NCGNE1581_Application_20230123

FOR AGENCY USE ONLY
NCGNE l_�i$'1 JAN 2 3 2023
Assigned to: C00W
ARO FRO MRO RV 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 permitted facilities in North Carolina, DEMUR 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rescinded, your facility must continue to abide by the terms and conditions of the current permit.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 forthe 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 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 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://deo. nc.gov/about/divisions/e nergy-m i neral-land-resources/npd es -no -exposure.
Directions: Print or type all entries on this application form. Send the original, signed application to: NCDEMLR
Stormwater Program, 2612 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 5

1. Owner/Operator (to whom all permit correspondence will be mailed):
Name of legal organizational entity:
Legally responsible person (as signed in Item 7 below):
Zoetis
cuAnueq
Street address:
City: I
State
Zip Code
1040 Swabia Ct
Durham
I NC
27703
Telephone number:
Email address:
a> a -uses 1I4-3U$- 32.1
wu kis. 'xy 0 Zoe ;s Conn
Type of Ownership:
Government
El County ❑Federal El Municipal El State
Non -government
ID 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:
Facility environmental contact:
Zoetis 1040 Swabia
David Smith
Street address:
Telephone number:
1040 Swabia Ct
919-314-2635
Email address:
[e-mail]
- -
'
City
County Y
.�:.-.�:
State .mot �...---ry.Zip
Code
Durham
Durham
ti_
NC �s �'
27703�"'
Latitude of entrance 5:876220
Longitude of entrance:r-78.844530
Parcel (dent fiit tion Number (PIN):,,
0747-04 63,0857 ,,..a""`'
Date operatfon"begagT
d —` ;_
:Standard' Industrial Classification (SIC) Code` -
Feb 12013 -'
2836,,,5144, 0259, 2834
Brief descnptiorj,of theitypes)of m1.dustrialactv)ties and products produced at this facilityi;,�
Research, design, and assembly of Biodevices for poultry egg vaccination'��,,_ d`s'
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 0 No [I N/A
Materials or residuals on the ground or in stormwater inlets from spills/leaks
❑Yes 0 No ❑N/A
Materials or products from past industrial activity
❑ Yes ❑ No ❑ N/A
Material handling equipment (except adequately maintained vehicles)
❑Yes 0 No ❑ N/A
Page 2 of 5

Materials or products during loading/unloading or transporting activities
El Yes 0 No ❑ N/A
Materials or products stored outdoors (except final products intended for outside use [e.g., new
❑ Yes 0 No [I 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,
❑Yes 0 No ❑ N/A
and similar containers
.Materials or products handled/stored on roads or railways owned or maintained by the discharger
❑Yes 0 No ❑ N/A
Final products that would be mobilized in stormwater discharges (e.g., rock salt)
El Yes 0 No ❑ N/A
Waste material (except waste in covered, non -leaking containers [e.g., dumpsters])
❑Yes 0 No ❑ N/A
Application or disposal of process wastewater (unless otherwise permitted)
❑Yes 0 No ❑ N/A
Particulate matter or visible deposits of residuals from roof stacks and/or vents not otherwise
❑Yes ID No ❑ N/A
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 closed
❑Yes 0 No ❑ 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
El Yes 0 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 tfie"no exposure exclusion
,-X ---
Are exterior ASTs or piping free ofrrust damaged orweathered coating,-pits;or deterioration or4
- ;;
" ^ Yi
❑Yes0No0N/A
evidence of leaks? 3
Is secondary conta_inme`nt
provided for all exterioriASTs? If so is it free of.any cracks, holes, or `
€�
evidence of leaks,
s, f , ^�
and are drain valves maintamed locked shut?
❑Yes ❑No ON/A
Is secondary-containme mp ovided for single`abc ve ground storage containerrs (including drums, '�
—
'p
❑Yes❑No 0 N/A
-.:.
barrels, etc.) with capacity of more than 660-gallons? 4
a
Is secondary contalgment prov�ded�fot,above ground storage containers stored in close.proximit`y-
to with of 1 320 gallons?/'�+� -
❑Yes ❑No ❑ N/A
each other a combined capacity more than
Is secondary containment provided for Title III Section 313 Superfund Amendinenis,and
Reauthorization Act (SARA) water priority chemicals?
❑Yes ❑No 0 N/A
Is secondary containment provided for hazardous substances designated in 40 CFR §116?
❑Yes ❑No 0 N/A
Are release valves on all secondary containment structures locked?
❑Yes ❑No 0 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 0 No ❑ N/A
Does this facility store used, recycled, or otherwise reclaimed pallets outside?
DYes ❑ No ❑ N/A
Does this facility have coal piles on site?
El Yes 0 No ❑ N/A
Does this facility store other fuel sources outside in piles, such as wood chips, sawdust, etc.?
❑Yes 0 No ❑ N/A
Page 3 of 5

