NCGNE1006_COMPLETE FILE - HISTORICAL_20140602

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCGNE
DOC TYPE
❑HISTORICAL FILE
HOC DATE
❑ 30N V b Oa
YYYYMMDD

4�
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory John E. Skvarla, III
Governor Secretary
June 2, 2014r�
American Custom Finishing
LEDC)NR
V i r
Attention: Ms, Amy A. Conn ouuirr916 West Main Street�st�o.mwatrBranct,
Haw River, North Carolina 27258
Subject: No -Exposure Certification NCGNE1006
American Custom Finishing
2830 Hwy 70 SE
Catawba County
Dear Ms. Conn:
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 the inspection dated May 20,
2014, 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 unpermitted 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 DEMLR 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.
Division of Energy, Mineral, and Land Resources
Land Quality Section - Mooresville Regional Office
610 East Center Avenue, Suite 301, Mooresville, North Carolina 28115
Telephone: [phone] I FAX: [phone] • Internet: http7llportal.ncdenr.orglweb1lrlland-quality
An Equal Opportunity I Affirmative Action Employer— 50% Recycled / 10% Post Consumer Paper

American Custom Finishing
No -Exposure Certification
June 2, 2014
If you have any questions or need further information, please contact Mr. Samar Bou-
ghazale at [phone], or at [e-mail].
Sincerely,
Zahid S. Khan, CPM, CPESC, CPSWQ
Regional Engineer
Land Quality Section
Enclosure: Inspection Report
cc:;,Bradley-Bennett,_Stormwater Permitting Program, No- Exposure Files NCGNE1006

SOC: Effective:
County: Catawba
Region: Mooresville'
Contact Person: Amy Conn
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Compliance Inspection Report
- 'Expiratioru­ -Ownarr-American Cstom-Finishing ---- - -...-
Expiration: Facility: American Custom Finishing
2830 Hwy 70 Se
Title:
Inspection Date: 05/20/2014 Entry Time: 11:00 AM
Primary Inspector: Samar E Bou Ghazale
Secondary Inspector(s):
Hickory NC 28603
Phone: [phone]
Certification:
Exit Time: 11:35 AM
Phone:
Phone: [phone]
Ext.2199
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Stormwater Discharge, No Exposure Certificate
Facility Status: ® Compliant ❑ Not Compliant
Question Areas:
EN Miscellaneous Questions Misc
(See attachment summary)
Page: 1

Permit: NCGNE1006 Owner - Facility: American Custom Finishing
Inspection-gate:.,!'�'2C,'2C.', _�w.,,lnspection Type: Compfiance.�yaivatiors. _. _ �'Reasonjor Visit:- Routine
Inspection Summary:
This facility was approved for no exposure based on an inspection dated 0512011 a4_
Misc
Is the facility compliant?
Comment: See Summary.
Yes No NA NE
D 0 0 0
Page: 2

A
:-
Noa*n GROUNA oer?wr�+rJrr of
ENVIRONMENT AND NRl1PAL RE] RCM
Division of Water Quality / Surface Water Protection
National Pollutant Dischame.Elimination System
ANNUAL NO EXPOSURE EXCLUSION SELF RE -CERTIFICATION
NCGNEOOOO
Do not submit this form to DWQ unless requested.
For questions, please contact the DWQ Regional Office for your area or the Central Office.
(Please print or type)
Facility's No Exposure Exclusion No. Date Completed (MM/DD/YYYY)
N I C I G N I E
1) Has the facility name or owner changed? ❑ Yes ❑ No
(if yes, please submit a separate Name/Ownership Change Form to DWQ located at
http://portal,ncdenr.org/web/wq/ws/su/npdessw#Applicatio.n_Forms_N PDES)
2) 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 to maintain your no exposure exclusion, and must immediately apply for a permit from DWQ.
a. Using, storing, or cleaning industrial machinery or equipment, and areas where ' [:]Yes ❑ 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 ❑ No
c. Materials or products from past industrial activity ❑ Yes ❑ No
d. Material handling equipment (except adequately maintained vehicles) ❑ Yes [:]No
e. Materials or products during loading/unloading or transporting activities ❑ Yes [:]No
f. Materials or products stored outdoors (except final products intended for outside ❑ Yes_ ❑ 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 [:]No
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes [:]No
the discharger
i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters]) ❑ Yes [:]No
.-Application_ or-disposaLof_process was.tewater_(unless_otherwise-permitted) _❑_Yes,._❑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 ❑ No
(i.e., not closed and stored upside down to prevent precipitation accumulation)
Page 1 of 3
SWU-NESR-29M2010

