NCGNE1396_No Exposure Application_20200103

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DiViNi011 of Energy, Nlinerai and Land Resources v� Di`lth oDiv
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'1�National Pollutant Discliar�_e I-limination SS�stem NO I-APOSURE Cl''RTH IGN I I(3V fir 1:�clusionIVED
f`nviranrnentul NCGNEOOOO
Qualify JAN 03 2020
DE �r
National Pollutant Discharge Elimination System application for exclusion from a 5tase ,+q, c c,t IfVG
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Exposure Certification and your NPDES permit is rescinded, your facility must continue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 NPOES 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 has no expiration date
BUT MUST BE self re -certified at least annually.
Please look for information about re -certification under the No )exposure section on this page'
htts7sa/deq.nc ovlaboutldlvisionslener -mineral land reso _.
rat 'and-permitsistorInwa1131-
For
ermitslnpdesandustrial-svA
e contact the DEMLR Regional Office for your area.
(Please print or type)
1) Mailing address of ownerloperator (address to which all certification comes ondence will be mailed :
Name
Contact
Street Address
City
Telephone No.
rU•NCGNE
Neslle Waters North America
James Brown
1840 Lindbergh Street
Charlotte
713 559-3206
Page 1 of 7
State r`c ZIP Code 20101
Fax �.
Last revised 9128/2016

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NCGNE0000 No Exposure Certification
2) Location of facility producing discharge:
Facility Name Ready Refresh by Nestle - Raleigh
Facility Contact James Brown
Street Address 5921 Triangle Dr
City Raleigh
County Wake
Telephone No. 713 558.3206
3) Physical location information:
State NC ZIP Code 27617
Fax
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) n,rn nghi off Rt 70 (Glenwood Avenuoi to facilify
(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 17 No
5) Is this a Federal facility? CI Yes ❑ No
6) Latitude 35 deg 53' 41.1354` -_ Longitude 74 de9 44' 41 8164"
(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
El Existing
Date operation began May2019
❑ Renewal of existing No Exposure Certification Certification No - NCGNE
8) Was this facility or site ever covered under an NPDES Stormwater Permit? 0 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 indust^lal
activity at this facility
SIC Code 4 2 9 4
10) Provide a brief description of the types of industrial activities and products produced at this facility:
Warehouseina and local trucking of bottled water and associated eauioment
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
0 No
El Yes
!f yes, list the permit numbers for all current Non -Discharge permits for this facility:
SWi.I-NMNE
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t�
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 ❑ Yes 0 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
Ip Yes (3 No O NIA
c Materials or products from past industrial activity
❑ Yes p No © NIA
d Material handling equipment (except adequately maintained vehicles)
❑ Yes fJ No © NIA
e. Materials or products during loading/unloading or transporting activities
❑ Yes a No ❑ NIA
f Materials or products stored outdoors (except final products intended for outside
© Yes El No ❑ NIA
use [e.g., new cars] where exposure to stormwater does not result in the
discharge of pollutants)
g Malenals contained in open, deteriorated or leaking storage drums, barrels,
❑ Yes C] No to NIA
tanks. and similar containers
h Materials or products handled/stored on roads or railways owned or maintained
❑ Yes El No ❑ NIA
by the discharger
i. Waste material (except waste in covered, non -leaking containers [e.g.,
❑ Yes El No © NIA
dumpsters])
I Application or disposal of process wastewater (unless otherwise permitted)
❑ Yes 13 No D NIA
k Particulate matter or visible deposits of residuals from roof stacks and/or vents o Yes CI No ❑ NIA
not 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 p No p 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 © 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 0 Yes ❑ No 0 N/A
deterioration. or evidence of leaks?
b_ Is secondary containment provided for all exterior ASTs? If so is it free of any n Yes 0 No © NIA
cracks, holes. or evidence of teaks, 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.
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NCGNE0000 No Exposure Certification
a Is secondary containment provided for single above ground storage containers ❑ Yes ❑ No p NIA
(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 El NIA
in close proximity to each other with a combined capacity of more than 1.320-
gailons';
c Is secondary containment provided for Title III Section 313 Superfund ❑ Yes ❑ No 0 NIA
Amendments and Reauthorization Act (SARA) water priority chemicals'?
d. Is secondary containment provided for hazardous substances" designated in ❑ Yes p No El NIA
40 CFR §11V
e Are release valves on all secondary containment structures locked? ❑ Yes O No 0 WA
15) Hazardous Waste:
a Is this facil.ty a Hazardous Waste Treatment. Storage, or Disposal Facility? ❑ Yes o No 17 NIA
b. Is this facility a Small Quantity Generator (less than 1000 kg of hazardous o Yes ❑ No p NIA
waste generated per month) of hazardous waste?