Does this facility have air emissions associated with industrial activity (e.g., degreasing operations, ©Yes El No © N/A
plating, painting, or metal finishing)?
if yes:
Describe the industrial activity:
Are those emissions permitted by an Air Quality Permit? ©Yes E]No
Please specify:
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-year floodplain.
If checked, describe how the area is protected from flooding:
❑O This facility is a (mark all that apply)
I] Hazardous Waste Generation Facility
❑ Hazardous Waste Treatment Facility
❑ Hazardous Waste Storage Facility
❑ Hazardous Waste Disposal Facility
If checked, indicate:
• Kilograms of waste gen'eraated each months Zoetls is a VSQG amounts vary but are small '"
) .
• Type(s) o�f�w,asteslab waste, Medical waste � t
• How material is stored: -In poly containers with secondary containment._
• Where material'ts stored: In doors in a dedicaiedstorage.room.,_„-�_„f
� f '
• Number of waste shipments per year: Hazardous waste as needed and in compliance with requlr ments: Medical waste weeldy.
• Name of.transport/disposal vendor?* Veelia,f9r .izarddus waste. Stedcycle for medical w ste
• Transport/disposal vendor EPA ID: NCD966166338
• Vendor address: 2176 Will Suitt Rd., Creedmoor NC, 27522
❑ This facility is located on a Brownfield orSUPERFUND 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):
❑ 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 4 of 5

7. Applicant Certification
North Carolina General Statute 143-215.66 (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 ($10,000). 1 hereby request exclusion from NPDES stormwater permitting.
Under penalty of law, I certify that:
l 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.
El- I have read and understand the eligibility requirements for claiming a condition of "no exposure" and obtaining an
exclusion from NPDES stormwater permitting.
0 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 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 M54 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 recertifications on file at the facility.
O I understand that in the event that
under an NPDES permit prior to an
El The information
coverage
based on
my
inquiry of the person: or persons who manage the system;!or those persons directly responsible for gathering the
information.,il,f
Printed Name*of Person S� nin :--' -
g g CurtisShuey
Title: Vice President
Jan 3, 2023
Signature of Applicant Date Signed
Mail the entire package to: DEMLR—Stormwater Program
Department of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
Page 5 of 5

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` `�.•.`p� LIMITED LIABILITY COMPANY ANNUAL REPORT
116=
NAME OF LIMITED LIABILITY COMPANY: ZoetiS LLC
SECRETARY OF STATE ID NUMBER: 1278920 STATE OF FORMATION: DE
REPORT FOR THE CALENDAR YEAR: 2022 AMENDING DOC ID
u
SECTION A: REGISTERED AGENT'S INFORMATION
1_ NAME OF REGISTERED AGENT: CT Corporation System
E - Filed Annual Report
1278920
CA202207406882
3/15/2022 03:30
2. SIGNATURE OF THE NEW REGISTERED AGENT:
SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT
3. REGISTERED AGENT OFFICE STREET ADDRESS & COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS
160 Mine Lake Ct Ste 200
160 Mine Lake Ct Ste 200
Raleigh, NC 27615-6417 Wake County Raleigh, NC 27615-6417
SECTION B:
1. DESCRIPTION OF NATURE OF BUSINESS: MANUFACTURE AND SALES OF PHARMACEUTICAL PRODUCTS
2. PRINCIPAL OFFICE PHONE NUMBER: [phone] 3. PRINCIPAL OFFICE EMAIL: Privacy Redaction
4. PRINCIPAL OFFICE STREET ADDRESS 5. PRINCIPAL OFFICE MAILING ADDRESS
10 Sylvan Way 10 Sylvan Way
Parsippany, NJ 07054 Parsippany, NJ 07054
6. Select one of the following if applicable. (Optional see instructions)
❑ The company is a veteran -owned small business
❑ The company is a service -disabled veteran -owned small business
SECTION C: COMPANY OFFICIALS (Enter additional company officials in Section E.)
NAME: ZOETIS HOLDINGS LLC NAME:
TITLE: Member
ADDRESS:
10 Sylvan Way
TITLE:
ADDRESS:
NAME:
TITLE:
ADDRESS:
Parsippany, NJ 07054
SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business entity.
ZOETIS HOLDINGS LLC, by Mandy Hendricks Power of Attorney 3/15/2022
SIGNATURE DATE
Form must be signed by a Company Official fisted under Section C of This form.
ZOETIS HOLDINGS LLC, by Mandy Hendricks Power of Attorney Member
Print or Type Name of Company Official - Print or Type Ti6e of Company Official
This Annual Report has been filed electronically.
MAIL TO: Secretary of State, Business Registration Division, Post Office Box 29526. Raleigh, NC 27626-0625