�1
NCGNE0000 No Exposure Self Re -Certification
m. For any exterior ASTs, as well as drums, barrels, tanks, and similar containers ❑ Yes . ❑ No
stored outside, has the facility fiad any releases In1he past three (3) years? T
3) Above Ground Storage Tanks (ASTs): If you answer "No" to any of the following items, you are not
eligible to maintain your no exposure exclusion, and must immediately apply for a permit from DWQ.
a. Are exterior ASTs and piping free of rust, damaged or weathered coating, pits, or [—]Yes[:] No ❑ NIA
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any [:]Yes[:] No ❑ NIA
. cracks, holes, or evidence of leaks, and are drain valves maintained locked shut?
4) Secondary Containment: If you answer "No" to any of the following items, you are not eligible to
maintain your no exposure exclusion, and must immediately apply for a permit from DWQ.
a. Is secondary containment provided for all single above ground storage ❑Yes❑ No ❑ NIA
containers (including drums, barrels, etc.) with a capacity of more than 660-
galions?
b. Is secondary containment provided for above ground storage containers stored ❑Yes❑ No ❑ NIA
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 ❑Yes❑ No ❑ NIA
Amendments and Reauthorization Act (SARA) water priority chemicals*?
d. Is secondary containment provided for hazardous substances** designated in 40 [:]Yes[:] No ❑ NIA
CFR §116?
e. Are release valves on all secondary containment structures locked? ❑Yes❑ No ❑ NIA
Footnotes to Questions 4) 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.
5) Other information: If you answer "Yes" to any of the following items, and the answer if.different from
how it was answered when originally applying, you might not be eligible to maintain your no exposure
exclusion. Please contact the Division if this is the case.
a. Does your facility store used, recycled, or otherwise reclaimed pallets outside?
b. Does your facility have coal piles on site?
c. Does your facility store'other fuel sources outside in piles, such as wood chips,
sawdust, etc.?
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:
❑ Yes [:]No
❑ Yes ❑ No
❑ Yes ❑No
❑ Yes ❑ No
[:]Yes[:] No❑NIA
SWU-NESR-29Ju12010
Page 2 of 3

NCGNE0000 No Exposure Self Re -Certification
6) 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/maintaining 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 44 CFR 122.26(g)(2)).
I understand that I am obligated to annually self re -certify No Exposure and, if requested, submit this 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 provided. Based on my
inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the
information, the information provided is to the best of my knowledge and belief true, accurate and complete. I am aware
that there are significant penalties for providing false information, including the possibility of fine and imprisonment for
knowing violations.
I certify that I am familiar with the information contained in this document and that to the best of my knowledge and belief
such information is true, complete, and accurate.
Printed Name of Person Signing:
Title:
(Signature)
(Date Signed)
Please note: The Regional Office may 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 Artide; 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).
This completed form must be kept on file at the facility for at least 5 years. Do not submit this
form to DWQ unless requested.
Page 3 of 3
SWU-NESR-29Jul2010

f�
RC®ENR
North Carolina Department of Environment and Natural Resources
Pat McCrory John E. Skvarla, III
Governor Secretary
June 2, 2014
American Custom Finishing
Attention: Ms. Amy A. Conn
916 West Main Street
Haw River, North Carolina 27258
Subject: No -Exposure Certification NCGNE1006
American Custom Finishing
2830 Hwy 70 SE
Catawba County
Dear Ms, Conn:
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 the inspection dated May 20,
2014, 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 unpermitted 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 DEMLR 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.
Division of Energy, Mineral, and Land Resources
Land Quality Section - Mooresville Regional Office
610 East Center Avenue, Suite 301, Mooresville, North Carolina 28115
Telephone: [phone] FAX: [phone] • Internet: http:llportal.ncdenr.org/web/Iriland-quality
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper

American Custom Finishing
No -Exposure Certification
June 2, 2014
If you have any questions or need further information, please contact Mr. Samar Bou-
ghazale at [phone], or at [e-mail].
Sincerely,
Zahid S. Khan, CPM, CPESC, CPSWQ
Regional Engineer
Land Quality Section
Enclosure: Inspection Report
cc: Bradley Bennett, Stormwater Permitting Program, No- Exposure Files NCGNE1006

Compliance Inspection Report
pc; ;;}t:-�yrr(�E:: OS ffe� ivo: `'Expiratio7: ,.:..-O;+vnar:•-American C.atom-Finrishing.-.. _
SOC: Effective: Expiration: Facility: American Custom Finishing
County: Catawba 2830 Hwy 70 Se
Region: Mooresville
Contact Person: Amy Conn
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Title:
Inspection Date. 0512012014 EntryTime: 11:00 AM
Primary Inspector: Samar E Bou Ghazale
Secondary Inspector(s):
Hickory NC 28603
Phone: [phone]
Certification:
Exit Time: 11:35 AM
Phone:
Phone: [phone]
Ext.2199
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Stormwater Discharge, No Exposure Certificate
Facility Status: ® Compliant 0 Not Compliant
Question Areas:
® Miscellaneous Questions E Misc
(See attachment summary)
0
Page: 1

Permit: NCGNE1006 Owner - Facility: American Custom Finishing
inspection Dat �5,'2Q,'2C? 4_ Inspection Type:. _Compfiance.Eva!pation. _.�, , , _... aeason;fo.r Visit: _ Routine:_.__
Inspection Summary:
This facility was approved for no exposure based on an inspection dated 061201104.
Misc
Is, the facility compliant?
Comment: See Summary,
Yes No NA NE
nnnn
Page: 2

NORT1-, C w U_ Orr mrx or
E1WRONM AND NRi(i...L Wr RctS
Division of Water Quality / Surface Water Protection
National Pollutant Discharge Elimination System
ANNUAL NO EXPOSURE EXCLUSION SELF RE -CERTIFICATION
NCGNE0000
Do not submit this form to DWQ unless requested.
For questions, please contact the DWQ Regional Office for your area or the Central Office.
(Please print or type)
Facility's No Exposure Exclusion No. Date Completed (MM/DD/YYYY)
N I C I G I N I E
1) Has the facility name or owner changed? ❑ Yes ❑ No
(if yes, please submit a separate Name/Ownership Change Form to DWQ located at
http://portal. ncdenr.org/web/wq/ws/su/npdessw#Application_Forms_N PDES)
2) 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 to maintain your no exposure exclusion, and must immediately apply for a permit from DWQ.
a. Using, storing, or cleaning industrial machinery or equipment, and areas where ❑ Yes ❑ 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 ❑ No
c. Materials or products from past industrial activity ❑ Yes ❑ No
d. Material handling equipment (except adequately maintained vehicles) ❑ Yes ❑ No
e. Materials or products during loading/unloading or transporting activities ❑ Yes []No
f. Materials or products stored outdoors (except final products intended for outside ❑ Yes ❑ 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 ❑ No
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes ❑ No
the discharger
i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters]) ❑ Yes ❑ No
_-_----_-_--j._Applicatio.n-oLdisposal_of_process-wastewater_(unless_otherwise_permitte.d) _❑_Yes_❑.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 ❑ No
(i.e., not closed and stored upside down to prevent precipitation accumulation)
Page 1 of 3
SWU-NESR-29Ju12010

