NCGNE1068_COMPLETE FILE - HISTORICAL_20180410

PERMIT NO.
DOC TYPE
DOC DATE
STORMWATER DIVISION CODING SHEET
NCG PERMITS
NCGNEjrl6 )0(-� �
"ISTORICAL FILE
, o i� D�I J
YYYYMMDD

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO. /V CCU
DOC TYPE
DOC DATE
❑ HISTORICAL FILE
❑ MONITORING REPORTS
YYYYMMDD

}1dire, NI�-4I9 *-
Energy, Mineral
and Land Resources
ENVIRONMENTAL QUALITY
April 10, 2018
Providencia, USA, dba, Berry Global Plastics
Attention: Tyler Robinson, EHS Lead
200 Deer Ridge Drive
Statesville, North Carolina 28625
Subject: No Exposure Certification NCGNE1068
Berry Global Statesville Plant
Iredell County
Dear Mr. Robinson:
ROY COOPER
Govemor
MICHAEL S. REGAN
Secretary
WILLIAM E. (TOBY) VINSON JR.
Interim Director
The Division of Energy, Mineral and Land Resources (DEMLR) has reviewed your submittal of the No Exposure
Certification for Exclusion from NPDES Stormwater Permitting form. Based on your submittal and signed certification of
no exposure at the above referenced facility as well as observations made during a site visit conducted by Mooresville
Regional Office staff on March 1, 2018 and pictures emailed on April 6, 2018, 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 quaWy for the No Exposure
Certification, 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 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 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.
If you have any questions or need further information, please contact Mr. James Moore at [phone].
Sincerely,
;�� s.. f—
Zahid Khan, CPM, CPESC, CPSWQ
Regional Engineer
Enclosure
cc: MRO — DEMLR, Stormwater Files (w/o enclosure)
Raleigh Stormwater permitting Program, No Exposure Files (w/o enclosure)
State of North Carolina J Environmental Quality I Energy, Mineral and Land Resources
Mooresville Regional Office 1 616 East Center Avenue I Mooresville, NC 28115
704-663-1699

Compliance Inspection Report
Permit: NCGNE1068 Effective: Expiration: owner: Providencia USA Inc
SOC: Effective: Expiration: Facility: Providencia USA, Inc.
County: Iredell 200 Deer Ridge Dr
Region: Mooresville
Statesville NC 28625
Contact Person: Rebecca Israel Title: Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On Site Representativels):
,Related Permits:
Inspection Date: 03/01/2018
Primary Inspector: James D Moore
Secondary Inspectorls):
Certification:
Phone:
Entry Time: 12:30PM Exit Time: 01:15PM
Phone:
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Stormwater Discharge, No Exposure Certificate
Facility Status: Compliant F1 Not Compliant
Question Areas:
Miscellaneous Questions
(See attachment summary)
Page: 1

permit: NCGNE1060 Owner - Facility: Providencia USA Inc
Inspection Date: 03/01/2018 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
The inspection was a follow up regarding a reinspection request for no exposure. Based on the inspection, I recommend that
no exposure be granted after they complete the construction of the pallet 1 wooden crate storage shelter.
Page: 2

Moore, James
From: [e-mail]
Sent: Friday, April 06, 2018 1:37 PM
To: Moore, James
Subject: Fw: [External] Statesville Berry Global- Storm Water No Exposure Certification Request
Attachments: IMG_5900.JPG; IMG_5898.JPG
CAUTION: External email. Do not click links or open attachments unless verified. Send all suspicious email as an
attachment to Report Spam.<mailto:[e-mail]>
----- Forwarded by Tyler Robinson/MONC/Berry Plastics on 04/06/2018 01:36 PM
From: Tyler Robinson/MONC/Berry Plastics
To: "Moore, James" <[e-mail]>
Cc:' "[e-mail]"
<[e-mail]>,
"Russell [e-mail]"
<[e-mail]>, "Khan,.Zahid"
<[e-mail]> -
Date: 03/26/2018 09:58 AM
Subject: RE: [External] Statesville Berry Global- Storm Water No
Exposure Certification Request
Mr Moore,
Per your recommendations, the Berry Global Statesville site has installed a structure in our current wooden pallet -
storage area. The structure is 26'x20', and will allow us to store all of our wooden pallets and boxes in a covered area as
they are being staged for disposal or recycle. Please let me know if you need additional photos, or exact specifications of
the structure we installed.
Thank you,
Have a SAFE Day!
Tyler Robinson MESH
EHS Lead- Statesville
Berry Global
200 Deer Ridge Drive
Statesville, NC 28625
T [phone]
M [phone]
[e-mail]
www.berryglobal.com
1

