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HomeMy WebLinkAboutNCGNE0018_COMPLETE FILE - HISTORICAL_20060929STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. NCGNE o DOC TYPE HISTORICAL FILE DDC DATE YYYYMMDD O� \NA TF Michael F. Easley, Governor RQ William G. Rnss Jr„ Secretary North Carolina Department of Environment and Natural Resources Alan W. Klimek, P. E. Director y Division of Water Qunlity Coleen H. Sullins, Deputy Director Division of Water Quality September 29, 2006 Mr. Jeff Sexten Con -way Freight 110 Parkland Plaza Ann Arbor, MI 48103 Subject: Name Change No Exposure Certification NCGNE0018 Con -way Freight Formerly: CNF, Inc. 6701 Old Statesville Road, NC Mecklenburg County Dear Mr. Sexton: The Division has reviewed your submittal of the permit name/ownership change form for your No -Exposure Certification, which we received on September 11, 2006. Division personnel have reviewed and approved your request to change your name 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 conditional no -exposure exclusion expires in five years (June 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 (919) 733-5083, ext. 502, or at sarah.young@ncmail.net. Sincerely, A�L P � Alan Klimek, P.E. Cam_., fo i`;�,,,�.�� cc: Mooresville Regional Office Central -Files — w/attachments y Stormwater Permitting Unit Files N. C, Division of Water Quality 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919) 733-7015 AM MW Customer Service 1-877-623-674 R i �. 4h: W A rERQ� ot Mr. Jeff Sexten Con -Way Freight 110 Parkland Plaza Ann Arbor, MI 48103 l / d l (3tW Michael F. Easley, Governor r✓ William G. Ross Jr., Secretary North Carolina Departmen of Environment and Natural Resources ° V WEE SAP DENR - WA" ER QUALITY Wetfands 8 §10i' twaler Branch Alan W. Klimek, P.E. Director Division of Water Quality Subject: Permit name or ownership change request Permit NCGO80600 Your request for a permit name change or ownership change received on is being returned due to: ❑ Permit Name/Ownership Change Form is missing. ❑ Permit Name/Ownership Change Form is incomplete. ❑ Permit Name/Ownership Change Form signatures missing. ❑ Missing legal document of the transfer of ownership (such as a contract or a deed). d Other our Nl-t'� S �� { f -Q tX . T l2 aS e l ( 0-1,4 +1'_c or ra rka � arJ S &-4 C 2 r rt LV . ty,Q ri a ry\-c C(n�'� , So w-e Casa_ nA- r� w Please return the information so we can continue processing your request. If you have any additional questions, please contact Sarah Young at (919) 733-5083 extension 502. Our mailing address is as follows: Wetlands and Stormwater Branch 1617 Mail Service Raleigh, NC 27699-1617 J . a'a IVl• DWQ Stormwater Permitting Unit Cc: DWQ Central Files SPU NorthCarolina Al atrrrallJ North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Phone (919) 733-7015 Customer Service Intemet: h2o.enr.state.nc.us 512 N. Salisbury St. Raleigh, NC 27604 FAX (919) 733-2496 1-877-623-6748 An Equal Opportunity/Affirmative Action Employer— 50% Recycled110% Past Consumer Paper HOC+ =2} � L ti tJ :. C� %tichael F. liatilcy. Govvnior 1c, William G.RttN%Jr.,-Seciday Qw:N41ilh t :urrlina OV1143uiunl 401 l vin rnTk'nl :rn�! N.r4rral HOx)unLS -` Alan W. Klirn k. P.E. Dim"tor r�{ ,r _ 1}� liars of WaterOtiaiily SURFACE: WATER PROTECTION SECTI43N Q(9V0_& PERMIT NAMEIOWNERSRW CHANGE FORM: �-sY 1. Please enter the permit number for which the change is requested. NPDES Permit (or) Certificate: of Coverage TIT N C C 11. Permit status for to status change. l!j E D t a. b. �VF . �lr1C F irxt / Ml / Last L xmc-z - -3 2-/--1 0 -- -W+ 11� Permit livider Mailing Address teal C) - - - O - - - - q .