NCGNE0481_COMPLETE FILE - HISTORICAL_20081024

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NCDENR
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Division of Water / Surface Water Protection
National Pollutant Discharge Elimination System
NO EXPOSURE CERTIFICATION for Exclusion
NCGNE0000
FOR AGENCY USE ONLY
Date Received
Year
I Month Da _
C
1
Certificate of Coverage
�C
NO EXPOSURE CERTIFICATION OCT 2 4 2008
National Pollutant Discharge Elimination System application for exclusion from a Stormwater Permit
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UdbWU U11 IVV F-Ar VJVr%C. ¢ Ir
Submission of this No Exposure Certification constitutes notice that your faclIV' does, not require permit
f�
authorization for its Stormwater discharges associated with industrial activity a State of North-•� 4(
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 owner/operator (address to which all certification correspondence will be mailed :
Name Lr V-?-\? VJ. G�1rr.-N•lnrC,�
Street Address C r rv_ c G TAN t!L � {'�a3a�c ! 148
City 6-.qyrdN % State NCB _ ZIP Code _ 0565 3 - IIL4A
Telephone No. (�� G �' Fax: ?69 •—
,01ion
2) Location of facility producing discharge:
Facility Name CtZ,V069-5 G.r "A4- VJAi9 C-wAT&Z_ '(-fz.0 Trt%C.ryT 'I✓ -ANT
Facility Contact �00 �
Street Address aLl_ IAw'�
City �A-5rf-oXJ IA State_ji X ZIP Code ZSQ!
County &/A->TbN
Telephone No. _16' _ 262f _ G G 55 Fax: '�?Og{ (off
Page 1 of 5
SWU-NE-060607 . Last revised 06/06/07

NCGNE0000 No Exposure Certification
3) Physical location information:
Please provide a narrative description of how to get to the facil� (use street names, state rid rru b rs, and
distance and direction from a roadway intersection). rxo►M L-S� orS . 7-OZ +,1 14-16 H. I c,.Jp
ex4 17 63 053Z1. _����ca :10OT4 QrL Is,
(A copy of a map with the facility clearly located on it should be included with the certification application.) 6auii�
4) Is the facility located on Native American ands? ❑ Yes 19 No Cc-eA-L
5) Is this a Federal facility? ❑ Yes C� No
6) Latitude 2)6 Id 00" /1/ Longitude jR1a rl1 -.I, +"' (deg, min, sec)
7) This NPDES Permit Application applies to which of the following:
❑/ New or Proposed Facility Date operation is to begin
�l Existing Date operation began
8) Was this facility or site ever covered under an NPDES Stormwater Permit? Yes ❑ No
If yes, what is the NPDES Permit Number? l�� & l 100 5J
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: -15— Z
10) Provide a brief descriptioof the types of industrial activities and products produced at this facility:
J t n VAL OAsTE WAT ` F-g_A T ►a E,NT
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
VN 0
❑ 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 load inglunloading or transporting activities
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 ® No
❑ Yes ®No
❑ Yes 2i o
1-1YesINo
❑ Yes iNo
❑ Yes iN 0
Page 2 of 5
5WU-NE-060607 Last revised 06/06/07

NCGNE0000 No Exposure Certification
g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks,
❑ Yes
WNo
and similar containers
/
In. Materials or products handled/stored on roads or railways owned or maintained by
❑ Yes
ICJ No
the discharger
i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters])
❑ Yes
2 N0
M No
j. Application or disposal of process wastewater (unless otherwise permitted)
❑ Yes
iNo
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not
❑ Yes
otherwise regulated (i.e., under an air quality control permit) and evident in the
stormwater outflow
L Empty containers that previously contained materials that are not properly stored
❑ Yes
CV N0
(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
IM No
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. /Yes
a. Are exterior ASTs or piping free of rust, damaged or weathered coating, pits, or ❑ No
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any iiyes ❑ 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 M 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 iyes ❑ No
in close proximity to each other with a combined capacity of more than 1,320-
gallons?
c. Are release valves on all secondary containment structures locked? Yes ❑ No
Page 3 of 5
SWU-NE-060607 Last revised 06/06/07

NCGNEOOOO No Exposure Certification
15) Hazardous Waste: /
a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? ❑ Yes o
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste ❑ Yes JNo
generated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste ❑ Yes h 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:
How is material stored: _
Where is material stored:
How many disposal shipments per year:
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 Name of Person Signing: �o$
Title: 5�Q �1�,11,4��u2. t011y
a trite
Signed)
7
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 4of5
SWU-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).
There is currently no fee for a No Exposure Exclusion.
Final Checklist
Thi 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 ......
[phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
[phone]
Washington Office ...(252)
946-6481
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........
[phone]
Page 5 of 5
SWU-NE-060607 Last revised 06/06/07

T Division of Water Quality / Surface Water Protection
NCDENRNational Pollutant Discharge Elimination System
C��- Du�.e-or NO EXPOSURE CERTIFICATION for Exclusion
Eima�Hrxr ti+� N.asArt Re�ou.ces NCGNE0000
NO EXPOSURE CERTIFICATION
FOR AGENCY USE ONLY
Date Received
Year
Month
Day
Certificate of Coverage
-NICIGINIE1
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 facilit - �asrs o for
individual outfalls. If any industrial activities or materials are, or w" e,.:exposed to precipitatio ,
facility is not eligible for the no exposure exclusion. By signing an mitting this No Ex re
Certification form, you certify that a condition of no exposure exists hl. facilit o are
obligated to comply with the terms and conditions of40 CFR 122.2E(g).
You are required to reapply for the No Exposure Exclusion once every five (5) }tears.
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
Street Address
City State
Telephone No. Fax:
2) Location of facility producing discharge:
Facility Name
Facility Contact
Street Address
City
County
Telephone No.
Page 1 of 5
ZIP Code
W W
State ZIP Code
Fax:
SWU-NE-060607 Last revised 06/06/07

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).
(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 Americ:�N
ands? El Yes EY`o
5) Is this a Federal facility? El Yes o
6) Latitude Longitude (deg, min, sec)
7) This NPDES Permit Application applies to which of the following:
❑ New or Proposed Facility
❑ Existing
Date operation is to begin
Date operation began_
8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes ❑ No
If yes, what is the NPDES Permit Number?
9) Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code:
10) Provide a brief description of the types of industrial activities and products produced at this facility:
11) s this facility have any Non -Discharge permits (ex: recycle permits)?
7o
❑ 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 Nd/
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 ❑ Yes �o
c. Materials or products from past industrial activity 0 Yes o
d. Material handling equipment (except adequately maintained vehicles) ❑ Yes `
Ge Materials or products during ioadinglunloading or transporting activities Ll Yes f�f
f. Materials or products stored outdoors (except final products intended for outside ❑ Yes iNrd
use [e.g., new cars] where exposure to stormwater does not result in the discharge
of pollutants)
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
011 -
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by
❑ Yes
the discharger
/14
i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters])
❑ Yes
j. Application or disposal of process wastewater (unless otherwise permitted)
❑ Yes
ffo
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not
❑ Yes
d
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
❑ YesT
(i.e., not closed and stored upside down to prevent precipitation accumulation)
/
m. For an exterior s well as drums, barrels, r containers
y or ASTs, a m , ba a s, tanks, and similar
❑ Yes
2
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, y/es
a not
eligible for the no exposure exclusion.
a. Are exterior ASTs or piping free of rust, damaged or weathered coating, pits, or ; ❑o
deterioration, or evidence of leaks?
'P p,
s secondary containment provided for all exterior ASTs? If so, is it free of any 0 e , El No
cracks holes or evidence of leaks and are drain valves maintained to k
14) Secondary Containment: If you answer "No" to any of the following items, you are not eligibl for the
no exposure exclusion. /
a. Is secondary containment provided for single above ground storage containers f?I es ❑ No
(including drums, barrels, etc.) with a capacity of more than 560-gallons?
b. Is secondary containment provided for above ground storage containers stored s ❑ No
in close proximity to each other with a combined capacity of more than 1,320-
gallons?
c. Are release valves on all secondary containment structures locked?
r Yes ❑ No
AA� 1"R
d,4
Page 3 of 5
5WU-NE-060507 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 ce/0.-
�
�s this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste l�s �No
generated per month) of hazardous waste? La,,,`�',�. c� %C,'-
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste © Yes �6
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 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 Name of Person Signing:
Title:
(Signature of Applicant)
(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).
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 ......
[phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
[phone]
Washington Office ...(252)
946-6481
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........
[phone]
Page 5 of 5
SWU-NE-060507 Last revised 06/06/07

of w.a rF9
oa o� Permit Coverage
r
Rescission R_epuest Form
=s —
Q National Pollutant Discharge Elimination System
General Permit NCG110000
Certificate of Coverage Number
NCG110G&&
5 .
Please fill out and return this form paly if you no longer need to maintain your NPDES stormwater permit.
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 Contact Information
Facility Name:
Facility Physical Address:
Facility Contact.
Mailing Address:
Phone Number:
Fax Number
Email Address
Owner Affiliation- Information
Owner / Organization Name:
Owner Contact:
Mailing Address:
Phone Number:
Fax Number.
E -mail address:
Long Creels VWTP
3000 Long Creek Disposal Plant Rd
Dallas, NC 28034
David Vance Morgan
5642 S York Rd
Gastonia, NC 28054
704-854-6655 Ext.
704-866-9405
CRowofws GTLf—E.1c WUYTn
34 57- Yomc- V"11
_ C�c'/a9'CDti l A NL L$d5Z
* Rescission notice will be marled to the owner address
City of Gastonia
Danny O'Crew _ C,AKX Jy W, C,,yMn, 1rgC,C
PO Box 1748
Gastonia, NC 280531748
704-866-6896 Ext. 54 664 8 _
Reason.for resion request (This is required information. Attach separate sheet if necessary):
Z„ i i %, nc=oea 2-f crA10,K O 11aC G IVG_ f �t7
REQUEST AND CERTIFICATION
I, as an authorized representative, hereby request rescission of certificate of coverage NCG110056 under NPDES
Stormwater General Permit NCGI10000 for the subject facility. I am familiar with the information contained in this
request and to the best of my knowledge and belief such information is true, complete and accurate.
Signature
t or. type name of person signing above
Date l/ /3 4
.5fcrewz
Title
Please return this completed rescission request form'to: SW General Permit Coverage Rescission
Stormwater Permitting Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617