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NCGNE0793_COMPLETE FILE - HISTORICAL_20160715
STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. NCGNE i DOC TYPE ❑HISTORICAL FILE DOC DATE ❑ YYYYMMDD vaVtEo �q3 -aa;ve- Division of Energy, Mineral and Land Resources Land Quality Section National Pollutant Discharge Elimination System NO EXPOSURE CERTIFICATION for Exclusion Energy. Mineral NCGNE0000 and Land Resources ENVIRONMENTAL OUALITY ONi.Dayrage M National Pollutant Discharge Elimination System application for exclusion from a Stormwater Permit based on NO EXPOSURE: Submission of this No Exposure Certification constitutes notification that your facility does not require a permit for 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. For permitted facilities in North Carolina, DEMLR must approve your application for No Exposure Certification before this exclusion is effective. Until you are issued a No Exposure Certification and your NPDES permit is rescinded, your facility must continue to abide by the terms and conditions of the current permit. 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). If approved, your conditional no -exposure exclusion must be self re -certified at least annually. Please see information here: httg:Hportal.ncdenr.org/web/ir/npdes-stormwater For questions, please contact the DEMLR Regional Office for your area. (See page 6) (Please print or type) 1I) Mailing address of ownerloperator (address to which all certification correspondence will be mailed): Name Multiwall Packaging Contact Raul Lio Street Address 615 Industrial Ave. City Salisbury State NC ZIP Code 28144 Telephone No. 704- 633-5151 Fax: 704-633-2858 RECEIVED Page 1 of 7 JUL 15 2016 DENR-LAND QUALITY SWU-NCGNE STORMWATER FLastyrevised 112512016 NCGNE0000 No Exposure Certification 2) Location of facility producing discharge: Facility Name Multiwall Packaging Facility Contact Raul Lio Street Address 615 Industrial Ave City Salisbury State NC ZIP Code 28144 County Rowan Telephone No. 704-633-5151 Fax: 704-633-2858 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)..25 miles from intersection of Jake Alexander Blvd. and Industrial Ave in Salisbury, NC (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 19/No 5) Is this a Federal facility? ❑ Yes N/No 6) Latitude 360 40' 48" Longitude 80' 30' 01" (deg., min., seconds) 7) This NPDES No Exposure Exclusion application applies to which of the following: ❑ New or Proposed Facility Date operation is to begin ZExisting Date operation began1966 l/Renewal of existing No Exposure Certification Certification No.: NCGNE0793 8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes ❑ No If yes, what is the NPDES Permit Number? NCGO50000 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: 2 6 7 9 10) Provide a brief description of the types of industrial activities and products produced at this facility: Corrugated Packaging Material - Paper 11) Does this facility have any Non -Discharge permits (ex: recycle permits)? l� No ❑ Yes If yes, list the permit numbers for all current Non -Discharge permits for this facility: Page 2 of 7 SWu-NCGNE Last revised 1/25/2016 NCGNE0000 No Exposure Certification Ex osure 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 2 o ❑ NIA 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 V o ❑ NIA c. Materials or products from past industrial activity ❑ Yes A ❑ NIA d. Material handling equipment (except adequately maintained vehicles) ❑ Yes VNo ❑ NIA e. Materials or products during loadinglunloading or transporting activities ❑ Yes t<o ❑ NIA f. Materials or products stored outdoors (except final products intended for outside ❑ Yes Vl o ❑ NIA use [e.g., new cars] where exposure to stormwater does not result in the discharge of pollutants) g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, ❑ Yes VNo ❑ NIA and similar containers h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes ®'No 177 NIA the discharger i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters]) ❑ Yes A ❑ NIA j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes LKNo ❑ NIA k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes V4o ❑ NIA 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 W o ❑ NIA (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 i/ No ❑ NIA 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 @'NIA deterioration, or evidence of leaks? b. Is secondary containment provided for all exterior ASTs? If so, is it free of any ❑ Yes ❑ No 7</A cracks, holes, or evidence of leaks, and are drain valves maintained locked shut? Page 3 of 7 SWU-NCGNE Last revised 1/25/2016 NCGNE0000 No Exposure Certification 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 ❑ Yes ❑ No W61A (including drums, barrels, etc.) with a capacity of more than 660-gallons? b. Is secondary containment provided for above ground storage containers stored ❑ Yes ❑ No AA in close proximity to each other with a combined capacity of more than 1,320- gallons? c. Is secondary containment provided for Title tlI Section 313 Superfund ❑ Yes ❑ No VNIA Amendments and Reauthorization Act (SARA) water priority chemicals*? d. Is secondary containment provided for hazardous substances** designated in 40 ❑ Yes ❑ No V</A CFR §116? e. Are release valves on all secondary containment structures locked? ❑ Yes ❑ No Lol NIA 15) Hazardous Waste: a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? ❑/Yes IV No ❑ NIA �r b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste Yes © No ❑ N/A generated per month) of hazardous waste? c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste ❑ Yes WK0 ❑ NIA generated per month) of hazardous waste? If you answered yes to questions b. or c., please provide the following information: Type(s) of waste: oil How is material stored: In a 55 -gallon drum on a spill containment pallet Where is material stored: Inside the building How many disposal shipments per year: two 55 gallon drums per year or less Name of transport 1 disposal vendor: Safety — Kleen Inc. Vendor address:2320 Yadkin Ave. Charlotte, NC 28205 Footnotes to Questions 14) c. & d. *Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require secondary containment. However, some exceptions may be made for de minimis amounts of certain substances, and/or other qualifiers, as described in the exemptions from reporting requirements of Title ill SARA 313 in 40 CFR §372.38. **Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require secondary containment. However, some exceptions may be made for amounts less than the Reportable Quantities of the hazardous substances listed in 40 CFR §117.3. Page 4 of 7 SWU-NCGNE Last revised 1/25/2016 NCGNEO00O No Exposure Certification 16) Other information: If you answer "Yes" to any of the following items, you might not be eligible for the no exposure exclusion. A more in-depth evaluation of the site circumstances may be required. a. Does your facility store used, recycled, or otherwise reclaimed pallets outside? ❑ Yes P o ❑ NIA b. Does your facility have coal piles on site? ❑ Yes N4o ❑ NIA c. Does your facility store other fuel sources outside in piles, such as wood chips, ❑ Yes SA ❑ NIA sawdust, etc.? d. Does your facility have air emissions associated with its industrial activity (e.g., ❑ Yes I/No ❑ NIA degreasing operations, plating, painting and metal finishing)? If so, describe the industrial activity: e. If you answered yes to d., are those emissions permitted by an Air Quality Permit? 0 Yes ❑ No V<IA Please specify: f. Please list any other environmental program permits (federal, state, etc.) not specified earlier in this application (such as Hazardous Waste Permits, etc.): Permit: Program: Permit: Program: Permit: Program: Permit: Program: Permit: Program: Permit: Program: Permit: Program: Page 5 of 7 SWU-NCGNE Last revised 1/25/2016 NCGNEOOOO No Exposure Certification 17) 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 t5) 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, 1 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: EHS Manager .. -16 (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. 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 ($10,000), There is currently no fee for a No Exposure Exclusion. Page 6 of 7 SWU-NCGNE Last revised 1/26/2016 NCGNE0000 No Exposure Certification Final Checklist This application should include the following items: This completed application and all supporting documentation. �d A map with the location of the facility clearly marked. © If the site currently has an NPDES Stormwater Permit, be sure to indicate the permit number in Question 8. Mail the entire package to: Stormwater Permitting Unit Program Division of Energy, Mineral and Land Resources 1612 Mail Service Center Raleigh, North Carolina 27699-1612 Note The submission of this document does not guarantee the issuance of a No Exposure Exclusion. For questions, please contact the DEMLR Regional Office for your area. DEMLR Regional Office Contact Information: Asheville Office ...... (828) 2964500 Fayetteville Office ... (910) 433-3300 Mooresville Office ... (704) 663-1699 Raleigh Office ........ (919) 791-4200 Washington Office... (252) 946-6481 Wilmington Office ... (910) 796-7215 Winston-Salem ...... (336) 771-5000 Central Office ......... (919) 807-6300 Page 7 of 7 5WU-NCGNE Last revised 1/25/2016 . lt� T V j r .7c V.— lit 7�7 bF IP 10 JV j 2 eq; L 5', rn-, J z�,j� "" 7jlpwere J X T WSTP j W.• I ;jdLo'W T ' • Sub : j -7� Al. Y A,, VA ;!E1 41 14 A., N Real Reel Corporation M 7 I— j Salisbury nil'c 4 Q. N. L? x M Pol 11 afIon 3I e t i5. Fie.10 Tow h r Z. (W$ ."N or 77 M, N, N -A 5 t M "i j. 7 qg� Yr Latitude: 35040'48" " 30 Longitude: 8011 '01NCG050375 Facility County: Rowan Real Reel Corporation Location Strearn'Class: C Receiving Stream: Grants Creek Stream Index: 12- 110 Sub -basin: 03-0-04 (Yadkin River Basin) NOT ICALIED 7/11/2016 615 Industrial Ave - Google Maps Google Maps 615 industrial Ave Multiwall Packaging £ 1 1� jyF'� I j l�. �.inAy�� A>t ny{yM� mn.sM .•.kr. �.. yr' 4 S S :•.•y e voogie Map data 02016 Google 500 ft }` t ..} 7 rid ?y r` �iy �A• r4 G'3 'i'-t� • Work 615 Industrial Ave Salisbury, NC 28144 https:/Mrww.g000e.comlm aps/placet6l5+lndustri al+Ave,+Salisbury,+N C+2814,V@35.6776834,-80.50236M,l6z/data=!4m5l3m4i lsOx885M57eftk2d2F0x97b&. 112 NCDENR North Carolina Departmient of Environment and Natural Resources Beverly Eaves Perdue Governor Mr, Doug Shelton, Plant Manager Multiwall Packaging 615 Industrial Avenue Salisbury, NC 28144 Dear Mr. Shelton: Givisicn of Water Quality Coleen H. Sullins Director August 23, 2011 Subject: No -Exposure Certification NCGNE0793 PGT Industries — Salisbury Facility Rowan County Dee Freeman Secretary The Division has reviewed your submittal of the No -Exposure Certification form for exclusion from NPDES Stormwater Permitting. Based on your submittal and signed certification of no -exposure at the above referenced facility, and a site visit on August 11, 2011, by Ms. Barbara Sifford with this Office, the Division is granting your conditional exclusion from stormwater permitting as provided for under 40 CFR 122.26(g), which is incorporated by reference in North Carolina regulations. Since your facility has attained no -exposure status, your existing Certificate of Coverage No. NCG050375 is no longer needed and is hereby rescinded. 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. Failure to obtain a No -Exposure exclusion could also subject you to enforcement for an unpermitted stormwater discharge. You must self re -certify your No -Exposure status annually using the included form or obtain NPDES permit coverage for any stormwater discharges from your facility. The annual self re -certification does not need to be submitted to DWQ uniess requested. Please note that 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 Ms. Sifford at (704) 663-1699 or by email at Barbara. Sifford@ncdenr,gov. Sincerely, forColeen H. Sullins cc: Stormwater Permitting Unit No- Exposure Files (Brian Lowther) Fran McPherson, Budget Office Stormwater Permitting File NCG050375 Mooresville Regional Office . Onc Location: 610 East Center Ave., Suite 301 Mooresville, NC 28115 NordiCarolzna Phone: (704) 663-16991 Fax: (704) 663-60401 CoEslomer SeNiGe: 1-877-623-6748 Internet: wvnv.ncwaterqua%,org Compliance Inspection Report Permit: NCC-NE0793 Effective: Expiration: Owner: Itw Multiwall Packaging SOC: Effective: Expiration: Facility: ITW Multiwall Packaging County: Rowan 615 Industrial Ave Region: Mooresville Salisbury NC 28144 Contact Person: Doug Shelton Title: Phone: 704-633-5151 Directions to Facility: System Classifications: Primary ORC: Certification: Phone: Secondary ORC(s): On -Site Representative(s): Related Permits: Inspection Date: 08111/2011' Entry Time: 10:00 AM Exit Time: 11:00 AM Primary Inspector: Barbara Sitford Phone: 704-663-1699 Ext.2196 Secondary Inspector(s): Reason for Inspection: Routine Inspection Type: Compliance Evaluation Permit Inspection Type: Stormwater Discharge, No Exposure Certificate Facility Status: M Compliant ❑ Not Compliant Question Areas: 0 Miscellaneous Questions ® Misc (See attachment summary) CEN North Carolina Department of Environment and Division of +relater Quality Beverly Eaves Perdue Governor Mr. Doug Shelton, Plant Manager Multiwall Packaging 615 Industrial Avenue Salisbury, NC 28144 Dear Mr. Shelton: Coleen N. Sullins Director August 23, 2011 Natural Resources Subject: No -Exposure Certification NCGNE0793 PGT Industries —Salisbury Facility Rowan County Dee Freeman Secretary The Division has reviewed your submittal of the No -Exposure Certification form for exclusion from NPDES Stormwater Permitting. Based on your submittal and signed certification of no -exposure at the above referenced facility, and a site visit on August 11, 2011, by Ms. Barbara Sifford with this Office, the Division' is granting your conditional exclusion from stormwater permitting as provided for under 40 CFR 122.26(g), which is incorporated by reference in North Carolina regulations. Since your facility has attained no -exposure status, your existing Certificate of Coverage No. NCGO50375 is no longer needed and is hereby rescinded. 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. Failure to obtain a No -Exposure exclusion could also subject you to enforcement for an unpermitted stormwater discharge. You must self re -certify your No -Exposure status annually using the included form or obtain NPDES permit coverage for any stormwater discharges from your facility. The annual self re -certification does not need to be submitted to DWQ unless requested. Please note that your conditional exclusion from permitting does not affect your fa iiity's legal requirements to obtain environmental permits that may be required ur.jer other federal, state, or local regulations or ordinances. If you have any questions or need further information, please contact Ms. Sifford at (704) 663-1699 or by email at Barbara,Sifford@ncdenr.gov. Sincerely, for Coleen H. Sullins cc: Stormwater Permitting Unit No- Exposure Files (Brian Lawther) Fran McPherson, Budget Office Stormwater Permitting File NCGO50375 Mocresviiie Regional Office One Location: 610 East Center Ave., Suite 301 P:looresville, NO 28115 N OJ t l Ca Qf lli a Phone: (704) 663 -1699 1 Fax- (704) 6633-60401 Customer Service: 1-877-623-6748 Internet: www.nmalerquality.org Nate f °all y it Compliance Inspection Report Permit: NCGNE0793 Effective: Expiration: Owner: Itw Nlultiwall Packagirg SOC: Effective: Expiration: Facility: IN1 Muitiwall Packaging 615 Industrial Ave County: Bowan Region: Mooresville - Salisbury NC 28144 Contact Person: Doug Shelton Title: Phone: 704-633-5151 Directions to Facility: System Classifications: Primary ORC: Certification: Phone: Secondary ORC(s): On -Site Representative(s): Related Permits: Inspection Date: 0811112011' Ebtry Time: 10:00 AM Exit Time: 11:00 AM Primary Inspector: Barbara Sifford phone: 704-663-1699 Ext.2196 Secondary Inspector(s): Reason for Inspection: Routine Inspection Type: Compliance Evaluation Permit Inspection Type: Stormwater Discharge, No Exposure Certificate Facility Status: ® Compliant ❑ Not Compliant Question Areas: M Miscellaneous Questions 0 Misc (See attachment summary) Page. 1 ApT-WIFAA Division of Water Quality 1 Surface Water Protection NCDENRNational Pollutant Discharge Elimination System �„TH , tom. OF NO EXPOSURE CERTIFICATION for Exclusion FuvsarwFvr� Nuiau.ib^na.xNrn NCGNE0000 FOR AGENCY USF ONLY Date Received Yeu Month Da Certificate of Coverage NICIGINIE1017IR NO EXPOSURE CERTIFICATION Please check here if this is a renewal: ❑ RENEWAL National Pollutant Discharge Elimination System application for exclusion from a Stormwater Permit based on NO EXPOSURE: Submission of this No Exposure Certification constitutes notification that your facility does not require a permit for 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. For permitted facilities in North Carolina, DWQ must approve your application for No Exposure Certification before this exclusion is effective. Until you are issued a No Exposure Certification and your NPDES permit is rescinded, your facility must continue to abide by the terms and conditions of the current permit. 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 6) (Please print or type) 1) Mailing address of owner/operator (address to which all certification correspondence will be mailed): Name -1Tw - MN 140., (1 04C_W-w1;ng Contact U o u G 5 N IELT o N Street Address 6IS Vv%dus-b .a l Ave City 5.4 1,: Sur y. State A/c, ZIP Code z 6 r ti v Telephone No. low 433- 5 F5 / Fax: -?,oy 633 —Faso P=@PM0WP= 0 of Pi JUL 27 2011 S W U-N E-021309 I wetlands a S19rwatef "ncfi I Last revised 2/13/2009 NCGNE0000 No Exposure Certification 2) Location of facility producing discharge: Facility Name r-r W M a I---+a_11 Pa c 44 •, i Facility Contact Street Address a;s' rrduc kr., I A use City _ 15g t, f b u r y State NG ZIP Code r $1 y 4 County _F-o1wa r Telephone No. lay &33- Sfs l Fax: `70Y (.33 - ISTo 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). . z 5 rr.. les ;,, 4-ev ce,4;", a� Take l4leanalcv Alvd cw,d -T^ys+y: Q 1 Ave in :541 j u r,e . N c- (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 9 Na 5) is this a Federal facility? ❑ Yes ffNo 6) Latitude 36*qo'ge" Longitude $D° 3u"o�` (deg., min., seconds) 7) This NPDES No Exposure Exclusion application applies to which of the following: ❑ New or Proposed Facility it Existing Date operation is to begin Date operation began 1 qG6 ❑ Renewal of existing No Exposure Certification Certification No.: NCGNE 8) Was this facility or site ever covered under an NPDES Stormwater Permit? YYes ❑ No If yes, what is the NPDES Permit Number? PJe- dro Seooe juror-) 5a3yS 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: Z- (o 7 9 10) Provide a brief description of the types of industrial activities and products produced at this facility: C,aYru4ait''� CaGt�-ypy! �rLa�tr. Gi - Pb --- -- 11) Does this facility have any Non -Discharge permits (ex: recycle permits)? G'No ❑ Yes It yes, list the permit numbers for all current Non -Discharge permits for this facility: Page 2 of 7 SWU-NE-021309 Last revised 2/13/2009 NCGNE0000 No Exposure Certification 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 D Yes Ef No ❑ NIA 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 Q No ❑ NIA c. Materials or products from past industrial activity ❑ Yes © No ❑ NIA d. Material handling equipment (except adequately maintained vehicles) ❑ Yes YNo ❑ NIA e. Materials or products during loading/unloading or transporting activities ❑ Yes B No ❑ NIA f. Materials or products stored outdoors (except final products intended for outside ❑ Yes t! No ❑ NIA use [e.g., new cars] where exposure to stormwater does not result in the discharge of pollutants) g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, ❑ Yes & No ❑ NIA and similar containers h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes &No ❑ NIA the discharger i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters]) ❑ Yes ©'No ❑ NIA j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes l3'No ❑ NIA k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes C3' No ❑ NIA 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 &No ❑ NIA (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 t/No ❑ N/A 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 no eligible for the no exposure exclusion. a. Are exterior ASTs or piping free of rust, damaged or weathered coating, pits, or ❑ Yes ❑ No YN/A deterioration, or evidence of leaks? b. Is secondary containment provided for all exterior ASTs? If so, is it free of any ❑ Yes ❑ No E(N/A cracks, holes, or evidence of leaks, and are drain valves maintained locked shut? Page 3 of 7 SW U-NE-021309 Last revised 2/13/2009 NCGNE0000 No Exposure Certification 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. Is secondary containment provided for Title III Section 313 Superfund Amendments and Reauthorization Act (SARA) water r)riority_chemicals*? d. Is secondary containment provided for hazardous substances* designated in 40 CFR §116? e. Are release valves on all secondary containment structures locked? 