�i 2_�a City Slate "Zip ( 1 C) C) f ) Fluxes Fax c. Facility name (discharge): i��( SS NG/4 d. Facility address: (e701 (�ld-s��—SV/J1e Rd Address C -of-%- - /UG City - - - - - state Zip e. Facility contact person: 72rr!N 9'd1tfl First / Me / Lae Phorte ^ M. Please provide the following for the requested change (revised permit). a. Request for change is a result of- ❑ Change in ownership of the facility 0 Name change of the facility /�C)o�r owner If other please explain: . A iea4 _�t�c� � S,S r 1'i 0417q P� tt-i--y— W ► !Ljr r- b. Permit issued to (company name). C fri r 1 k+ c. Person legally responsible for permit: - First / Mt / Last i'1—� Title 10 22Aa-"d P1a�a Permit Holder Mailing Address City State Zip � {�"�_)_�-��{—�CpJ�_�"--�2Xi-�t�^12-{�tc✓�OYL,� Cd Phone E-mail Address d. Facility name (discharge): —E9=1 Q vr�- r- A/O H e. Facility address: _ 2-01 d[ 5t P_i tie Address City State Zip f. Facility contact person: rt:� aVi C I VA_ Fust ' / MI / Last Phone - _ E-mail Address _ l _ _j Revised 7/2005 ' 1 t I'INNUT NAMI OWN1 11SH11' CIIAN(& FORM Page 2 (if 2 A;.'.I ,.. ✓I. [.: .. , r'.. IV. Permit contact'informatlon:--(if different frairi:tlir>flerson.`legaIly"ri S'ponsibW-forrthelperiiiit) Permit contact: First I M.1 ! I.Lst Title Mailing Addn-ss Pity State Zip 1't>,me F-inail Addre"" V. Will the permitted facility continue to conduct the samei industrial activities conducted prior to this ownership or name change? s •1 yes ❑ No ( please explain) r: 1 IY' 1� VI. Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS ARE INCOMPLETE OR MISSING: $r This completed application is required for both name change and/or ownership change requests. Ll Legal documentation of the transfer of ownership (such as relevant pages of a contract deed,.or a'bill of sale) is -required for an ownership change request. Articles of incorporation are not sufficient for an ownership change. , ••r•rrr••••r•err••r.•rrrrr�•••••r•r•r•r•r•••••r•••r•rr•••rr.•rr•••rr••r••r rr••••r•r••r•••r•••rr•••.r• i The certifications below must be completed and signed by both the permit holder prior to the change, and the new applicant in the case of an ownership change request. For a name change request, the signed Applicant's Certification is sufficient. PERMITTEE CERTIFICATION (Permit holder prior to ownership change): {, attest that this application for a namelownership change has been reviewed and is accurate and complete to the best of my knowledge. l understand that if all required parts of this application are not completed and that if all required supporting information is not included, this application package will be returned as incomplete. Signature Date APPLICANT CERTIFICATION: I, D—e_f-� s ek+e.-- , attest that this application for a namelownership change has been reviewed and is accurate and complete to the best of my knowledge. I understand that if all required parts of this application are not completed and that if all required supporting information is not included, j this application package will be returned as incomplete. Signature [late 0 Y 490 �Z-1;0; r•rr•••r•••••rr•rrr• PLEASE SEND THE GOMPLETEAPPCICATION PACKAGE TO: Division of Water Quality Surface Water Protection Section 1617 Mail Service Center Raleigh, North Carolina 27699-1617 0( WA,F9 Permit Coverage Renewal Aaalication Form National Pollutant Discharge Elimination System Certificate of Coverage Number. Stormwater General Permit NCGO80000 NCG080+600 The following is the information currently in our database for your facility. Please review this information carefully and make all corrections/ additions as necessary in the space provided to the right of the current information. Owner Information G Owner/ Organization Name: CNF, Inc. QVl— Wuv F Vt'. Owner Contact: Robert Weaver 5e 4 Mailing Address: 3240 Hillview Avenue &A,. ! 1 Palo Alto, CA tt-- A&T Y o 94304 � r '? t7 t Phone Number: 650-494-2900 4 7 Fax Number: E-mail address: r. -WC Facility Information Facility Name: Con -way Southern Express -NCH Facility Physical Address: 6701 Old Statesville Road Charlotte, NC 28269 Facility Contact: Terry Rankin Mailing Address: 6701 Old Statesville Road Charlotte, NC 28269 Phone Number: 704-599-6777 Fax Number: E-mail address: Permit Information Permit Contact: 5tco C Ct y Q w L4 K, Mailing Address: Phone Number: Fax Number: E-mail address: Discharge Information Receiving Stream: UT to Irwin Creek Stream Class: C Basin: Catawba Sub -Basin: 03-08-34 Number of Outfalls: Facility/Activity Changes Please describe below any changes to your facility or activities since issuance of your permit. Attached a separate sheet if necessary. CERTIFICATION I