NCGNE0472_COMPLETE FILE - HISTORICAL_20090224

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCGNE D(jq
DOC TYPE
❑HISTORICAL FILE
DOC GATE
❑ �CY�S Ua C�
YYYYMMDD

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO. /V CCU
DOC TYPE I HISTORICAL FILE
I
f DOC DATE
MONITORING REPORTS
YYYYM M DD

NCDENR
North Carolina Department of Environment and Natural-Ressourcesm -'
Division of Water Quality ., ; .
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director FEB 2u19Secretary
February 16, 2009
Mr. Gerald Patton 4,�,
The Pepsi Bottling Group, Inc. D�ilQ-j
�+ I"�iii±lion
5047 Hwy 24-27 E.
Midland, NC 28107
Subject: No -Exposure Certification NCGNE0472
The Pepsi Bottling Group, Inc.
5047 Hwy 24-27 E., Midland NC
Cabarrus County
Dear Mr. Patton:
The Division has reviewed your submittal of the No -Exposure Certification for Exclusion from NPDES Stormwater
Permitting form. Based on your submittal and signed certification of no exposure at the above referenced facility, the
Division is granting your conditional exclusion from permitting as provided for under 40 CFR 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 (February 20, 2014). At that time you must re -certify with the Division, or obtain NPDES permit
coverage for any stormwater discharges from your facility.
Your conditional exclusion from permitting 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 Brian Lowther at [phone], or at
[e-mail]. .
Sincerely,
for Coleen H. Sullins
cc: Mooresville Regional Office
Stormwater Permitting Unit No, Exposure Files
Fran McPherson -Budget Office
Wetlands and Stormwater Branch . One
1617 Mail Service Center, Raleigh, Norih Carolina 27699-1617 NorthCarolina
Location: 512 N, Salisbury St. Raleigh, North Carolina 27604 r
Phone: [phone] FAX: [phone] I Customer Service: 1-877-623-6748 Aw rl lly
Internet: www.ncwalerquality.org U
An Fmia10nnnrturif0 Alfirmafive Arfinn Fmnlnvar

NC®ENR
North Carolina Department of Environtent and Natural Resources.
Beverly Eaves Perdue
Governor
Mr. Gerald Patton
The Pepsi Bottling Group, Inc.
5047 Hwy 24-27 E.
Midland, NC 28107
Dear Mr. Patton:
Division of Water Quality
Coleen H. Sullins
Director
February 16, 2009
Subject: No -Exposure Certification NCGNE0472
The Pepsi Bottling Group, Inc.
5047 Hwy 24-27 E., Midland NC
Cabarrus County
Dee Freeman
Secretary
The Division has reviewed your submittal of the No -Exposure Certification for Exclusion from NPDES Stormwater
Permitting form. Based on your submittal and signed certification of no exposure at the above referenced facility, the
Division is granting your conditional exclusion from permitting as provided for under 40 CFR 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 mairitain 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 (February 20, 2014). At that time you must re -certify with the Division, or obtain NPDES permit
coverage for any stormwater discharges from your facility.
Your conditional exclusion from permitting 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 Brian Lowther at [phone], or at
[e-mail]. .
Sincerely,
ORIGINAL SIGNED BY
KEN PICKLE
for Coleen H. Sullins
cc: Mooresville Regional Office
Stormwater Permitting Unit No, Exposure Files
Fran McPherson -Budget Office
Wetlands and Slormwater Branch One 1
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 ' NOI h Car01 i n a
Location: 512 N. Salisbury St, Raleigh, North Carolina 27604 � �a��`��`I�
Phone: [phone] FAX: 9IM07-64941 Customer Service: 1-877.623-6748
Internet: www,ncwaterqualiry.org
An Fw.11 r]r=Ojinily 1 Alfirmaliv? Antinn Fmnlnvar

:r
4
M(�o
RCDENR
E+wwon tw Iwo Ii,at - ftes es
Division of Water Quality / Surface Water Protection
FOR AGENCY USE ONLY
Date Received
Year
Month
Day
�O
ID 'ficatc*o£ vCCB e
National Pollutant Discharge Elimination System
NO EXPOSURE CERTIFICATION for ExclusionR�
t f
NCGNE0000 -
NO EXPOSURE CERTIFICATION
OCT 2 4 2008
National Pollutant Discharge Elimination System application for exclusion from a Stormwater Permit
based on NO EXPOSURE:
Submission of this No Exposure Certification constitutes notice that your �l�l� does not. require � �miF z �
authorization for Its stormwater discharges associated with industrial activity 1n the State of North, > : Uic . ion
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 produces
would be mobilized in stormwater discharges (e.g., rock salt}. 1s
A No Exposure Certification must be provided for each facility qualifying for the no exposure ex
'Jo7n<::),In
addition, the exclusion from NPDES permitting Is available on a facility -wide basis only=not
Individual outfalls. If any Industrial activities or materials are, or will be, exposed to precipitatiofacility
Is not eligible for the no exposure exclusion. By signing and submitting this No Exposu
Certification form, you certify that a condition of no exposure exists at this facility or site and ar
g
�,
obligated to comply with the terms and conditions of 40 CFR 122.26(g).
o
You are reauired to reauDly for the No Exoosure Exclusion once every five (5) v
For questions, please contact the DWQ Regional Office for your area. (See page 5)
(Please print or type)
I ) Mailing address of ownerloperator (address to which all certification correspondence will be mailed):
Name The Pepsi Bottling Group Inc.
Street Address 5047 Hwy 24-27 E .
City Midland State NC ZIP Code 28107
Telephone No. 704 888-3800 Fax: [phone]
2) Location of facility producing discharge:
Facility Name The Pepsi Bottling Group Inc.
Facility Contact Gerald Patton- -
Street Address 5047 Hwy 2 4- 2 7 E.
City Midland State NC ZIP Code 28107
County Cabarrus -
Telephone No. 704 888-3800 Fax: [phone]
Page 1 of 5
SWU-NE-060607 Last revised 06/06/07

