NCGNE0743_COMPLETE FILE - HISTORICAL_20101216

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCGNE U�143
DOC TYPE
❑HISTORICAL FILE
DOC DATE
❑
YYYYMMDD

ADivision of Water Quality / Surface Water Protection
NCDENRNational Pollutant Discharge EIimination System
NO EXPOSURE CERTIFICATION for Exclusion
rN:no'Nr.tr .iu> N4,zu✓*r.,n..�:ra
NCGNE0000
FOR AGENCY USE ONLY
Date Received
Year
Month Day
2
Certificate of cove e
N NE
DIVISION OF WATER
QUALITY
DEC 16 2010
NO EXPOSURE CERTIFICATION
SWP SECTION
National Pollutant Discharge Elimination System application for exclusion from a Sto0rmWer1I0&rFiiiQja-'SQd OFFICE
on NO EXPOSURE:
Submission of this No Exposure Certification constitutes notification that your facility does not require a
permit for 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.
For permitted facilities in North Carolina, DWO must approve your application for No
Exposure Certification before this exclusion is effective. Until you are issued a No
Exposure Certification and your NPDES permit is rescinded, your facility must continue
to abide by the terms and conditions of the current permit.
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 self re -certify your No Exposure Exclusion annually.
For questions, please contact the D WO Regional Office for your area. (See page 6)
(Please print or type)
1) Mailing address of owner/operator
Name
Contact
Street Address
City
Telephone No.
Email
lIx Cc7 lCC,F�1r1GiG i'LS
� u I urrl S 1'Z
will
State YA C_ ZIP Code G 6 to _') �5
to -i 3 D Fax: Z t-} Ivy - to-1 3 Z
DEC 0 32010
Page 1 of 7
DENR-WATER QUALITY
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NCGNE0000 No Exposure Certification
2) Location of facility producing discharge: �
Facility Name Tia C o �G�� n o 0 i f S L—L-1/�
'"
Facility Contact � t!� 5 . Gt Ck I.
Facility Street Address I'Zq5 Qu r✓• % 5 — FO Gor
City C W ►\. State V\ G ZIP Code
County GG\ A W 10 q
Telephone No. S- Z- - - 14 L, H - to -7 3 b Fax: IR Z F) H - L 13 Z
Email imfteS, ward A f'kfc0 . Gower
3) Physical location information:
Please provide a narrative description of how to get he facility (use str et names state road numbers,
distan a and direction from a roadway intersection). SC e. Guar ke VV\(%c h a K,
ice 0nj 41,k S. Ockc We It -
(A copy of a map with the facility clearly located on it shooshoi illd be included with the certification application.)
4) Is the facility located on Native American Lands? ❑ Yes 0<o
5) Is this a Federal facility? ❑ Yes "o
6) Latitude 35 • b g Oy b46 Longitude —91, ZbSb9`I (deg., min., seconds)
7) This NPDES No Exposure Exclusion application applies to which of the following:
❑New or Proposed Facility Date operation is to begin
/—t
6� Existing Date operation began + F
❑ Renewal of existing No Exposure Certification Certification No.: NCGNE
8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes V100**
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: 2 (o —1 D
10) f vide a brief ascription of the types of industrial activit�" s and products produced at this facility:
c1, e ,( r.v c ,� � r ti , ry r w\ S y- • r -h 1' q
11)Does this facility have any Non -Discharge permits (ex: recycle permits)?
VesO
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
SWU-NE-12Aug2010
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NCGNE0000 No Exposure Certification
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
I/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
❑ Yes
o
c. Materials or products from past industrial activity
❑ Yes
o
d. Material handling equipment (except adequately maintained vehicles)
❑ Yes
M/No
e. Materials or products during loading/unloading or transporting activities
❑ Yes
V///No
f. Materials or products stored outdoors (except final products intended for outside
El Yes
ig'N0
use [e.g., new cars] where exposure to stormwater does not result in the discharge
of pollutants)
/
g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks,
❑ Yes
�F No
and similar containers
��
h. Materials or products handled/stored on roads or railways owned or maintained by
❑ Yes
YIN
the discharger
Yes
V No
i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters])
❑
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 ly6 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 V 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 t/ 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. C. Pro pqhe TanK 6Y,
a. Are exterior ASTs and piping free of rust, damaged or weathered coating, pits, or 1(Yes © No ❑ N/A
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any ❑ Yes ❑ No VIA
cracks, holes, or evidence of leaks, and are drain valves maintained locked shut?
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NCGNE0000 No Exposure Certification
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 all single above ground storage
❑ Yes
❑ No V NIA
containers (including drums, barrels, etc.) with a capacity of more than 660-
gallons?
b. Is secondary containment provided for above ground storage containers stored
❑ Yes
❑ No V<A
in close proximity to each other with a combined capacity of more than 1,320-
gallons?
VN/A
c. Is secondary containment provided for Title III Section 313 Superfund
❑ Yes
❑ No
Amendments and Reauthorization Act (SARA) water priority chemicals'?
N
d. Is secondary containment provided for hazardous substances— designated in 40
❑ Yes
❑ No N/A
CFR §116?
/
V
e. Are release valves on all secondary containment structures locked?
❑ Yes
❑ No NIA
15) hazardous Waste:
a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
❑ Yes 1K No
OhM N
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste
No
generated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste
❑ Yes V'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 I disposal vendor:
Vendor address:
Footnotes to Questions 14) c. & d.
'Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require
secondary containment. However, some exceptions may be made for de minimis amounts of certain substances,
and/or other qualifiers, as described in the exemptions from reporting requirements of Title III SARA 313 in 40 CFR
§372,38.
"Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require
secondary containment. However, some exceptions may be made for amounts less than the Reportable Quantities
of the hazardous substances listed in 40 CFR §117.3.
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NCGNE0000 No Exposure Certification
16) Other information: If you answer "Yes" to any of the following items, you. might not be eligible for the
no exposure exclusion. A more in-depth evaluation of the site circumstances may be required.
a. Does your facility store used, recycled, or otherwise reclaimed pallets outside? ❑ Yes �l�o
b. Does your facility have coal piles on site? ❑ Yes V60
c. Does your facility store other fuel sources outside in piles, such as wood chips, ❑ Yes V1 0
sawdust, etc.?
d. Does your facility have air emissions associated with its industrial activity (e.g.,
degreasing operations, plating, painting and metal finishing)? If so, describe the
industrial activity:
e. If you answered yes to d., are those emissions permitted by an Air Quality Permit?
Please specify:
f. Please list any other environmental program permits (federal, state, etc.) not
specified earlier in this application (such as Hazardous Waste Permits, etc.):
Permit:
Program:
Permit:
Program:
Permit:
Program:
Permit:
Program:
Permit:
Program:
Permit:
Program:
Permit:
Program:
❑ Yes VlO
❑ Yes ❑ No ZIA
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NCGNEOOOO No Exposure Certification
17) 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 annually self re -certify No Exposure and, if requested, submit the re -certification to
DWQ or 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.
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: G (�E64 G 4 4 `--
Title:
r 30 �o
(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.
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.
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Print Parcel Map
Page 1 of 1
iNHA +CCOUNTy, NC
Real
Estate
Search
Parcel Summa
I Printed Map Scale 1 inch = 248ft
Parcel ID: 3740075926291
Parcel Address: 1205 BURRIS RD, NEWTON
Owner: HAMCO MANUi=ACTURING
I Address: 1205 BURRIS RD
City: NEWTON
Owner2:
Address2:
State/Zip; NC, 28658-1953
Building(s) Value: $1,576,500
Land Value: $332,500
j Total Value: $1,909,000
DISCLAIMER: This map/report product was prepared from the Catawba County, NC Geospatiai information Services. Catawba County has made
substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this report. Catawba County
promotes and recommends the independent verification of any data contained on this map/report product by the user. The County of Catawba,
its employees, agents, and personnel, disclaim, and shall not be held liable for any and all damages, loss or liability, whether direct, indirect or
consequential which arises or may arise from this map/report product or the use thereof by any person or entity.
http://www.gis.catawba.nc.uslwebsitelParceUprintMap.asp?pinc=374007592629&paddy--1205%20... 1 /4/2011

Ll
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1205 Burris R d , Newton, NC 28658 � 4
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Data SIC, NOAA, US Navy. NGA, GESCO 218 It (P 2010 Gaople Go og[e
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35°40'50 28" N 81 12.18.73" W elev 991 It Apr 11, 2010 Eye alt 1791 It F