certify that I am familiar with the information contained in the application and that to the best of my knowledge and belief such informatio is true; c mplete and accurate. �/2 l Signature Date /1 D S Print or type name of.person signing above "` 3 Title SW Genera Permit Coverage Renewa Please return this completed application form to: Stormwater Permitting Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617 -D BY ("NI tAL Fib t F WA 7-F Michael F. Easley, Governor `O�O 9QG William G. Ross Jr.. Secretary North Carolina Department of Environment and Natural Resources cow 7 Alan W. Klimek, P. E. Director ofLwiterQuality Coleen H. Sullins, Deputy Director n Division of �V,ater Quality April 20, 2005= APR 2 7 2005 Robert Weaver CNF Inc 3240 Hillview Ave Palo Alto, CA 94304 WATERW,.,dly SECMN Subject: No Exposure Certification NCGNE0018 Con -Way Southern Express -NCH - 6701 Old Statesville R Mecklenburg County Dear Permittee: The Division has reviewed your submittal of the No -Exposure Certification for Exclusion from NPDES Stormwater Permitting form, which we received on February 15, 2002. We apologize for the extended period it has taken us to get back to you on this request and we appreciate your patience as we have worked through this process. 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 (April 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 Jonathan Diggs at (919) 733-5083 ext. 537, or at jonathan.diggs@ncmail.net. Sincerely, For Alan W. Klimek, P.E. cc: Mooresville Regional Office Central Files — wlattachments Stormwater Permitting Unit Files G„ NCDf t4R N. C. Division of Water Quality 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919) 733-7615 Customer Service 1-877-623-6749 O� W A jF Michael F. Easley, Governor Rp William G. Ross Jr., Secretary `p G North Carolina Department of Environment and Natural Resources Or Alan�w rJUiia' it ': E: llirector , J "ti f�?c�YfLlilter Quality 4 i '/ 1 �pF��►StColcett'l�,Sril rL,Q�irector 'v tkl Rr"—LI]tvisiin of Water Quality i September 29, 2006 OCR _ 2 200t Mr. Jeff Sexten Con -way Freight 110 Parkland Plaza Ann Arbor, MI 48103 Subject: Name Change No Exposure Certification NCGNE0018 Con -way Freight Formerly: CNF, Inc. 6701 Old Statesville Road, NC Mecklenburg County Dear Mr. Sexten: The Division has reviewed your submittal of the permit name/ownership change form for your No -Exposure Certification, which we received on September 11, 2006_ Division personnel have reviewed and approved your request to change your name 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 conditional no -exposure exclusion expires in five years (June 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 (919) 733-5083, ext. 502, or at sarah.young@ncmail.net. cc:_Mooresville-Region al _Office . Stormwater Permitting Unit Files Sincerely, ORIGINAL SIGNED BY KEN PICKLE for Alan W. Klimek, P.E. Central Files — w/affachments N. C. Division of Water Quality 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919) 733-7015 NMENR Customer Service 1-977-623-6748 jLJn&wStates Er)v11b1vnwwW P, , - mr 'a Agem* OI�Mta OtZt1 + NPDES i AM WaaWngwn. DC 20460 FORM 4 `�' NO EXPOSURE CER'i7FlCATICN for Exd1t>oiit�lt from NPOES Storm WaWr Pan tdng Submission aloft No Exaow m Cart kaftn aanshkoen rhatica that the entity iderudw in Set *m Adam not teghrlrw om nil aldh0ed taaia4l)rlir rra attiruh writer discharges asaoaeueo with ihdttenel atsrrrrty in the Sate cIerif SW in Section B unaer EPA's Storm Water AAu*4Sec1or Genw* Pernad due to the et�lce at a condition at no +tea. A conadim of no exposure stoats at an inckistriai ftc* y when ail industrial rnal4nalis SM &CMM§ea are pas teclea bye atone rMIaMMII atheMar n pee+rerM exposure 10 rain. =XW anealwraa. ant W runoff. Induatr10 malen" or scovW" induce. bud are not MOM 14 mitenal haflOM n @ghlterdhatrt or adrrlli@L industrial rnacJtiner% raw rnparta' kdenheaiafe omA cm by-products, final producla. or waste Product:. MaWrWd hahtlitlp uWAlliae 0000 the elars+gft kwaing and unlasoft tranepwoolion. or =rAryanpe at any raw material, i ienneaiala pro m tines PnxkxX or waste protluad. A Mwo nalOW11114raW it not regtarea