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HomeMy WebLinkAboutNCGNE0440_COMPLETE FILE - HISTORICAL_20071231Michael F. Easley, Governor William G. Ross Jr., Secretary North Carolina Department of Environment and Natural Resources December 28, 2007 Ms. Kelly Moultine Eaton Corp. 5808 Long Creek Park Drive Suite K Charlotte, NC 28269 r- i 14 1Z.Oli— ni—t— D EC 3 1 2007 Subject: No Exposure Certification NCGNE0440 Eaton Corporation -Clutch Division of Water Quality 5808 Long Creek Park Drive, Suite K, Charlotte Mecklenburg County Dear Ms. Moultine: The Division has reviewed your submittal of the No -Exposure Certification for Exclusion from NPDES Stormwater Permitting form, which we received on July 3, 2007. 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 31, 2012). 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�j 9,f_Je_Z for Coleen H. Sullins cc: Mooresville Regional Office -Mike Parker Central Files,— wlattachments Stormwater Permitting Unit Files NCDENIR N. C. Division of Water Quality 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919) 733-7015 Customer Service 1-877-623-6748 Ede: 3rd gs•oup of no exposures NCGNE0438, NCGNE0439, NCGNE... Subject: Re. 3rd group of no exposures NCGNE0438, NCGNE0439, NCGNE0440, NCGNE0442 From: Michael Parker <michael.parker@ncmail.net> Date: Mon, 17 Sep 2007 12:12:51 -0400 To: Sarah Young <sarah.young@ncmai 1. net> Issue at your convenience. Mike Sarah Young wrote: Michael Parker - Mlchael.Parker@ncmail.net Environmental Engineer II Forth Carolina Dept. of Environment & Natural Resources Division of Water Quality 610 East Center Avenue Suite 301 Mooresville, NC 28115 Ph: (704) 663-1699 Fax: (704) 663-6040 1 of 1 12/1 1/2007 1:50 PM A- L :%� Division of Water Quality / Surface Water Protection +ram �r � NCDENRNational Pollutant Discharge Elimination System NO EXPOSURE CERTIFICATION for Exclusion EMvigOwerrt .wo N.QIAwL R� NCGNEOOOO NO EXPOSURE CERTIFICATION FOR AGENCY USE ONLY Date Received Year Month Day 0 Certificate of Coverage NIC E National Pollutant Discharge Elimination System application for exclusion from a Stormwate it ~— based on NO EXPOSURE: camE Submission of this No Exposure Certification constitutes notice that your facility does not r ergh authorization for its stormwater discharges associated with industrial activity in the State of Carolina because it qualifies for a no exposure exclusion. A condition of no exposure at an i al = facility means all industrial materials and activities are protected by a storm resistant shelter @!� some exceptions) to prevent exposure to rain, snow, snowmelt, and/or runoff. tag Industrial materials or activities include, but are not limited to: material handling equipment or activities, industrial machinery, raw materials, intermediate products, by-products, final products, or waste products. Material handling activities include the storage, loading and unloading, transportation, or conveyance of any raw material, intermediate product, final product or waste product. A storm resistant shelter is not required for the following industrial materials and activities: drums, barrels, tanks, and similar containers that are tightly sealed, provided those containers are not deteriorated and do not leak. "Sealed" means banded or otherwise secured and with locked or non -operational taps or valves; adequately maintained vehicles used in material handling; and final products, other than products that would be mobilized in stormwater discharges (e.g., rock salt). A No Exposure Certification must be provided for each facility qualifying for the no exposure exclusion. In addition, the exclusion from NPDES permitting is available on a facility -wide basis only -not for individual outfalls. if any industrial activities or materials are, or will be, exposed to precipitation, the facility is not eligible for the no exposure exclusion. By signing and submitting this No Exposure Certification form, you certify that a condition of no exposure exists at this facility or site and are obligated to comply with the terms and conditions of 40 CFR 122.26(g). You are required to reapply for the No Exposure Exclusion once every five (5) years. For questions, please contact the DWQ Regional Office for your area. (See page 5) (Please print or type) 1) Mailing address of owner/operator (address to which all certification correspondence will be mailed): Name Ll, ii Cod pWr4wo — lu.6k blvigicvl Street Address L L Y I z_ tt, City 0 hLi (D" e- State {J G - - ZIP Code � �L Telephone No. _� W S-1 — q -7 :23 ^Fax: 2) Location of facility producing discharge: Facility Name Facility Contact Street Address City County Telephone No. Eai Ct7iretL{�rn - ('.Ike �Iv�si�yl State N(, ZIP Code r — q 1 Z3 Fax: �- 591- U -72 0 Page 1 of 5 SWU-NE-060607 Last revised 06i06/07 - - � �. sa � � -� .. � . � is i �. . r � _ , j �=. L i �1 i a . 1' L � r �� 11 �� �_ -� _.» � ' A l NCGNE0000 No Exposure Certification 3) Physical location information: Please provide a narrative description of how to get to the facility (use street names, state road numbers, and distance and direction from a roadway intersection). SiG j ij( Ag-yii IW,A (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 ANo 5) Is this a Federal facility? ❑ Yes )4 No 6) Latitude _95 0 2 ' NJ I Longitude KOO VJ (deg, min, sec) 7) This NPDES Permit Application applies to which of the following: ❑ New or Proposed Facility Date operation is to begin �( Existing Date operation began_ 8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes X 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: 3-2 1 10) Provide a brief description of the types of industrial activities and products produced at this facility: 11) Does this facility have any Non -Discharge permits (ex: recycle permits)? X No ❑ Yes If yes, list the permit numbers for all current Non -Discharge permits for this facility: Exposure Checklists (12. - 14.) 