NCGNE1110_COMPLETE FILE - HISTORICAL_20160330

STORMWATER DIVISION i
NCG PERMIT
PERMIT NO. JNCGNE I 1 1 0
DOC TYPE I O-HISTORICAL FILE
DOC DATE ❑ �0��p o 3
YYYYMMDD

Energy, Mineral
and Land Resources
ENVIQONMENTAL QUALITY
March 30 2016
Carolina Dairy
Attn John Winnie
116 Industrial Park Drive
Biscoe, NC 27209
Subject No Exposure Certification NCGNEl 110
Carolina Dairy
Montgomery County
[or:MWI 115,01 -
S
PAT MCCRORY
Governor
DONALD R VAN DER VAART
ecretary
1 RACY DAVIS
Director
The Division of Energy, Mineral and Land Resources 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 as well as observations made during a site visit
conducted by Lori H Britt with the Fayetteville Regional Office on February 11 2016, the Division is granting
your conditional exclusion from permitting as provided for under 40 CFR 122 26(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 the
No Exposure Certification, 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 You must self re -certify annually using the enclosed form, or obtain NPDES permit coverage for
any stormwater discharges from your facility The annual self re -certification does not need to be submitted
to DEMLR unless requested
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 Lori H Britt at [phone]
Sincerely
for racy E Davis, CPM, Director
Enclosure
cc FRO — DEMLR, Stormwater Files (w/o enclosure)
Stormwater Permitting Program, No Exposure Files (w/o enclosure)
State of North Carolina I Environmental Quality I Energy Mineral and Land Resources
Fayetteville Regional Office 1 225 Cotten Street Suite 714 1 Fayetteville NC 28301
910-433 3300

LTIFAA
Division of Energy, Mineral and Land Resources
Land Quality Section
NCDENRNational Pollutant Discharge Elimination System
CA�_JMx .twor NO EXPOSURE CERTIFICATION for Exclusion
DMROMMEK AMP N&Wr la�"
NCGNE0000
FOR AGENCY USE ONLY
Pate Recelved
Year
Month
Ua
Certificate orC ve gc
.NICIGINE
National Pollutant Discharge Elimination System application for exclusion from a Stormwater Permit based
on NO EXPOSURE
J A N 1 2 2016
Submission of this No Exposure Certification constitutes notification that your facility does not require a
permit for stormwater discharges associated with industrial activity in the State of North Carolina because
it qualifies for a no exposure exclusion A condition of no exposure at an industrial facility means all
industrial materials and activities are protected by a storm resistant shelter (with some exceptions) to
prevent exposure to rain, snow, snowmelt, and/or runoff
For permitted facilities to North Carolina, DEMLR must approve your application for No `
Exposure Certification before this exclusion Is effective Until you are Issued a No
Exposure Certification and your NPDES permit is rescinded, your facility must continue
to abide by the terms and conditions of the current permit
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
stormwa€er 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)
If approved, your conditional no -exposure exclusion must be self re -certified at least annually
Please see information here
For questions, please contact the DEMLR Regional Office for your area (See page 6)
1) Mailing address of ownerioperator
Name
Contact
Street Address
City
Telephone No
(Please prant or type)
ess to which all cer
30bt4 W T��JYC ciQ 1CaA�Z
r Y
L3t5 CAP State NC^ ZIP Code ~120
Cf
Fax
RECEIVED
DEC 2 9 2015
Pane 1 of 7 I)ENR 1~,i N0 QUAD T Y
�')'TWHUTI #R PERMITTAG

NCGNE0000 No Exposure Certification
2) Location of facility producing discharge
Facility Name C,O�,Y� 1_�G't VOj %
Facility Contact
Street Address
City
County
Telephone No
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) 1-4�tj
(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 *0
S) Is this a Federal facility O Yes `%No
6) Latitude 2�5s NIDZWSq Longitude "1q V096'9 (deg , min , seconds)
7) This NPDES No Exposure Exclusion application applies to which of the following
❑ New or Proposed Facility Date operation is to begin
Existing Date operation began q/ t
❑ Renewal of existing No Exposure Certification Certification No NCGNE
6) Was this facility or site ever covered under an NPDES Stormwater Permit? © Yes %$No
If yes, what is the NPDES Permit Number?
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 Z. () Z 2
10) Provide a brief description of the types of industrial activities and products roduced at this facility
4 clmui, - Maunu�ac � i rvn i l,n}ri ro nI inn% L_V_
11) Does this facility have any Non -Discharge permits (ex recycle permits)?
Lq No
❑ Yes
If yes list the permit numbers for all current Non -Discharge permits for this facility

NCGNEOOOO No Exposure Certification
Exposure Checklists (12 - 14 )
12) Are any of the following materials or activities exposed to precipitation, now or in the foreseeable
futures (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 ArNo ❑ NIA
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 O Yes Ao ❑ NIA
c Materials or products from past industrial activity ❑ Yes t,No ❑ NIA
d Material handling equipment (except adequately maintained vehicles) ❑ Yes t31No ❑ N/A
e Materials or products during loading/unloading or transporting activities ❑ Yes f4No ❑ N/A
f Materials or products stored outdoors (except final products intended for outside ❑ Yes 5*o ❑ N/A
use [e g new cars] where exposure to stormwater does not result in the discharge
of pollutants)
g Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, ❑ Yes 5 Jo ❑ NIA
and similar containers
h Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes 4o ❑ NIA
the discharger
i Waste material (except waste in covered, non -leaking containers [e g , dumpsters]) ❑ Yes 4o ❑ NIA
t Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes ❑ No 14 NIA
k Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes -XNo ❑ NIA
otherwise regulated (i a under an air quality control permit) and evident in the
stormwater oufflow
I Empty containers that previously contained materials that are not properly stored ❑ Yes ELNo ❑ NIA
(i a 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 ❑ No -AN/A
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 ❑ No -4 NIA
deterioration, or evidence of leaks?
b Is secondary containment provided for all exterior ASTs? If so, is it free of any ❑ Yes ❑ No A -NIA
cracks, holes, or evidence of leaks and are drain valves maintained locked shut?

NCGNE0000 No Exposure Certification
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 4 NIA
(including drums, barrels, etc ) with a capacity of more than 660-gallons'?
b Is secondary containment provided for above ground storage containers stored ❑ Yes ❑ No 4tN/A
in close proximity to each other with a combined capacity of more than 1 320-
gallons7
c Is secondary containment provided for Title III Section 313 Superfund ❑ Yes ❑ No 44-N/A
Amendments and Reauthorization Act (SARA) water priority chemicals,?
d Is secondary containment provided for hazardous substances" designated in 40 ❑ Yes ❑ No 6,N/A
CFR §116?
e Are release valves on all secondary containment structures locked' ❑ Yes ❑ No I�N/A
15) Hazardous Waste
a Is this fatality a Hazardous Waste Treatment, Storage or Disposal Facility? ❑ Yes 4No ❑ N/A
b Is this facility a Small Quantity Generator (less than 1000 kg of hazardous waste ❑ Yes 0 No 1AN/A
generated per month) of hazardous waste?
c Is this facility a Large Quantity Generator (1000 kg or more of hazardous waste ❑ Yes ❑ No AN/A
generated per month) of hazardous waste?
If you answered yes to questions b or c , please provide the following information
Type(s) of waste
How is material stored
Where is material stored
How many disposal shipments per year
Name of transport 1 disposal vendor _
Vendor address
Footnotes to Questions 14) c & d
'Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require
secondary containment However, some exceptions may be made for de mmimis amounts of certain substances
and/or other qualifiers, as described in the exemptions from reporting requirements of Title III SARA 313 in 40 CFR
§372 38
"Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require
secondary containment However some exceptions may be made for amounts less than the Reportable Quantities
of the hazardous substances listed in 40 CFR §117 3

NCGNE0000 No Exposure Certification
16) Other information If you answer "Yes" to any of the following items, you might not be eligible for the
no exposure exclusion A more in-depth evaluation of the site circumstances may be required
a Does your facility store used recycled or otherwise reclaimed pallets outside? ❑ Yes 4No ❑ NIA
b Does your facility have coal piles on site?
c Does your facility store other fuel sources outside in piles, such as wood chips,
sawdust etc?
d Does your facility have air emissions associated with its industrial activity (e g
degreasing operations, plating painting and metal finishing)? If so describe the
industrial activity
e If you answered yes to d , are those emissions permitted by an Air Quality Permit?
Please specify
f Please list any other environmental program permits (federal, state etc ) not
specified earlier in this application (such as Hazardous !Waste Permits, etc )
Permit
Program
Permit
Program
Permit
Program
Permit
Program
Permit
, Program
Permit
Program
Permit
Program
❑ Yes n�lqo ❑ NIA
❑ Yes 04*o ❑ NIA
❑ Yes ❑ tis ❑ NIA
❑ Yes ❑ No -4 NIA

NCGNE0000 No Exposure Certification
17) Certification
I certify under penalty of taw that t 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 ex op sure 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 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
Panted a of Person Signing •
Title NaV.1 /)PR /a ils-.ij
(Sr ure of Applicant) (DA Signed)
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 13(1) provides that
Any person who knowingly makes any false statement representation or certification in any application record report plan or other
document fled 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 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

NCGNE0000 No Exposure Certification
Final Checklist
This application should include the following itoms
Vi This completed application and all supporting documentation
A map with the location of the facility clearly marked
❑ If the site currently has an NPDES Stormwater Permit be sure to indicate the permit number in question 8
Mad the entire package to
Stormwater Permitting Unit Program
Division of Energy Mineral and Land Resources
1612 Mail Service Center
Raleigh North Carolina 27699-1612
Note
The submission of this document does not guarantee the issuance of a No Exposure Exclusion
For questions, please contact the DEMLR Regional Office for your area � 1
DEMLR Regional Office Contact Information
Asheville Office
[phone]
Fayetteville Office
[phone]
Mooresville Office
[phone]
Raleigh Office
[phone]
Washington Office
[phone]
Wilmington Office
[phone]
Winston-Salem
[phone]
Central Office
[phone]

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