NCGNE0167_COMPLETE FILE - HISTORICAL_20050420

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NGGNE
DOC TYPE
❑HISTORICAL FILE
DOC GATE
❑ (���`-1��
YYYYMMDD

F WATF Michael F. Fasley, Governor
`O=0 r William G. Ross Jr., Secretary
North Carolina Department of Fnvironment and Natural Resources
Alan W. Klimek, P. E. Director
Division of Water Quality
(] Coleen H. Sullins, Deputy Director
Division of Water Quality
April 20, 2005
Janice Patrick
Patrick Yarn Mill Inc
700 S Railroad Ave
Kings Mountain, NC 28086
Subject: No Exposure Certification NCGNE0167
Patrick Yarn Mill Incorporated - 700 S Railroad Ave
Cleveland 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 3, 2004. 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. In addition, your coverage under general permit NCG170074 is also
hereby rescinded. This rescission is based upon your certification of no exposure conditions at this facility.
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 [phone] ext.
537, or at [e-mail].
Sincerely,
for Alan W. Klimek, P.E.
-
cc: Mooresville Regional Office Central Files — wlattachments
Stormwater Permitting Unit Files Fran McPherson - DWQ Budget
N. C. Division of Water Quality 1617 Mail Service Center Raleigh, North Carolina 27699-1617 [phone]
M w
NCDENR
Customer Service
1-877-623-6748

Patrick Yam Mills, Inc.
January 29, 2004
DWQ
Stormwater and General Permits
1617 Mail Service Center
Raleigh, NC 27699-1617
Attn: Valery Stephens
RE: NCG170074
700 Railroad Avenue
Kings Mountain, NC 28086
[phone]
[phone] Fax
F E g 3 2004
Patrick Yarn Mill, Inc. is applying for No Exposure Certification for exclusion from
NPDES Storm Water Permitting. Enclosed is our application for exclusion.
I hope I have done everything that is required for this request. If you have any
questions, please contact me at [phone].
Sincerely,
Janice Patrick
Office Manager

��S vn iey� "UN 0
° Permit Coverage
° Renewal A lication Form
National Pollutant Discharge Elimination System
Stormwater General Permit NCG170000
Certificate of Coverage Number
NCG170074
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.
Owner Information
Owner / Organization Name:
Owner Contact:
Mailing Address:
Phone Number:
Fax Number:
E-mail address:
Facility Information
Facility Name:
Facility Physical Address
Facility Contact:
Mailing Address:
Phone Number:
Fax Number:
E-mail address:
Permit Information
Permit Contact:
Mailing Address:
Phone Number:
Fax Number:
E-mail address:
Discharcie Information
Receiving Stream:
Stream Class:
Basin:
Sub -Basin:
Number of Outfalls:
CERTIFICATION
Patrick Yarn Mill Inc
Janice Patrick
700 S Railroad Ave
Kings Mountain, NC 28086
704-739-4119 Ext.
Patrick Yarn Mill Incorporated
700 S Railroad Ave
Kings Mountain, NC 28086
a UT of Beason Creek
C
Broad
030805
I certify that I am familiar with the information contained in the application and that to the best of my knowledge and
belief such information is true, complete and accurate.
Signature
Print or type name of person signing above
Date
Title
Please return this completed renewal application form to: SW General Permit Coverage Renewal
Attn: Valery Stephens
Stormwater and General Permits Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

United States Environmental Protection Agency Form Approved
g y OMB No. 2040-0211
NPDES � EPA NO EXPOSURE Washington, DC 20460
FORM
3510-1 'I `�' CERTIFICATION for Exclusion from
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, and/or runoff. Industrial materials or activities include, but are not limited to, material handling equipment or activities,
industrial machinery, raw materials, intermediate products, by-products, final products, or waste products. Material handling activities include the storage,
loading and unloading, transportation, or conveyance of any raw material, intermediate product, final product or waste product. A storm resistant shelter is
not required for the following industrial materials and activities:
— drums, barrels, tanks, and similar containers that are tightly sealed, provided those containers are not deteriorated and do not leak. "Sealed"
means banded or otherwise secured and 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 roust 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, 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
1. Name: Qi�LT_i'liR_1N I. _1rn l_i l�_LL1__1N.IC l 1 2. Phone: I� I� li I� 1319
3. Mailing Address: a. Street:
7J 0A ISI I I I I I I I I 1 I I
b. City: 1Kti 1 P IG IS 1 r -' 10 P IN iT IPv I t INI I I I I I I I I G. State: ICJ d. Zip Code: I810 � Ib 1— I I I I I
S. Facility/Site Location Information
1. Facility Name: 1p 1111T A l l lc -I N{� ILT XK IIN 1 I) i l L1/�LI I�'c-i I I I I I I 11 1
2. a. Street Address: D 10101 I S '` I I k I I�-' r`I0 1 A 10 1 A IV ilf l N U I E I I I I I I I Y I I I-1
b. City: 1k<i f P I(, is I P"ki QP 1NT A I k INI I I I I I I 11 c. County: M IS AI i I i I I 11
d. State: P I `I e. Zip Code: �L IT IQ IK Ito I — I I I 1 1
3. Is the facility located on Indian Lands? Yes ❑ No
4. Is this a Federal facility? Yes ❑ No
5. a. Latitude: N 1 I o La N l r l� b. Longitude: I
6. a. Was the facility or site previously covered under an NPDES storm water permit? Yes ® No ❑
b. If yes, enter NPDES permit number:N C0.r It 7 O n y
7. SIC/Activity Codes: Primary: a I al; i ' Secondary (if applicable): 1 I l 1
8. Total size of site associated with industrial activity: b a o acres
9, a. Have 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 21 One to five acres ❑ More than five acres ❑
EPA Form 3510-11 (1 D-99) Page 1 of 4

NPDESFORM NO EXPOSURE CERTIFICATION for Exclusion from Form Approved
FARM ",EPA 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
[7
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 spillslleaks
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
Z,
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])
d
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
d
(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 10 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; 43LNLCCI P Il t I t iR I l IC—I!G I I I I I I I I I I I I I I I I] I I
Print rue: Pf IPr I i I GE-i M&' `f k6 1lt1 (�, I I I I I I I I I I I! I I I 11 I
Signature:
Date: � 101 1 la R 141 1
EPA Form 3510-11 (10-99) Page 2 of 4