12) Are any of the following materials or activities exposed to precipitation, now or in the foreseeable future? (Please check either "Yes" or "No.") If you answer "Yes" to any of these items, you are not eligible for the no exposure exclusion. a. Using, storing, or cleaning industrial machinery or equipment, and areas where 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 c. Materials or products from past industrial activity d. Material handling equipment (except adequately maintained vehicles) e. Materials or products during loading/unloading or transporting activities f. Materials or products stored outdoors (except final products intended for outside use [e.g., new cars] where exposure to stormwater does not result in the discharge of pollutants) ❑ Yes XNo ❑ Yes ).(No ❑ Yes No ❑ Yes No ❑ Yes XNo ❑ Yes ANo Page 2 of 5 SWU-NE-060607 Last revised 06/06/07 NCGNE0000 No Exposure Certification g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, ❑ Yes No and similar containers h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes No the discharger i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters]) ❑ Yes No j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes `I No k, Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes )o No otherwise regulated (i.e., under an air quality control permit) and evident in the stormwater outflow I. Empty containers that previously contained materials that are not properly stored ❑ Yes XNo (i.e., not closed and stored upside down to prevent precipitation accumulation) m. For any exterior ASTs, as well as drums, barrels, tanks, and similar containers ❑ Yes )0o 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 WA ❑ Yes ❑ No deterioration, or evidence of leaks? b. Is secondary containment provided for all exterior ASTs? If so, is it free of any N/A Cl Yes ❑ No cracks, holes, or evidence of leaks, and are drain valves maintained locked shut? 14) Secondary Containment: If you answer "No" to any of the following items, you are not eligible for the no exposure exclusion. a. Is secondary containment provided for single above ground storage containers O)h ❑ Yes ❑ No (including drums, barrels, etc.) with a capacity of more than 660-gallons? b. Is secondary containment provided for above ground storage containers stored OJA in close proximity to each other with a combined capacity of more than 1,320- I gallons? c. Are release valves on all secondary containment structures locked? w \ ❑ Yes ❑ No ❑ Yes ❑ No Page 3of5 SWU-NE-060607 Last revised 06/06/07 NCGNE0000 No Exposure Certification 15) Hazardous Waste: a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? ❑ Yes )(No b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste I Yes ❑ No generated per month) of hazardous waste? c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste Cl Yes X,No generated per month) of hazardous waste? If you answered yes to questions b. or c., please provide the following information: Type(s) of waste: Q I , C7rf a S e- � Tv1 K Pir l � _ ELLM Chowr�I n.f � , A cro � CLt o 5 How is material stored: a o Where is material stored: DtC I A I\L44 d Lt)ra,t MS .TtnC , AA 1 2 How many disposal shipments per yi Name of transport 1 disposal vendor: Vendor address: 16) Certification: certify under penalty of law that I have read and understand the eligibility requirements for claiming a condition of "no exposure" and obtaining an exclusion from NPDES stormwater permitting. I certify under penalty of law that there are no discharges of stormwater contaminated by exposure to industrial activities or materials from the industrial facility or site identified in this document (except as allowed under 40 CFR 122.26(g)(2)). I understand that I am obligated to submit a no exposure certification form once every five (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. Printed Naft of Person Si ning: K>✓i W _ lul l TI V1t✓ Title: _ E}S CNY- iV\61 t:Lc 6-a(0 -off (Signature ofAp icant) (Date 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. Page 4 of 5 SWU-NE-060607 Last revised 06/06/07 .k --; , 1 i i-��,t•-i •--`: ryr- �- arJ-r r >,f\. ----- �� tirrr7�--� /-' � 5.�it �! r "/ f/�i -. J � �i ��L • � `. i . �' � � '4 ��\r� �t %�.\��-^ti.,,.. ��ff ,� \f�f:{%1_ � � ` L�"'4'�% ����i�,.'`ti':.'e�- �� ! (�r{' � � �,,y��'` /`-' `` •'� � '. __�, X~' \�, \'�v�/ "Z��- � / _�� \� f� 1\ j� � (t ( / ill ��''��_.:"Pr ��.�7 /', 5��• � 1 =� ��- ��1� ; / �fii�y� °+ ,.i �j U i I . 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Al tR; • :7 ;l _ �� rfiA 1 tr' i �3� ./' �,�j°r47B_Y a `t• ;' {�.Yjj1 1u _ �� � rift\'jt, - _ c/'��,f,}'y�_ L`-r %! � �'rp Ij` 't�,•Y[1 `� r \ Y� i•�'��T��.r ���f 4 n ,�. 11. ;� ;� )n �r w�' / .l��r ". `. ,I. \ I.Y'T��-'"•`�, .,.' �'r� � r 'I � I ��y� } �1� I'd Eu� l fI ' /tj� 91 I � j `It Elton Corp. ClutcnUivisron �\� •: r'l:' 1 it%= %G;ifratlrllalefi — { 21E2Jr^ dill ' �� l4 `t'' �' �1.r1'st y1r�C r �rs�� � ,,� � „ �s} �r wd) �~ �� : ��/�/( -�'� Ll 111 . • � N r; C; ,��� ! ! 1 5ti ' �`5 • '�t� �`i' a/ `• �V�./.�•.. ••• Y S �.• �J �L4 l ~��� ■ /ti2.•l \'�_ •� � r l ,�, �. \ywi ��s .i'`1 4 �.,. • •,•:.-E � '�=� '` '� � - � , ;,4ett01ina a u3�1 _ /a`'C'a\ r•`nr_--�.