NCGNE0084_COMPLETE FILE - HISTORICAL_20060209

Z V
NORTH CAROLINA
Department of Environmental Qua

s2�
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCGNE �d 0
DOC TYPE
HISTORICAL FILE
DOC DATE
❑ � � n oa O
YYYYMMDD

Michael F. Easley, Governor
William G. Ross Jr., secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
Kernersville Town
720 McKaughan Street
KernersviIle, NC 27284
Subject: General Stormwater Permit Inspections
Kernersville Fleet Maintenance
Permit No. NCGNE0084
Forsyth County
Dear Sir or Madaam:
Your facility holds a General Permit from the North Carolina Division of Water Quality to
discharge stormwater associated with industrial activities performed at your facility. Please be
advised that the Winston-Salem Regional Office will be performing NPDES Stormwater
Inspections sometime in the near future.
If this office has not previously inspected your facility, you should be prepared to demonstrate
compliance with all terms and conditions included in the Permit. Specifically, we will be
evaluating the following: Stormwater Pollution Prevention Plan, Stormwater Outfail Locations,
Qualitative and Analytical Monitoring Data and any other activities required by your permit.
Copies of the general permits and accompanying documents can be accessed from the following
webpage: http://h2o.enr.state,nc.uslsu/Forms Documents.htm#StormwaterGP.
If you have any questions, please contact Rose Pruitt in the Winston-Salem Regional Office at
[phone].
Sincerely,
Rose Pruitt
cc: NPS Compliance & Assistance Oversight Unit
SWP-Central Niles
WSRO Files
Carolina
North Carolina Division of Water Quality 585 Waughtown Street Winston-Salem, NC 27107 Phone [phone] Fax [phone]
Internet: h2o.enr.state.nc.us
An Equal OpportunitylAf it mtative Action Employer— 50% Recyded1G% Post Consu me. Paper

F WAT�
Michael F. Easley, Governor
0EnvWilliam
G. Ross Jr., Secretary
North Carolina Department of ironment and Natural Resources
Alan W. Klimek, P. E. Director
Division of Water Quality
0 t
Coleen 11. Sullins, Deputy Director
Division of Water Quality
April 20, 2005
Randy E McCaslin
Kernersville Town
PO Drawer 728
Kernersville, NC 27285
Subject: No Exposure Certification NCGNE0084
Kernersville Fleet Maintenance - 720 McKaughan St
Forsyth County
Dear Permittee:
The Division has reviewed your submittal of the No -Exposure Certification for Exclusion from NPDES
Stormwater Permitting form, which we received on March 10, 2003. We apologize for the extended period it
has taken us to get back to you on this request and we appreciate your patience as we have worked through
this process. Based on your submittal and signed certification of no exposure at the above referenced facility
the Division is granting your certification as provided for under 40 CFR 126.22(g) which is incorporated by
reference in North Carolina regulations.
Please note that by our acceptance of your no exposure certification, you are obligated to maintain no
exposure conditions at your facility. If conditions change such that your facility can no longer qualify for a no -
exposure exclusion, you are obligated to immediately obtain NPDES permit coverage for your stormwater
discharge. Otherwise, the discharge becomes subject to enforcement as an un-permitted discharge. Your
conditional no -exposure exclusion expires in five years (April 30, 2010). At that time you must re -certify with
the Division, or obtain NPDES permit coverage for any stormwater discharges from your facility.
Your certification of no exposure 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 Jonathan Diggs at [phone] ext.
537, or at [e-mail].
Sincerely,
for Alan W. Klimek, P.E.
cc: Winston-Salem Regional Office _ Central Files — wlattachments
Stormwater Permitting Unit Files
N. C. Division of Water Quality 1017 MaiI Service Center Raleigh, North Carolina 27699-1617 [phone]
ASA
NCDENR
Customer Service
1-877-623-6748