15) Hazardous Waste: a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of hazardous waste? c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of hazardous waste? If you answered yes to questions b. or c., please provide the following information: Type(s) of waste: o . / ❑ Yes ❑ No Cf' NIA ❑ Yes ❑ No Q'NIA ❑ Yes ❑ No YNIA ❑ Yes ❑ No 13'NIA ❑ Yes ❑ No &N/A ❑ Yes Lf No ❑ NIA 9 Yes ❑ No ❑ NIA ❑ Yes iZ No ❑ NIA How is material stored: Tr ct ra v++ s e r, co„ fw,„ m f r t a. Ile.+s . Where is material stored: T►+s-d- How many disposal shipments per year: T%jo Name of transport/ disposal vendor: deeessa ry o Vendor address: _t_soo _&re-e j � a_ ►4o-e— B-- rib -TN 974. L o - -40 Y S Footnotes to Questions 14) c. & d. "Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require secondary containment. However, some exceptions may be made for de minimis amounts of certain substances, and/or other qualifiers, as described in the exemptions from reporting requirements of Title III SARA 313 in 40 CFR §372.38. "Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require secondary containment. However, some exceptions may be made for amounts less than the Reportable Quantities of the hazardous substances listed in 40 CFR §117.3. Page 4 of 7 SWu-NE-021309 Last revised 2AV2009 NCGNE0000 No Exposure Certification 16) Other information: If you answer "Yes" to any of the following items, you might not be eligible for the no exposure exclusion. A more in-depth evaluation of the site circumstances may be required. a. Does your facility store used, recycled, or otherwise reclaimed pallets outside? ❑ Yes Q No ❑ NIA b. Does your facility have coal piles on site? ❑ Yes RNo ❑ NIA c. Does your facility store other fuel sources outside in piles, such as wood chips, []Yes Q No © NIA sawdust, etc.? d. Does your facility have air emissions associated with its industrial activity (e.g., ❑ Yes GrNo ❑ NIA degreasing operations, plating, painting and metal finishing)? If so, describe the industrial activity: e. If you answered yes to d., are those emissions permitted by an Air Quality Permit? ❑ Yes ❑ No R NIA Please specify: f. Please list any other environmental program permits (federal, state, etc.) not specified earlier in this application (such as Hazardous Waste Permits, etc.): Permit: Program: Permit: Program: Permit: Program: Permit: Program: Permit: Program: Permit: Program: Permit: Program: Page 5 of 7 SWU-NE-021309 Last revised 2J13/2009 NCGNE0000 No Exposure Certification 17) 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 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: Doug S kAML4►., Title: PfanA- Mdoaat✓ (Signatur of Applicant) (D to Stgned) 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. 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. Page 6 of 7 SW U-NE-021309 Last revised 2/13/2009 NCGNE0000 No Exposure Certification 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. ❑ If this is a renewal, indicated current NCGNE number in Question 7. ❑ If the site currently has an NPDES Stormwater Permit, be sure to indicate the permit number in Question 8. 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) 296-4500 Fayetteville Office ... (910) 433-3300 Mooresville Office ... (704) 663-1699 Raleigh Office ........ (919) 791-4200 Washington Office ...(252) 946-6481 Wilmington Office ... (910) 796-7215 Winston-Salem ...... (336) 771-5000 Central Office .........(919) 807-6300 Page 7 of 7 SWU-NE-021309 Last revised 2/13/2009 r v a 406_ j a N '.7 :1 S13 Tj�-RY� 7, s �o a lk < y j re I�id •d Ij i T, b i�v e'r .7_!�. Ilk � V Su A• •b �r* jib 14b V? rr ;j 4, 1 K, F 1A, . - VA Real Reel Corporation V Salisbury A I S�u q S i -Z14 I rr 1 400 , o i 4 r) M P1 13 4 7fi C et 41 W V F f e l 01 71. r A N, Towbrs A01 V Z., k N WN. Latitude- 35'40'48" Longitude: 80030'01" NCG050375 Facility MY a, 11,4 Real Reel Corporation County: Rowan Location Stream Class: C Receiving Stream: Grants Creek Stream Index: 12- 110 POOT ICALIND Sub -basin: 03-07-04 (Yadkin River Basin)