NCGNE1041_COMPLETE FILE - HISTORICAL_20150113

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO. NCGNE I 0'11
DOC TYPE Ct HISTORICAL FILE
DOC DATE ❑V l J D( 13
YYYYMMDD

NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
S&DCoffee
Attention: Mr. John Weibel
Post Office Box 1628
Concord, North Carolina 28026
Dear Mr. Weibel:
Donald R. van der Vaart
Secretary
January 13, 2015 ..
Subject: No -Exposure Certification
NCGNE1041
S & D Coffee West Winds Roasting
7955 West Winds Boulevard NW
Concord, North Carolina 28027
Cabarrus County
-- - -The Division f�as reviewed your submittal of the No=Exposure Certification formYfor - -
Exclusion from NPDES Stormwater Permitting. Based on your -submittal and signed
certification of no exposure at the above referenced facility, and the inspection dated
December 8, 2015, 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 and the form can be
downloaded by visiting: http:llportal.ncdenr.org/web/Ir/npdes-stormwater the web page for
the Division of Energy, Mineral and Land Resources Stormwater Program. The annual
self re -certification does not need to be submitted to DEMLR unless requested. A copy
should be maintained in your file.
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 - Mocresville Regional Office
610 East Center Avenue, Suite 301, Mooresville, North Carolina 28115
Telephone: [phone] FAX: [phone] • Internet: http:/lportal.ncdenr.org/weblir/land-quality
An Equal Opportunity I Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper

No -Exposure Certification
S & D Coffee
January 13, 2015
Page 2 of 2
If you have any questions or need further information, please contact Mr. Samar Bou-
Ghazale at [phone], or at [e-mail].
Sincerely,
tee..-.� s . �—
Zahid S. Khan, CPM, CPESC, CPSWQ
Regional Engineer
Land Quality Section
Enclosure: Inspection Report
cc: Bradley Bennett, Stormwater Permitting Program, No- Exposure Files NCGNE 1041

Permit: NCGNE1041
SOC:
County: Cabarrus
Region: Mooresville
Contact Person: John Weibel
Compliance Inspection Report
Effective: Expiration: Owner: S&D Coffee Inc
Effective: Expiration: Facility: S&D Coffee West Winds Roasting
7955 W Winds Blvd Nw
Title:
Concord NC 28027
Phone: [phone] Ext.4526
Directions to Facility: .
Go West on Concord Mills Boulevard from 1-85 for 1.4 miles. Turn right onto Derita Road. Go 1 mile then turn left onto West Wnds
Boulevard NW.
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
i
Inspection Date: 01/08/2015 Entry Time: 04:30PM Exit Time: 04:45PM
Primary Inspector: Samar E Bou Ghazale Phone: [phone] Et.2199
Secondary Inspector(s):
i
Reason for Inspection: Other inspection Type: Technical Assistance
Permit inspection Type: Stormwater Discharge, No Exposure Certificate
Facility Status: ® Compliant [] Not Compliant
Question Areas:
HE Miscellaneous Questions ® Misc
(See attachment summary)
4
Page: 1

. permit: NCGNE1041 Owner - Facility:S&DCoffee Inc
Inspection Date: 01/08/2015 inspection Type : Technical Assistance Reason for Visit: Other
Inspection Summary:
Facility applied for no exposure. Based on inspection dated 1-8-2015, this office is granting the no exposure status for this
facility.
Page: 2