C
4
NCGNE0000 No Exposure Certification
3) Physical location information:
Please provide a narrative description of how to get to the facility (use street names, state road numbers, and
distance and direction from a roadway intersection). I" 485 S.. to Exit 41
east approximately 10 miles and the facility is on the left
(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 N No
5) Is this a Federal facility? ❑ Yes N No
6) Latitude 080 29 1 3. 6 Cokbitude . 15 1 4. 51 (Ueg, min, sec)
7) This NPDES Permit Application applies to which of the following;
❑ New or Proposed Facility
3 Existing
Date operation is to begin
Date operation began 1987
8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes KI No
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: 5 1 4 9
10) Provide a brief description of the types of industrial activities and products produced at this facility:
Beverage Distribution Facility
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
IX No
❑ Yes.
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
❑ Yes KI No
❑ Yes )p No
❑ Yes )€] No
❑ Yes )d No
❑ Yes )V No
❑ Yes )IP No
SWU-NE-060607
Last revised 06/06/07

"r
NCGNE0000 No Exposure Certification
g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, ❑ Yes -Z No
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes E No
the discharger
i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters]) ❑ Yes Z No
j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes 50 No
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes l No
otherwise regulated (i.e., under an air quality control permit) and evident in the
stormwater outflow
I. Empty containers that previously contained materials that are not properly stored ❑ Yes 1 No.
(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 ❑ Yes Z No
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 =:X Yes ❑ No
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any Yes ❑ 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 drums, 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?
R Yes © No
IR Yes ❑ No
[A Yes ❑ No
5WU-NE-060607
Page 3 of 5
Last revised 06106/07

NCGNE0000 No Exposure Certification
15) Hazardous Waste:
a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? ❑ Yes J0 No
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste ❑ Yes K] No
generated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste ❑ Yes 11 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.
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 every 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 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.
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.
Printed Name of Person Signing: Gerald Patton
Title: Unit Sales Manager
(Signature of Applicant)
10 9 07
(Date Signed)
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 06/06/07

NCGNEOQ00 No Exposure Certification
North Carolina General Statute 143-215.6 B(i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, 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 Class 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:
Stormwater 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 D WQ Regional Office for your area.
DWQ Regional Office Contact Information:
Asheville Office ......
(828) 2964500
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
(919) 7914200
Washington Office ...(252)
946-6481
Wilmington Office ...
[phone]
Winston-Salem _....
[phone]
Central Office .........(919)
733-5083
Page 5 of 5
SWU-NE-060607 Last revised 06/06/07

NC OneMap Viewer Page 1 of 1
http://gisdata.usgs.net/website/NC_OneMap/viewer.asp 10/9/2007

AL Division of Water Quality / Surface Water Protection
�As
NCDENRNational Pollutant Discharge Elimination System
NORT. Gaouw DEPw�ewO NO EXPOSURE CERTIFICATION for Exclusion
E�vwo. E. -o Nm -Roa> m NCGNE0000
NO EXPOSURE CERTIFICATION
FOR AGENCY USE ONLY
Date Received
Year Month
Day
/Q
Certificate of Coverage
National Pollutant Discharge Elimination System application for exclusion from a Stormwater Permit
based on NO EXPOSURE:
Submission of this No Exposure Certification constitutes notice that your facility does not require permit
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 fhat_ __
would be mobilized In stormwater discharges (e.g., rock salt). Is
A No Exposure Certification must be provided for each facility qualifying for the no exposure a on fl
In addition, the exclusion from NPDES permitting is available on a facility -wide basis onl�--not c-
Individual outfalls. If any industrial activities or materials are, or will be, exposed to precipitatio
facility Is not eligible for the no exposure exclusion. By signing and submitting this No Exposur
Certification form, you certify that a condition of no exposure exists at this facility or site and ar g v
obligated to comply with the terms and conditions of 40 CFR 122.26(g). o
ti L1lKJ
V.... ..... ....-....—A ♦.. .........1.. L... •L.— L1.. C-............ C-.wl....:w� �-..... ......�.. i....- !t1 _
For questions, please contact the DWQ Regional Office for your area. (See page 5)
(Please print or type)
1) Mailing address of owner/operator (address to which all certification correspondence will be mailed):
Name The Pepsi Bottling Group Inc.
Street Address 5047 Hwy 24-27 E .
C ity
Telephone No.
Midland State NC ZIP Code 28107
704 888-3800 Fax: [phone]
2) Location of facility producing discharge:
Facility Name
Facility Contact
Street Address
City
County
Telephone No.
The Pepsi Bottling Group Inc.
Gerald Patton
5047 Hwy 24-27 E.
Midland State NC ZIP Code 28107
Cabarrus
704 888-3800 Fax: [phone]
Page 1 of 5
SWU-NE-060607 Last revised 06/06107