��t�'�� �• .�ir3 ,�_ � � - - -mot_,- � � aiogrol, s •,` C'.�� '� ...•,��s .•--s•• 1 ---•. `� /., yh IN �'����• n �� :4: ;'���. .�i'.•zr''� qq(- ~ -�'r .=.tir"". �a=a . \ .1 r,„��i' �.. te: �';i wl ,f f , k 1 . 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NCGNE0000 No Exposure Certification North Carolina General Statute 143-215.6 B(i) provides that: Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan, or other document filed or required to be maintained under this Article or a rule implementing this Article; or who knowingly makes a false statement of a material fact in a rulemaking proceeding or contested case under this Article; or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the [Environmental Management] Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars ($10.000). There is currently no fee for a No Exposure Exclusion. Final Checklist This application should include the following items: ❑ This completed application and all supporting documentation. ❑ A map with the location of the facility clearly marked. Mail the entire package to: Stormwater Permitting Unit Division of Water Quality 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Note The submission of this document does not guarantee the issuance of a No Exposure Exclusion. For questions, please contact the DWQ Regional Office for your area. DWQ Regional Office Contact information: Asheville Office ...... (828) 296-4500 Fayetteville Office ... (910) 433-3300 Mooresville Office ... (704) 663-1699 Raleigh Office ........ (919) 791-4200 Washington Office ...(252) 946-6481 Wilmington Office ... (910) 796-7215 Winston-Salem ...... (336) 771-5000 Central Office ......... (919) 733-5083 Page 5 of 5 SWU-NE-060607 Last revised 06/06/07 Driving Directions from Raleigh, NC to 5808 Long Creek Park Dr, Charlotte, NC Pagel of2 {, Sorry! When printing directly from the browser your map may be incorrectly cropped. To print the entire map, try clicking the "Printer -Friendly" link at the top of your results page. Raleigh, NC 27699, US Total Est. Time: 2 hours, 53 minutes v, m,�f ��g , 1 -, F fM 5808 Lang Creek Park Dr Charlotte, NC 28269-5744, US Total Est. Distance: 172.32 miles Maneuvers Distance 1: Start out going SOUTH on SOLHEIM LN toward CUPP CT. 0.1 miles 2: Turn LEFT onto MEDIATE DR. <0.1 miles 3: Turn RIGHT onto SUGARLOAF WAY. <0.1 miles 4: Turn LEFT onto SEASTONE ST. <0.1 miles O5: Turn LEFT onto OLD STAGE RD. 3.5 miles oarM 6: Turn RIGHT onto FAYETTEVILLE RD / US-401 N. Continue to follow US- 401 401 N. 3.0 miles 7: Merge onto I-40 W via the ramp on the LEFT toward CARY / DURHAM. 71.1 miles 8: Take I-85 S toward CHARLOTTE. 9: Take the HARRIS BLVD / NC-24 W exit- EXIT 45B. F 88.0 miles 0.2 miles s,s, 10: Turn SLIGHT RIGHT onto W WT HARRIS BLVD / NC-24 W. 5.0 miles O 11: Turn LEFT onto LAKEVIEW RD. 12: Turn LEFT onto US-21 / STATESVILLE RD: 13: Turn LEFT onto LONG CREEK DR. 0.5 miles 0.4 miles <0.1 miles 14: End at 5808 Long Creek Park Dr Gr�tl� E Charlotte, NC 28269-5744, US ( J �ufii. '.S; rn_Ajo �_bux Total Est. Time: 2 hours, 53 minutes Total Est. Distance:.172.32 miles http://w-vvw.mapquest.com/directions/main.adp?go=1 &do=nw&rmm=1 &un=m&cl=EN&c... 6/26/2007 Driving Directions from Raleigh, NC to 5808 Long Creek Park Dr, Charlotte. NC Page 2 of 2 Sorry! When printing directly from the browser your map may be incorrectly cropped. To print the entire map, try clicking the "Printer -Friendly" link at the top of your results page. &11 rights reserved. Use Subject to license/Copyright These directions are informational only. No representation is made or warranty given as to their content, road conditions or route usability or expeditiousness. User assumes all risk of use. MapQuest and its suppliers assume no responsibility for any loss or delay resulting from such use. http:llwww.mapquest.corfldirectionslmain.adp?go=1 &do=nw&rmm=1 &un=m&cI=EN&c... 6/26/2007 NCDENR N� C�C� E.vno�tl NR[1ML ROouwes Division of Water Quality / Surface Water Protection National Pollutant Discharge Elimination System NO EXPOSURE CERTIFICATION for Exclusion NCGNE0000 FOR AGS NCY USE ONLY Date Received Year I tvl 6 Day Certificate ofCovcragc NO EXPOSURE CERTIFICATION National Pollutant Discharge Elimination System application for exclusion from a Stormwater Permit based on NO EXPOSURE: Submission of this No Exposure Certification constitutes notice that your facility does not require permit authorization for its storynwater 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. Industrial materials or activities include, but are not limited to: material handling equipment or activities, industrial machinery, raw materials, intermediate products, by-products, final products, or waste products. Material handling activities include the storage, loading and unloading, transportation, or conveyance of any raw material, intermediate product, final product or waste product. A storm resistant shelter is not required for the following industrial materials and activities: drums, barrels, tanks, and similar containers that are tightly sealed, provided those containers are not deteriorated and do not leak. "Sealed" means banded or otherwise secured and with locked or non -operational taps or valves; adequately maintained vehicles used in material handling; and final products, other than products that would be mobilized in stormwater discharges (e.g., rock salt). A No Exposure Certification must be provided for each lacIELty qualifying for the no exposure exclusion. In addition, the exclusion