i.e., under an air quality control permit) and evident in the
stonnwater outflow
I. Empty containers that previously contained materials that are not properly stored
© Yes
041
. (i.e., not closed and stored upside down to prevent precipitation accumulation)
m. For any exterior ASTs, as well as drums, barrels, tanks, and similar containers
0 Yes
Olio
stored outside, has the facility had any releases in the past three (3) years?
13) Above Ground Storage Tanks (ASTs): If you answer "No" to any of the following items, you are not
eligible for the no exposure exclusion.
a. Are exterior ASTs or piping free of rust, damaged or weathered coating, pits, or i Yes ❑ No
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any eYes ❑ No
cracks, holes, or evidence of leaks, and are drain valves maintained locked shut?
14) Secondary Containment: If you answer "No" to any of the following items, you are not eligible for the
no exposure exclusion.
a. Is secondary containment provided for single above ground storage containers
(including drams, barrels, etc.) with a capacity of more than 660-gallons?
b. Is secondary containment provided for above ground storage containers stored
in close proximity to each other with a combined capacity of more than 1,320-
gallons?
c. Are release valves on all secondary containment structures locked?
CTYes ❑ No
PSYes ❑ No
Page 3 of 5
SWU-NE-060607 Last revised 06/06/07

NCGNE0000 No Exposure Certification
15) Hazardous Waste:
a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? ❑ Yes -o
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste ❑ Yes ;'No
generated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste ❑ Yes Ja'No
generated per month) of hazardous waste?
If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste:
How is material stored:
Where is material stored:
How many disposal shipments per year:
Name of transport 1 disposal vendor:
Vendor address:
16) Certification:
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 stormwater permitting.
I certify under penalty of law that there are no discharges of stormwater 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 ave[y five (5,)_years to the North Carolina
Division of Water Quality 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 North Carolina Division of Water
Quality, 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.
In the event that the site no longer qualifies for a No Exposure Exclusion, I understand that I must obtain coverage under
an NPDES permit prior to any point source discharge of stormwater 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 property 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.
I certify that I am familiar with the information contained in this application and that to the best of my knowledge and
belief such information is true, complete, and accurate.
Please note: This application for the No Exposure Exclusion is subject to approval by the
NCDENR Regional Office prior to issuance. The Regional Office may inspect your facility for
compliance with no exposure conditions prior to that approval. The Regional Office may also
inspect your facility at any time in the future for compliance with the No Exposure Exclusion.
Page 4 of 5
SWU-NE-060607 Last revised 06IM07

NCGNEOOOO No Exposure Certification
North Carolina General Statute 143-215.6 B(l) provides that:
Any person who knowingly makes airy false statement, representation, or certification in any apprication, record, report, plan, or other
document filed or required to be maintained under this Article or a rule implementing this Article; or who knowingly makes a false
statement of a material fact In a rulemaking proceeding or contested case under this Article; or who falsifies, tampers with, or knowingly
renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
[Environmental Management] Commission implementing this Article shall be guilty of a Gass 2 misdemeanor which may include a fine
not to exceed ten thousand dollars ($10,000).
There is currently no fee for a No Exposure Exclusion.
Final Checklist
This application should Include the following items:
This completed application and all supporting documentation.
A map with the location of the facility clearly marked.
Mail the entire package to:
Storrnwater Permitting Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Note
The submission of this document does not guarantee the Issuance of a No Exposure Exclusion.
For questions, please contact the DWQ Regional Office for your area.
DWQ Regional Office Contact Information:
Asheville Office......
(828) 2964500
Fayetteville Office ...
[phone]
Mooresville Office...
[phone]
Raleigh Office ........
[phone]
Washington Office ...
[phone]
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........
[phone]
Page 5 of 5
SWU-NE-050607 Last revised 06/06/07

Directions to STATESVILLE, NC
Page I of 1
Directions to STATESVILLE, NC
Summary and Notes
START P MOORESVILLE, NC
FINISH P 693 Bell Farm Rd, STATESVILLE, NC
f-GL G r Kw i
Total Distance: 20.5 miles, Total Time:
25 mins (approx.) i
LOCAL
Map!
Add your notes here...
I {
yistance
LUMLIWIVe
P MOORESVILLE, NC
1. Starting in MOORESVILLE, NC on W IREDELL AVE
go < 0.1 mi
< 0.3- mi
2- Turn on N BROAD ST(NC-115)
go 0.3 mi
0.3 mi
3- Turn on W MCLELLAND AVE(NC-152)
go 0.9 mi
1.2 mi
4. Bear on HIGHWAY 150 W(NC-150)
go 0.3 mi
1.5 mi
5. Continue to follow NC-150
go 1.5 mi
3 mi
6. Turn Q to take ramp onto 1-77 N
go 12.5 mi
15.5 mi
I 7- Take exit #49AIG BAGNAL BOULEVARD onto E GARNER
go 0.5 mi
16 mi
BAGNAL BLVD(US-70) toward US-70 E
I 8. Continue to follow US-70
go 2.7 mi
18.7 mi
I 9. Bear 0 on BELL FARM RD
go 1.7 mi
20.4 nZi
10. Arrive at 693 BELL FARM RD, STATESVILLE
I
LP 693 BELL FARM RD, STATESVILLE, NC
Distance: 20.5miles, Time: 25 mins
using any dining directions or map, it's a good idea to do a reality check and make sure the road still exists, watch out for
construction. and follow all traffic safety precautions. This is onty to be used as an aid in planning.
http_//xmll .maps. yahoo .con/pmt.php?v3=0&mvt=m&q2=693 BELL FARM RD, Statesvill... 7/5/2007

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DISCHARGE
STATESVILLE-FOURTH
TREATMENT PLANT
NCO031836
FOURTH CREEK
27:
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Latitude: --ISL4636-
Longitude:
80'47'15"
USGSQuad #:
D15SE
River Basin #:
03-07-06
Receiving Stream:
Fourth Creek -
Stream Class-.
c
Fourth Creek WIY/TP
NCO031836
Irtdeu col-Inty

ATT. B
Non -Discharge Permits
• Permit # WQ0001759 — Surface Disposal/Monofil
• Permit # WQ0006245- N Viro Process
• Permit # WQ0014543- City of Statesville Land Application