NCGNE0000 No Exposure Self Re -Certification
m. For any exterior ASTs, as well as drums, barrels, tanks, and similar containers ❑ Yes ❑ No
stored outside, has the facility had any releases in the past three (3) years?
3) Above Ground Storage Tanks (ASTs): If you answer "No" to any of the following items, you are not
eligible to maintain your no exposure exclusion, and must immediately apply for a permit from DWQ.
a. Are exterior ASTs and piping free of rust, damaged or weathered coating, pits, or ❑Yes❑ No ❑ NIA
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any [:]Yes[:] No ❑ NIA
cracks, holes, or evidence of leaks, and are drain valves maintained locked shut?
4) Secondary Containment: If you answer "No" to any of the following items, you are not eligible to
maintain your no exposure exclusion, and must immediately apply for a permit from DWQ.
a. Is secondary containment provided for all single above ground storage [:]Yes[:] No ❑ 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 ❑ NIA
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 [:]Yes[:] No ❑ NIA
Amendments and Reauthorization Act (SARA) water priority chemicals"?
d. Is secondary containment provided for hazardous substances'* designated in 40 ❑Yes❑ No ❑ NIA
CFR §116?
e. Are release valves on all secondary containment structures locked? ❑❑ YesNo ❑NIA
Footnotes to Questions 4) 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,
5) Other information: If you answer "Yes" to any of the following items, and the answer if different from
how it was answered when originally applying, you might not be eligible to maintain your no exposure
exclusion. Please contact the Division if this is the case.
a. Does your facility store used, recycled, or otherwise reclaimed pallets outside? ❑ Yes ❑ No
b. Does your facility have coal piles on site? ❑ Yes ❑ No
c. Does your facility store other fuel sources outside in piles, such as wood chips, ❑ Yes [:]No
sawdust, etc.?
d. Does your facility have air emissions associated with its industrial activity (e.g., ❑ Yes [:]No
— -- 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❑ No❑NIA
Please specify:
Page 2 of 3
5WU-NESR-29Ju12010

NCGNE0000 No Exposure Self Re -Certification
6) 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/maintaining 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 44 CFR 122.26(g)(2)).
I understand that I am obligated to annually self re -certify No Exposure and, if requested, submit this 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 provided. Based on my
inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the
information, the information provided is to the best of my knowledge and belief true, accurate and complete. I am aware
that there are significant penalties for providing false information, including the possibility of fine and imprisonment for
knowing violations.
I certify that I am familiar with the information contained in this document and that to the best of my knowledge and belief
such information is true, complete, and accurate.
Printed Name of Person Signing:
Title:
(Signature)
(Date Signed)
Please note: The Regional Office may 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).
This completed form must be kept on file at the facility for at least 5 years. Do not submit this
form to DWQ unless requested.
Page 3 of 3
SWU-NESR-29Jul2010

m a _�_a Hi d 2-k�x
Division of Energy, Mineral, and Land Resources
NCDENRNational Pollutant Discharge Elimination System
FOR AGENCY USE ONLY
Date Received
Year
I Month
I Day
14
1 ON
I Orl
Certificate of Coverage
NC N ool�
C__U r,<„. NO EXPOSURE CERTIFICATION for Exclusion✓//yy
Elmap+MFHT AND Nov Rr_souACE � P",
NCGNE0000 O. '�4G
NO EXPOSURE CERTIFICATION ,tom, "+Fc L?
r
National Pollutant Discharge Elimination System application for exclusion from�ya Stormwater Permit based
\rA CV19 AL.11[]L'. �� l �X
vii iw �Ar%J.7Wr«.
Submission of this No Exposure Certification constitutes notification thiVyour facility does not require a
permit for storm water discharges associated with industrial activity in the State�of North Carolina because
u.
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, DEMLR 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
terns and conditions of 40 CFR 922.26(g).
You are required to self re -certify your No Exposure Exclusion annually.
For questions, please contact the DEMLR Regional Office for your area. (See page 6)
(Please print or type)
1) Mailing address of owner/operator (address to which all certification correspondence will be mailedl:
Name: American Custom Finishing
Contact: Amy A. Conn
Street Address: 916 West Main Street/PO Box 612
City: Haw River State: NC ZIP Code: 27258 t) l /
Telephone No.: 336-578-5476 Fax: [phone] L� V L�j�
Email: aconnC@_unichem.com U
APR o 7 2014
Page 1 of 7 DENR- WATER QUALITY
TLA�'SAND STORMWATER BRANCH

:�
y
r
..
ti � .