from NPDES pennitting is available on a facility -wide basis only —not for individual outfalls. N 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 terns and conditions of 40 CFR t 22.26(g). You are required to reapply for the No Exposure Exclusion once every five is) years. For questions, please contact the DINO Regional Office for your area. (See page 5) 1) Mailing address of ownerioperator Name Street Address City Telephone No. (Please print or type) State MC, ZIP Code 2.92bi 5q-+ - +So Fax: -40-1 - 511 - L4 -+10 2) Location of facility producing discharge: Facility Name Facility Contact Street Address City County Telephone No. Page 1 of 5 SWU-NE-060607 Last revised 06106i07 t NCGNE0000 No Exposure Certification 3) Physical location information: Please provide a narrative description of how to get to thffl facility (use street names, state road numbers, and distance and direction from a roadway intersection). (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 >(No 5) Is this a Federal facility? © Yes XNo 6) Latitude ZS J t-F)i A� Longitude �Oa Sbr U) (deg, min, sec) 7) This NPDES Permit Application applies to which of the following: ❑ New or Proposed Facility Date operation is to begin X Existing Date operation began ] " i G — C _- 8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes 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: -� —+ I y 10) Provide a brief description of the types of industrial activities 11) Does this facility have any Non -Discharge permits (ex: recycle permits)? KNo '❑ es If yes, list the permit numbers for all current Non -Discharge permits for this facility: Exposure Checklists (1 Z - 14.) at this facility: 12) Are any of the following materials or activities exposed to precipitation, now or in the foreseeable future? (Please check either "Yes" or "No.") If you answer "Yes" to any of these items, you are not eligible for the no exposure exclusion. a. Using, storing, or cleaning industrial machinery or equipment, and areas where 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 spilisAeaks c. Materials or products from past industrial activity d. Material handling equipment (except adequately maintained vehicles) e. Materials or products during load inglunloading or transporting activities f. Materials or products stored outdoors (except final products intended for outside use [e.g., new cars] where exposure to stormwater does not result in the discharge of pollutants) ❑ Yes KNO ❑ Yes XNo ❑ Yes )(No ❑ Yes XNo ❑ Yes IXNo ❑ Yes )(No Page 2 of 5 SWU-NE-060607 Last revised 06/06/07 NCGNE0000 No Exposure Certification g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, ❑ Yes No and similar containers h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes XNO the discharger i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters]) ❑ Yes XNO j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes XNO k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes KNO otherwise regulated (i.e., under an air quality control permit) and evident in the stormwater outflow i. Empty containers that previously contained materials that are not properly stored ❑ Yes YNo (i.e., not closed and stored upside down to prevent precipitation accumulation) m. For any exterior ASTs, as well as drums, barrels, tanks, and similar containers ❑ Yes XNo 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. l' a. Are extenorAST s or piping free of rust, damaged or weathered coating, pits, or NIX ID Yes ❑ No deterioration, or evidence of leaks? b. Is secondary containment provided for ail exterior ASTO If so, is it free of any Q f � ❑ Yes ❑ No cracks, holes, or evidence of leaks, and are drain valves maintained locked shut-.? J 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 (including drums, barrels, etc.) with a capacity of more than 660-gallons? b. Is secondary containment provided for above ground storage containers stored in close proximity to eacli other with a combined capacity of more than 1,320- gallons? c. Are release valves on all secondary containment structures locked? Olk ❑ Yes ❑ No PIN ❑ Yes ❑ No 91h ❑ Yes ❑ No Page 3 of 5 SWU-NE-060607 Last revised 06/06/07 APR 17 08 NCGNE0000 No Exposure Certification 15) Hazardous Waste: a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? ❑ Yes XN 0 b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste ❑ Yes KN 0 generated per month) of hazardous waste? c. Is this facility a Large Quantity Generator (1000 kg, or more of hazardous waste ❑ Yes KNO 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: 16) Certification: I certify under penalty of law that I have read and understand the eligibility requirements for claiming a condition of "no exposure" and obtaining an exclusion from NPDES stormwater permitting. I certify under penalty of taw 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 1 am obligated to submit a no exposure certification form once every five (5) years to the North Carolina Division of Water Quality and, if requested, to the operator of the local municipal separate storm sewer system (MS4) into which the facility discharges (where applicable). I understand that I must allow the North Carolina Division of Water Quality, or MS4 operator where the discharge is into the local MS4, to perform inspections to confirm the condition of no exposure and to make such inspection reports publicly available upon request. In the event that the site no longer qualifies for a No Exposure Exclusion, I understand that I must obtain coverage under an NPDES