NCGNE0250_COMPLETE FILE - HISTORICAL_20110105

STORMWATER DIVISION CODING SHEET
RESCISSIONS
PERMIT NO.
Nc c, /""
DOC TYPE
❑COMPLETE FILE -HISTORICAL
DATE OF
RESCISSION
❑ ��� %� US
YYYYMMDD

NCDENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Division of Water Quality
Coleen H. Sullins
Director
.larluary 5, 2011
Sheila W. Higgins
Marshall Flexiblcs LLC - Marshall Flexibles LLC
100 Kenpak Lane
Marshall, NC 28753
Dear Pcrinittec:
Dee Freeman
Secretary
Subject: Rescission of NPDES Stonmwater Permit
Certificate or Coverage Number NCGNI-0250
Marshall Flexibles LLC - Marshall Flexibles LLC
Madison County
On l 2/15/2010, the Division of Water Quality received your request to rescind your coverage under
Certificate of Coverage Number NCGNI 0250. In accordance with your request, Certificate or Covcrage
Number NCGNE0250 is rescinded effective immediately.
Operating a treatment facility, discharging; wastewater or discharging specific types of stormwatcr to
waters of the State without valid coverage under an NPDES permit will subject the responsible party to a
civil penalty of up to S25,000 per day. It is the intention of DWQ that enforcement proceedings will
occur for persons that have voluntarily relinquished permit coverage when, in fact, continuing permit
coverage was necessary. If, in retrospect, you feel the site still requires permit coverage, you should
notify this office immediately. Furthermore, irin the future you wish to again discharge to the State's
surface waters, you must first apply for and receive a new NI'DES permit.
If the facility is in the process of being sold, you will be performing a public service if you would inform
the new or prospective owners of their potential need for NPDES permit coverage.
If you have questions about this matter, please contact Brian Lowther at [phone], or the Water
Quality staff in our Asheville Regional Office at NPDLS SW.
Sincerely,
e� ifcll�
for Colecn I -I. Sullins, Director
cc: Asheville Regional Office
Stormwater Permitting Unit
Iran McPherson, DWQ Budget Off -ice
Wetlands and Stormwater Branch olle
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Nof-thCarol ina
Locations 512 N. Salisbury 5l. Raleigh, North Carolina 27604 l��
Phone: [phone] FAX: [phone] CustomN�t1,��s/
Customer Service: 1-877-623.6748 Li
Internet www.ncwaterquality.crg
An Equal Opportunity 1 Affirmative 40on Employer

QT3 @c�od��
F-ANO 5 2011
A "L
�-'A
No .CD ems... , a.
E.vkRo,,C,7 b 0 Nwr RES CCS
549110 DEC 14, 2010 ACT WT LTR t1PK 1
SERVICE IDA BILL UT LTR
TRACKINGN 1Z5491100145763758 ALL CURRENCY USD
REF 1:STORMUATER
REF 2:
Division of Water Quality 1 Surl
HANDLING CHARGE 0.00 FRT: SHP
SHIPMENT PUB RATE CHARGES: SVC 20.63 USD
National Pollutant Discharge I DV 0.00 COD 0.00 RS 0.00
DC 0.00 DGD 0.00
AH 0.00 PR 0.00 ROD 0.00
RESCISSION REQU TOT PUB CHG 20.63 PUB+HANDLING 20.63
Please fill out and return this form if you no longer need to maintain your NPDES stormwater permit.
1) Enter the permit number to which this request applies:
Individual Permit (or) Certificate of Coverage
N C�: '5hN„�CjG� N E 0 2 5 0
2) Owner/Facility Information: * Final correspondence will be mailed to the address noted below
Owner/Facility NameMarshallFlexibles, LLC.
Facility Contact
Street Address
City
County
Telephone No.
Sheila W. Higgins
100 Kenpak Lane
Marshall
Madison
828 649-3114
StateNC ZIP Code 28753
E-mail Address [e-mail]
Fax: [phone]
3) Reason for rescission request (This is required information. Attach separate sheet if necessary):
( I ❑ Facility closed or is closing on x:. ,.jl' . All industrial activities have ceased such that no discharges of
stormwater are contaminated by exposure to industrial activities or materials.
0 Facility sold to Print�� packmrl @ on 9/10/2010 . If the facility will continue operations under the new
owner it may be more appropriate to request an ownership change to reissue to permit to the new owner.
❑ Other:
4) Certification:
I, as an authorized representative, hereby request rescission of coverage under the NPDES Stormwater Permit for the
subject facility. I am familiar with the information contained in this request and to the best of my knowledge and belief
such information is true, complete and accurate.
Signature Date Jib
Print or type name of person signing above Title
Please return this completed rescission request form to:
SW NPDES Permit Coverage Rescission
Stormwater Permitting Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
1;17 Mr ii S_rP-^ C�n;�r, Pa':y�,11 rh Car�lira 27„9-i^17
Ln=!c-: 512 ti, Salistur/ S-� Ra'a gh, Ncr' Ca, lira 27;:014 (jn

11@fuw�i
JAN 0 5 Z011
Job Printpc�ck inc.
2800 OVERLOOK PARKWAY. • ATLANTA, GA 30339 - 6240 • PHONE [phone]
11.0. BOX 723608 • ATLANTA, GA 31139 — 0608
9/17/10
(RESPECTIVE SUPPLIERS)
To Whom It May Concern:
Effective September 10, 2010, Printpack Inc. will be the new owner of the Marshall, NC facility, previously owned by Amcor
Medical Flexibles. We are instructing you to submit invoices after this effective date to:
Printpack Inc.
100 Kenpak Lane
Marshall, NC 28753
"The purchase order number will need to be referenced on all invoices.
If you have any questions, please do not hesitate to contact either Bryan Falk at 404-460-7145, or Vonda Braun at 828-649-
3326.
Thank you for your continued support.
Respectively yours,
"Tripp Seitter
Director, Supply Chain Management

Division of Water Quality 1 Surface Water Protection
NCDENRNational Pollutant Discharge Elimination System
R .,MCAROo , , RESCISSION REQUEST FORM
E�+�narrurr ua0N r+-.rw.� raeaaincea
FOR AGENCY USE ONLY
Date Received
Year Month Day
Please fill out and return this form if you no longer need to maintain'your NPDES stormwater permit.
1) Enter the permit number to which this request applies:
Individual Permit (or) Certificate of Coverage
N I C I S N C I G I N I E 1 0 1 2 1 5 0
2) Owner/Facility information: " Final correspondence will be mailed to the address noted below
Owner/Facility NameMarshallFlexibles, LLC.
Facility Contact
Street Address
City
County
Telephone No.
Sheila W. Higgins _
100 Kenpak Lane_
Marshall
Madison
828 649-3114
StateNC ZIP Code 28753
E-mail Address [e-mail]
Fax: [phone]
3) Reason for rescission request (This is required information. Attach separate sheet if necessary):
❑ Facility closed or is closing on F­71 . All industrial activities have ceased such that no discharges of
stormwater are contaminated by exposure to industrial activities or materials.
® Facility sold to Printpack, Inc. on 9/10/2010 . If the facility will continue operations under the new
owner it may be more appropriate to request an ownership change to reissue to permit to the new owner.
❑ Other:
4) Certification:
I, as an authorized representative, hereby request rescission of coverage under the NPDES Stormwater Permit for the
subject facility. I am familiar with the information contained in this request and to the best of my knowledge and belief
such information is true, complete and accurate.
Signature
i
TrrIt 'ae,s
Print or type name of person signing above
Please return this completed rescission request form to:
1617 Mall Service Center, Ralegh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Ralegh, North Carolina 27604
Phone: [phone] I FAX: [phone] I Customer Service: 1-877-623-6748
Internet: www.nmaterquality.org
An Equal Opportunity 1 Affirmative Action Employer
Date l .Z/J y/JD
`platJ 06khO-
Title
SW NPDES Permit Coverage Rescission
Stormwater Permitting Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617 L
Nne
orth
Am

s4 UNi7E0 BTATE3 UNTTEn sTATEs MARSHALL OUAORANOLE
3� DEPARTMENT OF 7I46 INTERION TFNNESSEE VALLEY AUTHORITY NORTH C.AROLINA S
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Ad' A
NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
August 31, 2010
RAMIRO MARI:'INFs%
VICES PRI--SIDE--N,F
MARSHALI. ]7`LI3XI13LES LLC
6600 VALLI�Y VI11W S11tEET
13UENA PARK CA 90620
Dee Freeman
Secretary
Subject: Name/Ownership Change
No Exposure Certification NCGNE0250
Marshall Flexibles, LLC
Formerly Pechiney Plastic Packaging
100 Kenpak Lane, Marshall, NC
Madison. Count;
Dear Mr. Martinez:
The Division has reviewed your submittal of the permit name/ownership change form for your No -Exposure Certification,
which we received on August 2, 2010. Division personnel have reviewed and approved your request to change coverage under
your Certificate of No -Exposure.
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 certification of no exposure does not affect your facility's legal requirements to obtain environmental permits that may
be required under other federal, state, or local regulations or ordinances.
If you have any questions or need further information, please contact the Stormwater Permitting Unit at [phone].
Sincerely,
414 ORIGIM SIGNS 8V
KEN PfC U
for Coleen H. Sullins
cc: Asheville Regional Office `
Stormwater Permitting Unit Files
Amber D. Cicotte, CHMM, Senior Scientist, BB&J, 500 North Dearborn Street, Suite 712, Chicago, IL 60654
wetlands and Stormwater Branch One
1617 Mail Service Center, Ralegh, North Carolina 27699-1617 NorthCal-ol lna
Location: 512
9-8 N. Salisbury St. Ralegh, North Custom r 7604
Service:
�atkrally
Phone: 919�807-630t11 FAX: 919�07-'i4921 Customer Service: 1.877�23-6748
Intemet: www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer

V 6
4

' 1 1
&B
July 29, 2010
North Carolina Department of Environment and Natural Resources >
Division of Water Quality p
M
1617 Mail Service Center ¢9
Raleigh, North Carolina 27699-1617 t�
ry
Re: General Stormwater Permit — Name and Ownership Change Form Co
Marshall Flexibles, LLC]
100 Kenpak Lane
Marshall, North Carolina
General Permit No. NCGNE0250
To Whom It May Concern:
On behalf of Marshall Flexibles, LLC (Marshall Flexibles), Bradburne, Briller & Johnson, LLC (BB&J) is
submitting the enclosed Name and Ownership Change Form for the General Permit, Permit Number
NCGNE0250, issued for the facility located at located at 100 Kenpak Lane in Marshall, North Carolina
(Subject Property). On July 1, 2010, Pechiney Plastic Packaging, Inc. [a subsidiary of Alcan Packaging, Inc.,
(Alcan)] transferred ownership of the facility to Marshall Flexibles. In accordance with Title 15A of the North
Carolina Administrative Code Section 02H.1013, Marshall Flexibles understands that permits may be
modified as necessary. As such, Marshall Flexibles is submitting the Name and Ownership Change Form,
certifying that the information provided is accurate and complete to the best of its knowledge. Signatures
of both the permittee (Alcan) and applicant (Marshall Flexibles) are included on the Name and ownership
Change Form.
The facility will now operate under the name Marshall Flexibles, LLC and this change in ownership will not
result in any changes to current operations, personnel, or organization at the facility. The plant manager
and point of contact will remain the same at this facility. The plant manager is Mr. Emery Coffey who can be
reached at [phone]. If you have any questions regarding the information included in the Name and
Ownership Change Form, please contact Ms. Amber Cicotte of BB&J at 312-644-8556, extension 221.
Sincerely,
BRADBURNE, BRILLER & JOHNSON, LLC
J. Tim Bradburne, P.G.
Principal
cc: Sarah Schaefer, Alcan
Nicola Davey, Marshall Flexibles, LLC
Enclosures
0"'A' a.""
Amber D. Cicotte, CHMM
Senior Scientist
Bradburne, Briller & Johnson, LLC • 500 North Dearborn Street, Suite 712 • Chicago, Illinois 60654 • Phone [phone]

IR
Bavcrly Eaves Pcrdue, Govcr�or
Dee Freeman, 5ecrettuy
North Carolina Deparno¢at orEnvironnient mid Natural Pesourecs
6I.ecn H. Sullins, Difectur
Division of Mucr Quality
I. Please enter the permit number for ~which the change -is requested.
NPDFS Permit
(or) Certificate of Coverage ,
N q-40 1 1 1 1 =
I N I CG.NLe.O
H. Pcrmit status rElor,to status change.
a. Permit -issued to (company name):
b. Person legally responsible for permit;
_Rr,ii,rIlq- "Y
First M!
ALag
1 /
J11���.�.;lS� ��Ht4tt_L�_LtM�'7 ry~N�C�tti,- fh,lw�f"Y
Title.
Pc nit Haider Mailing Address
,�rhr t✓rc3D LC��trli�c (rpG..s I-3L��-`J'
City State Zip
(77,3 &,57' (773).3!�2 39s�
Plione FMx
c. 'Facility name (discharge):.
d. Facility address:
1 Dr, f e u a� ac i C
Address
IYrx�-_;ItaL1 AA.1146im-Q6� 46 B.T�
City Slate Zip
e. Facility -contact person:'
r' o `
First! / MI / Last Phone
IIl. Please provide the following for'the requested Change (revised perntit).
a. Request for change is'a result of:
�Chaiige in ownership of the facility
N-Vame change of the facility or owner
if other. please explain:
b. Permit issued to (company nanie):
c. Person legally respoiisible.for periiiit:
d. Facility name (discharge):
e. Facility address:
f: Facility contact person:
�GtilMt r-C3
MI !i ast
Virst
title
6 m `'A.AP,4
� a' ,11-
P— c�lioldcr Mailing Andress
C'
Gity
State Zip
w%1 Sr
t7
Phone
//
{� /E-mail Address
j %1
1!�213 ICZ A
Lrx.u,_
Address
*',It28
L/Izrpl Z.-
City
State Zip
Lc),&
f!u f V_tr
te
First
f
MI Las(
-- 2 4—MCx.Gv tout
Phonc
r-mail Address

PERMIT NAME/OWNERSHIP CHANGE FORM
Page 2:of 2
IV. Pei-mit coutact-inforrnatlon (if different from the person legally responsible for the-pertrlit)
Permit contact: e '
First MI Lost
V.
W
ritic'
rl ++F Maithtg Addr
ess
1�iarSL�:aljt! — fWd,r�r. C.u`DttGr�i,
City State p� ZIP.
Phone E-mail Address
Will the permitted facility continue to condtict the same industrial activities conducted prior
to -this ownership or dame change?
Yes
❑ No,(please explain)
Requtredltems,: THISAPPLICATIONWILL-DERETURNED
ARE, INCOMPLETEO.RMISSING:
UNPROCESSED IF ITEMS
This completed application is required for both name change and/or ownership change
requests.
Lkgal.documentatioti of the transfer of ownership (such as relevant.pages of a contract deed,
or a bill of sale) is.reauired for an ownership change request.. Articles of incorporation are
not sufficient for an ownership change.
The certifications beloiv.intist be completed and signed by both the permit holder prior to die change; and
the new applicant in the case'of mrownership change request. For a name change request, the signed
Applicant's Certification -is sufficient.
PEIRMITTGE CERTIFICATION (Permit holder prior to ownership change):
1, .� attest that this Rpplicittion-for a name/ownership change has been reviewed and is accurate and
complete tti'the best of my knowledge. I understand that if all required ports. of this application are not
cottipleted md)liai If'all required stipportiiig information is not included, thisapplication package will be
returned a Incomplet
Signature Dale
APPLICANT CETrf) ICATION
1, � attest dint this application fora mime/ownership change has been reviewed acid is accurate:and
coniplete.to the -best of tity knowledge. ('understand that if all required 'parts ofthis.application the not
completed and that if Mi. required :suppotting information is not included, this application package lvill" be
ret •led as inc
VUcy 0%1 f A*10 — —
S.igq Diu, Date
PLEASE SEND THE; COMPLETE APPLICATION PACKAGE TO:
Division of Witter Quality.
Surface Water Protection Section
1617 Mail Service Center
Raleigh, North.Carolkia 27699.1617
Reviled 1f1Q09

Execution Version
HILL OF SALE AND ASSIGNMENT AND ASSUMPTION OF
RIGHTS AND OBLIGATIONS AGREEMENT
This BILL OF SALE AND ASSIGNMENT AND ASSUMP ITON OF RIGHTS AND OBLIGATIONS
AGREEMENT (this "Agreement'), is made and entered into as of July 1, 2010 by and between Pechiney Plastic
Packaging, Inc., a corporation organized under the laws of the State of Delaware ('Assignoe j, and Marshall
Flexibles, LLC, a limited liability company organized under the laws of the State of Delaware ("Assignee").
WHEREAS, certain affiliates of Assignor, Amcor Limited ("Amcor'), certain affiliates of Amcor and certain other
Rio Tinto Alcan Group companies have entered into a Transaction Agreement, dated as of December 22, 2009 (as
amended and restated on January 27, 2010 and January 31, 2010, the "Transaction Agreement"} pursuant to which
Amcor or its Designated Transferee have agreed to purchase certain of the assets of Assignor;
WHEREAS, Assignee has acceded to the Transaction Agreement as a Designated Transferee by letter agreement
dated June 28.2010; and
WHEREAS, pursuant to the Transaction Agreement, Assignor has agreed to assign certain assets and contract
rights to Assignee, and Assignee has agreed to assume certain Liabilities of Assignor, as set forth herein, and this
Agreement is contemplated by Article I (Safe and Purchase) and Paragraph l(aXi) of Part D of Schedule 8 (Closing
and Post -Closing Arrangements) of the Transaction Agreement;
NOW, THEREFORE, for and in consideration of the mutual covenants contained herein, and for other good and
valuable consideration, the receipt, adequacy and legal sufficiency of which are hereby acknowledged, the parties do
hereby agree as follows:
Section 1. Definitions. Capitalized terms used herein and not otherwise defined herein have
the meanings given to them in the Transaction Agreement.
Section 2. Assignment and Assumation.
(a) Effective as of July 1, 2010 (the 'Lffective date') but subject to Section 4 below,
Assignor hereby sells, transfers, assigns, conveys, grants and delivers to Assignee (1) all of Assignor's right, title
and interest in and to the following Sale Assets: () subject to Article 5.7 and Part E of Schedule 8 (Closing and
Post -Closing Arrangements) the benefit of the Sale Contracts listed on Schedule A hereto; (a) the Business
Inventory located at Assignor's Plant located in Marshall, North Carolina ("Marxhali'j; (iii) the Business
Machinery and Equipment; (iv) the We Trading Receivables and the right to invoice in respect of the Notional Sale
Trading Receivables in accordance with Article 17.2; (v) the Business Records; and (vi) subject to Article 5.7 and
Part E and Part F of Schedule 8 (Closing and Post -Closing Arrangements) of the Transaction Agreement and to the
extent their transfer is permitted by applicable Law, the Governmental Consents, in the case of (iii) through (vi),
only to the extent exclusively related to or exclusively used at Marshall (collectively, the "Marshall Facility
Assets') and (2) all of Assignor's burdens, obligations and liabilities in connection with all the Assumed Obligations
to the extent such Assumed Obligations are related to the Marshall Facility Assets (together, the "Transfer and
Assignment').
(b) As of the IRMetive Date, Assignee hereby accepts the Transfer and Assignment and
assurnca and agrees to pay, perform, and discharge as and when due and owing, and to be bound by all the terms,
covenants, conditions, liabilities and obligation in and of the Assumed Obligations transferred pursuant to
paragraph (a) above.
Section 3. EgdbaAssurances. Assignor and Assignee hereby agree to execute such further
instruments and documents of transfer and assignment and perform such iiuther acts as may be reasonably required
to carry out the provisions hereof and the transactions contemplated hereby.
Section 4. '£cans ofthe Transaction Aunt. This Agreement is entered into pursuant to
the terms of the Transaction Agreement and Assignor and Assignee are entitled to the benefits of, and this
instrument is subject to, all pertinent provisions of the Transaction Agreement, including but not limited to the
LONDON:380590A

covenants and undertakings of the parties thereto in respect of the Marshall Facility Assets and the Assumed
Obligations to the extent such Assumed Obligations are transferred pursuant to paragraph (a) of Section 2 above,
which Assignor and Assignee acknowledge and agree shall not be superscdcd hereby but shall remata in full force
and effect to the full extent provided therein, including the provisions of Article 5.7 and Part E and Part F of
Schedule 8 (Closing and Post -Closing Arrangements) thereof. In the event of any conflict, inconsistency or
ambiguity between the terms of the Transaction Agreement and the terms hereof, the terms of the Transaction
Agreement shall govern. For the avoidance of doubt, references to "Closing" in Part D, E and F of Schedule 8
(Closing and Post -Closing Arrangements) shall be deemed to be references to "Deferred Closing" for purposes
hereof
Section 5. Miscellaneous.
(a) Headinss. The headings of this Agreement are for purposes of reference only and shall
not limit or otherwise affect the meaning or interpretation of this Agreemnent.
(b) Glgverning Last. This Agreement shall be governed by and construed in accordance with
the laws of the State of Delaware.
(c) [;quntmasts. This Agreement may be executed in one or more counterparts, each of
which shall be deemed on original but all of which together shall constitute one and the same instrument.
[Signatures Appear on the Following Page[
PA
LONDON:380590.4

a
IN WITNESS WHERBOR Ebb Agreement is signed by duty audu rued mpresentadws of the p.rdea as of the date
first above written.
Pechiney Phutic Packaging, Inc.
17
By:
Name:
Titles
MarsMH Flexible, LLC
By:
Name:
Title:
LANDON!380MA
SIPOMPIP mM-dnsisillo[SAW—Mush&OFkdbt LLC

19
[N WITNESS WHEREOF, this Agreement is signed by duly authorized representatim of the parties as of the date
fast above written.
Pechiney Plastic Packaging, Inc.
By:
Name:
Title:
Marshall Flexibles, LLC
G� Q,,—
By: c
Name: 2AMt k4kn—,aG-
Title: .t%X etCxlaC,4r
LONDON:390590.4
SiQaatum Pago to Meditax Bin of Sate— Marslmn FkAbta, LLC

SCHEDULE A
Contract Tltle
Coan a
Date
1
A greemeat on Terms and Conditions of
Purchase of Flexible Packaging
Materials
Corning Incorporated
as of June 25, 2010
2
Vendor Purchase A ement
De xn to Inc.
May 1 2010
3
SuppIX A emcnt
Becton Dickinson and Company
October 1 2009
4
Supply A&Tmnt
Cardinal Health 200 LLC
June 1 2010
S
Supply Agmrnent
Slu
June 1 2010
6
Lease Agreement (as amended)
Sharp Business Systems-
Dela a Laden Financial Services
August 26.2009
7
Equipment Master Lease Agreement
number:224991
Lessor. Carolina Handling, LLC
Assi : Raymond Leasing Corporation
September 3, 2008
8
Master ement J
Wrizon Credit Inc.
may 28 20p8
Schedule A to Medilm Sin of Sale — Marshall Fkxibtes, l.l.0
LONDON:38059M

W A ] �n Michael F. Easley, Governor
`O=O 7QG William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
7 Alan W. Klimek, P. E. Director
5 Division of Water Quaiily
0 Coleen H. Sullins, Deputy Director
Division of Water Quality
December 30, 2005
Mr. David van den Bosch
Pechiney Plastic Packaging
8770 West Bryn Mawr Avenue
Chicago, IL 60631
Subject: No Exposure Certification NCGNE0250
Pechiney Plastic Packaging
100 Kenpak Lane, Marshall, NC
Madison County
Dear Mr. Hicks:
The Division has reviewed your submittal of the No -Exposure Certification for Exclusion from NPDES
Stormwater Permitting form, which we received on October 17, 2005. Based on your submittal and signed
certification of no exposure at the above referenced facility, the Division is granting your certification as
provided for under 40 CFR 126.22(g), which is incorporated by reference in North Carolina regulations.
Please note that by our acceptance of your no exposure certification, you are obligated to maintain no
exposure conditions at your facility. If conditions change such that your facility can no longer qualify for a no -
exposure exclusion, you are obligated to immediately obtain NPDES permit coverage for your stormwater
discharge. Otherwise, the discharge becomes subject to enforcement as an un-permitted discharge. Your
conditional no -exposure exclusion expires in five years (December 30, 2010). At that time you must re -certify
with the Division, or obtain NPDES permit coverage for any stormwater discharges from your facility.
Your certification of no exposure does not affect your facility's legal requirements to obtain environmental
permits that may be required under other federal, state, or local regulations or ordinances.
If you have any questions or need further information, please contact Sarah Young at [phone], ext.
502, or at [e-mail].
cc: Asheville Regional Office
Stormwater Permitting Unit Files
Sincerely,
��J P-,t�
for Alan W. Klimek, P.E.
Central Files—wlattachments
N. C. Division of Water Quality 1617 Mail Service Center Raleigh, North Carolina 27699-1617 [phone]
A�
iVCC]E _NR
Customer Service
1-877-623-6749

Issue NCGNI-0244, 250. 251, 252
1
Subject: Issue NCGNE0244, 250, 251, 252
From: <Sarah.Young @ncmalLnel>
Date: Sun, 27 Nov 2005 23:50:37 -0500
To: "Sarah Young" <[e-mail]>
Event reminder:
Issue NCGNE0244, 250,
jte: 2005-11-28
on.
251, 252
l of 1 12/29/2005 2:43 PM

/`
Form Approved
United States Environmental Protection Agency OMB No.2040-0211
NPDES � EPA Washington, DC 20460
FORM `� NO EXPOSURE CERTIFICATION for Exclusion from
3510-11
NPDES Storm Water Permitting
Submission of this No Exposure Certification constitutes notice that the entity identified in Section A does not require permit authorization for its storm water
discharges associated with industrial activity in the State identified in Section B under EPA's Storm Water Multi -Sector General Permit due to the existence
of a condition of no exposure.
A condition of no exposure exists at an industrial facility when all industrial materials and activities are protected by a storm resistant shelter to prevent
exposure to rain, snow, snowmelt, andlor runoff. Industrial materials or activities include, but are not limited to, material handling equipment or activities,
industrial machinery, raw materials, intermediate products, by-products, final products, or waste products. Material handling activities include the storage,
loading and unloading, transportation, or conveyance of any raw material, intermediate product, final product or waste product. A storm resistant shelter is
not required for the following industrial materials and activities:
— drums, barrels, tanks, and similar containers that are tightly sealed, provided those containers are not deteriorated and do not leak. "Sealed"
means banded or otherwise secured and without operational taps or valves;
— adequately maintained vehicles used in material handling; and
— final products, other than products that would be mobilized in storm water discharges (e.g., rock salt).
A No Exposure Certification must be provided for each facility qualifying for the no exposure exclusion. In addition, the exclusion from NPDES permitting is
available on a facility -wide basis only, rot for individual outfalls. If any industrial activities or materials are or will be exposed to precipitation, the facility is
not eligible for the no exposure exclusion.
By signing and submitting this No Exposure Certification form, the entity in Section A is certifying that a condition of no exposure exists at its facility or site,
and is obligated to comply with the terms and conditions of 40 CFR 122,26(g),
ALL INFORMATION MUST BE PROVIDED ON THIS FORM
Detailed instructions for completing this form and obtaining the no exposure exclusion are provided on pages 3 and 4
A. Facility Operator Information
Name:
3. Mailing.
3101010
b. city: �' I I 1 I C_ Ict I�2Ip„ i„I, I, I . 1 I„ I ._.�...l�L_ LJ 1 I I 1 c. State: JFJJ d. Zip Code:
B. FacilitylSite Location Information
1. Facility Name: 1>I C? 1G I h I 1 ill le l tl l Il I IG 151+1 + ICI 11 I't Ic- l i re c 11 i IGI I I I
2. a. Street Address; 1 L IU101 I IGI nigie I k 1i,1,21171 el I I i I I I I I I I I 11 I I I 1
b. City: 411r 151i1 la !! I I I I I I I I I I I I I I i I I 1 c. County; 1011a I A I IS I oI h I
1i'rl
I J15
��"
`
d. State: ALC.t e. Zip Code: I� 1715 3 i — I I 1
!rip
m` rn
•`•►�
3. Is the facility located on Indian Lands? Yes ❑ No
N
4. Is this a Federal facility? Yes ❑ No J
'r ' }
J��BJ~b-Longitude:
5. a. Latitude:--------------------
6. a. Was the facility or site previously covered under an NPDES storm water permit? Yes ❑ No
b. If yes, enter NPDES permit number;
7
x
`r
7. SIC/Activity Codes: Primary: 1-P1 (-1 !7 11 Secondary (if applicable);
8. Total size of site associated with Industrial activity: _z—j: R :� acres
9. a. }-lave you paved or roofed over a formerly exposed, pervious area in order to qualify for the no exposure exclusion? Yes
❑
No
b. If yes, please indicate approximately how much area was paved or roofed over. Completing this question does not disqualify you for the
no exposure
exclusion. However, your permitting authority may use this information in considering whether storm water discharges from your site are
likely to have
an adverse impact on water quality, in which case you could be required to obtain permit coverage.
Less than one acre ❑ One to five acres ❑ More than five acres ❑
EPA Form 3510-11 (10-99)
Page 1 of 4

'_1k
NPDES A Form Approved
FORM -,EPA NO EXPOSURE CERTIFICATION for Exclusion from OMB No.2040-0211
3510-11 NPDES Storm Water Permitting
C. Exposure Checklist
Are any of the following materials or activities exposed to precipitation, now or in the foreseeable future?
(Please check either "Yes' or "No- in the appropriate box.) If you answer"Yes" to any of these questions
(1) through (11), you are not eligible for the no exposure exclusion.
Yes
No
1. Using, storing or cleaning industrial machinery or equipment, and areas where residuals from using, storing
or cleaning industrial machinery or equipment remain and are exposed to storm water
2. Materials or residuals on the ground or in storm water inlets from spills/leaks
3. Materials or products from past industrial activity
❑
4. Material handling equipment (except adequately maintained vehicles)
5. Materials or products during loading/unloading or transporting activities
6. Materials or products stored outdoors (except final products intended for outside use [e.g., new cars] where
exposure to storm water does not result in the discharge of pollutants)
7. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, and similar containers
8. Materials or products handled/stored on roads or railways owned or maintained by the discharger
9. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters])
10. Application or disposal of process wastewater (unless otherwise permitted)
11, Particulate matter or visible deposits of residuals from roof stacks and/or vents not otherwise regulated
(i.e., under an air quality control permit) and evident in the storm water outflow
D. Certification Statement
I certify under penalty of law that I have read and understand the eligibility requirements for claiming a condition of "no exposure" and obtaining an
exclusion from NPDES storm water permitting.
I certify under penalty of law that there are no discharges of storm water contaminated by exposure to industrial activities or materials from the industrial
facility or site identified in this document (except as allowed under 40 CFR 122.26(g)(2)).
I understand that I am obligated to submit a no exposure certification form once every five years to the NPDES permitting authority and, if requested, to
the operator of the local municipal separate storm sewer system (MS4) into which the facility discharges (where applicable). I understand that I must
allow the NPDES permitting authority, or MS4 operator where the discharge is into the local MS4, to perform inspections to confirm the condition of no
exposure and to make such inspection reports publicly available upon request. I understand that I must obtain coverage under an NPDES permit prior
to any point source discharge of storm water from the facility.
Additionally, I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or
persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is to the best of my
knowledge and belief true, accurate and complete. I am aware that there are significant penalties for submitting false information, including the possibility
of fine and imprisonment for knowing violations.
Print Name! IPaIVIi JI IViGlhl le -Ole IVAI IEl0JSICI W I I I I I ,I I I I I I I I
Print Title:
Signature:
Date: V lri 1013P 51
EPA Form 3510-11 (10-99) Page 2 of 4

NPDES Instructions for the NO EXPOSURE CERTIFICATION for Form Approved
FORM ��-,EPA OMB No.2040-0211
3510-11 Exclusion from NPDES Storm Water Permitting
Who May File a No Exposure Certification Section B. Facility/Site Location Information
Federal law at 40 CFR Part 122.26 prohibits point source discharges of
storm water associated with industrial activity to waters of the U.S. without
a National Pollutant Discharge Elimination System (NPDES) permit. However,
NPDES permit coverage is not required for discharges of storm water
associated with industrial activities identified at 40 CFR 122.26(b)(14)(i)-
(ix) and (xi) if the discharger can certify that a condition of "no exposure"
exists at the industrial facility or site.
Storm water discharges from construction activities identified in 40 CFR
1 22.26(b)(1 4)(x) and (b)(15) are not eligible for the no exposure exclusion.
Obtaining and Maintaining the No Exposure Exclusion
This form is used to certify that a condition of no exposure exists at the
industrial facility or site described herein. This certification is only applicable
in jurisdictions where EPA is the NPDES permitting authority and must be
re -submitted at least once every five years.
The industrial facility operator must maintain a condition of no exposure at
its facility or site in order for the no exposure exclusion to remain applicable.
If conditions change resulting in the exposure of materials and activities to
storm water, the facility operator must obtain coverage under an NPDES
storm water permit immediately.
Where to File the No Exposure Certification Form
Mail the completed no exposure certification form to:
Storm Water No Exposure Certification (4203)
USEPA
401 M Street, SW
Washington, D.C. 20460
Completing the Form
You must type or print, using uppercase letters, in appropriate areas only.
Enter only one character per space (i.e., between the marks). Abbreviate
if necessary to stay within the number of characters allowed for each item,
Use one space for breaks between words. One form must be completed
for each facility or site for which you are seeking to certify a condition of no
exposure. Additional guidance on completing this form can be accessed
through EPA's web site at www.epa.gov/owm/sw. Please make sure you
have addressed all applicable questions and have made a photocopy for
your records before sending the completed form to the above address.
Section A. Facility Operator Information
1. Provide the legal name of the person, firm, public organization, or any
other entity that operates the facility or site described in this certification.
The name of the operator may or may not be the same as the name of
the facility. The operator is the legal entity that controls the facility's
operation, rather than the plant or site manager,
2. Provide the telephone number of the facility operator,
3. Provide the mailing address of the operator (P.O. Box numbers may be
used). Include the city, state, and zip code. All correspondence will
be sent to this address.
1. Enter the official or legal name of the facility or site.
2. Enter the complete street address (if no street address exists, provide
a geographic description (e.g., Intersection of Routes 9 and 551), city,
county, slate, and zip code. Do not use a P.O. Sox number.
3. Indicate whether the facility is located on Indian Lands.
4. Indicate whether the industrial facility is operated by a department or
agency of the Federal Government (see also Section 313 of the Clean
Water Act).
5. Enter the latitude and longitude of the approximate center of the facility
or site in degreeslminuteslseconds. Latitude and longitude can
be obtained from United States Geological Survey (USGS) quadrangle
or topographic maps, by calling 1-(888) ASK-USGS, or by accessing
EPA's web site at http:llwww,epa.gov/owm/sw/industry/indox.htm and
selecting Latitude and Longitude Finders under the Resources/Permit
section.
Latitude and longitude for a facility in decimal form must be converted
to degrees (°), minutes ('), and seconds (") for proper entry on
the certification form. To convert decimal latitude or longitude to
degreeslminuteslseconds, follow the steps in the following example.
Example: Convert decimal latitude 45.1234567 to degrees (1), minutes
('), and seconds (").
a) The numbers to the left of the decimal point are the degrees: 45°.
b) To obtain minutes, multiply the first four numbers to the right of the
decimal point by 0,006: 1234 x 0.006 = 7.404.
c) The numbers to the left of the decimal point in the result obtained
in (b) are the minutes: 7'.
d) To obtain seconds, multiply the remaining three numbers to the
right of the decimal from the result obtained in (b) by 0.06:
404 x 0.06 = 24.24. Since the numbers to the right of the decimal
point are not used, the result is 24".
e) The conversion for 45.1234567 = 45° 7' 24".
6. Indicate whether the facility was previously covered under an NPDES
storm water permit. If so, include the permit number.
7. Enter the 4-digit SIC code which identifies the facility's primary activity,
and second 4-digit SIC code identifying the facility's secondary activity,
if applicable. SIC codes can be obtained from the Standard Industrial
Classification Manual, 1987.
8. Enter the total size of the site associated with industrial activity in acres.
Acreage may be determined by dividing square footage by 43,560, as
demonstrated in the following example.
Example: Convert 54,450 ft2 to acres
Divide 54,450 ft2 by 43,560 square feet per acre:
54,450 ft2 � 43,560 ft2/acre = 1.25 acres.
9. Check "Yes" or "No" as appropriate to indicate whether you have paved
or roofed over a formerly exposed, pervious area (i.e,, lawn, meadow,
dirt or gravel road/parking lot) in order to qualify for no exposure. If yes,
also indicate approximately how much area was paved or roofed over
and is now impervious area.
EPA Form 3510-11 (10-99) Page 3 of 4

FORM �, Instructions for the NO EXPOSURE CERTIFICATION for Form Approved
FORM ��-,EPA OMB No. 2040-0211
3510-11 Exclusion from NPDES Storm Water Permitting
Section C. Exposure Checklist
Check "Yes" or "No" as appropriate to describe the exposure conditions at
your facility. If you answer "Yes" to ANY of the questions (1) through (11)
in this section, a potential for exposure exists at your site and you cannot
certify to a condition of no exposure. You must obtain (or already have)
coverage under an NPDES storm water permit. After obtaining permit
coverage, you can institute modifications to eliminate the potential for a
discharge of storm water exposed to industrial activity, and then certify to
a condition of no exposure.
Section D. Certification Statement
Federal statutes provide for severe penalties for submitting false information
on this application form. Federal regulations require this application to be
signed as follows:
For a corporation; by a responsible corporate officer, which means:
(i) president, secretary, treasurer, or vice-president of the corporation
in charge of a principal business function, or any other person
who performs similar policy or decision making functions for the
corporation, or
(ii) the manager of one or more manufacturing, production, or
operating facilities, provided the manager is authorized to make
management decisions which govern the operation of the
regulated facility including having the explicit or implicit duty of
making mayor capital investment recommendations, and initiating
and directing other comprehensive measures to assure long
term environmental compliance with environmental laws and
regulations; the manager can ensure that the necessary systems
are established or actions taken to gather complete and accurate
information for permit application requirements; and where
authority to sign documents has been assigned or delegated to
the manager in accordance with corporate procedures;
For a partnership or sole proprietorship: by a general partner or the
proprietor; or
For a municipal, State. Federal, or other public facility: by either a
principal executive or ranking elected official.
Paperwork Reduction Act Notice
Public reporting burden for this certification is estimated to average 1.0 hour
per certification, including time for reviewing instructions, searching existing
data sources, gathering and maintaining the data needed, and completing
and reviewing the collection of information. Burden means the total time,
effort, or financial resources expended by persons to generate, maintain,
retain, or disclose to provide information to or for a Federal agency. This
includes the time needed to review instructions; develop, acquire, install,
and utilize technology and systems for the purposes of collecting, validating,
and verifying information, processing and maintaining information, and
disclosing and providing information; adjust the existing ways to comply with
any previously applicable instructions and requirements; train personnel to
be able to respond to a collection of information; search data sources;
complete and review the collection of information; and transmit or otherwise
disclose the information, An agency may not conduct or sponsor, and a
person is not required to respond to, a collection of information unless it
displays a currently valid OMB control number. Send comments regarding
the burden estimate, any other aspect of the collection of information, or
suggestions for improving this form, including any suggestions which may
increase or reduce this burden to: Director, OPPE Regulatory Information
Division (2137), USEPA, 401 M Street, SW, Washington, D.C. 20460.
Include the OMB control number of this form on any correspondence. Do
not send the completed No Exposure Certification form to this address.
EPA Form 3510-11 (10-99) Page 4 of 4