NCGNE0000 No Exposure Certification
Dlf lgIpN
2) Location of facility producing discharge: 'A D�1AA
Facility Name: American Custom Finishing la,
Facility ND QU,q[ICS�QRC�S
Facility Contact: Keith Bollinger RA
Facility Street Address: 2830 HIM. 70, SE D�w,�42014
City: Hickory State: NC ZIP Code: 28603 AND+
County: Catawba �� READ, of v,N
Telephone No.: 828-261-4790 Fax: [phone] URcF3 7
Email: [e-mail] gZg ` �4—Z i)sy
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). From 1-40 take Exit 128 Fair rove Church Rd SE). Go
south to HWY 70-turn right-3.5 miles on the left (beside 84 LUMBERS .rid �q- LIlAf x-
(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 Et No
5) Is this a Federal facility? ❑ Yes a No
6) Latitude: 35°43'N Longitude: 81°23'W (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
El Existing Date operation began: 06/11
❑ Renewal of existing No Exposure Certification No.: NCGNE
8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes a No
If yes, what is the NPDES Permit Number?
9) Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: 2269
10) Provide a brief description of the types of industrial activities and products produced at this facility:
Custom fabric coating and finishing -for upholster ,y fabrics. Wn and d in of upholstery fabrics.
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
$ No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:

0
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 G 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 a No
c. Materials or products from past industrial activity ❑ Yes e No
d. Material handling equipment (except adequately maintained vehicles) ❑ Yes $ No
e. Materials or products during loading/unloading or transporting activities ❑ Yes $ No
f. Materials or products stored outdoors (except final products intended for outside ❑ Yes a 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 B No
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes a No
the discharger
i. Waste material (except waste in covered, non -leaking containers (e.g., dumpsters)) ❑ Yes E3 No
j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes a No
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes e 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 e 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 S 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 e NIA
deterioration, or evidence of leaks?
b. is secondary containment provided for all exterior ASTs? If so, is it free of any ❑ Yes ❑ No El NIA
cracks, holes, or evidence of leaks, and are drain valves maintained locked shut?

r
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
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:
How is material stored:
Where is material stored:
How many disposal shipments per year:
Name of transport 1 disposal vendor:
Vendor address:
Footnotes to Questions 14) c. & d.
6 Yes ❑ No ❑ NIA
B Yes ❑ No ❑ NIA
❑ Yes ❑ No B NIA
❑ Yes ❑ No $ NIA
e Yes ❑ No ❑ NIA
❑ Yes B No
❑ Yes fEl No
❑ Yes a No
*Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulls 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.

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? 9 Yes ❑ No
b. Does your facility have coal piles on site?
c. Does your facility store other fuel sources outside in piles, such as wood chips,
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: Textile upholstery coating__
e. If you answered yes to d., are those emissions permitted by an Air Quality Permit?
Please specify: Facility is exempt from Air Permitting per NCAC_15A
2Q.0102(C)(2)(e)(II)
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 S No
❑ Yes $ No
B Yes ❑ No
❑ Yes e No ❑ NIA

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
DEMLR 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 Energy, Mineral, and Land Resources (DEMLR),
or MS4 operator where the discharge is into the local MS4, to perform inspections to confirm the condition of no exposure
and to make such inspection reports publicly available upon request.
In the event that the site no longer qualifies for a No Exposure Exclusion, I understand that I must obtain coverage under
an NPDES permit prior to any point source discharge of stormwater from. the facility. Additionally, I certify under penalty of
law that this document and all attachments were prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on my
inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the
information, the information submitted is to the best of my knowledge and belief true, accurate and complete. I am aware
that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for
knowing violations.
I certify that I am familiar with the information contained in this application and that to the best of my knowledge and belief
such information is true, complete, and accurate.
Printed Name of Person Signing: Amy A. Conn
Title: Environmental Coordinator
o 1<
(Signatu 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.

NCGNE0000 No Exposure Certification
Final Checklist
This application should include the following items:
❑ This completed application and all supporting documentation. All
A map with the location of the facility clearly marked.
❑ If the site currently has an NPDES Stormwater Permit, be sure to indicate the permit number in Question 8. MIA
Mail the entire package to:
Stormwater Permitting Program
Division of Energy, Mineral, and Land Resources
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Note
The submission of this document does not guarantee the issuance of a No Exposure Exclusion.
For questions, please contact the DEMLR Regional Office for your area.
DEMLR 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]