permit prior to any point source discharge of stormwater from the facility. Additionally, I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is to the best of my knowledge and belief true, accurate and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. I certify that I am familiar with the information contained in this application and that to the best of my knowledge and belief such information is true, complete, and accurate. Printed Name of Person Signing: 't�f o�,1 �1-L Title: Eil-S : •,1�.Z ,n/ (Signature of to (D a 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. Page 4 of 5 SWU-NE-060607 Last revised 06/06/07 APR I Os NCGNE0000 No Exposure Certification North Carolina General Statute 143-215.6 B(i) provides that: Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan, or other document filed or required to be maintained under this Article or a rule implementing this Article; or who knowingly makes a false statement of a material fact in a rulemaking proceeding or contested case under this Article; or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the [Environmental Management] Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars ($10,000). There is currently no fee for a No Exposure Exclusion. Final Checklist This application should include the following items: ❑ This completed application and all supporting documentation. ❑ A map with the location of the facility clearly marked. Mail the entire package to: Stormwater Permitting Unit Division of Water Quality 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Note The submission of this document does not guarantee the issuance of a No Exposure Exclusion. For questions, please contact the DWQ Regional Office for your area. DWQ Regional Office Contact Information: Asheville Office ...... (828) 2964500 Fayetteville Office ... (910) 433-3300 Mooresville Office... (704) 663-1699 Raleigh Office ........ (919) 791-4200 Washington Office... (252) 946-6481 Wilmington Office ... (910) 796-7215 Winston-Salem ...... (336) 771-5000 Central Office ......... (919) 733-5083 Page 5 of 5 SWU-NE-060607 Last revised 06/06/07 Elul M co .r -m, Cl- e Driving Directions from Raleigh, NC to 5808 Long Creek Park Dr, Charlotte, NC Page 1 of 2 Sorry! When printing directly from the browser your map may be incorrectly cropped. To print the i`' entire map, try clicking the "Printer -Friendly" link at the top of your results page. Raleigh, NC 27699, US 5808 Long Creek Park Dr Charlotte, NC 28269-5744, US Total Est. Time: Total Est. Distance: 2 hours, 53 minutes 172.32 miles Maneuvers Distance 1: Start out going SOUTH on SOLHEIM LN toward CUPP CT.� _ 0.1 miles 2: Turn LEFT onto MEDIATE DR. <0.1 miles O 3: Turn RIGHT onto SUGARLOAF WAY. <0.1 miles 4: Turn LEFT onto SEASTONE ST. <0.1 miles -O 5: Turn LEFT onto OLD STAGE RD. 3.5 miles oRr 6: Turn RIGHT onto FAYETfEVILLE RD / US-401 N. Continue to follow US- 3.0 miles 401 401 N. —� • s 7: Merge onto I-40 W via the ramp on the LEFT toward CARY / DURHAM. 71.1 miles 8: Take I-85 S toward CHARLOTTE. 88.0 miles �] 9: Take the HARRIS BLVD / NC-24 W exit- EXIT 45B. 0.2 miles w_sl 24, 10: Turn SLIGHT RIGHT onto W WT HARRIS BLVD / NC-24 W. 5.0 miles e 11: Turn LEFT onto LAKEVIEW RD. 0.5 miles <e> 12: Turn LEFT onto US-21 / STATESVILLE RD. 0.4 miles <e13. > Turn LEFT onto LONG CREEK DR. <0.1 miles 14: End at 5808 Long Creek Park Dr GI`'d{fit 1 � S�CJ "i(d1 141J. Charlotte, NC 28269-5744, US v ( 5Av-C Ot,tr J� Total Est. Time: 2 hours, 53 minutes Total Est. Distance:.172.32 miles http://www.mapquest.com/directions/main.adp?go=1 &do=nw&rmm=1&un=m&cl=EN&c... 6/26/2007 , Driving Directions from Raleigh, NC to 5808 Long Creek Park Dr, Charlotte, NC Page 2 of 2 41�, Sorry! When printing directly from the browser your map may be incorrectly cropped. To print the entire map, try clicking the "Printer -Friendly" link at the top of your results page. All rights reserved. Use Subject to License/Copyright These directions are informational only. No representation is made or warranty given as to their content, road conditions or route usability or expeditiousness. User assumes all risk of use. MapQuest and its suppliers assume no responsibility for any loss or delay resulting from such use. http://www.mapquest.com/directions/main.adp?go=1 &do=nw&rmm=1&un=m&cl=EN&c... 6/26/2007 NC®ENR NORTH G.nou+. Dvwi &r of EX./IFmHM - N4 Re Rces `QS Division of Water Quality / Surface Water Protection National Pollutant Discharge Elimination System NO EXPOSURE CERTIFICATION for Exclusion NCGNE0000 NO EXPOSURE CERTIFICATION FO R AGENCY USE ONLY Date Received Year Month Day Certificate of Coverage INICIGINIE] National Pollutant Discharge Elimination System application for exclusion from a Stormwater Permit based on NO EXPOSURE: Submission of this No Exposure Certification constitutes notice that your facility does not require permit authorization for its 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. Industrial materials or activities include, but are not limited to: material handling equipment or activities, industrial machinery, raw materials, intermediate products, by-products, final products, or waste products. Material handling activities include the storage, loading and unloading, transportation, or conveyance of any raw material, intermediate product, final product or waste product. A storm resistant shelter is not required for the following industrial materials and activities: drums, barrels, tanks, and similar containers that are tightly sealed, provided those containers are not