NCGNE0844_COMPLETE FILE - HISTORICAL_20120504

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

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P.E.
Governor Director
May 4, 2012
Mr. Ken Downing
von Drehle Corporation
2245 West Maiden Road
Newton, North Carolina 28658
Dee Freeman
Secretary
Subject: No -Exposure Certification NCGNE0844
von Drehele Corporation — Maiden Operations
2245 West Maiden Road, Newton, NC 28658
Catawba County
Dear Mr. Downing:
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, the site visit of
April 20, 2012, and the photo documentation of the newly installed metal scrap dumpster cover the Division is granting
your conditional exclusion from permitting as provided for under 40 CFR 122.26(g), which is incorporated by reference
in North Carolina regulations.
Please note that by our acceptance of your no -exposure certification, you are obligated to maintain no -exposure
conditions at your facility. If conditions change such that your facility can no longer qualify for a No -Exposure
exclusion, you are obligated to immediately obtain NPDES permit coverage for your stormwater discharge.
Otherwise, the discharge becomes subject to enforcement as an un-permitted discharge.
You must self re -certify your No -Exposure status annually using the enclosed 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. 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 Marcia Allocco at [phone], or at
[e-mail].
Sincerely,
t
for Charles Wakild, P.E.
Enclosure: No -Exposure Self Re -certification Information sheet
Annual No -Exposure Exclusion Self Recertification form
Site inspection report
CC" Stormwater Permitting Unit No- Exposure Files (Brian Lowther)
Mooresville Regional Office One
Location: 610 East Center Ave., Suite 301 Mooresville, NC 28115 NorthCarolina
Phone: [phone] Fax: [phone] � Customer Service: 1-877-623-6748 ���' f�����
Internet: wvwncwaterquali y,org �l
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Compliance Inspection Report
Permit: NCGNE0844 Effective: Expiration: Owner: Von Drehle Corporation
SOC: Effective: Expiration: Facility: von Drehle Corporation Maiden Operations
County: Catawba 2245 W Maiden Rd
Region: Mooresville
Newton NC 28658
Contact Person: Ken Downing Title: Phone: [phone]
Directions to Facility:
from Hickory take US 321 S to exit 33 for Startown Rd - turn left on Startown Rd & left again on W Maiden Rd to 2245 W Maiden Rd
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 04/2012012 Entry Time: 01:22 PM Exit Time: 01:34 PM
Primary Inspector: Marcia Allocco Phone: [phone]
Ext.2204
Secondary Inspector(s):
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Stormwater Discharge, No Exposure Certificate
Facility Status: ■ Compliant rl Not Compliant
Question Areas:
M Miscellaneous Questions
(See attachment summary)
Page: 1

Permit: NCGNE0844 owner - Facility: Von Drehle Corporation
Inspection Date: 0412012012 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
The facility was visited through a new No -Exposure Certification request.
Stormwater at the site drains to one outfall (southwestern corner of property) with eventual discharge to an unnamed
tributary to the Catawba River (verified on USGS Reepsville Quadrangle).
The following source of stormwater exposure was noted during the inspection:
• There was an uncovered scrap metal dumpster on the western side of the facility. Runoff from the scrap metal
dumpster had stained the concrete beneath it and the staining lead to a nearby drop inlet in the parking lot.
Mr. Rick Moore with von Drehele Corporation provided photo documentation (via e-mail) to DWQ on May 1, 2012, that a
structure/canopy had been purchased and installed over the dumpster to prevent the introduction of stormwater in the
dumpster.
Therefore, with the installation of a cover over the scrap metal dumpster the facility meets the requirements of "No
Exposure".
Page: 2

WDENK
North Carolina Department of Environment and
Division of Water Quality
Natural Resources
Beverly Eaves Perdue Charles Wakild, P.E. Dee Freeman
Governor Director Secretary
May 4, 2012
Mr. Ken Downing
von Drehle Corporation
2245 West Maiden Road
Newton, North Carolina 28658
Subject: No -Exposure Certification NCGNE0844
von Drehele Corporation — Maiden Operations
2245 West Maiden Road, Newton, NC 28658
Catawba County
Dear Mr. Downing:
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, the site visit of
April 20, 2012, and the photo documentation of the newly installed metal scrap dumpster cover the Division is granting
your conditional exclusion from permitting as provided for under 40 CFR 122.26(g), which is incorporated by reference
in North Carolina regulations.
Please note that by our acceptance of your no -exposure certification, you are obligated to maintain no -exposure
conditions at your facility. If conditions change such that your facility can no longer qualify for a No -Exposure
exclusion, you are obligated to immediately obtain NPDES permit coverage for your stormwater discharge.
Otherwise, the discharge becomes subject to enforcement as an un-permitted discharge.
You must self re -certify your No -Exposure status annually using the enclosed 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. 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 Marcia Allocco at [phone], or at
[e-mail].
Sincerely,
for Charles Wakild, P.E.
Enclosure: No -Exposure Self Re -certification Information sheet
Annual No -Exposure Exclusion Self Recertification form
Site inspection report
cc: Stormwater Permitting Unit No- Exposure Files (Brian Lowther)
Mooresville Regional Office One
Location: 610 East Center Ave., We 301 Mooresville, NC 28115 NorthCaTo ina
Phone: [phone] Fax: [phone] Customer Service: 1-877-623-6748 �1'�����
��
Internet: www.ncwaterquality.org L4
An Equal Opportunity l Affirmative Action Employer - 30% Recycied110% Past Consumer paper

Compliance Inspection Report
Permit: NCGNE0844 Effective: Expiration: Owner: Von Drehle Corporation
SOC: Effective: Expiration: Facility. von Drehle Corporation Maiden Operations
County: Catawba 2245 W Maiden Rd
Region: Mooresville
Newton NC 28658
Contact Person: Ken Downing Title: Phone: [phone]
Directions to Facility:
from Hickory take US 321 S to exit 33 for Startown Rd - turn left on Startown Rd & left again on W Maiden Rd to 2245 W Maiden Rd
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 04/2012012 Entry Time: 01:22 PM Exit Time: 01:34 PM
Primary Inspector: Marcia Allocco Ext.2204 Phone: [phone]
Secondary lnspector(s):
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Stormwater Discharge, No Exposure Certificate
Facility Status: ■ Compliant n Not Compliant
Question Areas:
■ Miscellaneous Questions
(See attachment summary)
Page: 1

Permit: NCGNE0844 Owner - Facility: Von Drehie Corporation
Inspection Date: 04/20/2012 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
The facility was visited through a new No -Exposure Certification request.
Stormwater at the site drains to one outfall (southwestern corner of property) with eventual discharge to an unnamed
tributary to the Catawba River (verified on USGS Reepsville Quadrangle).
The following source of stormwater exposure was noted during the inspection:
• There was an uncovered scrap metal dumpster on the western side of the facility. Runoff from the scrap metal
dumpster had stained the concrete beneath it and the staining lead to a nearby drop inlet in the parking lot.
Mr. Rick Moore with von Drehele Corporation provided photo documentation (via e-mail) to DWQ on May 1, 2012, that a
structure/canopy had been purchased and installed over the dumpster to prevent the introduction of stormwater in the
dumpster.
Therefore, with the installation of a cover over the scrap metal dumpster the facility meets the requirements of "No
Exposure".
Page: 2

4CI
� A
NC®ENR
North -Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P.E. Dee Freeman
Governor Director Secretary
May 4, 2012
Mr. Ken Downing
von Drehle Corporation
2245 West Maiden Road
Newton, North Carolina 28658
Subject: No -Exposure Certification NCGNE0844
von Drehele Corporation — Maiden Operations
2245 West Maiden Road, Newton, NC 28658
Catawba County
Dear Mr. Downing:
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, the site visit of
April 20, 2012, and the photo documentation of the newly installed metal scrap dumpster cover the Division is granting
your conditional exclusion from permitting as provided for under 40 CFR 122.26(g), which is incorporated by reference
in North Carolina regulations.
Please note that by our acceptance of your no -exposure certification, you are obligated to maintain no -exposure
conditions at your facility. If conditions change such that your facility can no longer qualify for a No -Exposure
exclusion, you are obligated to immediately obtain NPDES permit coverage for your stormwater discharge.
Otherwise, the discharge becomes subject to enforcement as an un-permitted discharge.
You must self re -certify your No -Exposure status annually using the enclosed 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. 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 Marcia Allocco at [phone], or at
[e-mail].
Sincerely,
for Charles Wakild, P.E. I
Enclosure: No -Exposure Self Re -certification Information sheet
Annual No -Exposure Exclusion Self Recertification form
Site inspection report
cc: Stormwater Permitting Unit No- Exposure Files (Brian Lowther)
Mooresville Regional office One
Location: 610 East Center Ave., Suite 301 Mooresville, IBC 28115 NorthCarolina
Phone: [phone] Fax; (704) 663a401 Customer Service: 1-877-62N748
Internet: www ricwaterquality,org Naturally
An Equal Opportunity 1 Affirmative Action Employer- 30% Recycled110% Post Consumer paper

Compliance Inspection Report
Permit: NCGNE0844 Effective: Expiration: Owner: Von Drehle Corporation
SOC: Effective: Expiration: Facility: von Drehle Corporation Maiden Operations
County: Catawba 2245 W Maiden Rd
Region: Mooresville
Newton NC 28658
Contact Person: Ken Downing Title: Phone: [phone]
Directions to Facility:
from Hickory take US 321 S to exit 33 for Startown Rd - turn left on Startown Rd & left again on W Maiden Rd to 2245 W Maiden Rd
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 0412012012 ,Entry Time: 01:22 PM Exit Time: 01:34 PM
Primary Inspector: Marcia AlPhone: 704-663-1699
locc
Secondary Inspector(s): Ext.2204
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Stormwater Discharge, No Exposure Certificate
Facility Status: ■ Compliant D Not Compliant
Question Areas:
■ Miscellaneous Questions
(See attachment summary)
Page: 1

Permit: NCGNE0844 Owner - Facility: Von Drehle Corporation
Inspection Date: 04/2012012 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
The facility was visited through a new No -Exposure Certification request
Stormwater at the site drains to one outfall (southwestern corner of property) with eventual discharge to an unnamed
tributary to the Catawba River (verified on USGS Reepsville Quadrangle).
The following source of stormwater exposure was noted during the inspection:
• There was an uncovered scrap metal dumpster on the western side of the facility. Runoff from the scrap metal
dumpster had stained the concrete beneath it and the staining lead to a nearby drop inlet in the parking lot.
Mr. Rick Moore with von Drehele Corporation provided photo documentation (via e-mail) to DWQ on May 1, 2012, that a
structure/canopy had been purchased and installed over the dumpster to prevent the introduction of stormwater in the
dumpster.
Therefore, with the installation of a cover over the scrap metal dumpster the facility meets the requirements of "No
Exposure".
Page: 2

'Am

Allocco, Marcia
From: Rick Moore [Rick. [e-mail]]
Sent: Tuesday, May 01, 2012 119 PM
To: Allocco, Marcia
Cc: Dan Scott, Ken Downing
Subject: Follow-up resolution to issue for permit.
Attachments: METAL CONTAINER COVER 002 jpg. METAL CONTAINER COVER 001.jpg
Here is our resolution to the rain fall causing us an issue with this can, please let us know if this does not meet with
requirements or expectations. Thank you very much.
_1'R'1a
.ffainte uut" Alanagen
vh& eavoAaaan
Afaiden Oftaiian
828-428-8994

HCDENR
t40rrn c�— Der.w¢*eu. o.
ExnwpH— —0 NRURfl RE90 .5
Division of Water Quality 1 Surface Water Protection
National Pollutant Discharge Elimination.System
NO EXPOSURE CERTIFICATION for Exclusion
NCGNE0000
FOR AGENCY USE ONLY
Date Received
Year
Month
Day
Certificate of Coverage
N V-
DlVtatU1N Vt- VVAILR QU..LITY
MAR'29 2012
'NO EXPOSURE CERTIFICATION t'WP Sz``TIGN '
MOORESSVILLE REGIONAL OFFICE
National Pollutant Discharge Elimination System application for exclusion from a Stonmwater Permit based
on NO EXPOSURE:
Submission of this No Exposure Certification constitutes notification that your facility does not require a
permit for storm water 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 (wi(h 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 onl}--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 DWQ Regional Office for your area. (Seepage 6)
(Please print or type)
1) Mailing address of ownerloperator (address to which all certification correspondence will be mailed):
Name
Contact
Street Address
City
Telephone No.
Email
SWU-NE-12Aug2010
von Drehle Corporation
Ken Downing - Operator
2245 West Maiden Road
Newton State NC ZIP Code 28658
828-428-8994 Fax: [phone]
[e-mail]
Page 1 of 7
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NCGNE0000 No Exposure Certification
2) Location of facility producing discharge:
Facility Name von Drehle Corporation — Maiden Operations
Facility Contact Ken Downing
Facility Street Address 2245 West Maiden Road
City Newton
County Catawba
Telephone No. 828-428-8994
Email [e-mail]
3) Physical location information:
State NC ZIP Code 28658
Fax: [phone]
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). From Hickory take US-321 S to exit 33 for-Startown
Road then turn left on Startown Rd and left again on West Maiden Rd to 2245 West Maiden Road
(A copy of a reap with the facility clearly located on it should be included with the certification
application.)
4) Is the facility located on Native American Lands? ❑ Yes X No
5) Is this a Federal facility? ❑ Yes X No
6) Latitude Longitude (deg., min., seconds)
7) This NPDES No Exposure Exclusion application applies to which of the following:
I1 New or Proposed Facility
X Existing
Date operation is to begin
Date operation began: June 2002
❑ Renewal of existing No Exposure Certification Certification No.: NCGNE
8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes XNo
If yes, what is the NPDES Permit Number? NA
9) Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
NAICS 322121 Ca,` p11�
10) Provide a brief description of the types of industrial activities and products produced at this facility:
Light industrial operation converting, packaging and shipping large rolls of tissue and paper into towels and
tissue.
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
X No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility: NA
Page 2 of 7
SwU-NE-12Aug2010

NCGNE0000 No Exposure Certification
Exposure Checklists (12. - 94_)
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 X 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 X No
c. Materials or products from past industrial activity ❑ Yes X No
d. Material handling equipment (except adequately maintained vehicles) ❑ Yes X No
e. Materials or products during loading/unloading or transporting activities ❑ Yes X No
f. Materials or products stored outdoors (except final products intended for outside ❑ Yes X No
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 X No
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes X No
the discharger
i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters)) ❑ Yes X No
j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes X No
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes X No
otherwise regulated (i.e., under an air quality control permit) and evident in the
stormwater outflow
I. Empty containers that previous lycontained materials that are not properly stored ❑ Yes X 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 X 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 and piping free of rust, damaged or weathered coating, pits, or ❑ Yes ❑ No X 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 XN/A
cracks; holes, or evidence of leaks, and are drain valves maintained locked shut?
Page 3 of 7
5WU-NE-12Aug2o10

NCGNEOOOO 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
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 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?
If you answered yes to questions b_ or c., please provide the following information:
Type(s) of waste: NA
How is material stored:
Where is material stored:
How many disposal shipments per year:
Name of transport / disposal vendor:
Vendor address:
Footnotes to Questions 14) c. & d.
❑ Yes ❑ No X NIA
❑ Yes ❑ No X NIA
❑ Yes []No X NIA
❑ Yes ❑ No X NIA
❑ Yes ❑ No X NIA
❑ Yes X No
❑ Yes X No
❑ Yes X No
*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 Ill 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
SWU-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 X No
b. Does your facility have coal piles on site? ❑ Yes X No
c. Does your facility store other fuel sources outside in piles, such as wood chips, ❑ Yes X No
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 X No
❑ Yes ❑ No X NIA
Page 5 of 7
SWU-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 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 p6or to any point source discharge of stormwater from the facilfty. 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: Dan Scott
dan.scottevondrehle.com Phone [phone]
Title: Director of Environmental Health & Safety
(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.
Page 6 of 7
SWu-NE-12Aug2010

NCGNE0000 No Exposure Certification
Final Checklist
This application should include the following items:
X This completed application and all supporting documentation_
X A map with the location of the facility clearly marked.
X 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 the DWQ Regional Office for your area.
DWQ Regional Office Contact Information:
Asheville Office ...... [phone]
Fayettevilie 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-Mug2010