NCGNE0792_COMPLETE FILE - HISTORICAL_20110808

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCGNE 09 92�
DOC TYPE
❑HISTORICAL FILE
DOC DATE
0 aOL2 M
YYYYMMDD

August 4, 2011
NCDENR -- Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27669-1617
Re: PGT Industries r�
Permit NCGOGI�9T
Invoice period 8/ 1 /201 1 — 7/31 /2012
To Whom It May Concern:
Please find enclosed a copy of our `no exposure certification'. We stopped
manufacturing operations at our Salisbury, North Carolina operations on 7/1/201 1.
Should you have any questions or need additional information, please don't hesitate
to -contact me at the address or phone number above.
Thank you,
I
e e—)
Natalia R Wolter
�PGTEHS Manager
rU
Industries8 26�r
� Enclosure
1po�
1070 Technology Drive • M. Venice, FL 34275 • 941.480-1600 • pgtindustries.com

ff
NCDEN
Division of Water Quality / Surface Water Protection
Naiio1131 Pollutant Discharge Elimination System
NO J:'-XP0S1jRH C IZ'1'11 ICATION f0i, Iixclu sign
N'C;G'NE01000
NO EXPOSURE CERTIFICATION
r
FOR NGI
Uatc :received I )(r
Year �lur.,h iJa�
ceni:1ca•e sr COW r_,CC
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National Pollutant Discharge Elimination System application for exclusion from a Stormwater Permit based
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 170 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, DWQ must approve your application for No
Exposure Certification before this exclusion is effective. Until you are issued a No I
I Exposure Certification and your NPDES permit is rescinded, your facility mt.s:t continue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 i
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 f
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 f� qualifying for the no exposure exclusion7. 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 our No Exposure Exclusion annually.
F Tar gr.restions, please contact the D WO Regional Office for your area. (See pane G)u-___.__ . __
(Please print or type)
1) Mailing address of ow; nspm owner/operator {address to which all certification correondence will be ailed):
ne
Name �'!`�'__..�i�(C���i-5.- ��C-S - -- _ �---- --- -- ----
Conlact tiL 1 y1 e <;
Street Address.' .--Sla---
City �j1`s-S_ju{ �te ZIP Code --j ----
Telephone No. �dt> (o`3S� _ -- u Fax:
Email
Page l of 7
SWU-NE-12Aug2010 -F_N;r

, ,
r

i
NCGNE0000 No Exposure Certification
2) Location of facility producing discharge:
Facility Name QGj i _ C"<E! S
Facility Contact
Facility Street Address ---
City �t_-_ Statej� �(�,�—ZIP Code _A�
County C_ r,� 1
Telephone No. (�,��_ �y� `�_= Fax:
Email A e o,-k 3i q a-, L!%A w r cs c• ,-
3) Physical location information:
Please provide a narrative description of how to get to the facility (use street names, statQ road riumb?rs, and
distance�nd direction from
roadway inter%ion). _C;
rYT�I
(A copy of a map wi c - the facility arty located on it should be included urith t e certification application.)
4) Is the facility located on Native American Lands? ❑ Yes BNo
5) Is this a Federal facility? ❑ Yes );�-'No
5) Latitude t Longitude (�,��(deg., min., seconds)
7) This NPDES No Exposure Exclusion application applies to which of the following:
❑ Now or Proposed Facility Date operation is to begin
Existing Date operation began (� =d-_
El Renewal of existing No Exposijre Certification Certification No.: NCGNE_._.,__._ —
S) Was this facility or site ever covered under an NPDES Stormwater Permit?VYes ❑ 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 tacility
SIC Code: 3 C
1 p) F
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
�<No
Lt Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
Page 2 of 7
SWU NE-12Aug2010

NCGNE0000 No Exposure Certification
Exposure Checklists (12. - 14.1
12) Are any of the following materials or activities exposed to precipitation; now or in the foreseeable
future? (Plea:.,- check either "Yes" or "Ho.") I: you ;answer "Yes" to any of these ilams, you are not
eligible for the no exposure exclusion.
a. Using, storing, or cleaning industrial machinery or equipment, and areas where ❑ Yes Xilo
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 spillsileaks ❑ Yes )?�No
c. Materials or products from past industrial activity
❑ Yes
RNo
d. Material handling equipment (except adequately maintained vehicles)
ID Yes
''
�No
e. Materials or products during loadinglunioading or transporting activities
❑ Yes
t eNo
f. Materials or products stored outdoors (excepi final products intended for outside
117 Yes
TRIAO
use [e.g., new cars] where exposure to slorrnwater does not result in the discharge
of pollutants)
g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks,
❑ Yes
P(No
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by
❑ Yes
tKVO
the discharger
i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters])
1.3 Yes
Xo
;. Application or disposal of process wastewater (unless otherwise permitted)
v Yes
Plc
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not D Yes N�o
otherwise regulated (i.e., under an air quality control permit) and evident in the
stormwater outflow
I. Empty containers that previously contained materials that arc not properly stored 0 Yes IWo
(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 F1 Yes eX/jNo
stored outside, has the facility h<:d any reteasos in the, past three (3) years?
13) Above Ground Storage Tanks (ASTs): It you answer "No" to any of the following items, you are not
eligible for the no exposure exclusion.
a. Are exterior ASTs and piping free of rust, damaged o weathered coating, pits, or ❑ Yes 0 No KNfA
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? It so, is it tree of any o Yes ❑ No PQf IA
cracks, holes, or evidence of Ie ks, and are drain valves maintained locked shut?
Page 3 of 7
swu-NE-12Aug2010

NCGNE0000 No Exposure Certification
14) Secondary Containment: It 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 sine;ie above ground storago
containers (including drums, barrels, ote.) with a capacity of snore 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 Title III Section 313 Superfund
Amendments and Reauthorization Act (SARA) water priority chemicals'?
d_ Is secondary containment provided for hazardous substances" designated in 40
CFR §116?
e_ Are release valves on all secondary containment structures locked?
15) Hazardous Waste:
a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste
generated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste
generated per month) of hazardous waste?
It you answered yes to questions b. or c., please provide the following information:
Type(s) of waste: _ G \ .4-- S_`1 Vt r V4.42 nr1 11.,;
How is malarial stored:_�q.
Where is material stored:
How many disposal shipments per year:
Name of transport / disposal vendor: C4
Vendor address: _ S3_5-:"i 3 tso y
Footnotes to Questions 14) c. & d.
iJ Yes
t=i No
?,C"
❑ Yes
11 No
�61/A
© Yes
© No
IWA
*Yes
0No
LX6A
0 Yes
0 No
I�11A
0 Yes
53�NO
Xes
© No
0 Yes
EW
`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
§ 372.3f3_
"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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SWU-ME-12Aug201Q

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 lacilily store used, recycled, Or othr:rVASO n.Clailrred pallets nutsidu? ❑ Yes �No
b. Does your facility have coal piles on site? n Yes 5-6to
c. Does your facility store other fuel sources outside in piles, such as wood chips, 0 Yes V-L/No
sawdust, etc.?
d. Does your facility have air emissions associated with its industrial activity (e.g., ❑ Yes yK Vo
degreasing Operations, plating, painting and metal finishing)? If sc, describe the
industrial activity:
e. If you answered yes to d., are those emissions permitted by an Air Quality Permit? ❑ Yes ❑ No /A
Please specify:
1. Please list any other envircrimenlal program permits (federal, state, etc.) not
specified earlier in this application (such as Hazardous Waste Permits, etc.)
Permit: (� Program: {sJ�y�
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
Page 5 of 7
SWU-NE-t2Au ,2310

NCGNEOOOO No Exposure Certification
17) Certification:
I certily under penalty Of taw that I have read and understand the eligibility requirements for claiming a condition of "nn
exposure" and olniining an exclusion Irom NPE)E"•S s'tormw.aI01 Pe,rnitaing.
I certify under penally of law that there are no discharges of slormwater contaminated by exposure to industrial aclivilies
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-cortify No Exposure and, if requested, submit the recertification 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 o1 Water Quality, or M54 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 property 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: y,_
Title:
A"
3CSIgmN
._ of App ant) (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, orother
documeni filed or roquired 10 be maintained under this Article or a rule implementing this Article; or who knowingly makes a (also
statemenl of a material tact in a ru!emaking proceeding or Conaesleii case under thi ; Article; or who falsifies, lampors with, or knowingly
renders inaccurate any recording or monitoring device or method required to he operated or maintained under aids Article or rules of the
(Frivironmenlal Management] Commission implementing this Arlicle shall he guilty cf 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:
Page 6 of 7
SVI1U. N E-12Aug 2010

NCGNE000fJ No Exposure Certification
Final Checklist
This application should include the follovrfnq items:
iJ This completed application, and all supporting documentation.
d A map with the Iccaiion of the facility clearly marked.
1.y If the site currently has an NPDFS Stormwater Permit, be sure to indicate the permit number in Question 8.
Mail the entire package to:
Stormwaler 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 UI^/Q Regional Office for your area.
QWQ Regional Office Contact Information:
Asheville Office ...... [phone]
Fayetteville Office ... [phone]
Mooresville Office [phone]
Raleigh Office ........ [phone]
Washington Office ...[phone]
Wilmington Office ... [phone]
Winston-Salem ...... [phone]
Central Office .........[phone]
Page 7 of 7
SWU-NE-12Aug2030

4
Q�w--�-
N`CR
Not h Cai-olina Depall ment of En,.Aranment and
I;ivlsion of Vlater QuaNy
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
August 3, 2011
Mr. Danny Gaines, Facility Manager
PGT Industries
2121 Heilig Road
Salisbury, NC 28146
Dear Mr. Gaines:
Natural F,,Ls•ourc;.S
Subject: No -Exposure Certification NCGNE0792
PGT Industries — Salisbury Facility
Rowan County
Dee Freeman
Se. rotary
The Division has reviewed your submittal of the No -Exposure Certification form for exclusion from NPDES
Stormwater Permitting. Based on your submittal and signed certification of no --exposure at the above referenced
facility, and a site visit on July 13, 2011, by Ms. Barbara Sifford with this Office, the Division is granting your
conditional exclusion from stormwater permitting as provided for under 40 CFR 122.26(g), which is incorporated by
reference in North Carolina regulations. Since your facility has attained no -exposure status, your existing Certificate
of Coverage No. NCG030575 is no longer needed and is hereby rescinded.
Please note that by our acceptance of your no -exposure cerfEfication, 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. Failure
to obtain a No -Exposure exclusion could also subject you to enforcement for an unpermitted stormwater discharge.
You must self re -certify your No -Exposure status annually using the included form or obtain NPDES permit
coverage for any stormwater discharges from your facility. The annual self re -certification does not need to be
submitted to DWQ unless requested, Please note that your conditional exclusion From permitting 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 fuFther,information, please contact Ms. Sifsford at [phone] or by email at
[e-mail].
�J�erely,
forColeen H. Sullins
CC'. Stormwater Permitting Unit No- Exposure Files (Brian Lawther)
Fran McPherson, Budget Office
Stormwater Permitting File N00030575
PGT industries Home Office , Florida
Mooresville Regional Office �tTOne t 1
Location:610 Eat Center Ave., Suite 301 Mooresville, NC 28115 NorthC arolina
Phone: [phone] Fax: (7u4) 663-6040 L Customer Sertice: 1-877-623-6748
Internet::nvv�.navaierqua'ity.cr,Aa1`�ld'�1���

Compliance Inspection Repo*
Permit: NCGNEr;792 Effective: Expiration: Owner: Pgt lndustr;es
SOC: Effective: Expiration: Facility: PGT Industries
County: Rowan
212'1 I feeling Rd
Region: Mooresville
Salisbury NC 28146
Contact Person: Brian Tanguay Title: Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 08/01/2011 Entry Time: 04:00 PM
Primary Inspector: Barbara Siiford
Secondary Inspector(s):
Certification: Phone:
Exit Time: 04:30 PM
Phone: [phone]
Ext.2196
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Stormwater Discharge, No Exposure Certificate
Facility Status: U Compliant ❑ Not Compliant
Question Areas:
E, Miscellaneous Questions L,,q Mrsc
(See attachment summary)
Page: 1

Permit: ,NCGNF0792 Owner - Facility: Pet Industries
Inspection Cate: 08/01/2011 Inspection Type: CompFance Evaluation Reason for Visit: Routine
Inspection summary:
]VIisC
is the facility compliant?
Comment: Property does not have any exposure for stormwater to be contaminated.
Currently manufacturing has ceased and facility is used as a warehouse for shipping to
Florida. Spill kits are available if fuel spills occur from tractor trailer saddle tanks.
Yes No NA NE
Page_ 2

yea..
NCDENR
North ra ohna Department of Environment acid Nattara
Division of Vtlater Quality
Beverly Eaves Perdue Coleen H. Sullins
Governoc
Mr. Danny Gaines, Facility (Manager
PGT Industries
2121 Heilig Road
Salisbury, NC 28146
Dear Mr. Gaines:
Director
August 3, 2011
Subject: No -Exposure Certification NCGNE0792
PGT Industries --Salisbury Facility
Rowan County
Dee Freeman
S retar v
The Division has reviewed your submittal of the No -Exposure Certification form for exclusion from NPDES
Stormwater Permitting. Based on your submittal and signed certification of no-expcsure at the above referenced
facility, and a site visit on JJy 13, 2011, by Ms. Barbara Sifford with this Office, the Division is granting your
conditiona4 exclusion from stormwater permitting as provided for under 40 CFR 122.26(g), which is incorporated by
reference in North Carolina regulations. Since your facility has attained no -exposure status, your existing Certificate
of Coverage No. NCG030575 is no longer needed and is hereby rescinded.
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 facNty can no longer qualify for a No -Exposure
exclusion, you are obligated to immediately obtain NPDES permit coverage for your stormwater discharge. Failure
to obtain a No -Exposure exclusion could also subject you to enforcement for an unpermitted stormwater discharge.
You must self re -certify your No -Exposure status annually using the included form or obtain NPDES permit
coverage for any stormwater discharges from your facility. The annua4 self re -certification does not need to be
submitted to DWQ unless requested. Please note that your conditional exclusion from permitting 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 Ms Sifford at [phone] or by email at
Barbara. [e-mail].
SaereIy,
for Coleen H. Sullins
CC" Stormwater Permitting Unit No- Exposure Files (Brian Lawther)
Fran McPherson, Budget Office
Stormwater Permitting File NCGO30575
PGT Industries Horne Office , Florida
Mooresville Regional Olfte
Location: 610 East Center Ave., Suile 301 Mooresville, NC 28115
Phone: (7041, E63-16991 Fax: (704) 66M0401 Gustomer Service: 1-877-623-6746
Internet: r, m,ncwiterquaiily.erg
(one
NorthCarcifina
� Mill

Compliance inspection Reporr
Permit: NCGNE079- Effective: Expiration: Owner: Pot Industries
SOC: Effective: Expiration: Facility: PGT Industries
County: Rowan 2121 Heiliq Rd
Region: Mooresville
Salisbury NO 26146
Contact Person: Brian Tanguay Title: Phone: [phone]CO
Directions to Facility:
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC{s):
On -Site Representative(s):
Related Permits:
Inspection Date: 08/01/2011 Entry Time: 04:00 PM Exit Time: 04:30 PM
Primary inspector: Barbara Sifford Phone: [phone]
Ext.2196
Secondary Inspectors):
Reason for Inspection: Routine Inspection Type: Compliance Evaivation
Permit Inspection Type: Stormwater Discharge, No Exposure Certificate
Facility Status: p Compliant ❑ Not Compliant
Question Areas:
E] Miscellaneous Questions ffl Misc
(See attachment Summary)
Page: 1

Permit: NCC'. NE77C792 Owner - Facility: ?ct incustnes
Inspection Cate: 081Cl12011 Inspection Tyne: Compliance Evaluation Reason for visit: Rouiine
Inspection Summary:
Miso
Is the facility compliant?
Comment: Property does not have any exposure for stormwater to be contaminated.
Currently manufacturing has ceased and facility is used as a warehouse for shipping to
Florida. Spill kits are available if fuel spills occur from tractor trailer saddle tanks.
Ya-z Mn NA NF
m n n o
rage. 2

Compliance Inspection Report
Permit: NCGNE0792 Effective: Expiration: Owner: Pgt Industries
SOC: Effective: Expiration: Facility: PGT Industries
County: Rowan 2121 Heilig Rd
Region: Mooresville
Salisbury NC 28146
Contact Person: Brian Tanguay Title: Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 08/0112011 Entry Time: 04:00 PM Exit Time: 04:30 PM
Primary Inspector: Barbara Sifford Phone: [phone]
Secondary Inspector(s): Ext2196
Reason for inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Stormwater Discharge, No Exposure Certificate
Facility Status: ® Compliant n Not Compliant
Question Areas:
99 Miscellaneous Questions ® Misc
(See attachment summary)
Page: 1