deteriorated and do not leak. "Sealed" means banded or otherwise secured and with locked or non -operational taps or valves; adequately maintained vehicles used in material handling; and final products, other than products that would be mobilized in stormwater discharges (e.g., rock salt). A No Exposure Certification must be provided for each facility qualifying for the no exposure exclusion. In addition, the exclusion from NPDES permitting is available on a facility -wide basis only --not for individual outfalls. If any Industrial activities or materials are, or will be, exposed to precipitation, the facility is not eligible for the no exposure exclusion. By signing and submitting this No Exposure Certification form, you certify that a condition of no exposure exists at this facility or site and are obligated to comply with the terms and conditions of 40 CFR 122.26(g). You are required to reapply for the No Exposure Exclusion once every five (5) years. For questions, please contact the DWQ Regional Office for your area. (See page 5) (Please print or type) 1) Mailing address of ownerloperator (address to which all certification correspondence will be mailed): Name C-76-hi1 Cur o�YCuhtin — 0_1u6D bIviSI&I Street Address r� g 0 9 Ll d A lire _�L_ r+�t�f.L_ D r. K City P htv10fp, J State _%G ZIP Code r2 1,2 (a r Telephone No. ---104 519 -7 - y -7 23 Fax: `104 4-1 Q D 2) Location of facility producing discharge: Facility Name Facility Contact Street Address C ity County Telephone No. �u hm oT ow" u. �t 1 V i S I Ry+rn11011 I . I . art Page 1 of 5 Last revised 05/05/07 National Pollutant Discharge Elimination System application for exclusion from a Stormwater Permit based on NO EXPOSURE: Submission of this No Exposure Certification constitutes notice that your facility does not require permit authorization for its 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. Industrial materials or activities include, but are not limited to: material handling equipment or activities, industrial machinery, raw materials, intermediate products, by-products, final products, or waste products. Material handling activities include the storage, loading and unloading, transportation, or conveyance of any raw material, intermediate product, final product or waste product. A storm resistant shelter is not required for the following industrial materials and activities: drums, barrels, tanks, and similar containers that are tightly sealed, provided those containers are not deteriorated and do not leak. "Sealed" means banded or otherwise secured and with locked or non -operational taps or valves; adequately maintained vehicles used in material handling; and final products, other than products that would be mobilized in stormwater discharges (e.g., rock salt). A No Exposure Certification must be provided for each facility qualifying for the no exposure exclusion. In addition, the exclusion from NPDES permitting is available on a facility -wide basis only --not for individual outfalls. If any Industrial activities or materials are, or will be, exposed to precipitation, the facility is not eligible for the no exposure exclusion. By signing and submitting this No Exposure Certification form, you certify that a condition of no exposure exists at this facility or site and are obligated to comply with the terms and conditions of 40 CFR 122.26(g). You are required to reapply for the No Exposure Exclusion once every five (5) years. For questions, please contact the DWQ Regional Office for your area. (See page 5) (Please print or type) 1) Mailing address of ownerloperator (address to which all certification correspondence will be mailed): Name C-76-hi1 Cur o�YCuhtin — 0_1u6D bIviSI&I Street Address r� g 0 9 Ll d A lire _�L_ r+�t�f.L_ D r. K City P htv10fp, J State _%G ZIP Code r2 1,2 (a r Telephone No. ---104 519 -7 - y -7 23 Fax: `104 4-1 Q D 2) Location of facility producing discharge: Facility Name Facility Contact Street Address C ity County Telephone No. �u hm oT ow" u. �t 1 V i S I Ry+rn11011 I . I . art Page 1 of 5 Last revised 05/05/07 - NCGNE0000 No Exposure Certification 3) Physical location information: Please provide a narrative description of how to get to the facility (use street names, state road numbers, and distance and direction from a roadway intersection).. CO( _J IY(' H15 Y1 (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 KNo 5) is this a Federal facility? ❑ Yes No 6) Latitude ° Longitude 5W 5(J W (deg, min, sec) 7) This NPDES Permit Application applies to which of the following: ❑ New or Proposed Facility Date operation is to begin Existing Date operation began_ — 10 — 2-06: 8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes X 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: 10) Provide a brief description of the types of industrial activities and products produced at this facility: 11) Does this facility have any Non -Discharge permits (ex: recycle permits)? XNo ❑ Yes If yes, list the permit numbers for all current Non -Discharge permits for this facility: Exposure Checklists (12. - 14.) 12) Are any of the following materials or activities exposed to precipitation, now or in the foreseeable future? (Please check either "Yes" or "No.") If you answer "Yes" to any of these items, you are not eligible for the no exposure exclusion. a. Using, storing, or cleaning industrial machinery or equipment, and areas where ❑ Yes No residuals from using, storing or cleaning industrial machinery or equipment remain and are exposed to stormwater b. Materials or residuals on the ground or in stormwater inlets from spills/leaks c. Materials or products from past industrial activity d. Material handling equipment (except adequately maintained vehicles) e. Materials or products during loading/unloading or transporting activities f. Materials or products stored outdoors (except final products intended for outside use [e.g., new cars] where exposure to stormwater does not result in the discharge of pollutants) ❑ Yes X.No 0 Yes X No ❑ Yes ANo ❑ Yes XNo ❑ Yes ANo Page 2 of 5 SWU-NE-060607 Last revised 06/06/07 NCGNE0000 No Exposure Certification g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, ❑ Yes No and similar containers h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes No the discharger i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters]) ❑ Yes XNo j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes )4 No k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes V No otherwise regulated (i.e., under an air quality control permit) and evident in the stormwater outflow 1. Empty containers that previously contained materials that are not properly stored ❑ Yes XNo (i.e., not closed and stored upside down to prevent precipitation accumulation) m. For any exterior ASTs, as well as drums, barrels, tanks, and similar containers ❑ Yes WNo 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 N'A ❑ Yes ❑ No deterioration, or evidence of leaks? b. Is secondary containment provided for all exterior ASTs? If so, is it free of any O/A ❑ Yes ❑ No cracks, holes, or evidence of leaks, and are drain valves maintained locked shut? 14) Secondary Containment: If you answer "No" to any of the following items, you are not eligible for the no exposure exclusion. a. Is secondary containment provided for single above ground storage containers I )Jh ❑ Yes ❑ No (including drums, barrels, etc.) with a capacity of more than 660-gallons? b. is secondary containment provided for above ground storage containers stored O J A in close proximity to each other with a combined capacity of more than 1,320- I gallons? c. Are release valves on all secondary containment structures locked? w1 k 0 ❑ Yes ❑ No ❑ Yes ❑ No Page 3 of 5 SWU-NE-060607 Last revised 06/06107 NCGNE0000 No Exposure Certification 15) Hazardous Waste: a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? ❑ Yes )(No b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste Yes ❑ No generated per month) of hazardous waste? c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste © Yes XNo generated per month) of hazardous waste? If you answered yes to questions b. or c., please provide the following information: Type(s) of waste: C Tyik d kG Ck4.'r6I,'1 ALrop l Caves How is material stored: uYt r ' Where is material stored: Ucaji MS Td 2 How many disposal shipments per year: Name of transport 1 disposal vendor:S�-AT__10",rgLrAAJ Vendor address: P.O. &1A 1y43 [ Xlnoir . NC 9'3(0qS 16) Certification: certify under penalty of law that I have read and understand the eligibility requirements for claiming a condition of "no exposure" and obtaining an exclusion from NPDES stormwater permitting. certify under penalty of law that there are no discharges of stormwater contaminated by exposure to industrial activities or materials from the industrial facility or site identified in this document (except as allowed under 40 CFR 122.26(g)(2)). I understand that I am obligated to submit a no exposure certification form once every five (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. Printed Na ft of Person Si ning: Kt'ii lUi Iv101A l T f Vl�. __ Title: _ t�S 1T i V1rA lk_ (Signature of Aplicant) (Date 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. Page 4 of 5 5WU-NE-060607 Last revised 06/06/07 NCGNE0000 No Exposure Certification North Carolina General Statute 143-215.6 B(i) provides that: Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan, or other document filed or required to be maintained under this Article or a rule implementing this Article; or who knowingly makes a false statement of a material fact in a rulemaking proceeding or contested case under this Article; or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method required 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). 17— There is currently no fee for a No Exposure Exclusion. Final Checklist This application should include the following items: ❑ This completed application and all supporting documentation. © A map with the location of the facility clearly marked. Mail the entire package to: Stormwater Permitting Unit Division of Water Quality 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Note The submission of this document does not guarantee the issuance of a No Exposure Exclusion. For questions, please contact the DWQ Regional Office for your area, DWQ Regional Office Contact Information:_ Asheville Office ...... (828) 296-4500 Fayetteville Office ... (910) 433-3300 Mooresville Office... (704) 663-1699 Raleigh Office........ (919) 791-4200 Washington Office ...(252) 946-6481 Wilmington Office... (910) 796-7215 Winston-Salem ...... (336) 771-5000 Central Office ......... (919) 733-5083 Page 5 of 5 SWU-NE-060607 Last revised 06/06107 SERIAL NI LL44618 PAY TD \� ' r`', t'NE TIABf; ONCE= IN THE i1 S ANW 0SSE5510�ES aSEE,;EIIEftSEjW4RJlHG,\� ADDRESS „,a, , , a . �� ��° �; ���,�• ����� \ , CLERK a,r l G.. J� 2 s � y,, � a;,i,',[t��2c.0 •.h��, �y\f7 � Q�'0., l fti��H���� ..� � �k:=�\�i 1 Aonaes "�a��u�{Wf1 Z` l u3� a� P );�'• _ Ea a t b .,a�_��}\`!•).plQ�U�I{' kl ���Q \��w \t ;?'.Y .0 1, �� C.O D. NO, OR LSED FDR I_� tt�� t�C [ 'i.- t, ti yS�• 1 1� 1L �(+�� � �+�i• 5ar 5 .�/�� ta.; �� Michael F. Easley, Governor William G, Ross Jr., Secretary North Carolina Department of Environment and Natural Resources Coleen H. Sullins, Director Division of Water Quality March 1, 2008 NPDES Stormwater Permit Owner/Operator Subject: NPDES Stormwater Permit Sampling and Certification Requirements - Correction and Clarification Dear Stormwater Perm=t e You may have received correspondence in the past about whether stormwater samples must be analyzed by a certified lab. If you are covered under a General Permit that was renewed in 2007, the information in our issuance letter and previous Technical Bulletins may have misguided you about how certification rules apply to stormwater sampling and results. We are sending this letter to correct our misunderstanding of the rules and provide more accurate direction to you on this issue. We have also posted this information on our website (http://h2o.enr,state.nc.us/su/Forms_Doci�ments.htm#stormwaterGP) and in various revised stormwater General Permit Technical Bulletins. In the fall of 2007, DWQ received a request for clarification of certification requirements during the public comment period of draft renewal stormwater General Permits NCG030000, NCG060000, NCG080000, NCG090000, NCG100000, and NCG120000, In the final issuance letter for those permits, we advised permittees that all analytical results (including pH, which must be measured within 15 minutes) must adhere to the certification requirements in T15A NCAC 2H .0800, as administered by DWQ's Laboratory Section Certification Branch. Whiie that is true for wastewater discharges originating from Water Pollution Control Systems defined under T15A NCAC 8G .0300, North Carolina certification procedures do not apply to stormwater-only discharges at this time., However, any monitcrrlg of discharges under an NPDES permit (including stormwater) must be conducted in accordance to test procedures a roved under federal regulations in 40 CFR §136. All labs certified by North Carolina perform .analyses in accordance with those procedures. So, even if'your facility is not a classified Water Pollution Control System (which handles wastewater and not stormwater), any data gathered under an NPDES permit must conform to federal requirements. This includes measuring pH properly within the 15- minute hold time. Using a North Carolina certified lab is often the easiest way to comply with NPDES Program requirements. A list of North Carolina certified labs can be found on-line at: htto:/lh2o.enr.state.nc.us/Iab/cert.htm. Information on labs certified to measure field parameters (such as pH) and technical guidance on field pH measurement can also be found at that website (sae the-_dcvvnloa-js s _tic^). The_G!t�r„tt,ve to us; ,g a cast":;ied idu is io adequately train'personnel to perform analyses and use equipment in accordance with the same standards. Please be sure to share this information with the employees responsible for stormwater management and NPDES permit compliance at your facility. If you have any questions regarding this information please contact a staff member of the Central Office Stormwater Permitting Unit at (919) 733-5083. Sincerely, ly Bradley Bennett, Stormwater Permitting Unit Supervisor cc: DWQ Central Files Stormwater Permitting Unit General Permit Files No` Carolina NturallY North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Intemet h2o.enr.state.nc.usisulstormwater.html 512 N. Salisbury St. Raleigh, NC 27604 An Equal Opportunity/Affirmative Action Employer — 50% Recycledi10% Post Consumer Paper Phone (919) 733-7015 Customer Service FAX (919) 733-9612 1-877-623.6748 NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES 2 0 0 8 P R 0 0 2 8 0 2 INVOICE Annual Permit Fee This annual fee is required by the North Carolina Administrative Code, it covers the administrative costs associated with your permit. It is required of any person holding a permit for any time during the annual fee period, regardless of the facility's operating status, Failure to pay the fee by the due date will subject the permit to revocation. Operating without a valid permit is a violation and is subject to a S 10,000 per day fine. If the permit is revoked and you later decide a permit is needed, you must reapply, with the , understanding the permit request may be denied due to changes in environmental, regulatory, or modeling conditions. Permit Number: NCG030303 Cabarrus County Eaton Corp -Clutch Div Corey Woolard Eaton Corporation 5908 Long Creek Dr Ste K Charlotte, NC 28269 Annual Fee Period: 2008-02-01 to 2009-01-31 Invoice Date: 03/19/08 Due Date: 04/18/08 Annual Fee: $100.00 Notes: I. A $25.00 processing fee will be charged for returned checks in accordance with the North Carolina General Statute 25-3-512. 2. Non -Payment of this fee by the payment due date will initiate the permit revocation process. 3. Remit payment to: NCDENR - Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 4. Should you have any questions regarding this invoice, please comtact the Annual Administering and Compliance Fee Coordinator at 919-733-5083 extension 210 (Return This Portion With Check) ANNUAL PERMIT INVOICE Permit Number: NCG030303 Cabarrus County Eaton Corp -Clutch Div Corey Woolard Eaton Corporation 5908 Long Creek Dr Ste K I�IIIIIIIII�IIIII�VI�II��A�I�A� Annual Fee Period: 2008-02-01 to 2009-01-31 Invoice Date: 03/19/08 Due Date: 04/18/08 Annual Fee: $100.00 Check Number: