NCGNE0530_COMPLETE FILE - HISTORICAL_20090313

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO. N E--u S5 0
DOC TYPE LQ/HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE ❑ �U��j �)�
YYYYMMDD

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
February 27, 2009
RECEIVED
N.C.OeoL of ENR i
Mr. Jimmy Milam
MAR 13 2009
IRC/TT Electronics
736 Greenway Road winstcn-Salem
Boone, NC 28607 Regional office
Subject: No-Exposure Certification NCGNE0530
IRCITT Electronics
736 Greenway Rd., Boone, NC 28607
Watauga County
Dear Mr. Milam:
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 permit number
NCG030435.
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 (February 26, 2014). 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 Robert Patterson at [phone], or at
[e-mail].
Sincerely, ---�--
for Coleen H. Sullins
cc: Winston-Salem Regional Office-Sue White Stormwater Permitting File NCG030435
Stormwater Permitting Unit No- Exposure Fifes Fran McPherson-Budget Office
Wetlands and Stormwater Branch One
1617 Mail Service Center,Raleigh,North Carolina 27699-1617 NorthCarolina
Location:512 N.Salisbury St.Raleigh,North Carolina 27604
Phone:[phone] FAX:[phone] Customer Service:1-877-623-6748 �r�aturall�/
Internet:www.ricwaterquality org ;/
An Equal Opportunity 1 Affirmafive Aclior Employer

WOMA
NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
February 27, 2009
Mr. Jimmy Milam
IRCITT Electronics
736 Greenway Road
Boone, NC 28607
Subject: No-Exposure Certification NCGNE0530
IRCITT Electronics
736 Greenway Rd., Boone, NC 28607
Watauga County
Dear Mr. Milam:
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 permit number
NCG030435.
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 (February 26, 2014). At that time you must re-certify with the Division, or
obtain N PDES 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 Robert Patterson at(919) 807-6375, or at
[e-mail].
Sincerely,
ORIGINAL SIGNED BY
KEN PICKLE
for Coleen H. Sullins
cc: Winston-Salem Regional Office-Sue White Stormwater Permitting File NCG030435
Stormwater Permitting Unit No- Exposure Files Fran McPherson-Budget Office
Wetfands and Stormwater Branch One
1617 Mail Service Center,Raleigh,North Carolina 27699-1617 NorthCarol.ina
Location:512-8 7 Salisbury S1.Raleigh,North Carooina r Service:
)Vaturally
Phone:919�07-63pD l FAX:[phone] Customer Service:1-$77�23�74B
Internet:www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer

r'atauga Co non exposure requests
Subject: Watauga Co non exposure requests
From: Sue White <S [e-mail]>
Date: Mon, 06 Oct 2008 12:41 :40 -0400
To: [e-mail]
Hi Sarah:
NCGNE0530 Irc/Tt Electronics - IRC/TT Electronics
NCGNE0533 Town of Boone - Jimmy Smith WWTP
Both of these non exposure requests were the result of an inspection by me and my recommendation to
purstEe it. I recommend that these be approved. Thanks!
Sue White
NC DENR Winston-Salem Regional Office
Division of Water Quality, Water Quality Section
585 Waughtown Street
Winston-Salem, NC 27107
Voice: (336) 771-4966
FAX: (336) 771-4630
"Adventure in .itself is Worthwhile"
-Amelia Earhart-
Sue White <Sue.White rr,NCmail.net>
WSRO
NC DENR
1 of' 1 1/31/2009 2:47 PM

'(Tr) tdectronics
. ...................................
International Resistive Company, Inc.
Wirewound and Film Technologies Division
736 Greenway Fr gad, P.O. Box 1860
Boone, North Cyr-olina 28607, USA
Telephone: +1 l )28) 264 8861
Facsimile: +i +;328)264 8866
Email: waft.saler®irctt-com
W ebsite:w%vwJri ct.corn
FAX transmission
Date: ' -�vo
Company: ��,� ��,� fax# '7'�
To:
From: Jim Mifam
('nvironmentaf/Safety Manager
Ph: 628.263.5270
Fax: [phone] S 1
E,,mail: [e-mail]
Subject
Page 1 :a#
"Sac
ram;r;147
Ili!r A subsidiary of TT electronics plc
Y •d 002E 1317a�)SIJ-1 dH WFJ-1,2 : T t 0002 91 ono

