NCGNE0460_COMPLETE FILE - HISTORICAL_20080409

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCGNE Dy L
DOC TYPE
VHISTORICAL FILE
DOC DATE
❑ aW �OH O
YYYYMMDD

a
i r
Y
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleco li. Sullins, Director
Division of Water Quality
April 4, 2008
r _ p'C
Mr. Gary Norber
Timberline, LLC II J r
235 Warehouse Road APR 998
Henderson, NC 27536
�I OENR RALEI Ofti,L OFFICEi
Subject: No -Exposure Certification NCGNE0460
Timberline, LLC
235 Warehouse Road, Henderson, NC
Vance County
Dear Mr. Norberg:
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. We are also hereby
rescinding your current Certificate of Coverage NCG210314.
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 (March 31, 2013). 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 Sarah Young at [phone], ext.
502, or at [e-mail].
cc: Raleigh Regional Office-Myrl Nisely
Stormwater Permitting Unit Files
NCG210314 Permit File
Sincerely,
/_"-e2j�
for Coleen H. Sullins
DWQ Central Files — wlattachments
Fran McPherson -Budget Office
N. C. Division of Water Quality 1617 Mail Service Center Raleigh, North Carolina 27699-1617 [phone]
NAdC R
Customer Service
1-877-623-6748

Michael 1'. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Y
r
� Coleen H. Sullins, Director
-� Division of Water Quality
April 4, 2008
Mr. Gary Norberg
Timberline, LLC
235 Warehouse Road
Henderson, NC 27536
Subject: No -Exposure Certification NCGNE0460
Timberline, LLC
235 Warehouse Road, Henderson, NC
Vance County
Dear Mr. Norberg:
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. We are also hereby
rescinding your current Certificate of Coverage NCG210314.
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 (March 31, 2013). 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 Sarah Young at [phone], ext.
502, or at [e-mail].
cc: Raleigh Regional Office-Myrl Nisely
Stormwater Permitting Unit Files
NCG210314 Permit File
Sincerely,
for Coleen H. Sullins
DWQ Central Files —w/attachments
Fran McPherson -Budget Office
N. C. Division of Water Quality 1617 Mail Service Center Raleigh, North Carolina 27699-1617 [phone]
En
Customer Service
1-877-623-6748

IFwd: Re: Timberline NCGNE0460]
Subject: [Fwd: Re: Timberline NCGNE0460]
From: Myrl Nisely <[e-mail]>
Date: Tue, 01 Apr 2008 13:30:39 -0500
To: Sarah young <[e-mail]>
Here you are!
M
------- Original Message--------
Subject:Re: Timberline NCGNE0460
Date:Tue, 01 Apr 2008 07:37:52 -0500
From:Myrl Nisely <myrl.niscly ct,ncmail.uet>
To:Robert Patterson <lZobert.Patterson a ticmail.net>
References: <47F I I B05.6010303 a ricmail.net> <47FI4AF6.6060707(cr,ncmail.net>
<471, 1 3CC8.5000509 a,ncmail.net>
That wording should be adequate. Have Sarah go ahead. In about 8 to 10
months we should go back for a look around!
Myrl
Robert Patterson wrote:
> Sorry about that.
> Myrl Nisely wrote:
>> Robert, I don't think you attached the agreement. Please try again.
>> Myrl
>> Robert Patterson wrote:
>>> Myrl,
>>> Here is the lease agreement modification
>>> for Timberline's NE. Does this work for
>>> one to her list to issue the NE?
>>> Thanks.
Myrl A. Nisely <°))))><
Environmental Chemist
NC DENR - Div. Water Quality
Raleigh Regional Office
1628 Mail Service Center
Raleigh, NC 27699-1628
Telephone: [phone] or x4255
Fax: [phone]
[e-mail] ><((((°>
Myrl A. Nisely <°))))><
Environmental Chemist
for Timberline and Dominion
you? Should Sarah add this
I of 2 4/3/2008 3:52 PM

[Fwd: Re: Timberline NCGNE04601
NC DENR - Div. Water Quality
Raleigh Regional Office
1628 Mail Service Center
Raleigh, NC 27699-1628
Telephone: [phone] or x4255
Fax: [phone]
[e-mail] ><((((°>
2 of 2 4/3/2008 3:52 PM

Nccn/Lo`t60
T113,_✓Lu vl=
ADDENDUM TO LEASE AGREEMENT BETWEEN NORBERG PROPERTIES, LLC
(LANDLORD) AND DOMINION PRECAST, LLC (TENANT).
Housekeeping: Tenant agrees to reasonable housekeeping measures to include
sweeping, at least monthly, the concrete/paved areas adjacent to Timberline's
manufacturing facility. Sweeping is required to minimize the concrete dust that is a by-
product of the concrete operations. Sweeping the asphalt parking lot in front of the
facility is not required as the parking lot is not used during the manufacture/handling of
concrete products.
Date:
rresioent,
Dominion Precast, LLC
Date:
r l I I Rd PR11,
Norberg Properties, LLC
E-WATER
Z008
DENR QUALI