C. Is this fac,l ty a Large Quantity Generator (1000 kg or more of hazardous waste ❑ Yes ❑ No p NfA
generated per month) of hazardous waste?
If you answered yes to questions b. or c . please provide the following mformation-
Type(s) of
waste
vendor
How is material stored
Where is material stored.
How many disposal shipments per year
Name of transport / disposal
Vendor address.
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 §1173.
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.
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NCGNEOOOO No Exposure Certification
a Does your facility store used, recycled, or otherwise reclaimed pallets outside
b. Does your facility have coal piles on site?
c. Does your facility store other fuel sources outside in piles, such as wood chips,
sawdust, etc-?
d Does your facility have air emissions associated with its industrial activity (e.g.,
degreasing operations, plating, painting and metal finishing)? If so, describe the
industrial activAy-
e. If you answered yes to d., are those emissions permitted by an Air Quality
Permit? Pease spec.fy-
f Please fist any other environmental program permits (federal, state, etc ) not
specified earlier In this application (such as Hazardous Waste Permits, etc)
Permit. None �.n.... +�� _ Program:
Permit _ Program:
Permit Program:
Permit _ Program:
Permit. Program:
Permit Program:
Permit: Program:
0 Yes 13 No ❑ NIA
p Yes 0 No M NIA
p Yes CO No El NIA
0 Yes O No ❑ NIA
❑ Yes Q No S NIA
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NCGNEOOOO No Exposure Certification
17) Certification:
certify under penalty of law that I have read and understand the eligibility requ;rements for claiming a condition of -no
exposure' and obtaining an exclusion from NPQES stormwater permitting
I certify under penalty of law that there are no discharges of stormwater contaminated by exposure to industrial activities or
materals 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 mainWn no exposure conditions and complete a Self -Recertification form at least once
eazh year. and if requested provide this certhfcation 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 tr a Nort) Caro:ina Divis-on of
Energy. Mineral, and Land Resources cr MS4 operator where the discharge is into the local MS4 is perform inspections
to confrm the condition of no exposure and to make such inspection reports publicly avatlab:e upon request. I understand
must keep a copy of annual re -certifications an file at the facility
In the event that the site no longer qualifies for a No Exposure Exclusion, I understand that I must obtan coverage under
an NPOES permit pr,or to any point source discharge of stormwater from the facility Additionally. I certify under penally 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
rnquiry 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 awa-e
that there are significant penalties for submitting false information including the possibility of fine and imprisonment fo-
knowing violations
t certify that I am familiar with the ►nformation contained in this application and that to the best of my knowledge and be
such information is true, complete and accurate
Printed Name of Person Signing Danielle Johnson
Title Sr. SHE Execution Manager, Ready Refresh by Nestle Waters North America
Iq
(Signature of Applicant) (Date Signed)
Please note: This application for the No Exposure Exclusion is subject to approval by the NCDEQ
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 ;nakes any false statement representation, ❑• cert;ficat on n any application. record. report, plan, or other
document fi+ed or required to be maintained under this Article or a rule implementing this Anicte or who knowingly makes a false
statement of a materiat fact in a rulemaking proceed ng or contested case under th s Article, or vAio lalsdies. tampers with, or knowingly
renders inaccurate any recording or monitonng device or method required to be operated or maintained under this Article or rules of the
[Environmental Managernentl Commission implementing this Article shall be girlty of a Class 2 misdemeanor which rnay include a fine
not to exceed ten thousand dollars 1510 000)
There is currently no fee for a No Exposure Exclusion.
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NCGNE0000 No Exposure Certification
Final Checklist
This application should include the following items.
0' This completed application and all supporting documentation.
J' 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:
DEMLR - Stormwater Program
Dept. of Environmental Quality
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.
DEMt_R_.Regional Office Contact Information:
Asheville Office, [phone]
Fayetteville Office.. [phone] # -
ROt at7
Mooresville Office. [phone] `'
Raleigh Office,.... [phone]
Washington Office [phone]
Wilmington Office [phone] :,,r'_�
Winston-Salem .. [phone] Faychrritta --'
Central Office ....... [phone] •,.
WilrrH nglon
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