'r.;•'" ��( FOR AGENCY USE ONLY
•' Daec Rseeivui
� �• Division of Water Quality/Surface Water Prat action Year ays�„m noy
NC®ENR National Pollutant Discharge Elimination Systi:rn carofitatE orcov ge
NJCIGINJE
NO EXPOSURE CERTIFICATION for Exclus:on
NCGNEOOOO
NO EXPOSURE CERTIFICATION "`` •-
National Pollutant Discharge Elimination System application for excluslor from a S-,1L a*t Perrnrt
based o-i NO EXPOSURE:
Submis::ron of this No Exposure Certification constitutes notice that youa facility does not require permit
authorba3tion for its stormwater discharges associated with industrial aci: vity in the State of North
Caroline because it qualifies for a no exposure exclusion. A condition of i io exposure at an lndusiriaf
facility r•leans all industrial materials and activities are protected by a sto,m resistant shelter(with some
exceptions) to prevent exposure to rain, snow, snowmelt, and/or runoff.
Industrl d materials or activities include, but are not limited to: material to rndling equipment or activities,
industriarl machinery, raw materials,intermediate products, by-products, final products, or waste
product.,. Material handling activities include the storage, loading and ur foading, transportation, or
conveyz,ace of any raw material, Intermediate product, final product or wit ste product. A storm resistant
shelter i;not required for the following industrial materials and activities: drums, barrels, tanks,.and
similar c ontainers that are tightly sealed,provided those containers are n-)t deteriorated and do not leak.
"Sealed means banded or otherwise secured and with locked or non-opa;rational taps or valves;
adequa0ly maintained vehicles used In material handling;and final prods cts, other than products that
would b:r mobilized in starmwater discharges(e.g., rock salt).
A No Exosure Certification must be provided for each facili qualifying.br the no exposure exclusion.
In additi:in, the exclusion from NPDES permitting is available on a facility.wide basis only—not for
Individual outfalts. if any industrial activities or materials are, or will be, c rposed to precipitation, the
facility I:; not eligible for the no exposure exclusion. By signing and subni lting this No Exposure
Certitica Hon form, you certify that a condition of no exposure exists at the, facility or site and are
obligate:l to comply with the terms and conditions of 40 CPR 122.26(g).
You aro! required to reapply for the No Exposure Exclusion_ of ce every five (5) years.
For questions,please contact the OWO Regional Office for ya:ir area. (See page 5)
(Please print or type)
1) Mailing address of owner/operator(address to which all certification c irres ondence will be mailed):
Nam- i_LnM.y M i t c�►.�
StreE 1:Address 6 0 re,01,ve.w R 0 .
City v o n•e'_ _ State IV G _ZIP Code ,7k, o7
Telephone No. —E 94 L 68b 1 Fax:
2) Location of facility producing discharge:
Facili ty Name F-R C hie c
Facility Contact
Stree l Address 90. VP r 36-
% IleQ.
City t_ State JVC ._ZIP Code __ 640 7
County ue_ a�
Telechon9 No. ,� (a`�—� (e 1 Fax:
Page 1of5
5WU-NE•1-0607 Last revised 1 VoGiD7
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NCGNF.0000 No Exposure Certification
3) Phyaoical location information:
Plea_•e provide a narrative description of how to get to the facility (use strec t names, state road numbers, and
distance and direction from a roadway intersection), z5u, tv,/!iioera Nc, to 23NDcwr�
(A a'py of a map with the facility clearly located on it should be included wil 1 the certification application.)
4) Is th.-facility located on Native American Lands?❑ Yes g rf4o
5) Is this a Federal facility? ❑ Yes tz✓No
30
la) Latilude 3L c)PS,W m.30 S.Longitude a8�_:22m;.v (deg, min, i:ec)
7) This NPDES Permit Application applies to which of the following:
❑ New or Proposed Facility Date operation is to begin
w l:.xisting Date operation began / S: 3
8) Was this facility or site ever covered under an NPDES Stormwater Peel rnit? ❑ Yes ❑ No
If ye:., what is the NPDES Permit Number? A14C G _ �23 Q flfJU /U`e- 3
a z�3S
9) Standard Industrial Classification:
Prov de the 4 digit Standard Industrial Classification Code (SIC Code) that,iescribes the primary industrial
activ ty at this facility
SIC ::ode:3- �L_ 2 6—
10) Pro%I�dee a/brief description of the types of/industrial activities and pro.iucts produced at this facility:
dl�l,l'✓C� �G�' 1fi}/Vf. J/.t
11) Doer:this facility have any Non-Discharge permits (ex: recycle permit;:)?
EX,
© Y1:s
If ye:,, 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 precipitath, n, now or In the foreseeable
future? (Please check either "Yes" or "No.") If you answer "Yes" to a ,y of these items,you are not
eligi:rle for the no exposure exclusion.
a. U.,;ing, storing, or cleaning industrial machinery or equipment, and areas "here © Yes V/N"O
rt:siduals from using, storing or cleaning industrial machinery or equipm+int remain
a-id are exposed io stormwater
b. M:;terials or residuals on the ground or in stormwater inlets from spills/le;iks ❑ Yes V<//o
c. Materials or products from past industrial activity ❑ Yes �'No
d. M.:iterial handling equipment (except adequately maintained vehicles) ❑ Yes M 1i 0
e. Materials or products during loadinglunloadina or transporting activities ❑ Yes 314110
f. 1,Az::erials or products stored outdoors (except final products intended for )utside 0 Yes 4 o
us:1 je.g., new cars} where exposure to stormwater does not result in the iischarge
of :;ollutants)
Page 2 of 5
SWU-NE,110607 Last revIsW 11105/07
E - OOZE 1�31783SU-1 dH WFJSZ : T T BOOZ 91 gnu

NCGNI::0000 No Exposure Certification
g. Materials contained in open, dotoriorated or leaking storage drums, barn; Is, tanks, ❑ Yes GVNo
and similar containers
h, M_iter4s or products handled/stored on roads or railways owned or mair tained by ❑ Yes V*N0
tho discharger
i. Miste malarial (except waste in covered, non-leaking containers [e.g., dr. mpsters]) ❑ Yes 2 No
j. Ap:Jlication or disposal of process wastewater(unless otherwise permitter 1) ❑ Yes VNo
k. Particulate matter or visible deposits of residuals trom roof stacks andfor vents not ❑ Yes [/N0
ell ierwise regulated (i.e„ udder an air quality control permit) and evident i i the
stormwater outflow
I. En iply containers that previously contained materials that are not propel, stored ❑ Yes VNe
(Lu., not closed and stored upside down to prevent precipitation accumu ation)
m. For any exterior ASTs, as well as drums, barrels,tanks, and similar con ainers ❑ Yes VNo
stared outside, has the facility had any releases in the past three (3) year;?
13) Above Ground Storage Tanks (ASTs): If you answer "No"to any of ih a following items, you are not
eligible for the no exposure exclusion.
a. A,a exterior ASTs or piping free of rust,damaged or weathered coating, )its, or I7 Yes I No
drierioration, or evidence of leaks?
b. IS secondary containment provided for all exterior ASTs? If so, is it free )f any V es ❑ No
cr,�.cks, holes, or evidence of leaks, and are drain valves maintained lock.ld shut?
14) Secondary Containment: If you answer "No"to any of the following i ems,you are not eligible for the
no exposure exclusion.
a. Is secondary containment provided for single above ground storage con+liners 9/yes ❑ No
(ircluding drums, barrels, etc.) with a capacity of more than 660-gallons"
b. Is secondary containment provided for above ground storage containers stored tw'Yes ❑.No
in close proximity to each other with a combined capacity of more than 1.320-
gellons? /
c. Is secondary containment provided for any amount of Title Ill Section 31:I O'Yes ❑ No
St perfund Amendments and Reauthorization Act (SARA) water priority
chemicals?
d. Is secondary containment provided for any amount of hazardous substar ces? WXes ❑ No
e. Ai,q release valves on all secondary containment structures locked? ryes ❑ No
Page 3 of 5
SWU•NE-' 10607 Last revised 11/06/07
°I 002C 13CN3Sd'1 dH WUGa : 1 T BOOz 91 onu