SPANGLrER
ENVIRONMENTAL, INC.
Land Planning • Permitting Environmental Consulting Construction Management
February 15, 2008
Robert Patterson, PE
NC DENR DWQ
RE: No Exposure Certificate for Timberline LLC
Robert,
a
Expert
Please find attached the No Exposure Certificate for Timberline, LLC. I am looking forward to
our meeting at the facility in Henderson on February 281h at 10:00 am. Please contact me if you
have any comments regarding this document or our upcoming meeting.
Sincerely,
Spangler Environmental, Inc.
Chad Broadway
Environmental Scientist
224 Fayetteville Street , Suite 400 P.O. Box 387 Raleigh, N.C. 27602 tel [phone] fax [phone]
3961-B Market Street Wilmington, N.C. 28403 te1910-343-9375 fax [phone]-SPANCLER www.spanglerenvironmental.com

Alt

RECEIVED Fro 9 3 ZDDS
API Division of Water Quality / Surface Water Protection
`�
WC®ENR National Pollutant Discharge Elimination System
N��»a, o ,EMor NO EXPOSURE CERTIFICATION for Exclusion
wo ��aw AE,aa�e,
NCGNE0000
NO EXPOSURE CERTIFICATION
FOR AGENCY USE ONLY
D.w Received
Ycar Month
Du
CWifle.w of Cn,cMt c
p
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, snowme/t, 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 DWO 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 NoRReR%
Street Address WAiZEHoLtSE 1ZOAl�
City h1En1DFR6OP4 StateNJL ZIPCode ar7S36
Telephone No. r-fga- 61,4Ll . Fax: asa W9a- W30
2) Location of facility producing discharge:
Facility Name
Facility Contact
Street Address
City
County
Telephone No.
TTMBEpLTNE LLC
Page 1 of 5
SWU-NE-110607 Last revised 11/06/07

NCGNE0000 No Exposure Certification
3) Physical location information:
Please provide a narrative description of how to get to the facilit (use street names, state road numbers, and
distance and direction from a roadway intersection). FRo N ALE f 6 H , t ( No iTE{ T6
twll =NDF_4ZSofo /� TAR 1,US- uS- ( s?i.�-r. TvR,-> 12=r,Ni=oN it>Re{% F_
(A copy of a map with the facility clearly located on it should be included with the certification application.) 'Rphb
4) Is the facility located on Native American Lands? ❑ Yes >c No
5) Is this a Federal facility? ❑ Yes ErNo
6) Latitude S/ ° 17 t WAN Longitude r7f *,1 irO$1w(deg, min, sec)
7) This NPDES Permit Application applies to which of the following:
❑ New or Proposed Facility Date operation is to begin
*r Existing Date operation began
8) Was this acili r fever covered under an NPDES Stormwater Permit? aYes ❑ No
If yes, what is the NPDES Permit Number? N & G a \O 314
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:
MA-icF12 n;: /tj. ol6 1 I&JOon <Nr3Pwe, /I?JrTF< /AND
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
1eNo
❑ 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 X'No
❑ Yes XNo
❑ Yes R No
❑ Yes CK No
❑ Yes R1 No
❑ Yes WNo
Page 2 of 5
SWU-NE-110607 Last revised 11/06/07

NCGNE0000 No Exposure Certification
g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, ❑ Yes eNo
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes WNo
the discharger
i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters]) ❑ Yes $I'No
j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes KNo
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes & 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 XNo
(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 V- 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. rj/A _ 10o AST /S ON S
a. Are exterior ASTs or piping free of rust, damaged or weathered coating, pits, or ;9 Yes ❑ No
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any X'es ❑ 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. NIA _ /`'o (oN rJE� o`
5
a. Is secondary containment provided for single above ground storage containers WYes ❑ No
(including drums, barrels, etc.) with a capacity of more than 660-gallons?
b. Is secondary containment provided for above ground storage containers stored
es ❑ No
in close proximity to each other with a combined capacity of more than 1,320-
gallons?
c. Is secondary containment provided for any amount of Title III Section 313
Yes ❑ No
Superfund Amendments and Reauthorization Act (SARA) water priority
chemicals?
d. Is secondary containment provided for any amount of hazardous substances?
ZYes ❑ No
e. Are release valves on all secondary containment structures locked? kYes ❑ No
Page 3 of 5
SWU-NE-110607 Last revised 11/06/07