Permit: NCGNE0792 Owner - Facility: Pgt Industries
Inspection Date: 0810112011 inspection Type: Compliance Evaluation
Inspection Summary:
Misc
Is the facility compliant?
Reason for Visit: Routine
Comment: Property does not have any exposure for stormwater to be contaminated.
Currently manufacturing has ceased and facility is used as a warehouse for shipping to
Florida. Spill kits are available if fuel spills occur from tractor trailer saddle tanks.
Yes No NA NE
®nnn
Page:2

FOR AGENCY USE ONLY
Date Received
Division of Water Quality / Surface Water Protection Year munth Day
NCDEN�+ Ceninc to of Coveraee
� National Pollutant Discharge Elimination System -11-
-..rn C—, '—[�r.�;x�M_+r o, NO EXPOSURE CERTIFICATION for (Exclusion ti 7L-01viblUN t PATER QUALITY
fHv,mNr.<�wu N.cta.+f NCGNEOOOO
JUL 2 8 nii
NO EXPOSURE CERTIFICATION SWP Si
MOORESViLLE EC O;V„L OFFICE
National Pollutant Discharge Elimination System application for exclusion from a Stormwater Permit based
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, DWQ 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).
Y
L For questions, please contact the DWQ Regional Office for your area. (See page 6)
(Please print or type)
1) Mailing address of owner/operator (address to wl
Name 1 1_i" &. _�4 r� le
Contact
�'vlv!' yyC%.s M E S
Street Address
City
Vl kj „ State
Telephone No.
-[-C4 _(1 Fax:
Finail
clao...'A C S 6 Lk,-_i_IJ-L _4AI 05 11i-1
Page 1 of 7
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Mai
ZiP Code
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JUL 2 5 2011
SWU-NE-12Aug2010

NCGNE0000 No Exposure Certification
2) Location of facility producing discharge:
Facility.Name QG 1 Q
Facility Contact iz !kph_
Facility Street Address
City, c�: �1 _ State_C, _ ZIP Code
County
Telephone No. f —Q-Fax:
Email C�G��S�_ c`f'�n u r•F�•[cr-
3) Physical location information:
Please provide a narrative description of how to get to the facility (use street names, statg road numb rs, and
distance nd direction fro a roadway in erse tion). - Ae u�j%. �d . eG
-AZ7 .p,l`i'-f � on�a ► x r t A h o� c u �t
(A copy of a map with the facility 06arly iocated'on it should be included with tl)e certification application.)
4) Is the facility located on Native American Lands? 0 Yes 2No
5) Is this a Federal facility? ❑ Yes )i�No
6) Latitude �Z�7� Longitude i (deg., min., seconds)
7) This NPDES No Exposure Exclusion application applies to which of the following:
❑ New or Proposed Facility
e Existing
Date operation is to begin
Date operation began
❑ Renewal of existing No Exposure Certification Certification No.: NCGNE
8) Was this facility or site ever covered under an NPDES Stormwater Permit? N&es ❑ No
\
It yes, what is the NPDES Permit Number? � ) f (
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: a 0 -
10) P vide a brief description o the types of indust'I activities and prod cts produced at this facility:
VTC rl i [ �rV � 1] % ) to � r- '� X M r G -0 sr V 'c' . D c_ % v" G►
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
15C,N o
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
Page 2 of 7
SWU•NE-12Aug2010,
V,

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 XKlo
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 )No
c. Materials or products from past industrial activity
❑ Yes
)R(No
d. Material handling equipment (except adequately maintained vehicles)
❑ Yes
I ' o
e. Materials or products during loading/unloading or transporting activities
❑ Yes
1ZNo
f. Materials or products stored outdoors (except final products intended for outside
❑ Yes
�RII<lo
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
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by
❑ Yes
!o
the discharger
i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters])
❑ Yes
X-�o
j. Application or disposal of process wastewater (unless otherwise permitted)
❑ Yes
+ , to
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not
❑ Yes Nlo
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 7<�o
(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 Ko
stored outside, has the facility had any releases in the past three (3) years?
13) Above Ground Storage Tanks (ASTs): It you answer "No" to any of the following iterns, you are not
eligible for the no exposure exclusion.
a. Are exterior ASTs and piping free of rust, damaged or weathered coating, pits, or ❑ Yes ❑ No -O<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 f VIA
cracks, holes, or evidence of leaks, and are drain valves maintained locked shut?
Page 3 of 7
SWU-NE-12Ajg2010

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 f �1A
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 kN/A
in close proximity to each other with a combined capacity of more than 1,320-
galfons?
c. Is secondary containment provided for Title Ili Section 313 Superfund
0 Yes
❑ No >e/A
Amendments and Reauthorization Act (SARA) water priority chemicals'?
d. Is secondary containment provided for hazardous substances" designated in 40
❑ Yes
❑ No X-6A
CFR §116?
e. Are release valves on all secondary containment structures locked?
❑ Yes
❑ No MIA
15) Hazardous Waste:
a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? ❑ Yes 5 /.N0
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste K�es ❑ No
generated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste ❑ Yes E> o
generated per month) of hazardous waste?
It you answered yes to questions b. or c., please provide the following information:
Type(s) of waste: .J_6 e . ( \ A
How is material stored:
Where is material stored: O G1n`
How many disposal shipments per year: c
Name of transport / disposal vendor:
Vendor address: 53
tiJecC,:�Qkr
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.
Page 4 of 7
SW U-NE-12Aug2010

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 >�/,No
b. Does your facility have coal piles on site? 0 Yes K/No
c. Does your facility store other fuel sources outside in piles, such as wood chips, Il Yes )41�No
sawdust, etc.?
d. Does your facility have air emissions associated with its industrial activity (e.g., ❑ Yes 7. 0
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? © Yes Ll No 44//A
Please specify:
f. Please list any other environmental program permits (federal, state, etc.) not
specified earlier inthisapplication (such as Hazardous Waste Permits, etc.)-
Permit: U � � j bS 5 Program: 5A pry LO rlr
Permit:
Program:
Permit:
Program:
Permit:
Program:
Permit:
Program:
Permit:
Program:
Permit:
Program:
r
1
11RO
—Mavc�w ��`acEo
ol/// z`/f,:�S
N66 o 3os ?s - �,
Aireavi
Page 5 of 7
5W U-NE-12Aug2010

NCGNE0000 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 peimitting.
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-cerlify 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 Qual;ty, 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,availabfe 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. Additionaily, 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 ofPersonSi ping: �NLYNti�l 1 "� ���, i\V--0
. i � I� { Title: �oer �, r
of
-7— ab..-`{ 1
(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 fled 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.
Page 6oi7
SWU-NE-12Aug2010

NCGNE0000 No Exposure Certification
Final Checklist
This application should include the following items:
This completed application and all supporting documentation.
IJ A map with the location of the facility clearly marked.
qi If the site currently has an NPDES Stormwater Permit, be sure to indicate the permit number in Question 8.
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 fhe DWO Regional Office far your area.
DWO 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 7 of 7
5W U-NF-12Aug2010

Legend
Stormwater Flow Direction
>. Former Soil Stockpile Area (During Previous Construction)
Former Sediment Trap (During Previous Construction)
Parcels
Streams
Contours
10,
50'
Manually Operated Stormwater Drain Valve
Catchment Basin
REFERENCE
NAD 1983 State Plane North Carolina FIPS 3200 Feel
Projection Lambert Conformal Conic
500
x Chiller
Cooling Tower
Chemical Spill Overflow Retention Pond
® Detention Pond
•� Outfall (SW-1)
Q Pond Overflow Device
y Rip Rap for Erosion Control
Shipping and Recleving
• Solid Waste Container and Equipment Storage
Vegetated Swale
0
SCALE 1:3,000
1 inch equals 250 feet
500
Feet
N
w L
S
07
Golder Associates NC. Inc DATE 11/28/TITLE
-_ Stormwater Drainage Pathways and
- DESIGN
Golder CAP Stormwater Controls
Associates GIS CGP
PROJECT No 063-6576 CHECK CLIENT PG7 Industries
FILE 063-6576 Figure 4.mxd REV 1 REVIEW Salisbury, NC FIGURE: 4