NCGNE0514_COMPLETE FILE - HISTORICAL_20081024

STORM'WAT,-ER DIVISION CODING SHEET
Y,-NCG PERMITS
PERMIT NO, NCGNE
DOC TYPE HISTORICAL FILE
DOC DATE 0 c
YYYYMMDD
0

BOA
Division o ter Quality /Surface Water �
Ptetc
NCDENRNational Pollutant Discharge Elimination
NO EXPOSURE CERTIFICATION f Exclusion
FOR AGENCY USE ONLY
pale Received
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NCGNE0000
OCT 2 4 2008
NO EXPOSURE CERTIFICATION T
National Pollutant Discharge Elimination System application for exclusion from "te lvuat60' 6rm
based on NO EXPOSURE: MIAIn Ct je;,.Q . 1AI. 44 . h—
Submission of this No Exposure Certification constitutes notice that your facility does not require
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 industr
facility means all industrial materials and activities are protected by a storm resistant shelter (with
exceptions) to prevent exposure to rain, snow, snowmelt, and/or runoff.
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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 DWO Regional Office for your area. (See page 5)
(Please print or type)
1) Mailing address of ownerloperator
- � fir• � A • �
44
2) Location of facility producing discharge:
Facility Name
Facility Contact
Street Address
City
County
Telephone No.
Page 1 of 5
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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 American Lands? ❑ Yes . �1 No
5) Is this a Federal facility? ❑ Yes 1� No
6) Latitude35- 38 '-1-7 " Longitude %SO' 1 i ' ,2� " W (deg, min, sec)
7) This NPDES Permit Application applies to which of the following:
❑ New or Proposed Facility Date operation is to begin
'k Existing Date operation began
8) Was this facility or site ever covered under an NPDES Stormw//ater Permit? 5K Yes El No
if yes, what is the NPDES Permit Number? _OC � (o on 6- 9
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: 4 4 a z D,
10) Provide a brief description of the types of industrial activities and products produced at this facility:
.1-� -_i . i_ i , C - A . n 4 _ — i _r _ 1 I 9 .1 _ %
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
5i.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 ❑ Yes N, 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 � No
❑ Yes N No
❑ Yes 0 No
❑ Yes K No
❑ Yes X No
Page 2 of 5
5WU-NE-110607 Last revised 11/06/07

NCGNE0000 No Exposure Certification -
g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks,
❑ Yes
9 No
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by
❑ Yes
Vf 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
56 No
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not
❑ Yes
® 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 A No
(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 la 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.
a. Are exterior ASTs or piping free of rust, damaged or weathered coating, pits, or Yes ❑ No
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any ❑ Yes fiQ No
cracks, holes, or evidence of leaks, and are drain valves maintained locked shut?
`t-;%e As-r :s C. L—PA1feC .z� --vat �����ci�ns wckko -FQ :x..p�4-"
�Si�en r T��S �S wcYQC<.�A e
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 each other with a combined capacity of more than 1,320-
gallons?
c. is secondary containment provided for any. amount of Title III Section 313
Superfund Amendments and Reauthorization Act (SARA) water priority
chemicals?
d. Is secondary containment provided for gny amount of hazardous substances?
e. Are release valves on all secondary containment structures locked?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Page 3 of 5
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NCGNE0000 No Exposure Certification
15) Hazardous Waste:
a. is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? ❑ Yes Ed No
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste ❑ Yes M No
generated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste ❑ 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:
How is material stored:
Where is material stored:
How many disposal shipments per year. -
Name of transport / 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.
f 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.
(Signature of Applicant)
(Date Signed)
Page 4 of 5
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NCGNE0000 No Exposure Certification
Please note: This application for the No Exposure Exclusion is subject to approval by the
NCDENR Regional Office prior to issuance. The Regional Office may inspect your facility for
compliance with no exposure conditions prior to that approval. The Regional Office may also
inspect your facility at any time in the future for compliance with the No Exposure Exclusion.
North Carolina General Statute 143-215.6 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 DWO 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 .........(919)
733-5083
Page 5 of 5
SWU-NE-110607 Last revised 11/06/07

Salisbury, North Carolina, United States
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Portions 0199t-2D05 Install5hieid Software Corporation. All rights reserved. Certain mapping and direction data 0 2005 NAVTEQ. All rights reserved. The Data for areas of Canada includes information taken with permission from Canadian authonlies.
including: 0 Her Majesty the Queen in Right of Canada, 0 Queen's Printer for Ontario. NAVTEQ and NAVTEQ ON BOARD are trademarks of NAVTEO. ® 2005 Tele Alias North America, Inc. All rights reserved. Tele Atlas and Tele Atlas North America are
trademarks of Tele Atlas, Inc.

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Figure 2-1. Site map showing location of FFM facility, Salisbury, North Carolina
(Source: USGS 7.5 Minute Quadrangle, Rowan Mills, North Carolina).

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Runoff Direction
---Property Boundary
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0 50 l00 Feet
Figure 2-2. Facility map showing potential pollutant sources, outfalls, and
drainage boundaries.

Salisbury
ASME ,� ° = '" a._, Maycdan Sfanevi�e f Yance Wle �'' s: .�
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Instruction
For
Toward
0.0
Depart Raleigh -Durham Airport on Local
164 yds
road(s) (West)
0.1
Bear RIGHT (West) onto Terminal Blvd
0.1 mi
0.2
Keep LEFT onto Airport Exit
0.4 mi
Airport Exit / Parking / Terminal C
Baggage Claim
0.6
Road name changes to Terminai Blvd
1.3 mi
1.9
Bear RIGHT (West) onto Airport Blvd, then
0.4 mi
immediately turn RIGHT (North-West) onto Ramp
-
2.3
Merge onto I-40
24.6 ml
26.9
At exit 259, take Ramp (LEFT) onto I-40 [I-85]
39A mi
66.3
Keep LEFT onto I-85 [US-70]
51.4 mi
I-85 / US-29 / US-70 / high Point /
Charlotte
117.7
At exit 72, turn RIGHT onto Ramp
0.2 mi
117.9
Turn RIGHT (North-West) onto Peach Orchard Rd
1.0 mi
118.9
Turn LEFT (South-West) onto US-29 [US-601]
0.3 mi
119.3
Turn RIGHT (North) onto Cedar Springs Rd
0.6 ml
119.9
Turn RIGHT (East) onto Circle M Dr
131 yds
119.9
Arrive 380 CIRCLE M DR. [380 CIRCLE M DR.,
Salisbury, NC 28144]