NCGNE0481_COMPLETE FILE - HISTORICAL_20090220

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCGNE Co� t I
DOC TYPE
HISTORICAL FILE
DOC DATE
❑ Q lgo 9 D &- '-�-o
YYYYMMDD

ANN WaA
.A.E.0
MCDENR
North Carolina Department of Environment and Na al Rvso ces
Division of Water Quality :
Beverly Eaves Perdue Coleen H. Sullins De�e"'Fkee n
Governor Director "F �" Secret
February 20, 2009 FED 2 4 2008
Mr. Joseph E. Bieker
City of Gastonia Dl -Surface, watt-f prolac�j1an
PO Box 1748
Gastonia, NC 28053-1748
Subject: Denial of No -Exposure Certification NCGNE0481
Crowders Creek WWTP
5652 York Hwy., Gastonia, NC 28052
Gaston County
Dear Mr. Bieker:
The Division has reviewed your submittal of the No Exposure Certification for Exclusion from NPDES Stormwater
Permitting form, which we received on November 16, 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.
It you have any questions or need further information, please contact Robert Patterson at [phone], or through
email at [e-mail].
Sincerely,
4 1,261&
for Coleen H. Sullins
cc: Mooresville Regional Office -Michael Parker
Stormwater Permitting Unit Files
NCG110055 Permit File
Wetlands and Stormwater Bran& One
1617 Mail Service Center, Ralegh, North Caraiina 27699-1617 NorthCarolina
Phone:
5-8 N. Salisbury St. Raleigh, Nor494 \ Carolina 27e04 ;Vatma rly
Phone: 919�07-6300 4 FAX: 919�D7-64941 Customer Service: 1-877-623-6748 I�i s/
Internet: www.ncwaterquality.org
An Eoual O000rtunity 4 Affirmative Action Emolover

Permit I Facility
Number Name - Facility Address Facility City
NCGNE0236 Green Fiber -
Green Fiber 1007 Amble Dr Charlotte No -(Dee Browder)
N C National
NC
GNE0376 and
- NC Nat
Gd- Belmont �300 N 6th St Belmont
N C National
NCGNE0389 Guard - NC Nat
Gd- Gastonia 2100 Robinwoo Gastonia
Phi * >
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-�¢ �$ ,?. di} �»jn¢ 1' yR:.-0 •r+v fk.T '�a'''Y FPk 'R ra. 9 K� 'X!o.� �.Y:r-•�S'' cry'.•
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The Pepsi
x Ate" t� '.1 SSA, J
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Bottling Group
a
NCGNE0.
The Pepsi
Bottling Group,
KA pvt it#<.{ L ••f P'''",4..'ty 5 .%%"'i` r1 S .b 9y 4F'¢`�)x.-�,�'�? yin •`r t +`
i'
f •
w i i. �x R tw: __s: r $L •. bg :', a �.. °:�. $ ] .tu
'kit—Y Of
NCGNE0465
Eek
WWTP
593 Bell Farm
Inc - Jack B.
NCGNE0467
Kelley -
Charlotte
RKP)
Terminal
6108 Old Mt Ho
Charlotte
Land O'Lakes -
NCGNE0476
Land O'Lakes
Purina Feeds,
LLC
173 McNess R Statesville
No -(Wes Bell)
City of Gastonia
NCGNE0480
- Long Creek
WWTP
3000 Long Cree Dallas
No-(WeS Bell)
City of Gastonia
-
NCGNE0481
- Crowders
Creek WWTP
5642 S York Rd. Gastonia
No -(Wes Bell)

%/Sy
Division of Water Quality / Surface Water Protection
NCDENRNational Pollutant Discharge Elimination System
Nom.0 Fo IW OFP -E_of NO EXPOSURE CERTIFICATION for Exclusion
E—nor e— —D NRL4AL RCbIX1RCE!
NCGNE0000
NO EXPOSURE CERTIFICATION
FOR AGENCY USE ONLY
Date Received
Year
I Month
Da
i
Certificate of Coverage
NICIGINUoTKEE
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 that
would be mobilized in stormwater 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 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) years.
For questions, please contact the DWQ Regional Office for your area. (See page 5)
(Please print or type)
1) Mailing address of ownerloperator (address to which all certification correspondence will be mailed):
2)
Name Lh¢e.g -vi. (:,:,j .,%N
Street Address r' , r-r cx GA9TaNIA
City
Telephone No.
State All (, ZIP Code ZW�S T — / 14A
Fax:
Location of facility producing discharge:
Facility Name Ci WOC_QS C.g€ Ae- 'PLANT
Facility Contact _ �oa A. TA&E-
Street Address 66 _5E ae-u- RWY
City
County
Telephone No.
Page 1 of 5
State. 61C, ZIP Code 7f6a5Z_
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 facili (use street names, state rid numb rs, and
distance and direction from a roadway intersection). F] r% L8~Ai ors TdRJ►J /Zl f ITT ".4o
ex4 17 63 05341 ; to :IauT4 C;D2 a-T—Wex q/r gvt;{es. ?Iam- It&i�r ;,..���al�l
(A copy of a map with the facility clearly located on it should be included with the certification application.) <j0UiL. A
4) Is the facility located on Native American ands? ❑ Yes L No Grwfc..
5) Is this a Federal facility? Ci Yes Cd No
6) Latitude 'c 6 Id 00"'
Al Longitude !R 10
111 64" w (deg, min, sec)
7) This NPDES Permit Application applies to which of the following:
❑/ New or Proposed Facility Date operation is to begin
rs� Existing Date operation began
_ lllqgz-
8) Was this facility or site ever covered under an NPDES Stormwater Permit? Yes ❑ No
If yes, what is the NPDES Permit Number?_ �a G_i i w
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: -1 Z-
10) Provide a brief description of the types of industrial activities and products produced at this facility:
V"ttj n1ti C,L'?AL OASt WATIEr— T-1LC.a~r m fhW -
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
VN o
❑ 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 spillstleaks
c. Materials or products from past industrial activity
d. Material handling equipment (except adequately maintained vehicles)
e. Materials or products during loadinglunloading 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 VNo
❑ Yes VINO
❑ Yes VNo
❑ Yes ®No
❑ Yes VNo
❑ Yes iNo
Page 2 of 5
SWU-NE-060607
Last revised 06/06/07

NCGNE0000 No Exposure Certification
g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, ❑ Yes [9 No
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes C� No
the discharger
i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters]) ❑ Yes ®No
j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes ICJ No
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes iN 0
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 CN'N0
(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 VN 0
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 /Yes ❑ No
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any Yes El 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?
M Yes ❑ No
/Yes ❑ No
Yes ❑ 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 I/No
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 ®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:
Now 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 eve five 5 ears 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 l 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: �oS1v
Title: S-rbe- AMATM 1Lt'TY A
Tl tclicf,r-
Signed)
7
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

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 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
Thi 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 DWQ Regional Office for your area.
DWQ Regional Office Contact Information:
Asheville Office ......
[phone]
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-060607 Last revised 06/06/07

Division of Water Quality / Surface Water Protection
NCDENRNational Pollutant Discharge Elimination System
N C-, i­ DVW E-cW NO EXPOSURE CERTIFICATION for Exclusion
�+v..oeiME+r Iwo rt..n/wi REs Ces
NCGNE0000
NO EXPOSURE CERTIFICATION
FOR AGENCY USE ONLY
Date Received
Yea
ont7hj
Day
Certificate of Coverage
NCGNE
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 that
would be mobilized in stormwater 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 facilit - asrs-o for
individual outfalls. If any industrial activities or materials are, or w' a xp so ed to precipitat►o ,ft
facility is not eligible for the no exposure exclusion. By signing an sir miffing this No Ex re
Certification form, you certify that a condition of no exposure exists -this facilit or 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 ever lLfi_v_e (5) years.
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
Street Address
City State
Telephone No. Fax:
2) Location of facility producing discharge:
Facility Name
Facility Contact
Street Address
City
County
Telephone No.
ZIP Code
�X- ("L �j LKr p
State ZIP Code _
Fax:
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 street names, state road numbers, and
distance and direction from a roadway intersection).
(A copy of a map with the facility clearly located on it should be included with the certification application.)
Ca 4) Is the facility located on Native American nds? ❑ Yes ' No
5) Is this a Federal facility? ❑ Yes No
6) Latitude Longitude (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 ❑ 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:
10) Provide a brief description of the types of industrial activities and products produced at this facility:
11) Do s this facility have any Non -Discharge permits (ex: recycle permits)?
ZL4i N o
❑ 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 ❑Yes l�lid
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 ❑ Yes /Oz
c. Materials or products from past industrial activity ❑ Yes
d. Material handling equipment (except adequately maintained vehicles) ❑ Yes L�1
/�
Iv' Materials or products during loading/unloading or transporting activities ❑ Yes
f. Materials or products stored outdoors (except final products intended for outside ❑ Yes 5d t
use [e.g., new cars] where exposure to stormwater does not result in the discharge
of pollutants)
Page 2 of 5
5WU-NE-060607 last revised 06/06/07

NCGNE0000 No Exposure Certification
/Mo/
g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks,
❑ Yes
and similar containers
/
/lib
h. Materials or products handled/stored on roads or railways owned or maintained by
❑ Yes
the discharger
i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters])
❑ Yes
j. Application or disposal of process wastewater (unless otherwise permitted)
❑ Yes
IYo
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not
❑ Yes
otherwise regulated (i.e., under an air quality control permit) and evident in the
stormwater outflow
1. Empty containers that previously contained materials that are not properly stored
0 Yes
(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
2/V
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 a not
eligible for the no exposure exclusion.
a. Are exterior ASTs or piping free of rust, damaged or weathered coating, pits, or l� es ❑ boo
\deterioration, or evidence of leaks?
s secondary containment provided for all exterior ASTs? If so, is it free of any f?� e ❑ No
U cracks holes or evidence of leaks and are drain valves maintained to k
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 iis ❑ No
(including drums, barrels, etc.) with a capacity of more than 660-gallons?
b. Is secondary containment provided for above ground storage containers stored Y s ❑ No
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? Vyes ❑ 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? I] Yes o
).generated
s this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste 2
I 'No per month) of hazardous waste? Ca ,`�'_� . ti a�i c>,- {
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste ❑ es.
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 i 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 eve five 5 ears 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:
Title:
(Signature of Applicant)
(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

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 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 (S10,000).
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 DWQ Regional Office for your area.
DWQ Regional Office Contact Information:
Asheville Office ......
[phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
[phone]
Washington Office ...(252)
946-6481
Wilmington Office_
[phone]
Winston-Salem ......
[phone]
Central Office .........
[phone]
Page 5 of 5
5WU-NE-060607 Last revised 06/06/07

e warF
0 90� Permit Coverage
2
a Rescission Request Form
.1
National Pollutant Discharge Elimination System
General Permit NCG110000
Certificate of Coverage Number
NCG11005&
. S
Please fill out and return this form galy if you no longer need to maintain your NPDES stormwater permit.
The following is the information currently in our database for your facility. Please review this information carefully and
make all corrections as necessary in the space provided to the right of the current information.
Facility Contact Information
Facility Name:
Facility Physical Address:
Facility Contact:
Mailing Address:
Phone Number:
Fax Number
Email Address
Owner Affiliation Information
Owner / Organization Name:
Owner Contact:
Mailing Address:
Phone Number:
Fax Number:
E-mail address:
Long Creek WWTP
3000 Long Creek Disposal Plant Rd
Dallas, NC 28034
David Vance Morgan
5642 S York Rd
Gastonia, NC 28054
704-854-6655 Ext.
&A-jTO*J i A LS657-
�� E_
704-866-9405
* Resclssion notice will be mailed to the owner address
City of Gastonia
Danny O'Crew C.A�KY �� C.��rsc-g
PO Box 1748
Gastonia, NC 280531748
704-866-6896 Ext. Z54 46G 8
Reason.for rescci^ ion request (This is required information. Attach separate sheet if necessary):
xrol i E u nin6J "_ >- %r u, n-rt oAf uN o.0- v Ak,6 NIr
REQUEST AND CERTIFICATION
I, as an authorized representative, hereby request rescission of certificate of coverage NCGI10056 under NPDES
Stormwater General Permit NCG110000 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
v �5 E, �s
or.type name of person signing above
Date
J_raRpt
Title
Please return this completed rescission request form to: SW General Permit Coverage Rescission
Stormwater Permitting Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

Sal, 6
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(!A'STONIANc —
Great Plate. Great People. Great Promise.
ENGINEERING DEPARTMENT STORMWATER SERVICES DIVISION
Novemhcr. 13, 2007
Bradle<< Bennett Fallorth Carolina Department of Environmentand Namral Resources NOV �aa7
DIArlsion of Water Quafir ; , :
pEN - `
V. Stormwater Permirring Unit WA RQUPL-I
1617 i\-Iad Service Center rmwaterara ncti ,
Wetlands � �
Raleigh, NC 27699-1 G 17
Re: Crowders Creek Waste Water Treatment Plant
Dear it-Ir. Bennett:
Enclosed please find the City's application and certification for No Exposure under NCGNEOOOO for
this facility. We have additionally enclosed the request fonn for the rescission of General Pennit
NCG110055. We hope you will find even'tlung in order. Should Vrou have further questions in regard to
rhis matter, or require additional information, please feel free to call me at [phone].
Sincerch ,
/ph h. Bicker, PE
rmwarer Utility- Administrator
c: lames M. 13alcnick: City- Manager
1. Philip Bombardier, 111; ,lssistant City ,\];imager (Operations)
helix A. Pruitt, P1.S, I'E.: Director of I:ng; iecring / Cite h.ngineer (w/cnc.)
\[atrhew \\'. Jordan, I'13: Director Public \Vorks / Public Utilitic: (u&/ene.)
[.arn, W. Cummings: \C'astewater Treatment Divisiun \tanager (w/etc)
Nktrt P., 13ckcrr, Fmvlronmeriral llarugemcm Svsterrra Coordinator (%r/enc.)
Datvid B. Shcllenharger. Assim-mit Manager Compliance \V\V I-D (w/enc.)
Jon A. Nage: Senior Mara Operator (Nv/enc.)
I'O Box 1.748 GASTONIA, NC 28053-1748
WWW.CITYOhGA5TONIA.COA4
I I / 1 3 / 2 0 0 7 1:vG6 1 tlr 1

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