NCGNE0000 No Exposure Certification
15) Hazardous Waste:
a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? ❑ Yes EKNIo
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste ❑ Yes RrNIo
generated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste ❑ Yes Xfklo
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 1 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:
Z- S-0s
(Date Signed)
Page 4 of 5
SWU-NE-110607 Last revised 11/06/07

NCGNE0000 No Exposure Certification
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.
Final Checklist
This application should include the following items:
m / 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 DWO Regional Office for your area.
DWO 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 .........(919)
733-5083
Page 5 of 5
SWU-NE-110607 Last revised 11/06/07

235 WAREHOUSE ROAD, HENDERSON, NC - Google Maps
Page I of I
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ATO Division of Water Quality / Surface Water Protection
i
NCDENK National Pollutant Discharge Elimination System
NPrtw GwCliru DVN�uEufM NO EXPOSURE CERTIFICATION for Exclusion
Er.nrouXCM wro NaVnK Rtldnrc[a
NCGNE0000
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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 o
facility means all industrial materials and activities are protected by a storm resistant shelter (with so =
exceptions) to prevent exposure to rain, snow, snowmelt, an runoff la a o
C
Industrial materials or activities include, but are not limited to: material handling equipment or activiG11
industrial'machinery, raw materials, intermediate products, by-products, final products, or waste 1�
products. Material handling activities include the storage, loading and unloading, transportation, or sm
conveyance of any raw material, intermediate product, final product or waste product. A storm resis
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 lea
"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 outfal/s. 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).
For questions, please contact the DWQ Regional Office for vour area. [See nacre 15)
(Please print or type)
1) Mailing address of owner/operator (address to which all certification correspondence will be mailed):
Name 6TARY NORBER&r
Street Address 235 WARCHOUSE RDAD
City _NEN'DERSON State MC ZIP Code 27536
Telephone No. 252 992- (Tl44 Fax: 252 i}�jZ— 7$3o
2) Location of facility producing discharge
Facility Name _FM_6ERLINE - Fipgn Rsoi�f
Facility Contact
Street Address 50 ff
i
City State i ZIP Code /
County
Telephone No. Fax:
Page 1 of 5
c>
V
N
O
0
v
SWU-NE-060607
Last revised 06/06/07

^t :dd) 84 a;kMRAL MM
APR 17 08
Myr`,'

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). FROM RArLE)&H, US-) NORMq -fU
HENDG4z-$bN. A'PTER ?)US I ) 5 -) SVL I'T i TURW R L&HT Oh) lnow-HmsE
(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 )'No
5) Is this a Federal facility? ❑ Yes XNo
6) Latitude RP' 0' 33"N Longitude 7602q SOS'V (deg, min; sec)
7) This NPDES Permit Application applies to which of the following:
❑ New or Proposed Facility Date operation is to begin ,
XExisting Date operation began I - I - Zoo 5
facili 8) Was thi r)ee ever covered under an NPDES Stormwater Permit? ❑ Yes ❑ No
If yes, what is the NPDES Permit Number? Nc& `L i O 3 1 L�
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 4 14
10) Provide a brief description of the I
11) Does this facility have any Non -Discharge pe
activities and products produced at this facility:
')N& GRf}'iES AIJD PALLETS -
permits)?
,KNo
❑ 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 )(No
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 XNo
c. Materials or products from past industrial activity
❑ Yes XNo
d. Material handling equipment (except adequately maintained vehicles)
❑ Yes XNo
e. Materials or products during loading/unloading or transporting activities
❑ Yes ;Ill/No
f. Materials or products stored outdoors (except final products intended for outside
❑ Yes 1�'No
use [e.g., new cars] where exposure to stormwater does not result in the discharge
of pollutants)
Page 2 of 5
SWU-NE-060607 Last revised 06/06/07

"if'o r,STMAL SH.S
APR 17 08

NCGNE0000 No Exposure Certification
g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, ❑ Yes X No
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes )<No
the discharger
i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters]) ❑ Yes XNo
j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes XNo
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes YN0
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 XNo
(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 XNo
stored outside, has the facility had any r� ses in the past three (3) years?
O �
13) Above Ground Storage Tanks (ASTs): If 4dota er "No" to any of the �ftollowing!items, you are not
eligible for the no exposure exclusion. G��N) /n N� A77-f rS Q • I S1 T E
a. Are exterior ASTs or piping free of rust, damaged or we ered coating, pits, or es ❑ No
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any es ❑ 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. q, A qt) 6DAIMA AS ON
a. Is secondary containment provided for single above ground storage containers Yes ❑ No U
(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?
ryes ❑ No
el -es ❑ No
Page 3 of 6
SWU-NE-060607 Last revised 06/06/07