T. ep �_ Nc6N-E /0�l
NCDENR
Ncern. G/+ — DEPV — O.
E.mA mEM — N�REsmRces
Division of Energy, Mineral and Land Resources
Land Quality Section �I,
National Pollutant Discharge Elimination Systeif's,
O
FOR AGENCY USE ONLY
Date Received
Year
Month Day
Cenificate of Coverage
N E
NO EXPOSURE CERTIFICA7 ION for Exclusfofi!'P
NCGNE0000 <
RECEIVED
NO EXPOSURE CER TIFICA TION
J N J 2 1� Please c ef here !f tlfis•i�La ,%newal: ❑
RENEWAL DENR-E AiVD i ? 'G� �DIs<� >G9C
Ql A.�TY ,h
National Pollutant Discharge Eiimiindtidnl5ystemEapQcation for exclusiorrfigm a Stormwater Permit based
on NO EXPOSURE: GiL.
Submission of this No Exposure Certification constitutes notification that yodr)fkility 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 (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
terms and conditions of 40 CFR 122.26(g).
You are required to reapply for the No Exposure Exclusion once every five (51 years.
For questions, please contact the DEMLR 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 S&D Coffee, Inc.
Contact Scott Seebold (Alternate: John Weibel)
Street Address PO Box 1628
City Concord State NC ZIP Code 28026
Telephone No. 704 782-3121 Fax [phone]
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NCGNEOOOO No Exposure Certification
2) Location of facility producing discharge:
Facility Name S&D Coffee West Winds Roasting
Facility Contact , John Weibel
Street Address 7955 West Winds Boulevard NW
City -
Concord State NC ZIP Code 28027
County Cabarrus
Telephone'No. " 704-782-3121 Fax: [phone]
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). Go W on Concord Mills Boulevard from 1-85 for 1.1 miles.
Turn right onto Derita Rd. Go 1 mile. Turn Left onto West Winds Boulevard NW.
(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 ❑ No
5) Is this a Federal facility? ❑ Yes ❑ No
6) Latitude 35d23m31s Longitude O8Od43m20s (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
IN Existing Date operation began October 2014
❑ Renewal of existing No Exposure Certification Certification No.: NCGNE
8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes ® 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: 2 0 9 5
10) Provide a brief description of the types of industrial activities and products produced at this facility:
Facility roasts, packages, and ships coffee. Waste includes chaff from roasted coffee beans. _
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:
35-3g0l�,
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NCGNEOOOO 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 ® No ❑ NIA
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 ❑ NIA
c. Materials or products from past industrial activity
❑ Yes
® No
❑ NIA
d. Material handling equipment (except adequately maintained vehicles)
❑ Yes
® No
❑ NIA
e. Materials or products during loading/unloading or transporting activities
❑ Yes
® No
❑ NIA
f. Materials or products stored outdoors (except final products intended for outside ❑ Yes ® No ❑ NIA
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 ❑ NIA
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes ® No ❑ NIA
the discharger
i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters]) ❑ Yes IN No ❑ NIA
j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes ® No ❑ NIA
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes ® No ❑ NIA
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 IN No ❑ N/A
(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 ® No ❑ N/A
stored outside, has the facility had any releases in the past three (3) years?
13) Above Ground Storage Tanks (ASTs): If you answer "No" to any of the following items, you are not
eligible for the no exposure exclusion.
a. Are exterior ASTs or piping free of rust, damaged or weathered coating, pits, or ❑ Yes ❑ No ® 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 IN N/A
cracks, holes, or evidence of leaks, and are drain valves maintained locked shut?
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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 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.
❑ Yes ❑ No ® NIA
❑ Yes ❑ No ® NIA
❑ Yes ❑ No ® NIA
❑ Yes [:No ® NIA
❑ Yes ❑ No ® NIA
❑ Yes ® No ❑ NIA
❑ Yes ® No ❑ NIA
❑Yes ®No ❑NIA
`Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require
secondary containment. However, some exceptions may be made for de minimis amounts of certain substances,
and/or other qualifiers, as described in the exemptions from reporting requirements of Title III SARA 313 in 40 CFR
§372.38.
""Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require
secondary containment. However, some exceptions may be made for amounts less than the Reportable Quantities
of the hazardous substances listed in 40 CFR §117.3.
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NCGNEOOOO 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 ❑ NIA
b. Does your facility have coal piles on site?
❑ Yes IN No ❑ NIA
c. Does your facility store other fuel sources outside in piles, such as wood chips,
❑ Yes ® No ❑ NIA
sawdust, etc.?
d. Does your facility have air emissions associated with its industrial activity (e.g.,
IN Yes ❑ No ❑ NIA
degreasing operations, plating, painting and metal finishing)? If so, describe the
industrial activity: Roasting Coffee and Dust Handling/Chaff Collection from Coffee handling
e. If you answered yes to d., are those emissions permitted by an Air Quality Permit?
❑ Yes ❑ No ❑ NIA
Please specify: Air Permit No.10359R01
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:
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NCGNE0000 No Exposure Certification
17) Certification:
certify under penalty of law that I have read and understand the eligibility requirements for claiming a condition of "no
exposure" and obtaining an exclusion from NPDES stormwater permitting.
I certify under penalty of law that there are no discharges of stormwater contaminated by exposure to industrial activities
or materials from the industrial facility or site identified in this document (except as allowed under 40 CFR 122.26(g)(2)).
I understand that I am obligated to submit a no exposure certification form once every five (5) years to the North Carolina
Division of Water Quality and, if requested, to the operator of the local municipal separate storm sewer system (MS4) into
which the facility discharges (where applicable). I understand that I must allow the North Carolina Division of Water
Quality, or MS4 operator where the discharge is into the local MS4, to perform inspections to confirm the condition of no
exposure and to make such inspection reports publicly available upon request.
In the event that the site no longer qualifies for a No Exposure Exclusion, I understand that I must obtain coverage under
an NPDES permit prior to any point source discharge of stormwater from the facility. Additionally, I certify under penalty of
law that this document and all attachments were prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on my
inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the
information, the information submitted is to the best of my knowledge and belief true, accurate and complete. I am aware
that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for
knowing violations.
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 Na of Person Signing: "Lofts�1Lr
Title: Ua o % 0 R cry fib )
t All
(Signature of
(Date Signed)
Please note: This application for the No Exposure Exclusion is subject to approval by the
NCDENR Regional Office prior to issuance. The Regional Office may inspect your facility for
compliance with no exposure conditions prior to that approval. The Regional Office may also
inspect your facility at any time in the future for compliance with the No Exposure Exclusion.
North Carolina General Statute 143-215.6 B(i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan, or other
document filed or required to be maintained under this Article or a rule implementing this Article; or who knowingly makes a false
statement of a material fact in a rulemaking proceeding or contested case under this Article; or who falsifies, tampers with, or knowingly
renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
[Environmental Management] Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine
not to exceed ten thousand dollars ($10.000).
There is currently no fee for a No Exposure Exclusion.
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NCGNE0000 No Exposure Certification
Final Checklist
This application should include the following items:
® This completed application and all supporting documentation.
® A map with the location of the facility clearly marked.
❑ If this is a renewal, indicated current NCGNE number in Question 7.
❑ 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 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]
Page 7 of 7
SWU-NE-021309 Last revised 6124/14

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