From: "Moore, James" <[e-mail]>
To: "[e-mail]"
<[e-mail]>, "Khan, Zahid"
<[e-mail]>
Cc: "[e-mail]"
<RussellLowery@ berryglobal.com>,
"[e-mail]"
<[e-mail]>
Date: 03/02/2018 11:43 AM
Subject: RE: [External] Statesville Berry Global- Storm Water No
Exposure Certification Request
Thanks for the email. Based on my inspection yesterday, the site is eligible for no exposure after the new structure for
outside storage of pallets/crates is constructed. Please email pictures when it is completed and I will send you the no
exposure letter.
James Moore MRO-LQ
-----Original Message -----
From: [e-mail] [mailto:[e-mail]]
Sent: Thursday, March 01, 2018 4:30 PM
To: Moore, James <[e-mail]>
Cc: [e-mail]; [e-mail]
Subject: [External] Statesville Berry Global- Storm Water No Exposure Certification Request
CAUTION: External email. Do not click links or open attachments unless verified. Send all suspicious email as an
attachment to Report Spam.< mailto:[e-mail]>
Mr Moore.
Following your inspection of our site this afternoon, Berry Global Statesville has committed to installing a covered area
for the exterior storage of wooden pallets. The proposed structure will be WxW and located in the current pallet
storage area. It will be designed to be large enough to accommodate all of our pallet storage and any wooden boxes
that may be temporarily staged outside prior to disposal. Our current time to completion for this project is 4-5 weeks
(based on information received today from the local company that has been contracted to install the structure).
Please let me know if you need any additional information. I will be sure to contact you once the structure is in place.
Thank you,
Tyler Robinson MESH
EHS Lead- Statesville
Berry Global
200 Deer Ridge Drive
Statesville, NC 28625

T [phone]
M [phone]
[e-mail]
www.berryglobal.com
Berry Plastics is now Berry Global. Our email addresses have changed from @berryplastics.com to @berryglobal.com,
Please update your contact information,
This E-mail (including attachments) is confidential and the property of Berry Global, Inc. and its subsidiaries (collectively,
\"Berry\"). If you are not the intended recipient, reading, copying, disclosure or any action or forbearance based on the
E-mail is prohibited. Berry retains all copyright and other intellectual property rights and objects to misuse. IF YOU HAVE
RECEIVED THIS E-MAIL IN ERROR, IMMEDIATELY CONTACT THE SENDER TO SO ADVISE OF THE ERROR AND
PERMANENTLY DELETE THIS E-MAIL.

�- IL
■

AMM ''. f -� I

Ar X_ WA
CDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Providencia, USA, Inc.
Attention: Rebecca Israel
200 Deer Ridge Drive
Statesville, North Carolina 28625
Dear Ms. Israel: .
Donald R. van der Vaart
Secretary
June 22, 2015
Subject: No -Exposure Certification
NCGNE 1068
Providencia, USA, Inc.
200 Deer Ridge Drive
Statesville, North.Carolina 28625
The Division has reviewed your submittal of the No Exposure Certification for Exclusion from
NPDES Stormwater Permitting form, which we received on May 19, 2015. The Division is unable
to concur with your certification of No -Exposure.
Based on an inspection of your facility on June 17, 2015 Mooresville Regional Office staff found
that industrial activities or materials on your site either are exposed, or have the potential to be
exposed. DEMLR cannot grant your requested exemption from permit coverage when industrial
activities or materials are exposed or have the potential to be exposed. Please see the attached
pictures.
If you have any questions or need further information, please contact James Moore at (704) 663-
1699.
Sincerely,
Zahid S. Khan, CPM, CPESC, CPSWQ
Regional Engineer
Land Quality Section
Enclosure: Inspection Report
cc: Mr. Bradley Bennett, Stormwater Permitting Program, No- Exposure Files NCGNE1068
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] a Internet; http:llportal.ncdenr.org/web/Ir/land-quality
An Equal Opportunity / Affirmative Action Employer— 50% Recycled 110% Post Consumer Paper