,f NCGN1::0000 No Exposure Certification
15) Haz;irdous Waste:
a. Is This facility a Hazardous Waste Treatment, Storage, or Disposal Facili,y? CI Yes ID40
b. Is'this facility a Small Quantity Generator (less than 1000 kg. of hazardo i s waste O Yes EAO
ge,ierated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator{1000 kg, or more of hazardous waste m es © No
gerierated per month) of hazardous waste?
If yo•.t answered yes to questions to. or c., please provide the following infori nation:
"ype(s) of waste: D—d .1 D--Q!D" o—oD 8 _Foo3 F - 00
I-low is material stored:C&era@ jOj,CeW So%f/cuse. iw &RAcM_5
Where is material stored: e
I-low many disposal shipments per year:
(Jame of transport 1 disposal vendor: F�Aa(A &Au9
endoorr address: gk.
16) Ceriification: �� , ,��G<�vara� sl,p� y y6��� 5 y,� = �D �u�✓
I certify under penalty of law that I have read and understand the eligibility requires cents for claiming a condition of"no
exposure"and obtaining an exclusion from NPDES slormwater permitting.
I certify under penalty of law that there are no discharges of slormwater contaminat ed by exposure to industrial activities
or m;iterials from the industrial facility or site identified in this document (except as allowed under 40 CFR 122.26(g)(2)).
I und�;rsland that I am obligated to submit a no exposure_certification form once er ery live 5 ears to the North Carolina
Divis )n of Water Quality and, if requested, to the operator of the local munfcipal s.:parate storm sewer system (MS4) into
which the facility discharges (where applicable). I understand that I must allow the. North Carolina Division of Water
Qual t-y,or MS4 operator where the discharge is into the local M54, to perform insl:ections to confirm the condition of no
exposure and to make such inspection reports publicly available upon request.
In thr!event that the site no longer qualifies for a No Exposure Exclusion, I undersI tnd that i must obtain coverage under
an N 'DES permit prior 10 any point source discharge of stormwater from the facitiC e,Additionally, I certify under penally
of law that this document and all attachments were prepared under my direction or supervision in accordance with a
syste in designed to assure that qualified personnel property gathered and evaluat.:d the information submitted. Based
on mi,inquiry of the person or persons who manage the system, or those persons iirectly responsible for gathering the
infori=.ration, the information submitted is to the best of my knowledge and belief trr e, accurate and complete. I am aware
that 1 Mere are significant penalties for submitting false information,including the pc ssibility of fine and imprisonment for
knoe%ing violations.
I Cert ly that I am familiar with the information contained in this application and thal to the best of my knowledge and
belie' such information is true, complete, and accurate.
I:rinsed Name of Person Signing: Jll�niy -
"itIe: G—,
1:3ign e of Applicant) (Dare 5igned) .
Page 4 of 5
SvYu-NE-1'10607 Last revised 11/06/07
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Aj, Data Received
Division of Water Quality/Surface Water Protection year Month Day
UV 03 1 3f
NCDENR National Pollutant Discharge Elimination System Cerlificale of covemp
N1cLQjN1E1Q1513:k?
Np lf­MO DU T. OF NO EXPOSURE CERTIFICATION for Exclusion -
EwvwOwi+U _D Nd _RESau 5
_- NCGNE0000
NO EXPOSURE CERTIFICATION
National Pollutant Discharge Elimination System application for exclusion from a Stormwate�Q mites
based on NO EXPOSURE:
Submission of this No Exposure Certification constitutes notice that your facility does not req permit #
authorization for its stormwater discharges associated with industrial activity in the State of No
Carolina because it qualifies for a no exposure exclusion. A condition of no exposure at an indu
facility means all industrial materials and activities are protected by a storm resistant shelter(wit e �.
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,
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 122.25(g).
You are required to reapply for the No Exposure Exclusion once every five (5) years.
For questions, please contact the DWQ Regional Office for your area. (See page 5)
(Please print or type)
1) Mailing address of owner/operator(address to which all certification correspondencewill be mailed):
Name (i!ILI,,
Street Address
City 000 6 State /V G ZIP Code 1'/11 07
Telephone No. _?AR a&iL —'383& 1 Fax: ?AN
2) Location of facility producing discharge:
Facility Name _�.._l�C 1�-/&c frCAVC 5
Facility Contact ;m
- Street Address
71 City 1 0c>0 e State A ZIP Code v2 60 7
County Lcl 1- c a-
Telephone No. _9 '�(o - Fax: :2 C-3 S/ I
Page 1 of 5
SWU-NE•110607 Last revised 11/06/07

NCGNED000 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). / fit/ /�Fcr„ NC- ¢"o BLS e- N,�
(A copy of a map with the facility clearly located on it should be include6 with the certification application.)
4) Is the facility located on Native American Lands? ❑ Yes D?1No
5) Is this a Federal facility? _❑ Yes 121No
3o sec..
6) Latitude 36_ ,ld Ni. 30 S.Longitude D34rv_ (deg, min, sec)
7) This NPDES Permit Application applies to which of the following:
❑ New or Proposed Facility Date operation is to begin
p/1=xisting Date operation began _�3
8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes ❑ No
If yes, what is the NPDES Permit Number? N4 G i�23U M
9) Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Cade (SIC Code)that describes the primary industrial
activity at this facility
SIC Code: 3 (p
10) Provide a brief description of the types of industrial activities and products produced at this facility:
11) Does this facility have any Non-Discharge permits(ex: recycle permits)?
[�10
❑ 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
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 VINo
c. Materials or products from past industrial activity ❑Yes se o
d. Material handling equipment (except adequately maintained vehicles) ❑ Yes 540
e. Materials or products during loadinglunloading or transporting activities ❑Yes 31110
f. Materials or products stored outdoors (except final products intended for outside ❑ Yes 4
eO
use [e.g., new cars] where exposure to stormwater does not result in the discharge
of pollutants)
Page 2of5
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 �'No
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes 2 No
the discharger
i. Waste material (except waste in covered, non-leaking containers [e.g., dumpsters]) ❑ Yes lia'No
j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes VNa
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes lINo
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 [a'No
(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 El Yes U'N0
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 ❑ Yes ry 0
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any V/Yes ❑ 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.
a. is secondary containment provided for single above ground storage containers 1Sa'Yes ❑ No
(including drums, barrels, etc.) with a capacity of more than 660-gallons?
b. Is secondary containment provided for above ground storage containers stored U'Yes ❑ 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 [ es ❑ No
Superfund Amendments and Reauthorization Act(SARA)water priority
chemicals?
d. Is secondary containment provided for any amount of hazardous substances? w es ❑ No
e. Are release valves on all secondary containment structures locked? 5/yes ❑ No
Page 3 of 5
SWU-NE-110607 East revised 11106/07

NCGNE0000 No Exposure Certification
15) Hazardous Waste:
a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? ❑ Yes GKo
b. is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste ❑ Yes GKlo
generated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste GVYes ❑ No
generated per month) of hazardous waste?
It you answered yes to questions b. or c., please provide the following information:
Type(s) of waste: I)—opj D=-c)V"7 0-Oa 8 roo3 _ F
How is material stored-C&ereZi�t�JKed
Where is material stored: INyi lr
How many disposal shipments per year: l 5— s
Name of transport 1 disposal vendor: Frei{dG ill 1 Y Souk � r C4,em;<<a S�Ju� ft"
Vendoorpr address: Su....e-6-r Sc ,
j 13o�1,baclC �r��1e . C.a-n.�cs:-c.r �D yam. Nair i�A�--.�'1�L�j� �,.✓
16) Certification: C P� � ��,ye„�J s J is S�yo.�� +`5 /,c
To �afi f f�, .14 - f/1
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 eves five (5)year 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 1 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, 1 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 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: Jlljlijw
Title: r c�
(Signa e of Applicant) (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 10 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:
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 ... (910) 433-330043
,r -{� r r rR�I01gh
Mooresville Office ... [phone]
Raleigh Office ........ [phone] 3t1v�16 Wit° .
Washington Office ...[phone] -
Wilmington Office ... [phone]
Winston-Salem ...... [phone]
Central Office .........[phone] A= +
YViI n9ton
r
Page 5 of 5
SWU-NE-110607 Last revised 11/06/07

1'
VVS(LD
FOR AGENCY USE ONLY
O;ue Receieed
� Division of Water Quality/Surface Water Protection Year tit„a,n nay
V 3 3 l
NCDENR National Pollutant Discharge Elimination System CeririexeofCovemge
NE
RomT.C—UN.6erraT'C> Of NO EXPOSURE CERTIFICATION for Exclusion
ENVIRONMENT n�NuvR�Rem JwCES
NCGNE0000
NO EXPOSURE CERTIFICATION mom
National Pollutant Discharge Elimination System application for exclusion from a Stormwat,� mit�'� 1
based on NO EXPOSURE: + j
Submission of this No Exposure Certification constitutes notice that your facility does not req' permit 1
authorization for its storm water discharges associated with industrial activity in the State of No ti7G
Carolina because it qualifies for a no exposure exclusion. A condition of no exposure at an induV*0
facility means all industrial materials and activities are protected by a storm resistant shelter(wit a
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,
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 reappiV for the No Exposure Exclusion once every five 5 ears.
For questions,please contact the DWQ 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 I i I".."
Street Address
City 300 ive _ State IV C ZIP Code ;;2 N67
Telephone No. _?ag 3L��8(� ! Fax: ljj�"aR—
2) Location of facility producing discharge:
Facility Name X 17-7` �i51eC roa//c5
Facility Contact i rn ro uu-w—
Street Address
City I ner,e __ State G ZIP Code 0'7
Countya—
Telephone No, a,ta'f--i3 alp I Fax:
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 facility (use street names, state road numbers, and
distance and direction from a roadway intersection). / W,' tirra NC- fe B--Ne— N.C,
(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 T No
5) is this a Federal facility? ❑ Yes GA
2. Sew.
6) Latitude 31 jeS.)a m, 30 S.Longitude 4J� om;.v (deg, min, sec)
7) This NPDES Permit Application applies to which of the following:
❑ New or Proposed Facility Date operation is to begin
p/�xisting Date operation began/yS3
8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes ❑ No
If yes, what is the NPDES Permit Number? IVC G� 4230
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:a L 7 {a
10) Prov�i�dee a brief�description of the types of industrial activities and products produced at this facility:
11) Does this facility have any Non-Discharge permits (ex: recycle permits)?
Q40
❑ 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 Sr/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 VNo
c. Materials or products from past industrial activity ❑ Yes V<O
d. Material handling equipment (except adequately maintained vehicles) ❑ Yes 540
e. Materials or products during loadinglunloading or transporting activities ❑ Yes azo
f. Materials or products stored outdoors (except final products intended for outside ❑ Yes 4 o
use [e.g., new cars]where exposure to stormwater does not result in the discharge
of pollutants)
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 13TI0
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes VN' o
the discharger
i. Waste material (except waste in covered, non-leaking containers [e.g., dumpsters]) ❑ Yes Iid No
j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes 6YNo
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 tg'No
(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 VN0
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 ❑ Yes VIN"'o
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any vyes ❑ 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.
a. Is secondary containment provided for single above ground storage containers 'Yes ❑ No
(including drums, barrels, etc.) with a capacity of more than 660-gallons?
b. Is secondary containment provided for above ground storage containers stored U Yes ❑ 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 Dl es ❑ No
Superfund Amendments and Reauthorization Act (SARA) water priority
chemicals?
d. Is secondary containment provided for any amount of hazardous substances? 5 es ❑ No
e. Are release valves on all secondary containment structures locked? Wyes ❑ No
Page 3 of 5
5Wu-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 NKO
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste ❑ Yes EKKO
generated per month) bf hazardous waste?
c. Is this facility a Large Quantity Generator (1000 kg, or more of hazardous waste GVYes Ej No
generated per month) of hazardous waste?
If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste: j)-6oI D-oo-1 0-op 8 Foo-3 F - 005-
How is material stored:Ca.er,ec?lOAC--d 5o%r�If /foxsc f.✓ Dt?a►ns
Where is material stored: /,yj� c,
How many disposal shipments per year: o ,
Name of transport I disposal vendor: Frwh(A Sat.L- en-s-ler ry Chq n4'cr< I Sdve,�
Vendor address: �r T 7_s�� �tr� l P.D. Suer _CC ,
I )lo11.�,ck lva+I 14112- - V U-05e-
16) Certification: <,t,,,l „"me- eLislere-� skej Y"It
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)).
l 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. 1 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:a6ms/ '�!1/JZ
Title: --,kr,F
(Signa e of Applicant) (Date Signed)
Page 4of5
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 tiled 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 knowingiy
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:
L/ This completed application and all supporting documentation.
G7/ 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.
DWQ Regional Office Contact Information:
v
Winston y, �^
Asheville Office ...... [phone] Salem
`�' ( '
Fayetteville Office ... [phone] r Ra! gh
Mooresville Office ... [phone]
Raleigh Office ........ [phone] g )
Washington Office ...[phone]
Wilmington Office ... [phone] {
Winston-Salem ...... [phone] r rcfiarrMe rt�`
Central Office .........[phone] ��,., �
ngton
Page 5 of 5
SWU-NE-110607 Last revised 11/06/07

i
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AZARDOU5 WASTE
FLAMMABLE MATL.
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ID elivery Fee r
ent Required)
Aage a Fees a •�s �'���� /liyJ� _
No.:
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OHO
Certification form, you certify that a condition of no exposure exists at this facility or site ano ar�
obligated to comply with the terms and conditions of 40 CFR 122.26(g),
You are re uired to rpp_p_plV for the No Exposure Exclusion once every five S ears.
For questions, please contact the DWQ 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 "Z�a �NU 1,,,
Street Address �07 _l-6 b d /Z 0 .
City ( 0o e State IV C ZIP Code l�.._
Telephone No. _-RAS_ a&+{-'386 J _ Fax:
2) Location of facility producing discharge:
Facility Name
Facility Contact i m M rr)
Street Address f�� 1&6 0
City L State ✓�ZIP Code v2 4
County
Telephone No. _ la ~�3 to �_- Fax:
Page 1 of 5

. .
�� - _ - _
i �,
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FOR AGENCY USE ONLY
Uate keceired
Division of Water Quality 1 Surface Water Protection year oay
.-..ram
NCDENR National Pollutant Discharge Elimination S}mcm CertifCXeQfCMerMge
ir CG 1iE
NW-C OurU!)Eru c-r0F NO EXPOSURE CERTIFICATION for I xclusion
EVyS-E.--N..-RESWY CES
NCGNF.0000
7__
NO EXPOSURE CERTIFICATION +' t.r,- ' ` �
c
National Pollutant Discharge Elimination System application for exclusion from a 5to water Per N
based on NO EXPOSURE:
Submission of this No Exposure Certification constitutes notice that your facility does not requ rm�
authorization for its stormwater discharges associated with industrial activity in the State of N I
Carolina because it qualifies for a no exposure exclusion. A condition of no exposure at an in trial
facility means all industrial materials and activities are protected by a storm resistant shelter(with s
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,
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 faciLty 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 reapplV for the No Exposure Exclusion once every five 5 ears.
For questions, please contact the DWQ 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 mailedl:
Name
Street Address 4. l 6 o `�� re,-�tub
City (30 o,(V e. State /t/ G __ZIP Code QX6--
Telephone No. G.&if-----8_(, 1 Fax: '
2) Location of facility producing discharge:
Facility Name 3:- C
Facility Contact i rrrn rA
Street Address fin 1S76 V
City L� e- State t,� _ZIP Code o2 X4 d 7
County u. 0.-
Telephone No. _ �,iO"f -��(01 Fax: _J�
Page 1 of 5
SWU-NE-110607 Last revised 11/06/07

NCGNEa000 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). / /V w
o SZ3 s �•`� vN G�rc,A/t_r O. Q/t/ /� f` SrUY7
(A co/py/of a map with the facility clearly located on it should be include with the certification application.)
4) Is the facility located on Native American Lands? ❑ Yes lefI o
5) Is this a Federal facility? ❑ Yes fxNo
30 .5ec-.
6) Latitude 3L Jee ,W Ai, 30 S.Longitude D8 -YD v,;N (deg, min, sec)
7) This NPDES Permit Application applies to which of the following:
❑ New or Proposed Facility Date operation is to begirt
Ev-rxisting Date operation began / 5­3
8) Was this facility or site ever covered under an NPDES Stormwater Permit? © Yes ❑ No
If yes, what is the NPDES Permit Number? 1V G �230 yeoj IVC
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:
14) Provide a/brief
er/description of the types of industrial activities and products produced at this facility:
f'v Y MyJ, yC,
11) Does this facility have any Non-Discharge permits (ex: recycle permits)?
v o
❑ 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 VINo
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 spiilslleaks ❑ Yes V'NNo
c. Materials or products from past industrial activity ❑ Yes ao
d. Material handling equipment (except adequately maintained vehicles) © Yes LVNVo
e. Materials or products during loading/unloading or transporting activities ❑ Yes Lilo
f. Materials or products stored outdoors (except final products intended for outside ❑ Yes CYNo
use [e.g., new cars] where exposure to stormwater does not result in the discharge
of pollutants)
Page 2 of 5
SWU-NE-110607 Last fevised 11/06107

NCGNE0000 No Exposure Certification
g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, ❑ Yes "o
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes 9No
the discharger
i. Waste material (except waste in covered, non-leaking containers f e.g., dumpsters]) ❑ Yes r N0
j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes bYN0
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes 52 IN0
otherwise regulated (i.e., under an air quality control permit) and evident in the
stormwater outflow /�
1. Empty containers that previously contained materials that. are not properly stored ❑ Yes M No
(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 0 Yes VNo
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 ❑ Yes Ao
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any VIyes r7 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.
a. Is secondary containment provided for single above ground storage containers 57 Yes ❑ No
(including drums, barrels, etc.) with a capacity of more than 660-gallons?
b. Is secondary containment provided for above ground storage containers stored VYes ❑ 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 Ies ❑ No
Superfund Amendments and Reauthorization Act (SARA) water priority
chemicals?
d. Is secondary containment provided for any amount of hazardous substances? U/ es E No
e. Are release valves on all secondary containment structures locked? tS/Yes ❑ No
Page 3 of 5
S\NU-NE-110607 Last revised 11/06/07

r NCGNE0000 No Exposure Certification
15) Hazardous Waste:
a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? ❑ Yes l�o
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste ❑ Yes IAO
generated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste U,/ es ❑ No
generated per month) of hazardous waste?
If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste: D--po j D--oO'7 Q—o0 8 Foo3 F - o D5--�
How is material stored:C6,,e Ked eus,-
1.v D e<ms
Where is material stored: /Nl_clm
How many disposal shipments per year: -169-911? S
Name of transport/disposal vendor: Free-�a(LL"j!Q3,. SaLt ex S4----rrJ C�,emi S �enlT
Vendor address: 7SS��4C�sfrr�f rpD. Su...��r SC .
Ro11clC S�Crz.<�� C�„n�G :wee aayp, iva-,i
16) Certification: Sf � �,vc- ( r`"`f
To
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 f5lyears 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 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: ih�
Title: , del �e 1—
(Signa e of Applicant) (Date Signed) .
Page 4of5
SWU-NE-t 10607 Last revised 11/06/07

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