Im BY CEWI N- WE'S
APR 17 08

NCGNE0000 No Exposure Certification
15) Hazardous Waste:
a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? ❑ Yes YNo
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste ❑ Yes XNo
generated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator (1000 kg, or more of hazardous waste ❑ Yes o
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.
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 under40 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 property gathered and evaluated the information submitted. Based
on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the
information, the information submitted is to the best of my knowledge and belief true, accurate and complete. I am aware
that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for
knowing violations.
I certify that I am familiar with the information contained in this application and that to the best of my knowledge and
belief such information is true, complete, and accurate.
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-080607 Lest revised 06/06107

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 certificatlon 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.
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: /0 p
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 .........(919)
733-5083
Page 5 of 5
SWU-NE-060607 Last revised 06106/07

23� WAKEHOUSE ROAD, HENOEKSUN, NC - Google Maps Page t of 1
Address Warehouse Rd Save trees. Go green!
oe Henderson, NC 27637 Download GoogleMapafarmot�le
Maps I Text maps to466453
!007

159
SPANGLER
ENVIRONMENTAL, INC.
Land Planning • Permitting Environmental Consulting Construction Management Expert Testimony
November 1, 2007
Mr. Robert D. Patterson, PE
Environmental Engineer
NCDENR I DWQ I Stormwater Permitting Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
RE: Rescission Request
Certificate of Coverage 4 NCG210314
Timberline -Vance (1102 Nicholas St., Henderson, NC 27536)
Dear Robert,
Per our e-mails and telephone conversations, please find attached a Rescis:
)cation
of the Timberline industrial operation. I have re -signed the copy that the owner sent to me, to make it a valid
original.
Also, please find enclosed a DRAFT proposed No Exposure Certification for Exclusion for the NEW location
of the Timberline industrial operation. We can use this proposed Certification for Exclusion as a forum for the
field review of the operation. If you determine that the operation should be more appropriately covered by
NCO210000 or NCG070000 (or both), we can facilitate the necessary documentation at your direction. I
understand that Mr. Gary Norberg, Member Manager of Timberline Acquisition, LLC and I will be meeting you
and Mr. Myrl Nisely at 10:00 a.m. on Wednesday, November 14, 2007 at the NEW Timberline location, 235
Warehouse Road, Henderson, NC 27536.
Please feel free to contact me directly, should you have any questions.
Sincerely,
Spangler Envir ental, Inc.
James A. Spangler, CEI
President
Attachment: Rescission Request Form
Enclosure: DRAFT NCGNE0000 Certification
CC: Gary Norberg, w/ Attachment and Enclosure
224 Fayetteville Street, Suite 400 P.O. Box 387 Raleigh, N.C. 27602 let 919-546-0754 fax [phone]
396'1-B Market Street Wilmington, N.C. 28403 let 910-343-9375 fax [phone]SPANGLER www.spanglerenvironmental.cont

APR 17 03
"� r

�e WATlRo� Permit Coverage
Rescission Request Form
National Pollutant Discharge Elimination System
Certificate of Coverage Number
NCG210334
General Permit NCG210000
Please fill out and return this form snly 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.
InformationFacility Conta!3
Facility Name:.
Timberline - Vance
Facility Physical Address:
1102 S Nicholas St
Henderson, NC 27536
Facility Contact:
Mailing Address:
-- Phone Number.
Fax Number
Email Address
'
Owner Affiliation Inforrnation
' Resti m mbw will be mailed to Me owner address
: - Owner / Organization Name:
Timberline Acquisition LLC '"r yrr i3 ER.LlT1E, L Le -
Owner Contact:
Cary Norbem
Mailing Address:
PO Box 1457
1enderson, NC 27536
Phone Number:
252-492.6144 EA.
Fax Number:
E-mail address:
Reasan for rescission request (This is required information. Attach separate sheet if necessary):
... ":2 tMe4 L ! -- I-hOI M.v VGY) ARVVh rla.j-�5 ,._ , lT A7N S
L1A/OC10 (/Ls 29 _eVQr owns r t�eec - wa cur.=>z6
T7sxaf7 "r, YI.ao Gr1 rla�erl
REQUESr AND CERTIFICATION
I, as an authorized representative, hereby request rescission of certificate of coverage NCG210314 under NPDES
Stormwater General Permit NCG210000 for the subject facility. I am familiar with the Information contained in this
request and to the best of my knowliAge and belief such inrormation is true, complete and accurate.
l
Signature 4
/:;dov, AlooRI-3r~2G J
Print or type name of person signing above
Please return this completed rescission request form to:
Date /O` /�J' 07 I/
.U�7�5t J4,A NA t� c"✓L
Title
SW General Permit Coverage Rescission
Stormwater Permitting Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
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