Compliance Inspection Report
Permit: NCGNE1068 Effective: Expiration: Owner: Providencia USA Inc
SOC: Effective: Expiration: Facility: Providencia USA, Inc.
County: Iredell 200 Deer Ridge Dr
Region: Mooresville
Statesville NC 28625
Contact Person: Rebecca Israel Title: Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 06/17/2015
Primary Inspector: James D Moore
Secondary Inspector(s):
Certification:
Phone:
Entry Time: 03:OOPM Exit Time: 03:301PM
Phone:
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Stormwater Discharge, No Exposure Certificate
Facility Status: ❑ Compliant ® Not Compliant
Question Areas:
® Misceilaneous Questions
(See attachment summary)
Page: 1

Permit: NCGNE1068 Owner - Facility: Providencia USA Inc
Inspection Date: 06117/2015 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
The facility applied for No Exposure exculsion for stormwater. Based on a site inspection 06/17/15 we can not concur at
this time. Please see attached pictures indicating a potential resin release,an uncovered dumpster and a trash can under
transfer pipes.
Page: 2

0
.K
V #'
- e 1�'+y°��_�5�••a.1R c,Cf. �' � 1'j E-..r'.xr,:iL-I.S�..ti-
-�4'V'i'N'.".90'1—�Ilw.. r•..rJ�IMNgw•ryl�9W�I ., '�' 'T1.. .. LL.,�Y.M ��-�-��u.i_" •
w lot.. _1

. 0

Permit: NCGNE1068
SOC:
County: Iredell
Region: Mooresville
Compliance Inspection Report
Effective: Expiration: Owner: Providencia USA Inc
Effective: Expiration: Facility: Providencia USA, Inc,
200 Deer Ridge Dr
Contact Person: Rebecca Israel
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 03/01/2018
Primary Inspector: James D Moore
Secondary tnspector(s):
Statesville NC 28625
Title: Phone: [phone]
Certification: Phone:
Entry Time: 12:30PM Exit Time: 01;15PM
Phone:
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Stormwater Discharge, No Exposure Certificate
Facility Status: Compliant F1 Not Compliant
Question Areas:
Miscellaneous Questions
(See attachment summary)
Page: 1

permit: NCGNE1068 Owner - Facility; Providencia USA Inc
Inspection Date: 03101/2018 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
The inspection was a follow up regarding a reinspection request for no exposure. Based on the inspection, I recommend that
no exposure be granted after they complete the construction of the pallet ! wooden crate storage shelter.
4
Page: 2

Compliance Inspection Report
Permit NCGNE1068 Effective: Expiration: owner: Providencia USA Inc
SOC: Effective: Expiration: Facility: Providencia USA, Inc.
county: Iredell 200 Deer Ridge Dr
Region: Mooresville
Statesville NC 28626
Contact Person: Reba Israel Title, Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC: Certification:
Secondary ORC{s):
On -Site Roprosontativo(s):
Related Permits:
Inspection Date: 06MV2015
Primary Inspector. James D Moore
Secondary inspector(s):
Phone:
Entry Time: 03:00PM Exit Time: 03:30PM
Phone:
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Stormwater Discharge, No Exposure Certificate
Facility Status: ❑ Compliant Not Compliant
Question Areas:
Miscellaneous Questions
(See attachment summary)
-31v1It �� F-z- NC,
A rS-- 2 ! IS
Page: 1

Perrn[t NCGNE1068 Owner - Facility; Providencla USA Inc
Inspection Date: W1712015 Inspection Type: Compliance Evaluation Reason far Vialt; Routine
Inspection Summary:
The facility applied for No Exposure exculsion for stormwater. Based on a site inspection 06/17/15 we can not concur at
this time. Please sea attached pictures indicating a potential resin release,an uncovered dumpster and a trash can under
transfer pipes.
Page: 2