LIMITED LIABILITY COMPANY ANNUAL REPORT
4..'
Us=
NAME OF LIMITED LIABILITY COMPANY: ZOefIS Services
SECRETARY OF STATE ID NUMBER: 1436267 STATE OF FORMATION: NC
REPORT FOR THE CALENDAR YEAR: 2022
SECTION A:
1. NAME OF REGISTERED AGENT: CT Corporation System
E - Filed Annual Report
1436267
CA202208105270
3IM2022 03:15
2. SIGNATURE OF THE NEW REGISTERED AGENT:
SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT
3. REGISTERED AGENT OFFICE STREET ADDRESS & COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS
160 Mine Lake Ct Ste 200
160 Mine Lake Ct Ste 200
Raleigh, NC 27615-6417 Wake County Raleigh, NC 27615-6417
SECTION B: PRINCIPAL OFFICE INFORMATION
1. DESCRIPTION OF NATURE OF BUSINESS: Sale and distribution of pharmaceutical products
2. PRINCIPAL OFFICE PHONE NUMBER: [phone] 3. PRINCIPAL OFFICE EMAIL: Privacy Redaction
4. PRINCIPAL OFFICE STREET ADDRESS 5. PRINCIPAL OFFICE MAILING ADDRESS
10 Sylvan Way 10 Sylvan Way
Parsippany, NJ 07054 Parsippany, NJ 07054
6. Select one of the following If applicable. (Optional see Instructions)
❑ The company is a veteran -owned small business
❑ The company is a service -disabled veteran -owned small business
SECTION C: COMPANY OFFICIALS (Enter additional company officials in Section E.)
NAME: Zoetis Subsidiary Holdings Inc
TITLE: Member
ADDRESS:
NAME:
TITLE:
ADDRESS:
NAME:
TITLE:
ADDRESS:
10 Sylvan Way
Parsippany, NJ 07054
SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a personibusiness entity.
Zoetis Subsidiary Holdings Inc, by Mandy Hendricks Power of Attorney 3/22/2022
SIGNATURE
Form must be signed by a Company Official fisted under Section C of This form.
DATE
Zoetis Subsidiary Holdings Inc, by Mandy Hendricks Power of Attorney Member
Print or Type Name of Company Official Print or Type Tdle of Company
This Annual Report has been filed electronically.
MAIL TO: Secretary of State, Business Regishation Div6ion, Post Office Box 29525, Raleigh, NC 27626-0525

LIMITED LIABILITY COMPANY ANNUAL REPORT
❑N2022
NAME OF LIMITED LIABILITY COMPANY: Zoetis US LLC
SECRETARY OF STATE ID NUMBER: 1435237 STATE OF FORMATION: DE
REPORT FOR THE CALENDAR YEAR:
2022 AMENDING DOC ID
u
SECTION A: REGISTERED AGENT'S INFORMATION
1. NAME OF REGISTERED AGENT: CT Corporation System
2. SIGNATURE OF THE NEW REGISTERED AGENT:
E- Filed Annual Report
1436237
CA202206904785
3/10/2022 12:30
SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT
3. REGISTERED AGENT OFFICE STREET ADDRESS & COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS
160 Mine Lake Ct Ste 200
160 Mine Lake Ct Ste 200
Raleigh, NC 27615-6417 Wake County Raleigh, NC 27615-6417
SECTION B:
1. DESCRIPTION of NATURE of BUSINESS: SALE AND DISTRIBUTION OF PHARMACEUTICAL PRODUCTS
2. PRINCIPAL OFFICE PHONE NUMBER: [phone] 3. PRINCIPAL OFFICE EMAIL: Privacy Redaction
4. PRINCIPAL OFFICE STREET ADDRESS
5. PRINCIPAL OFFICE MAILING ADDRESS
10 Sylvan Way 10 Sylvan Way
Parsippany, NJ 07054 Parsippany, NJ 07054
6. Select one of the following If applicable. (Optional see Instructions)
❑ The company is a veteran -owned small business
❑ The company is a service -disabled veteran -owned small business
SECTION C: COMPANY OFFICIALS (Enter additional company officials in Section E.)
NAME: Zoetis Subsidiary Holdings InC NAME:
TITLE: Member
ADDRESS:
10 Sylvan Way
Parsippany, NJ 07054
TITLE:
ADDRESS:
NAME:
TITLE:
ADDRESS:
SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business entity.
Zoetis Subsidiary Holdings Inc, by Mandy Hendricks Power of Attorney
SIGNATURE
Form must be signed by a Company Official listed under Section C of This form.
Zoetis Subsidiary Holdings Inc, by Mandy Hendricks Power of Attorney
Print or Type Name of Company Official
3/10/2022
Member
DATE
Print or Type Title of Company Official
This Annual Report has been filed electronically.
MAIL TO: Secretary of State, Business Registration Division, Post Office Box 29525, Raleigh, NC 27626-0525

Zoetis Inc.
1040 Swabia Ct
Durham, NC 27703
January 17, 2023
T [phone]
M 919 247 3450
E david. [e-mail]
NCDEMLR Stormwater Program
1612 MSC
Raleigh, NC, 27699-1612
Dear Brittany:
zoetis
jpy 3
Please see the enclosed documents for Zoetis for the No Exposure Certification. You will find the
application, maps of the location, and the reports to the NC Sectary of State for Zoetis. Additionally, we
have emailed copies of these documents to you. Please let me know if there is anything additional we
need to complete or provide for you and the program.
Best re ards
David Smith
Regional Director, Facilities and Risk Management Lead