for flhe bllawirrq iri�ttitrbM rrtateriaia and a/aiviEiee: - arurna, Darrela. ulMm ahn snriiar containers that are tightly aaataa. Orovioed Incite containers ale not deienMUNO Ind do not tacit. -SOWW mama Daum"" or ,10, t - goXXeo ono *ffVW A operational lap@ or vaniee. - edaquat tf wism ail o Vemdee Una in thermal 10 a-ng; and - final prOquate. atltsr M 1Motitlatt tlhill wauki bie maCiltoad in a -a i wwW deohVgee W46 rods AMi- A No Exdoaure Cer1 ntliim rslat be erorided for each Makly gualilying for the no wtpowm, amoral in addalom to awahnian trans WPM perurifal+041 avadable on a bcdkv`Mde bass@ orwf. not for nalvidual outlaft It airy inoustriat actmitin or matanait arc or wdi be expoeeto to pnalpOSOU .the faeiiillr i@ not exigible tar the no atmpsure aeon. 3v stoning ano suommirfq this No Exposure Cerufmition farm. the enitty in Section A is cenftnq tnat a conartion of no excosum arose at its tMA0 or she. I ano is aoagatea to comrny with the tents ono conarnona of 40 CFR 122.26ig). .ALL INFORMATION MUST BE PROVIDED ON THIS FORM. Detailed instructions for compiating this torn and obtaining the no exposure exclusion are provided an pages 3 arho 4. A. Fseility Operator information t. Name: i Nt i i iP?IIIIII I III11 11 1 2. Phone: IQ St 0 14 12 iH 11 t 3. Mailing Address: a. Street: I :Hilt L: Lj III i E i W l ' A nl ? e! fA i Q i 1_ ' I'. I I I l I t I 5. Cily: i P' A L'O ; , A iL !-T�C i ' • . _ '— _ . ' I Slate: ILA c. Zip Gone: I O l - i B. FacilitylSite Location information f=aality Name: CiOI +- -S'0,U R E G _.a.Strom wadresa: IG11'QOIL. 5'7iA-r& j. j _I 'L..L E R 0�R'at .- ' c.Cily: C, tptIIZ -T -t -.County: tu'K I L'C;t4l S iuCr a. Slate: N +G ! e. LP Coae: 7, ff 2, 9 : ci .. Is the tacsiily locates on Indian Lanas? Yes 'Jo + p i t n !S� LL�� VJJU r- s. Is triis a eaerar taatity? Yes l No I-T J j ' MAR - a. Latitude: �� IL�J ?' �. Lcnguuae: Q Ot 5 0: '3, 5. a. Was the faaiity or site orernous+v eoverea unaer an NPOES storm water cermn? No I, _ WATER QukL1TY NICG090Cn DENR WETLANDS AND STOR04TER8RANCIi o. If ves. enter NPOES oennn numoer: c, 7 SiC;Actrvnv Copes: Primary: 2 1 Seconoary tit aogncaolel: - ictal size of site assioctatea witrt mausmal activiiv: f a acres ?. a. Have you Davao or rooleo over a torment' exoosea. oervious area in order Io quaiity for lne no exposure exctuvon? Yes % No I]Z 7. it yes. please tnoicate aooroxtmateiv now mucn area was oaveo or roomea over. C,.moieung inns euestion toes not aisouality you for the no exmsun exausion. However. your Dermtning auinonty may use tars intormauon in consroenng wnetrier storm water cischarges tram your site are iikett' to naw an adverse ,moats on water cuality. in wntcn case you covia oe reeuirea to aotain Cermrt coverage. Less tnan are acre I� One to five acres I� More man five acres l— EPA Form 3510-11 (10.99) page t c )f NPOESt �NO EXPOSURE CERTIFICATION for Exciusion from � AUPOOO Fi�3SIO.11 �� NPOES Storm Water Permitting C. Exposure Cheita M are any of the fotlawKlg matanals or activities exposeia 10 precto tation. now or in the foresseade future? (Plessa check silfler'ltra' or -No' In the approonsle box.) tt you answer -Yea" to any of tltge gumborle (1) auviagm 411). you am not ttiugible tior the no exposure exclusion. yea No 7 . Using, storing or caart' i g iwtusltnal machinery or ecufpment, anal areas where resiouats from using. storing ❑ 21 or cdeanim induslira d ntaohitery or Squipntem remain aria are exposea to storm water 2. Maiensts or residuab an the grouno or in storm water utters ham spi lsAleako ❑ LW �. Materials. or prooum from p4m inouatnai activity ❑ ;. Matanal ha cWM 9"p merk 4aar m saeotlalaty matmainao verades) ❑ 5. 