03

Ap
� 1
.y y`
vi_4
P
,
M
i
1
F
per,

Aqw a

,�:�..
;n„
�.
}
,
'��
i
..
-..
i k
� �

. r
_ Chalam Pakaia Engineering and Environmental Solutions
10017 Allyson Park Dr., Charlotte, NC 28277 Tei [phone], Fax: [phone]
May 6, 2015
Ms. Jennifer Jones, Environmental Engineer 11
NC DENR - Stormwater Permitting Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Re: Request for NPDES Stormwater No Exposure General Permit
Providencia USA, Inc.
200 Deer Ridge Dr.
Statesville, North Carolina 28625
CPEES Protect No. 1153-006
Dear Ms. Jones:
On behalf of Providencia USA, Inc., located at 200 Deer Ridge Dr., Statesville, Iredell County,
North Carolina, CP Engineering and Environmental Solutions (CPEES) is pleased to submit the
attached NCGNE0000 request to the State for a NPDES Stormwater General Permit - No
Exposure for the subject facility operations. The facility conducts their operation under the SIC
code 2297 (NAICS = 31323) — "Nonwoven Fabric Mills". Therefore, the applicable NPDES
Stormwater General Permit for this SIC code is NCG170000. However, Providencia USA, Inc. is
very diligent in controlling the exposure of facility oil/chemical storage drumshotes and
loading/unloading operations to stormwater. Thus, Providencia USA, Inc., had requested CPEES
to review the facility operations and assess the NPDES Stormwater General Permit Exemption
criteria and No Exposure Certification.
SITE REVIEW
On May 05, 2015, CPEES had conducted a site review for the facility operations exposed to
stormwater. During the facility review, the following areas were reviewed for the stormwater
exposure:
• . Oil and Chemical storage areas/tanks outside the plant building;
• Materials storage outside the plant operations;
• Loading and unloading docks;
• Roof discharges;
• Best Management Practices (BM -Ps) implemented at the site;
• General site erosion and sediment transport; and
• General leaks from the building.

Chalam Pakala Engineering and Environmental Solutions
10017 Allyson Park Dr., Charlotte, NC 28277 Tel [phone], Fax: [phone]
FINDINGS
Based on the site review, CPEES believes Providencia USA, Inc., had implemented several
BMPs controls to mitigate the exposure of oillchernical storage areas, transfer practices and
general operations from stormwater. Some of our observations include:
• Minimal amounts of oils and chemicals in 55 gal drums are received at the site and they
are being handled either manually or with a hand trolleys for keeping them inside the
plant building. These drums are always inside the building on a secondary containment
pallet;
• No aboveground storage tanks (AST) are present at the site;
• All,empty drums are kept inside the building;
• No underground storage tanks were observed at the site;
• A trash dumpster with a lid was observed at the facility;
• Three long dumpsters were observed at the facility and the purpose of these dumpsters is
to receive either waste cardboard cores or waste woven cloth. No oily or scrap
equipment is thrown into these dumpsters;
• No to minimal soil erosion was observed at the facility, and
• The overall facility yard appeared to be well maintained with no materials exposed to
stormwater.
NO EXPOSURE APPLICATION
CPEES has completed the State NCGNE0000 "No Exposure" application package to meet the
State requirements. The package includes the application, a Ste Location Map (Figure 1), an
Aerial View Map (Figure 2) and a Site Layout Map,
CONCLUSIONS AND RECOMMENDATIONS
Based on our site review and findings, CPEES believes that the subject facility should be
exempted from the NPDES Stormwater General Permit at the present time.
However, should the facility decides to change the operations in the future and could potentially
impact the stormwater, then the facility should apply for the NPDES Stormwater Permit at that
time to meet the NC DENR Division of Water Quality Requirements.
CLOSING
It is my pleasure to complete this important project for Providencia USA, Inc., and please call me
at 704-541-4042 should you have any questions on this permit exemption request.
Respectfully submitted,
CP Engineering and Environmental Solutions
(A Cost Effective Sohitron Provider for hlam factttring)
Chalam V. Pakala, P.E.
Managing Principal
%,0 1 C A t il,/i
4 SEAL p
.19807

NPDES -NO EXPOSURE EXEMPTION PERMIT APPLICATION
NCGNE0000

�566mit by Emai[, Is
Print Form
NCDENR
Fnvw�vw.v+ �ro Nmal. M��esn
Division of Water Quality / Surface Water Protection
National Pollutant Discharge Elimination System
NO EXPOSURE CERTIFICATION for Exclusion
NCGNEQ000
NO EXPOSURE CERTIFICATION
FOR AaUKCY USE ONLY
Data RecciYed
Y=
Month
Day
terdficateofCovurage
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 mach nery,-raw materials, lntermediate.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
storm water 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 CF'R 122.26(g).
Y
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 which all certification correspondence will be mailed):
Name PROVIDENCIA USA, INC
Contact Ms. REBECCA ISRAEL
Street Address 200 DEER RIDGE DR
City STATESVILL.E State NC ZIP Code 28625
Telephone No. 704 247-9850 Fax: [phone]
Email israe[[e-mail]
Page i of 7
SW U-NE-12Aug2010

