Loading...
HomeMy WebLinkAboutNCGNE1566_Application _20221122FOR AGENCY USE ONLY NCGNE1-51_6 Assig d to: (d. cooK AROFO MRO RRO WARO WIRO WSRO Division of Energy, Mineral, and Land Resources National Pollutant Discharge Elimination System No Exposure Certification for Exclusion NCGNE0000 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. Industrial materials or activities include, but are not limited to: • material handling equipment or activities, • by-products, • industrial machinery, • final products, or • raw materials, • waste products. • intermediate 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 industrial materials stored in the following container types, provided the containers are not deteriorated and do not leak: • drums, • tanks, and • barrels, • similar containers. For new facilities, applicants should apply no earlier than 60 days before the start of operation. This will allow DEMLR staff to verify conditions during active operation. For facilities that already have an industrial stormwater permit 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 Until you are issued a No Exposure Certification and your NPDES permit is rescinded, your facility must continue to abide by the terms and conditions of the current permit. A No Exposure Certification must be provided for each facility qualifying for the no exposure exclusion. Additionally, 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 forthe 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 new facilities, applicants should not apply more than 60 days before the start of operation date. This If approved, your conditional No Exposure Certification has no expiration date but must be self -recertified at least annually. Please look for information about recertification under the No Exposure section on this page: https://deg.nc.gov/about/divisions/energy-mineral-land-resources/npdes-no-exoosure. Directions: Print or type all entries on this application form. Send the original, signed application to: NCDEMLR Stormwater Program, 1612 MSC, Raleigh, NC 27699-1612. The submission of this form does not guarantee exclusion from NPDES stormwater permitting. Prior to exclusion from NPDES stormwater permitting a site inspection will be conducted. Page 1 of 6 1. Owner/Operator (to whom all permit correspondence will be mailed): Name of legal organ fnational entity: — LepIly responsible person (as signed in Item 7 below): ufia eecc v�R 1 ebA (r07Mrn Street address: - 131 City: I State a /� Zip Code e-(--n: 1 �6 �V ? 3 7 Telephone number: 910 - 360 - 00 Email address ear . G wi S Uk . Type of Ownership: Government ❑ County ❑ Federal ❑ Municipal ❑ State Non -government 19 Business (If ownership is business, a copy of NCSOS report must be included with this application) ❑ individual 2. Industrial Facility (facility requesting exclusion): Facility name: �L / SG U� �e2SC USri 7�'0 Facility environmental contact: I�ieW L.O re Street address: � 3 ' V e-4e roll I Pa ) Telephone number: l ©00 Email address: Drc� h) co� I✓w. �G/'e Ct city -Fro rD County 0 ome/ State L Zip Code o273 7 Latitude of entrance:u� Longitude of entrance:? Parcel Identification Number (PIN): 7s� 001 K wY i Ott aU 0131 Asa �-ts Moro 7s.27 00;>9 200 Date operation began: Standard Industrial Classification (SIC) Code: Brief description of the types of industrial activities and products produced at this facility: "I"I diw &r Ca�su j� 3. Consultant (if applicable): Name of consultant: Consulting firm: Street address: City: State and zip code: Telephone number: Email address: 4. Exposure Checklists Are any of the following materials or activities exposed to precipitation, now or in the foreseeable future? If you answer "Yes" to any of these items, you are not eligible for the no exposure exclusion. 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 ❑ Yes 9 No ❑ N/A Materials or residuals on the ground or in stormwater inlets from spills/leaks ❑ Yes OrNo ❑ N/A Materials or products from past industrial activity ❑ Yes 0 No ❑ N/A Material handling equipment (except adequately maintained vehicles) ❑ Yes VNo ❑ N/A Page 3 of 6 Materials or products during loading/unloading or transporting activities ❑ Yes ]S No ❑ N/A Materials or products stored outdoors (except final products intended for outside use [e.g., new ❑ Yes 0 No ❑ N/A cars] where exposure to stormwater does not result in the discharge of pollutants) Materials contained in open, deteriorated, non -sealed', or leaking storage drums barrels, tanks, ❑ yeses No ❑ N/A and similar containers Materials or products handled/stored on roads or railways owned or maintained by the discharger ❑ YesX No ❑ N/A Final products that would he mobilized in stormwater discharges (e.g., rock salt) ❑ Yes %No ❑ N/A Waste material (except waste in covered, non -leaking containers [e.g., dumpsters]) ❑ Yes No ❑ N/A Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes ]ENO ❑ N/A Particulate matter or visible deposits of residuals from roof stacks and/or vents not otherwise ❑ Yes $(No ❑NJA regulated (i.e. under an air quality control permit) and evident in the stormwater outflow Empty containers that previously contained materials that are not properly stored (i.e., not dosed ❑yes �QNo ❑ N/A and stored upside down to prevent precipitation accumulation) For any exterior ASTs, as well as drums, barrels, tanks and similar containers stored outside, has ❑yes �No ❑ N/A the facility had any releases in the past three (3) years? 'Sealed means banded or otherwise secured and with locked or non -operational taps or valves. Above Ground Storage Tanks (ASTs) and Secondary Containment If you answer "No" to any of the following items, you are not eligible for the no exposure exclusion. Are exterior ASTs or piping free of rust, damaged or weathered coating, pits, or deterioration, or !$yes ❑ No El N/A evidence of leaks? Is secondary containment provided for all exterior ASTs? If so, is it free of any cracks, holes, or RYes ❑ No ❑ N/A evidence of leaks, and are drain valves maintained locked shut? Is secondary containment provided for single above ground storage containers (including drums, barrels, etc.) with a capacity of more than 660-gallons? I(/iK/ZZ ��bb WA(Ir4 4 n S: k ZYes ❑ No ❑ N/A Is secondary containment provided for above ground storage containers stored in close proximity Yes ❑ No ❑NJA to each other with a combined capacity of more than 1,320 gallons? Is secondary containment provided forTitle III Section 313 Superfund Amendments and i�Yes ❑ No ❑ N/A Reauthorization Act (SARA) water priority chemicals? Is secondary containment provided for hazardous substances designated in 40 CFR §116? Yes ❑ No ❑ N/A Are release valves on all secondary containment structures locked? ❑ Yes ❑ No 12�N/A 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. Are vehicles used in material handling in disrepair and/or leaking fluid? ❑ Yes tiKNo ❑ N/A Does this facility store used, recycled, or otherwise reclaimed pallets outside? ❑ Yes 25No ❑ N/A Does this facility have coal piles on site? ❑ Yes IX No ❑ N/A Does this facility store other fuel sources outside in piles, such as wood chips, sawdust, etc? ❑Yes No ❑ N/A Does this facility have air emissions associated with industrial activity (e.g., degreasing operations, )(Yes ❑ No ❑ N/A plating, painting, or metal finishing)? If yes: Describe the industrial activity: r1ropcirL 'Rai 3a kr5 L Are those emissions permitted by an Air Quality Permit? ❑ Yes PINo Pleasespecify: Pamd-z.rcn� *01 dklwelrrr S. Other Facility Conditions (check all that apply and explain accordingly): ❑ This facility has other NPDES permits. If checked, list the permit numbers for all current NPDES permits: ❑ This facility has Non -Discharge permits (e.g_ recycle permit). If checked, list the permit numbers for all current Non -Discharge permits: ❑ This facility stores hazardous waste in the 100-yearfloodplain. If checked, describe how the area is protected from flooding: ❑ This facility is a (mark all that apply) ❑ Hazardous Waste Generation Facility ❑ Hazardous Waste Treatment Facility ❑ Hazardous Waste Storage Facility ❑ Hazardous Waste Disposal Facility If checked, indicate: • Kilograms of waste generated each month: • Type(s) of waste: • How material is stored: • Where material is stored: • Number of waste shipments per year: • Name of transport/disposal vendor: c Transport/disposal vendor EPA ID: • Vendor address: ❑ This facility is located on a Brownfield or SUPERFUND site. If checked, briefly describe the site conditions: ❑ This facility is located on Native American Lands. 6. Required Items (Application will be returned unless all of the following items have been included): Lf Copy of most recent Annual Report to the NC Secretary of State (if applicable) This completed application and any supporting documentation Copy of county map or USGS quad sheet with the location of the facility clearly marked Page 5 of 6 7. Applicant Certification North Carolina General Statute 143-215.6B (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 ... shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars ($50,000).1 hereby request exclusion from NPDES stormwater permitting. Under penalty of law, I certify that: Lr7 I am the person responsible for the industrial activity, for satisfying the requirements of this exclusion, and for any civil or criminal penalties incurred due to violations of this exclusion. I have read and understand the eligibility requirements for claiming a condition of "no exposure" and obtaining an exclusion from NPDES stormwater permitting. f� 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)). 211 1 understand that I am obligated to maintain no exposure conditions and complete a Self -Recertification form at least once each year and, if requested, provide this certification 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 Energy, Mineral, and land Resources, or MS4 operator where applicable, to perform inspections to confirm the condition of no exposure and to make such inspection reports publicly available upon request. I understand I must — / keep a copy of annual recert�cations on file at the facility. I understand that in the eventthat the site no longer qualifies for a No Exposure Exclusion that I must obtain coverage /under an NPDES permit prior to any point source discharge of stormwater from the facility. D The information submitted in this NOI is, to the best of my knowledge and belief, true, accurate, and complete based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information. Printed Name of Person Signing. l/G�lr'Q �' cPULR4 �t Title: N(CG£it✓r,0f,/Nen� Ad141AL74"15 Signature o pelican Date Signed Mail the entire package to: DEMLR— Stormwater Program Department of Environmental Quality 1612 Mail Service Center Raleigh, NC 27699-1612 Page 6 of 6 Swat& Delegation of Authority Environmental Operational Permits, including waste, wastewater discharge and air emission I, Steven Douglas, Senior Vice President of Operations, Saputo Cheese USA Inc. ("SCUSA"), hereby delegate to Ms. Debra A. Guzman, Director of Environmental Affairs for SCUSA, the authority to sign on behalf of SCUSA, the applications for environmental operational permits required for each plant owned and/or operated by SCUSA as per applicable legislation, including waste, wastewater discharge, and air emission permits and all reports and information to be submitted to the authorities with respect to these permits. This delegation I$ effective until it is further revoked by representative of SCUSA executive branch. Signed this3 day of November 2014. Steven Douglas Senior Vice President of Operations Saputo Cheese USA Inc. NORTH CAROLINA e Department of the Secretary of State CERTIFICATE OF AUTHORITY I, ELAINE F. MARSHALL, Secretary of State of the State of North Carolina, do hereby certify that SAPUTO CHEESE USA INC. having filed on this date an application conforming to the requirements of the General Statutes of North Carolina, a copy of which is hereto attached, is hereby granted authority to transact business in the State ofNorth Carolina. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal at the City of Raleigh, this 27th day of May, 2022. v -- -1i Scan to verify online. Document Id: C202214601261 Secretary of State Verify this certificate online at https://www.sosuc.gov/verification =`= NORTH CAROLINA Department of the Secretary of State ._a To all whom these presents shall come, Greetings: I, ELAINE F. MARSHALL, Secretary of State of the State of North Carolina, do hereby certify the following and hereto attached to be a true copy of APPLICATION FOR CERTIFICATE OF AUTHORITY OF SAPUTO CHEESE USA INC. the original of which was filed in this office on the 27th day of May, 2022. _ IN WITNESS WHEREOF, I have hereunto set my C hand and affixed my official seal at the City of Raleigh, this 27th day of May, 2022. Scan to verify online. Certification# C202214601261-1 Reference# C20221460126 1 -1 Page: 1 of 4 Verify this certificate online at httpsJ/www.sosne.gov/verification Secretary of State State of North Carolina Department of the Secretary of State SOSID: 2423412 Date Filed: 5/27/2022 7:37:00 AM Elaine F. Marshall North Carolina Secretary of State C2022 146 01261 APPLICATION FOR CERTIFICATE OF AUTHORITY Pursuant to §55-15-03 of the General Statutes of North Carolina, the undersigned corporation hereby applies for a Certificate of Authority to transact business in the State of North Carolina, and for that purpose submits the following: 1. The name of the corporation is Saputo Cheese USA Inc. and if the corporate name is unavailable for use in the State of North Carolina, the name the corporation wishes to use is: 2. The state or country under whose laws the corporation was organized is: Delaware 3. The date of incorporation was 11/14/1988 4. Its period of duration is: � perpetual or El a date certain (mm/dd/yyyy) 5. Principal office information: (Select either a or b.) a. The corporation has a principal office. The street address and county of the principal office of the corporation is: Number and Street One Overlook Paint, Suite 300 City, State, Zip Code Lincolnshire, IL 60069 County Lake The mailing address, if different from the street address, of the principal office of the corporation is: Number and Street City, State, Zip Code County b.❑The corporation does not have a principal office. 6. The street address and county of the registered office in the State of North Carolina is: Number and Street 160 Mine Lake Ct., Ste. 200 City: Raleigh State NC, Zip Code: 27615-6417 County: Wake 7. The mailing address, if different front the street address, of the registered office in the State of North Carolina is: Number and Street City: State NC Zip Code: 8. The name of the registered agent in the State of North Carolina is: BUSINESS REGISTRATION DIVISION (Revised July 2017) County: C T Corporation System P. O. BOX 29622 RALEIGH, NC 27626-0622 (Form B-09) NW21-.II/92017W mKluwer Online 9. The names, littes, and usual business addresses of the current officers ofthe corporation are (attach if necessary): Name Terry Brockman 71de President BusinessAddress One Overlook Point, Ste 300, Lincolnshire, IL 60069 Maxime Therrien Secretary 6869 Boul. Metropolitain E, Montreal, Quebec, CA H1P 1XB Robert Edwards Vice President & CFO One Overlook Point, Ste 300, Lincolnshire, IL 60069 10. Attached is a Certificate of Existence (or document of similar import) duly authenticated by the Secretary of State or other official having custody of corporate records in the state or country of incorporation. The Certificate of Existence must be an original and less than six months old 11. If the corporation is required to use a fictitious name in order to transact business in this State, a copy of the resolution of its board of directors, certified by its secretary, adopting the fictitious name is attached. 12. This application will be effective upon filing, unless a delayed date and/or time is specified: This is the S day of �Na-f 20 22 NOTES: 1. Filing fee is $250. This document must be filed with the Secretary of State. BUSINESS REGISTRATION DIVISION (Revised July 2017) P. O. BOX 29622 Saputo Cheese USA Inc. IMWTJ E$)GIKa711z".Il1t(iRl Signature Robert Edwards, Vice President Type or Punt Name and Title RALEIGH, NC 27626-0622 (Form B-09) NCMI -1 U M17 W.Itm YJ. 0.1i Delaware The First State I, JEFFREY W. BULLOCK, SECRETARY OF STATE OF TER STATE OF DELAWARE,. DO HEREBY CERTIFY "SAPUTO CHEESE USA INC.^ IS DULY Page 1 INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE AND IS IN GOOD STANDING AND HAS A LEGAL CORPORATE EXISTENCE SO FAR AS THE RECORDS OF THIS OFFICE SHOW, AS OF THE TWENTY—SIXTH DAY OF MAY, A.D. 2022. AND I DO HEREBY FURTHER CERTIFY THAT THE ANNUAL REPORTS HAVE BEEN FILED TO DATE. AND I DO HEREBY FURTHER CERTIFY THAT THE FRANCHISE TAXES HAVE BEEN PAID TO DATE. 2178089 8300 SR# 20222364281 You may verify this certificate online at corp.delaware.gov/authver.shtml �mnr w. errocr_S.s.n.rr cl Nnr Authentication: 203531340 Date: 05-26-22 1 n..e------ 4 n1"1111 Acn. Oel n,...... • -CA 10/11/2022 11:11 North Carolina Secretary of State Business Registration Annual Report https://www.sosne.govlonriine_servicesfbusiness_registration/flow_annual_report/19051064 1/1 r ♦`ram ♦ 1 0 one t���� '��`�<� �� �a�`��a III ■� �;- at�,lrgryt, ��� � ■ ���� •"any .... .. I: 1�` l �Vli7.�1 frvP� AME • 11�1:y;e II 7pr� ?' W �"� .