11Aeadals or prodaaotr au" -- —4 OW liq Win Q or tmAsportlng acgiritlaa ❑ 6. Malanata or products stored altdoors texono Mal protsaaca imenoeo for outside use (e.g_ new c gral whirr ❑ ezoosure to storm wrtalr doss not result in the oiacrarge of podutantal Matenats contairtso in open, aatencrated aria" storage anima. barreia, tanks. ana sunder conrairrera ❑ ® i Mate nais or prommu nawleivoicireo on roaas or railwava owned or mainiainea cy the atsc narger El12 i 3. waste material texoept waste in coverea. non-iamung containers je.g., cumpstersj) �. Aopticauon or aispasal of process wastewater (unless otnerwise permate0 i Cl 1 7 1. Particulate matter or visible deposits of rresrouale from root stacks analar vents not otherwise regulated 0 a., unoer an air quaafy control perrrut) aria evident in me storm water outflow II Q. CartHtcaltfon StaUmumt I cerlify unoer penalty of law that I have real ana unaerstana ine euglbilily •eauuements for claiming a conaition of no exposure' ana obtaining an i exclusion from NPOES storm water permitting. cenity unaer penalty of law that there are no aischarges of storm water contaminates by exposure to inaustnal activities or rnaleriab from the industrial 'acifity or site aaentified in this oocument texceot as auowea unoer 40 CFR 122.261g)(2)). unoerstana tnat I am ooligateo to suorna a no exposure certification form once every five years to the NPOES pernwoM suMorily arid. it reptaestea. to ',e operator of the local muntapat separate storm sewer system iMS41 into wnicn 1he tastily aiscnarges twnere appiic able). I usuldirsUnd that I must 3itow one NPOES permitting autrionty, or MS4 operator where ine discharge Is into the local MS4, so pertorm inspeclaons to confirm Vie comilion at no exposure area to males suGn inspection reports ouottcly ayauaple upon request. I unaerstana that I must ootain coverage unoer an NPOES Permit prior *o anv point source cisCharge at storm water from the facility. ;�DDitionaily. I c+enrly, unoer penalty of law inai this Document ana all attachments were oreparea unoer my airection or Supervision in ac ccmnce with a system oesignea to assure that quatified personnel property gainerea ano evaivatea the information suommea. Based on airy inou" of the Person or ;ersons *no manage the system, or those persons aireCtly reWonsmie for gathering the information. the information SUbfndM is to the best of my .nowieage ana Deliet true. accurate ana complete. I am aware inai there are Significant penalties for suomining false information. including the Possibility it fine ana impnsOnMent for krtawahg violations. a•int Name: f °2,10 14b I E -Q rT I ( ,1.. 1A I SL I x1 int rlle: Signature: Date: EPA Form 3510-1 1 (10-99) Page 2 of BLYMYER.�L;, L ENG.lN E-ERS,-1NC. \ / w March 22, 2005 BEI Job No.201098.003 Attn: Aisha Lau / Sarah Young Stormwater and General Permits Unit North Carolina Dept.. of Environment and Natural Resources 1611 Mail Service Center Raleigh, North Carolina 27699-1617 MAR 9 Subject: No Exposure & Permit Rescission Request Con -Way Southern Express -'NCH WE"DSANDS70RMER WATERtTy BRANCH j -.6701 Old Statesville Road Charlotte, NC 28269 'Former Permit No. NCG680600 ' Dear Ms. Lau and Ms.Young: On February 11, 2002 a Rescission Request was submitted by Blymyer Engineers, Inc. on behalf of the subject facility, and included'a copy of a No Exposure Certification originally sent to your office on October, 26, 2001. These documents were sent'to the attention -of Valery Stephens in the -Stormrvater and General Permits Unit. Iri speaking with Ms. Lau this afternoon, she related that your office. does not have any record of receipt. of these documents; furthermore, permit fees have continued to'be paid, indicating that the permit Was never rescinded as requested: , Please- find enclosed a copy of the documents submitted in February 2002. It' is our understanding that the subject facility does not require permit. authorization for its storm water discharge because it is eligible for. a No Exposure Certification. Please address any questions to`Shani Carty at Blymyer, Engineers, Inc. at (800) 753-3773 x163- Sincerely, Blymyer Engineers, Inc. By: Sham C y- Environmental Specialist cc: Greg Tonkin, CNF, Inc. Jeff Sexten, Con -Way Transportation Services - Con -Way Southern Express --NCI-[ Enclosures _ H.LSTORINVT OT0 N'CN.N'O FlettmostaLeM5.doc 1 B•2 9 C L E M E N T, A V E N U E A E A,M F D A, C A 9 4 5 0 1 1 3.9 5 P N 0 N E 5 1 0. 5 2 1 °-3 7 7 3 F A X 5 1 0- 6 6 5. ° 2 5 9 4 BLYMYL,__Z E N G INEERS,INC. yis. Valery Stephens General Permit Coverage Rescission Stormwater and General Permits Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Subject: Rescission Request Form Dear'Ms. Stephens: February 1 1. 