NCGNEOOOO No Exposure Certification
2) Location of facility producing discharge:
Facility Name PROVIDENCIA USA, INC
Facility Contact MS. REBECCA ISRAEL
Facility Street Address 200 DEER RIDGE DR
City STATESVILLE State NC ZIP Code 28625
County IREDELL
Telephone No. 704 247-9850 Fax: [phone]
Email [e-mail]
3) Physical location inforrnatlon:
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). SEE ATTACHED USGS TOPO MAP
(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 a No
5) Is this a Federal facility? ❑ Yes © No
6) Latitude 35° 49' 8.97" E Longitude 80` 57' 18.15" 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
© Existing Date operation began December 2010
❑ Renewal of existing No Exposure Certification Certification No.: NCGNE
8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes CJ 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 Corte: F1 i1 F El
10) Provide a brief description of the types of industrial activities and products produced at this facility:
NON -WOVEN FABRIC MILLS
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:
Page 2 of 7
SW1l-NE-12Aug2010

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 El 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 El No
c. Materials or products from past industrial activity ® Yes [a No
d. Material handing equipment (except adequately maintained vehicles) f ] Yes pi No
e. Materials or products during loading/unloading or transporting activities ❑ Yes EI No
f. Materials or products stored outdoors (except final products intended for outside ® Yes p 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 m No --
and similar containers
In. Materials or products handled/stored on roads or railways owned or maintained by El Yes ED No
the discharger
L Waste material (except waste in covered, non -leaking containers [e.g., dumpsters]) . El Yes M No
j. Application or disposal of process wastewater (unless otherwise permitted) ID Yes lD 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
1. Empty containers that previously contained materials that are not properly stored Ej Yes fD 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 p Yes [Ell 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 B NIA
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? if so, is it free of any ❑ Yes 0 No 121 NIA
cracks, holes, or evidence of leaks, and are drain valves maintained locked shut?
Page 3 of 7
SW U-NE-12Aug2o1 C

NCGNEOOGO 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 ill 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:
❑ Yes El No © NIA
® Yes Ell No ED NIA
ID Yes El No ® NIA
©:Yes 0 No 0 NIA
® Yes E3 No ® NIA
a. Is this facility a Hazardous Waste Treatment, Storage, or [Disposal Facility? 10 Yes m No
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste ID Yes ta No
generated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste U Yes ® No
generated per month) of hazardous waste?
If you answered yes to questions b. or c., please provide the following information.
Type(s) of waste: NONE
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.
*Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require
secondary containment. However, some exceptions may he 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
§372.3&
"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 4of7
S W U-N E-12Aug20 t 0

NCGNEQ000 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?
El Yes ® No
b. Does your facility have coal piles on site?
ID Yes El No
c. Does your facility store other fuel sources outside in piles, such as wood chips,
tIIl Yes ® No
sawdust, etc.?
d. Does your facility have air emissions associated with its industrial activity (e.g.,
Yes Ia No
'degreasing operations, plating, painting and metal finishing)? It so, describe the
industrial activity: MINIMAL -AIR PERMIT EXEMPT
e. If you answered es to d., are those emissions permitted b an Air Quality Permit?
Y Y p Y Y
,
ED Yes ❑ No 0 NIA
Please specify: NONE
f. I lease 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: Prograrn:
Permit: Program:
Permit: Program:
Permit: Program:
Page b of 7
swu-Nt=-12Au92010

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.
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)).
understand that I am obligated to annually self_re-certify NoExposureand, 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 focal 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: CHRIS SCURON
Title: SENIOR PLANT DIRECTOR
(Signatulo 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 13(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
[Envirorunental Management] Comndssion implementing this Articlo 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 1
SWU-NE-12Aug2010

NGGNE0000 No Exposure Certification
Final Checklist
This application should include the following items:
to This completed application and all supporting documentation.
®. 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.
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 Off Ice 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
S W U-NE-12AU92010