NCGNE0000 No Exposure Certification
3) Physical location information:
Please provide a narrative description of how to get to the facility (use street names, state road numbers, and
distance and direction from a roadway intersection). I'"'485 S . to Exit 41
east approximately 10 miles and the facility is on the lett
(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 X No
5) Is this a Federal facility? ❑ Yes K No
080 29 13.6
6) Latitude f-okgitude 35 15 14.51(geg, min, sec)
7) This NPDES Permit Application applies to which of the following:
❑ New or Proposed Facility Date operation is to begin
IX Existing Date operation began 1987
v
8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes X1 No
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: 5 1 4 9
10) Provide a brief description of the types of industrial activities and products produced at this facility:
Beverage Distribution Facility
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
IX No
❑ Yes
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)
❑ Yes X1 No
❑ Yes )CI No
❑ Yes )] No
❑ Yes X1 No
❑ Yes G No
❑ Yes )] No
Page 2of5
SWU-NE-060607 Last revised 06/06/07

t t
1
NCGNE0000 No Exposure Certification
g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, ❑ Yes ,Xl No
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes EI No
the discharger
i. Waste material (except waste in covered, non -leaking containers (e.g., dumpsters]) ❑ Yes E No
j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes §7 No
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes I No
otherwise regulated (i.e., under an air quality control permit) and evident in the
stormwater outflow
I. Empty containers that previously contained materials that are not properly stored ❑ Yes 7 No
(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 ❑ Yes] No
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 N Yes ❑ No
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any Yes ❑ 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 drums, 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?
R Yes ❑ No
IX Yes ❑ No
IR Yes ❑ No
SWU-NE-060607
Page 3 of 5
Last revised 06/06/07

NCGNEOOOO No Exposure Certification
15) Hazardous Waste:
a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? ❑ Yes J0 No
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste © Yes �D No
generated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste ❑ Yes 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 / 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 every 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 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.
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.
Printed Name of Person Signing: Gerald Patton
Title: Unit Sales Manager
(Signature of Applicant)
10 9 07
(Date Signed)
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 4of5
SWU-NE-060607 Last revised 06/06/07

NCGNE0000 No Exposure Certification
North Carolina General Statute 143-215.6 B(i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan, or other
document fled 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 Class 2 misdemeanor which may include a fine
not to exceed ten thousand dollars ($10,000).
There is currently no fee fora 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:
Stormwater 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 D WQ Regional Office for your area.
DWQ Regional Office Contact Information:
Asheville Office ......
(828) 2964500
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
(919) 7914200
Washington Office ...(252)
946-6481
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........
[phone]
Page 5 of 5
SWU-NE-060607 Last revised 06/06/07

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VG Co-ordinate: 17SNV4654901430
Latitude: 35 15 17.62 N Longitude: 080 29 17.88 W
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Page 1 of 1
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Scale - 1:422,205
ayers
Location -
Geodetic
Structures
Transportation
Cadastral
Boundaries
Hydrography
Utility -Telecom
Economy
Health
Environment
Socio-
Demographic
Bio-Habitat
Geophysical
Weather
Land Cover
Imagery-
Basemap
In
10/9/2007
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AddressFacility
Green Fiber
1007 Amble Dr
Charlotte
Guard
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Gd- Belmont
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Gastonia
2100 :.. 1 ...
Gastoila
NCGNE0511
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Statesville
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Hd Supply - HID.1693
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Bottling Group
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Bottling Group,
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Inc.
50.
Midland
O-Ar
City of
NCGNE0466
Inc - Jack S.
NCGNE0467 Kelley -
Charlotte
6108 Old Mt HojChartotte
Land O'Lakes -
Land O'Lakes
NCGNE0476
Purina Feeds,
LLC
173 McNess R
'Statesville
NO -(Wes Bell)
City cf Gastonia
NCGNE0480
- Long Creek
WWTP
3000 Long Cret Gallas
No -(Wes Bell)
City of Gastonia
NCGNE0481
- Crowders
Creek WWTP
5642 5 York R .Gastonia
NO -(Wes Bell)