2002 BEI Job No. 93184 Enclosed please find the Rescission Request Form for the following CNF, Inc. facility: Con -Way Southern Express -NCH 6701 Old Statesville Rd Charlotte, NC 28269 Permit No.: NCGO80600 These forms are submitted by Blymyer Engineers, Inc. on behalf of CNF, Inc. facilities. Enclosures cc: Robert Weaver. CNF. Inc. Jeff Sexton, CTS Con -Way Southern Express -NCH Sincerely, Blymyer Engineers, Inc. By-, ,ndZ:� Neen Martelino Environmental Specialist I @@& @a MAR 2 9 ? �ti�3`i swy s Ewa s�oft+�w����ti a �c� 2 2? C L E K E ^. . A V E N U E - L A X E J A. _ .. 4 s 5 0 ;•,_- 5 =— c _. 0• 5 2 1•. i . X 5 1 0•= 6 5 __.- �0F w A rFR p PERMIT COVER XE _ RESCISSION REQUEST FORM National Pollutant Discharge Elimination System Stormwater General Permit NCG080000 CON WAY SOUTHERN EXPRESS -NCH COC Number NCGO80600 Mecklenburg County FACILITY INFORMATION The following is the information currently in our database for your facility. Please review this information carefully andmakeall corrections as necessary in the space provided to the right of the current ini'ormation. Facility Name: CON WAY SOUTHERN EXPRESS -NCH Mailing Address": 3240 HtLLv1EW AVE PALO ALTO. CA 9430-1 Location Address: 6701 OLD STATESVILLE RD CHARLOTTE, NC 123769 0 W NeIR.t C M F, t VV_ 1FAC-t1.1T1j GON-WA`I 5OVSi46F.N E,XT ,FL"b — r14 H Facility Contact: BOB CLARK 9.0%61LT wF,^YFrs Phone Number: 7045996777 Fax Number: No number on file E-mail address: No address on file -� This is the address to which all permit correspondence will be mailed Reason forrescission request: 'rA614tT`j_-DOGS r40-r iLSO.v\$LG 7alLM►T AUTIA1DR1_ERTt0tA tt7R IT15 SSORM WATEtZ A-" AG "NO ExP{�SV�b &1RTF1GRT1oN••• 'FORM) REQUEST AND CERTIFICATION L is an authorized representative. hereby request rescission of coverage under NPDES Stormwater General Permit NCGO80000 for the subject facility. I am I'amiliar with the intormation contained in this request and iha[ to the hest of my knowledge and behei'such information is true. complete and accurate. 7 Slgllalure �•�� 0'_qg Date L0166 S WGAg6r2 b\;LEL,IOR•, cbP.?. REAL~ GsTAIE Print or [vpe name of person SiLmin,! above Title P4easQ return this completed rescission reuue:t and any relevant documentation to General Permit Coverage Rescission Attn: V,tlery Stephens Stormwater and General Permits Emit i617 Mail Service Center Raleieh, North Carolina 27699-1617 a[UKEW195 MAR 2 9 DENR - WATER QUALITY WETLANDS AND STOR"W JEE BRAS lo�V Rescission vrn of Revues[ Date Q�oF \NArFRQG PERMIT COVERAGE RESCISSION REQUEST FORM National Pollutant Discharge Elimination System Stormwater General Permit NCG080000 CON WAY SOUTHERN EXPRESS -NCH i� COC Number NCG080600 Mecklenburg County FACILITY INFORMATION The following is the information currently in our database for your facility. Please review this information carefully and make all corrections as necessary in the space provided to the right of the current information. Facility Name: CON WAY SOUTHERN EXPRESS -NCH MailinLT Address*: 3240 H11,LVIFW AVE PALO ALTO, CA 94304 Location Address: 6701 OLia STATNSVILLE RD CHARLOTTE, INC 28269 Facility Contact: BOB CLARK Plione Number: 7015996777 Fax Number: No number on file E-mail address: No address on file OW1416P.: C"741vac.. FPt4tV�Zy��C4N-WA-4 5100n5R.N Gx4R-"b - p4cH R-O SSIL C _W E AV Itz- Ur. * This is the address to which all permit correspondence will he mailed or uiuce use BIMS El a I Reason for rescission request: VAC144Ty 'DCFS _NU-' R.SG.V\g.6 t"�C¢m1T AUT_11D1L%-iLfrTjotJ _'VyR- I T 5 SMR-rij WATER -D Sr-�Ap,m6n C (SG6 A-" fic -NF, 'E NO FK?t)$UV-6 C61Ri1F1cprno1j Po ir.tr+ ) REQUEST AND CERTIFICATION 1. as an authorized representative, hereby request rescission of coverage under NI'DES Stormwater General Permit NCGO80000 for the subject facility. I am familiar with the information contained in this request and that to the hest of my knowledge.md belief -such information is true, complete and accurate. Signature Zpp &'Rr�Date � —ZZ 'P -2 Y.0b,15 i W 6Ag6?- COIL?. R GAL. esTFti E Print or type name of person signing above Title Please relurn this completed rescission request and any relevant documentation to: General Permit Covera,e Rescission Aaw Valcry Stephens Stortwater and General Permits Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617 For Mice Usa Only ReSCIG51Uq WWDB Request Date ❑ BLYMYER". E N G I N E E R S,. I :N C. February 11, 2002 BEI Jo_ b No. 0184 Ms. Valery Stephens •7� General Permit Coverage Rescission Storinwater and General Permits Unit 1617 Mail Service Center co Raleigh, North Carolina 27699-1617 w �= r Subject: Rescission Request Form Dear Ms. Stephens:. Enclosed please find the Rescission Request Fortis for'the following CNF, Inc. facility: Con -Way Southern Express -NCH 6701 Old Statesville Rd Charlotte, NC 28269 Permit No.:_ NCGO80600 These forms are -submitted byBlymyer Engineers, Inc. on behalf of CNF, Inc. facilities. Sincerely, Blymyer Engineers; Ink, _ By: � Neen Martetino Environmental Specialist Enclosures cc: Robert Weaver, CNF, Inc. Jeff Sexton, CTS Con -Way Southern Express -NCH 1 .8 2 9 C L E M E N TA V E N U E A,-L A M E D A. C A 9 4 5 0 1 1 3 9 5. P H O N E 5 1 0 5 2 1 3 7 7 3 F A X 5 1- 0 8 6 5. • 2 5 9 4 /Ve Foriff Approved United States Environmen" Ll Protection Agency 0600 NPOSS ^ Washington. DC 20460 FORM a�� E A NO EXPOSURE CERTIFICATION for Exclusion from 3510.11 j NPDES Storm Water Permitting Submission of this No ExpoauroCon'B ,artlort constitutes notice that the emity identified in Sealer= A does not require permd euftiorlsilion for Ms atttrrll water discharges assodslad with Ytdtrstrisl activity in the State identified in Section B under EPA'>s Storm Water Mui*6eeaor General Permit due to the erislanos of a condition of no exposure. A condition of no exposure exists at an industrial facility when ail industrial materials and activities are protected by a storm resitiaoant ahOW 10 prevent exposure to rain, snow snowrrtelL anWar rutott Industrial materials or activities include, but are not limited to. material hartdf M equipment or acsivffies, industrial machinery, raw materiels. intermediate products. by-products, final products, or waste products. Material handling acoWdse include to storage. loading and unloading, transportabort. or conveyance of any raw material, intermediate product. final product or waste product A slam rstsislarM a WOM is not required for the following industt#si materials and activities: - drumi. barrels. tanks, and similar containers that are tightly sealed, provided those containers are not deteriorated and do not leak. 'Sealed" means banded or eCtsntriss secured and without operational tape or valves: adequately nuMatllssd lrttkldrJes used In material handling; and - fkW products, other than products that would be mobilized in storm water discharges *g- rods ssllj A No Exposure Certificstlon mull be provided for each facility Qualifying for the no exposure exclusion. In addlfbwk the exduion !tone NPDES penni 19 is available on a facilityvride basis only, not for inoividual.oultapa. If any industrial activities or materials are or wdi be exposed to prertipilits6M the facility is not eligible for the no exposure exclusion. By signing ano submining this No Exposure Certification form. the entity in Section A is cerittying that a condition of no exposure exists at its taciiity or site. ano is ocligated to comply with the terms ano conditions of 40 CFR 122.26fgI, I 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 1. Name: IC1N! F1��sLN L I _I 1 1 1, I r I �1 I ..,I I I I I r 1 I_I 1 1 f 2. Phone: j ;1 51014 1CI I li IIJC_10101 3. Mailing Address: a. Street: j, Z I H O 1 i H i 1 i 1-1 L I J 1 I I E i W+ 1 AI % r- 1 >a l U 16 I 1 1 1 I l l I I I I i b.City. j_P I A 1 t_ .d I I A IL iTiO I i1 I _ I ' c. State: ILA d. Zip Code: 0 - I I I S. FacilitylSite Location Information 1. Facility Name: 'Ctrs IN I- ;W. I S O:u 2.' a. Street Address: Ia lQ_' l _ d I L.10 , S ! A '•-r' & ' S V I ` L-'i l_ : E_ & ,O 1 A 1 o_+ t _ I _1 ± 1 b. Cily: 'CiSIAItz iL1(j-r 1-r: E1 1_f I , • c.Couniy: 1 M: 1<!QKi LIEItllRiu_�le- a. State: N i� e. Zp Cooe: 3, Is the facility located on Inaian Lanus? Yes I ; No II -1. Is this a Federal facility? Yes 17 No 3. a. Latitude: !1 I t : S i�l b. Longituae: O 8 ! O I ° 5 O : ' I (BSI 6• a. Was the facility or site previously covered under an NPDES storm water Permit? Yes } No I b. It yes, enter NPOES pennd number: NC(3090 a r) C3 d 7. SiClActivity Codes: Primary: i '� ( Seconoary (if aopricable): i 3. Total size of site associated with industrial activity: 3 acres 9. a. Have you paved or rooted over a formeny exPosea, pervious area in oraer to qualify for the no exposure exclusion? Yes No JW b. It yes, piease indicate approximately how much area was Paves or rooted over. Comoreting this question aces not disctuality you for the no exposure exclusion. However, your permitting authority may use this information in consloenng wnether storm water discharges from your site are likely to have an aaverse impact on water auality, in which case you couia be reautree to ootain Permn coverage. Less than one acre I 1 One to five acres I I More than five acres iJ EPA Form 351G-11 (10-99) Page 1 of 4 NPDES j NO EXPOSURE CERTIFlCATION for Exclusion from FonnApprored FORAM l ' C:PA OARS No.2040.0211 3510-11 I 16'111 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'Ytttd or'No' In the appropriate box.) If you answer "Yes" to any of these questions (1) through (11), you am 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 an the ground or in storm water inlets from spW&4eaks ❑ 3. Materials or products from past industrial activity ❑Lei 4. Material handling equipment (except adequately maintained vehicles) ❑ S. Materials or products during ioadingka*ttoading or transporting activities ❑ 6. Materials or products sfrorod outdoors (except final products intended for outside use (e.g.. new carat where ❑ Cz exposure to storm water does not result in the discharge of pollutants) 7. Materials contained in open, aetenoratea or leaking storage orums, barrels. tanks, and similar containers ❑ 3. Materials or proaucts nandled/storeo an roaas or railways ownea or matntainea by the discharger ❑ 9. Waste material (except waste in coverea, non -Leaking containers (e.g- cumpstersj) ❑ 4. Application or oisposai of process wastewater (unless otherwise permitteo) LAY 11. Particulate matter or visible deposits of residuals from roof stacks and/or vents not otherwise regulated ❑ (Le.. under an air quality control permit) and evident in the storm water outflow D. CertMestlon Statement t certify under penalty of law that I have read and unaerslano the eligibility equtrements for claiming a condition of 'no exposure' and obtaining an exclusion from NPDES storm water permitting. I certity'under penalty of law that there are no eisctarges of storm water contaminated by exposure to inaustrial activities or materials from the industrial facYlity or site identified in this oocument (except as allowea under 40 CFR 122.26(g)(2)). unaerslano that I am obligated to submit a no exposure cerlLficafion form once every five years to the NPDES permitting authority and, if requested, 10 i :ne operator of the local municipal separate storm sewer system (MS4) into wnich the facility aisenarges (where aopffcable). I understand that I must f atiow the NPDES permitting authority, or MS4 operator wnere the discharge is into the IocaL MS4, to perform inspections to corTfirm the conaftion of no t exposure and to make such inspection reports publicly available upon request. I unaerslane that f must obtain coverage under an NPDES permit prior I to any point source cisCharge of storm water from the facility. Aaaitionaffy, I certity unoer penalty of law that this ooCument ano all anacnments were prepares Unaer my direction or supervision in accordance with a I system designed to assure that qualified personnel properly gathered ano evatualea 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 i knowteage and belief true, accurate ana complete. I am aware that there are significant penalties for suomitting false information, including the passibility t of fine and imprisonment for knowing violations. Print Name: i 9,I3 Ob i E if. rT L i IL IrA i tL I r=i I 1 , I I i i I i i I I I Print Title: Signature: Hate: EPA Form 3510-11 (10-99) Page 2 of 4