NC(�N�eoS`�
United States Environmental Protection Agency Form Approved
OMB No. 2040-0211
NPDES !'' EPA Washington, DC 20460
FORM t,'Wl NO EXPOSURE CERTIFICATION for Exclusion from
351 Q-11
NPDES Storm Water Permitting
Submission of this No Exposure Certification constitutes notice that the entity identified in Section A does not require permit authorization for its storm water
discharges associated with industrial activity in the State identified in Section B under EPA's Storm Water Mufti -Sector General Permit due to the existence
of a condition of no exposure.
A condition of no exposure exists at an industrial facility when all industrial materials and activities are protected by a storm resistant shelter to prevent
exposure to rain, snow, snowmelt, and/or runoff. Industrial materials or activities include, but are not limited to, material handling equipment or activities,
industrial machinery, raw materials, intermediate products, by-products, final products, or waste products. Material handling activities include the storage,
loading and unloading, transportation, or conveyance of any raw material, intermediate product, final product or waste product. A storm resistant shelter is
not required for the following industrial materials and activities:
- drums, barrels, tanks, and similar containers that are tightly sealed, provided those containers are not deteriorated and do not leak. "Sealed"
means banded or otherwise secured and without operational taps or valves;
-. adequately maintained vehicles used in material handling; and
- final products, other than products that would be mobilized in storm water 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, the entity in Section A is certifying that a condition of no exposure exists at its facility or site,
and is obligated to comply with the terms and conditions of 40 CFR 122.26(g).
ALL INFORMATION MUST BE PROVIDED ON THIS FORM.
Detailed instructions for completing this form and obtaining the no exposure exclusion are provided on pages 3 and 4.
A. Facility Operator Information
1. Name: LF2W{ i IOIFf Ih1EIRQI9i&51�1I I1.iLi ( I I, I I I, i 1 1 2.Phone: [phone]f7131 �IZI lI
3. Mailing Address: a. Street 1P_I QJ �,. }LiaL�l i 418i I I I I I I_ _I i I I_ 1 I I I_ 1 I I 11 �1
b. City. IR I IN tlr i� 5 M I 1 1L I L & I I I I , I i I i f I c. State: � d. Zip Code: 4Z 17- t z1 S Si - 10 l7_48
l
R. FaciiitylSlte Location Information
1, Facility Name: fi` titimirr-iKissitl4i-I-I IF, Liagi t &UTAEITIMNIAdy--ir—
l1 1
2. a. Street Address: 10 1 Mr_XAIU i6 J4i AINI Si-[ikjflTi I I I I II I I I I I I !
b.City= 1EiQINI�J�151Y]LtL.Iu�J I I I I I I 1 .1 I_j c.County: 1riQ&5iYl'rIHi i)
d. State.: ]_LQ e. Zip Code: Izl �I�1 gi 41 - j2i).ii21
3. Is the facility located on Indian Lands? Yes ❑ No
4, Is this a Federal facility? Yes ❑ No
5, a. Latitude; I3 I✓I� , b. Longitude: I
180Q.ffj,
llg&
6. a. Was the facility or site previously covered under an NPDES storm water permit? Yes ❑ No �]
b. If yes, enter NPDES permit number: aa
7. SIC/Activity Codes: Primary: l Secondary (if applicable): I 1 1
8. Total size of site associated with industrial activity: _t/-kLacres
S. a. Have you paved or roofed over a formerly exposed, pervious area in order to qualify for the no exposure exclusion? Yes ❑ No CK
b. if yes, please indicate approximateiy how much area was paved or roofed over. Completing this question does not disqualify you for the no exposure
exclusion. However, your permitting authority may use this information in considering whether storm water discharges from your site are likely to have
an adverse impact on water quality, in which case you could be required to obtain permit coverage.
Less than one acre ❑ One to five acres ❑ More than five acres ❑
EPA Form 3510-11 (10-99) Page 1 of 4

NPDES NO EXPOSURE CERTIFICATION for Exclusion from Form Approved
FORM `��E�� OMB No.2040-0211
3510-11 NPDES Storm Water Permitting
C. Exposure Checklist
Are any of the following materials or activities exposed to precipitation, now or in the foreseeable future?
(Please check either "Yes" or "No' in the appropriate box.) if you answer"Yes" to any of these questions
(1) through (11), you are not eliglble for the no exposure exclusion.
Yes
No
1. Using, storing or cleaning industrial machinery or equipment, and areas where residuals from using, storing
IAN
or cleaning industrial machinery or equipment remain and are exposed to storm water
2. Materials or residuals on the ground or in storm water insets from spills/leaks
3. Materials or products from past industrial activity
4. Material handling equipment (except adequately maintained vehicles)
5. Materials or products during loadinglunloading or transporting activities
6. Materials or products stored outdoors (except final products intended for outside use ]e.g., new cars] where
exposure to storm water does not result in the discharge of pollutants)
7. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, and similar containers
8, Materials or products handtedlstored on roads or railways owned or maintained by the discharger
9. Waste material (except waste in covered, non -leaking containers [e_g., dumpsters])
10, Application or disposal of process wastewater (unless otherwise permitted)
11. Particulate matter or visible deposits of residuals from roof stacks and/or vents not otherwise regulated
(i.e.. under an air quality control permit) and evident in the storm water outfbw
A. Certification Statement
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 storm water permitting. ,
I certify under penalty of law that there are no discharges of storm water 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 years to the NPDES permitting authority 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 NPDES permitting authority, 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. I understand that I must obtain coverage under an NPDES permit prior
to any point source discharge of storm water 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 vlolatlons.
Print Name: [?AINID t,Yl l_t I" f sLAi.-�!ijtd t
Print Title_ LFLQMNL_MAiNAErzAi
Signature:
Date: 1013101 �� PI
EPA Form 3510-11 (10-99) Page 2 of 4

United States Environmental Protection Agency Form Approved
9 y OMB No.2Q40-0211
NPDES ,�
3510-11 �� Washington, fit, 2044i0
FORM ^; NO EXPOSURE CERTIFICATION for Exclusion from
NPDES Storm Water Permitting
Submission of this No Exposure Certification constitutes notice that the entity identified in Section A does not require permit authorization for its storm water
discharges associated with industrial activity in the State identified in Section B under EPA's Storm Water Multi -Sector General Permit due to the existence
of a condition of no exposure.
A condition of no exposure exists at an industrial facility when all industrial materials and activities are protected by a storm resistant shelter to prevent
exposure to rain, snow, snowmell, and/or runoit. 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 without operational taps or valves;
- adequately maintained vehicles used in material handling; and
final products, other than products that would be mobilized in storm water 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, the entity in Section A is certifying that a condition of no exposure exists at Its facility or site,
and is obligated to comply with the terms and conditions of 40 CFR 122.26(g),
ALL INFORMATION MUST BE PROVIDED ON THIS FORM.
Detailed instructions for completing this form and obtaining the no exposure exclusion are provided on pages 3 and 4.
A. Facility Operator Information t� p
1. Name: (, jJ aVii N I IOI ie I IK IP-lit N I P-1 C $1 V 11_ 11-1 i 1194 1 1 1 1 I 11 1 12. Phone: Lig 16 Ilb 131114 t
3. Mailing Address: a. Street: IPA A&A IW1111i 7 L5 I_ I 1 I I I I I I I „11 I I I I I I I
b. City: 1KIf IQIMI�.IIQ, IS�,��1,�-l��,i.�„�,1...1 c. State: 14 1!0 d. Zip Code: 122196l -a
%IZ&
B. FacilltylSite Location Information
1.17acilityName: nJ19ifLM9iAjS*iVi11t.11i IjKItL1CI%tQL4fj I(.I9LdI71i1A 1 1 1
2. a. Street Address: ]1 A ©t Mr-11VA-I u n 114lAli�b__ L-S T1OLi>ElarG iTi 11 I I 1I I I I I I I
b. City, l�)�J�jKIS1 ill l I141-1 L I I I_ L I I I I I I I c. County: II IOIIR Ii 111 ITI al 11
d. State: INIC e. Zip Cade: 1 2,4 7120 14 j - I I I I I
3. Is the facility located on Indian Lands? Yes ❑ No K
4. Is this a Federal facility? Yes ❑ No VI
5. a. Latitude: � 1J ' 101b] b. Longitude; L_I8io � A 441
6. a. Was the facility or site previously covered under an NPDES storm water permit? Yes ❑ No EK
b. If yes, enter NPDES permit number:
7. SIC/Activity Codes: Primary: S� Secondary (if
applicable):
B. Total size of site associated with industrial activity: _� r_I acres
9- a. Have you paved or roofed over a formerly exposed, pervious area in order to qualify for the no exposure exclusion? Yes ❑ No
b. If yes, please indicate approximately how much area was paved or roofed over. Completing this question does not disqualify you for the no exposure
exclusion. However, your permitting authority may use this information in considering whether storm water discharges from your site are likely to have
an adverse impact on water quality, in which case you could be required to obtain permit coverage.
Less than one acre ❑ One to five acres ❑ More than five acres ❑
EPA Form 3510-11 (10-99) Page 1 of 4

NPDES .� NO EXPOSURE CERTIFICATION for Exclusion from Form Approved
FORM �-%EpA OMB No. 2040-0211
3510-11 NPDES Storm Water Permitting
C. Exposure Checklist
Are any of the following materials or activities exposed to precipitation, now or in the foreseeable future?
(Please check either "Yes" or "No" in the appropriate box.) If you answer"Yes" to any of these questions
(1) through (11), you are not eligible for the no exposure exclusion.
Yes
No
1. Using, storing at cieaning industrial machinery or equipment, and areas where residuals from using, storing
or cleaning industrial machinery or equipment remain and are exposed to storm water
2. Materials or residuals on the ground or in storm water inlets from spillslleaks
3. Materials or products from past industrial activity
4. Material handling equipment (except adequately maintained vehicles)
5. Materials or products during load! nglunloading or transporting activities
6. Materials or products stored outdoors (except final products intended for outside use [e.g_, new cars] where
exposure to storm water does not result in the discharge of pollutants)
7. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, and similar containers
VN
S. Materials or products handiedlstored on roads or railways owned or maintained by the discharger
rA
9. Waste material (except waste in covered, non -leaking containers [e.g_, dumpsters])
KA
10. Application or disposal of process wastewater (unless otherwise permitted)
11. Particulate matter or visible deposits of residuals from roof stacks and/or vents not otherwise regulated
(i_e., under an air quality control permit) and evident in the storm water outflow
D. Certffication Statement
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 storm water permitting.
I certify under penalty of law that there are no discharges of storm water 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 years to the NPDES permitting authority 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 NPDES permitting authority, or M54 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. I understand that t must obtain coverage under an NPDES permit prior
to any point source discharge of storm water 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. f am aware that there are significant penalties for submitting false information, including the possibility
of fine and imprisonment for knowing violations.
Print Name: I IAINID It'1 IEl Ml CiCA1511..! I I NI I I I I I I I I_ I 11 1_ I I I L
Print Tide:
Signature:
Date:
IL3105y3I
EPA Form 3510-11 (10-99) Page 2 of 4

TOWN OF KERNERSVILLE Larry R. Brown, Mayor
Randy E. McCaslirjown Manager
P.O. Box 728
Kernersville, NC 27285-0728
March 6, 2003
Mr. Bill Mills
Stormwater & General Permits Unit
1617 Mail Service Center
Raleigh, North Caroline.27699-161.7
Subject: Municipal lndustrial,NPDES Pernhits
No Expbsure`Certificafions
Town of Kernersville
Forsyth County
134 East Mountain Street
Telephone [phone]
Fax [phone]
j
MAR a 0 2003
Dear Bill;
In accordance with applicable. State and Federal regulations enclosed are two (2) "No
Exposure. Certifications" for facilitie's .owned and/or. operated - by'• tli&"Town of
Kernersville._ ,These certifications °have bEcn signed -by Mr. Randy E., McCaslin, Town
Manageir,' As you will_note, I have also`included awo•"pictures for added information,
which show our fleet maintc=664ility;and the-recycleF,ccntdr. "-
The fleet maintenance "facility provides service and `repairs for all" Towne vehicles,
including, but.not prim:arily, garbage trucks and ambulances'These two types'of vehicles
represent well less than•50% of the total number of vehicles mainfained.. ,
Bill, thanks again for information and guidance you provided during our discussions and
your presentations. This really helped. -
Sincerely,
D
Russell D. Radford, P.E.
Town Engineer
Encl.
Cc: Mr. Randy E. McCaslin
Mr. Tim Shields
ALDERMEN
B. J. Ellender - Brian M. Green - Dawn H. Morgan - J. Irving Neal - Curtis L. Swisher
`�j�T., NtJFiTH CAROLINA'5
PIDMONT
TRIAD

March 5, 2003
Fleet Maintenance Facility for the 'town of Kernersville
Town of Kernersville
Public Works Department
720 McKaughan Street
Kernersville, North Carolina 27284

March 5, 2003
Town of Kernersville Recycle Center
Town of Kernersville
Public Works Department
720 McKaughan Street
Kernersville, North Carolina 27284