FIGURES
FIGURE ] : SITE LOCATION MAP
FIGURE 2: SITE AERIAL MAP
FIGURE 3: SITE LAYOUT MAP

Map Name: STATESVILLE WEST Scale: 1 inch = 2,000 ft.
Print Date: 03/17/14 Map Center: 035049' 09.46" N, 080° 57' 17.39" W
� ` 1 / i Ir��z.==^ /'tip :F 1 i I,ifi � ! . ' � --•' � r �., p � _ �n
11
z 'r / r
i A r T 11� .1 E � _ l�q� vJ �ll•• � 1``,k��k�a k+ O
o/ �y-z 7P\ 41
o ' v ,ram j �, /•if.
Wh "atland Lane `btrrg,pf_ sea#ts_Creek R"
o r
,Mohr r o p
M
a" z MCo
rnsonCreek Co
It-
�P7..-�-• - y � \J� /�l ,". �=ice 1 - �'� ` -,'�
'� �, � i �• 8ee�hbr, okiLane
Z f eacock' ar,R ad -I 'PROM ENCIq�s
m 9rn •- . ' .�,� Lam„ `r � # , f; - .
o
V:� .. l ! Nall'D,riue
o r � ��' Kh -� dustrr ►Ve �! - d
to
ao cS 1 '- / �iM`.. �� y .Y • ,ice. m
v �
N
Declination !\6A .f o ✓ ��y r . , „r1�R G �.
1 li 1 � lyr -�?
R
' z
VA
o
ij
a7p�,ve M
Jf o
CAN 0.03° E 58' 00.00" W 080° 57' 30.00" W 080° 57' 00.00" W 080° 56' 36.00" W 080
MN 7.61 ° W
SCALE 1:24000 SITE LOCATION MAP
0 1000 2000 3000 4000 5000 6000 PROVIDENCIA
STATESVILLE, NC
FEET FIGURE 1 JOB NO. 1153-001

�I ♦Rr rrrw•.rwti....Mr.r-i..orr.
1 Y� • w.. rlw"�iw� w � �w �
s
OATA
a ��
, � ®..w.'re�rr��
....: �.rw•w�r
\ n,•�
•\
.~,y fir. ..�..
.�wr.w.n
tiw�tir.
wy�.rw..r.u�w YrJ
...-►•�•. •. \pal ma.
�r�ww
�•.'�: a.: ��..'Tr
wmw �q�
yaa .�,o..: enlsna.,er.�w
G pV[Aa.Y
r uuww
H
r
INN lwafm 0•.-Loll G�w•
CJal.1�+1.1
IG.L. WILSON
SLOINGCCM A y
PEAL Q",�"1S
ma
,Ina..ww s�aao-+xrn na
RlOaaaaW Y 11��IMJ1.
®Ca.aGlMn
Prnvidmcia USA. Inc.
D.- Rwp0K
S�NaLtOvY.
sTrx
LAYOUT I ZDNINCa
& E.C. PLAN

NCDENR
North Carolina Department of'Environment and Natural Resources .
Pat McCrory
Governor
Providencia, USA, Inc.
Attention: Rebecca Israel
200 Deer Ridge Drive
Statesville, North Carolina 28625
..Dear.Ms. Israel:_
Donald R. van der Vaart
Secretary
.Tune 22, 2015
Subject: No -Exposure Certification
NCGNE 1068
Providencia, USA, Inc.
200 Deer Ridge Drive
Statesville, North Carolina 28625
The Division has reviewed your §ubmittal of the No Exposure Certification for Exclusion from
NPDES Stormwater Permitting form, which we received on May 19, 2015. The Division is unable
to concur with your certification of No -Exposure.
Based on an inspection of your facility on June 17, 2015 Mooresville Regional Office staff found
that industrial activities or materials on your site either are exposed, or have the potential to be
exposed. DEMLR cannot grant your requested exemption from permit coverage when industrial
activities or materials are exposed or have the potential to be exposed. Please see the attached
pictures.
If you have any questions or need further information, please contact James Moore at (704) 663-
1699.
Sincerely,
Zahid S. Khan, CPM, CPESC, CPSWQ
Regional Engineer
Land Quality Section
Enclosure: Inspection Report
cc: Mr. Bradley Bennett, Stormwater Permitting Program, No- Exposure Files NCGNE1068
Division of Energy, Mineral, and Land Resources
Land Quality Section - Mooresville Regional Office
610 East Center Avenue, Suite 301, Mooresville, North Carolina 28115
Telephone: 7C4-663-16991 FAX: [phone] • Internet: http:flportal.ncdenr.org/web/iriland-quality
An Equal Opportunity J Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper