NCGNE1334_COMPLETE FILE - HISTORICAL_20190327

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCGNE 3 3`7I
DOC TYPE
XHISTORICAL FILE
DOC DATE
❑ ! `)-
YYWMMDD

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v
DOC TYPE
❑ HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑
YYYYM M DD

�a
Energy, Mineral
and Land Resources
ENVIRONMENTAL QUALITY
March 27, 2019
Sonoco Products
Attention: David Tumey, Owner
1214 Highland Avenue North East
Hickory, North Carolina 28601
Subject: No -Exposure Certification NCGNEl334
Sonoco Products
Catawba County
Dear Mr. Tumey:
ROY COOPER
Governor
MICHAEL S. REGAN
Secrerary
S. DANIEL SMITH
Interim Director
The Division of Energy, Mineral and Land Resources (DEMLR) has reviewed your submittal of the
No -Exposure Certification form 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 13,
2019, the Division is granting your conditional exclusion from. permitting as provided for under 40
C)~R 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 the 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 the following web page for the Division of Energy, Mineral and Land Resources Stormwater
Program:
http://portal.ncden.r.org/web/ir/npdes-stormwater
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.
®!
State of North Carolina I Environmental Quality I Energy, Mineral and Land Resources
Mooresville Regional Office € 610 East Center Ave Ste 301 1 Mooresville, NC 28115
704 663 1699 T

Sunoco Products.
NCGNE1334
March 27, 2019
Page 2 of 2
If you have any questions or need further information, please contact Christopher Graybeal at (704)
663-1699, or at [e-mail].
Sincerely;
�.e-- 5. lam_
Zahid S. Khan, CPM, CPESC, CPSWQ
Regional Engineer
Land Quality Section
CG/CS
Enclosure: Inspection Report
cc: Annette Lucas, Stormwater Permitting Program, No- Exposure Files NCGNE1334

Compliance Inspection Report
Permit: NCGNE1334 Effective: Expiration: Owner. Sonoco Products
SOC: Effective: Expiration: Facility: Sonoco Products
County: Catawba 12U Highland Ave
Region: Mooresville
Hickory NC 28601
Contact Person: David Tumey Title: Phone: [phone]
Directions to Facility:
40 West. Right on Lenoir Ryhne Blvd Exit 125 go 1.5 mile to Highland Ave. turn right - 0.5 mile - Sonoco on right.
System Classifications:
Primary ORC: CertNication: Phone:
Secondary ORC(sj:
On -Site Representathre(s):
Related Permits:
Inspection Date: 03/1312019 Entry Time: 09:30AM Exit Time: 10:30AM
Primary Inspector: Christopher Graybeal Phone: [phone]
Secondary Inspector($):
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)
Page 1 of I

Permit NCGNE1334 Owner - Facility: Sonoco Products
Inspection Date: 0311312019 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
This was a no exposure inspection. Based on the site conditions I recomend that no exposure be granted.
Page 2 ofsk

Environmental
Quality
Division of Energy, Mineral and Land Resources
Land Quality Section
National Pollutant Discharge Elimination System
NO EXPOSURE CERTIFICATION for Exclusion
NCGNE0000
FOR AGENCY USE ONLY
Date Received
Year
Da
20tot
1OZ
Z4
Cenirlca[C OC COYiYa C
iGt1 fo..�
FEB 2 6 2013
National Pollutant Discharge Elimination System application for exclusion from a StofnwtLer�Potaped
on NO EXPOSURE: Sl'IJPt��NATrR Pc--Rr I i i €NG
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, 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).
If approved, your conditional No Exposure Exclusion has no expiration date
BUT MUST BE self re -certified at least annual.
Please look for information about re -certification under the No Exposure section on this page:
htt s:i/de .nc_ ov/about/divisions/ener -mineral-land-resourceslener -mineral-land- ermits/storrnwater-
For questions, please contact the'DEMLR Regional Office for your area. (See page 6) 71
(Please print or type)
1) Mailing address of owner/operator (address to which all certification correspondence will be mailed):
Name
Contact / 1 rat v; e(
Street Address 12-H 41Ck1oLj
City ffbc ko L, StateAJL ZIP Code
Telephone No. $�8 3L2- y Fax; �2.
Page 1 of 7
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NCGNE0000 No Exposure Certification
tE
Location of facility producing discharge:
Facility Name 017 oro
Facility Contact Yid
Street Address ! V. / A It j2!
City r Ca.
County
Telephone No.
3) Physical location information:
t-ax:
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). 40 R,4i�_f an/ (zjR c M*1
CO IV,. t1h �C -%vrrt_ IZ<ia1�f - yin L�i- t�L S9roC-O. Ov% �yr� &1<-17
(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? 0 Yes 1i0
5) Is this a Federal facility? 17 Yes ZV No
$) Latitude 3 73933s Longitude —gFI. 31YI O (deg., min., seconds)
7) This NPDES No Exposure Exclusion application applies to which of the following:
G New or Proposed Facility Date operation is to begin
l�( . Existing Date operation began + I t y s
in Renewal of existing No Exposure Certification Certification No.: NCGNE
8) Was this facility or site ever covered under an NPDES Stormwater Permit? D Yes YNo
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 ~1 6
10) Provide a T
brief description of the types of industrial activities and products produced at this facility.
.n7 RAV) �G Y r-93t�' I V rl l "Ta D2 NSed of /`C E f4? r coot /ram
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
;(No
0 Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
Page 2 of 7
SWU-NCGNE Last revised 912812016

NCGNE0000 No Exposure Certification
Exraosure 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 ahawer "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 0 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 C NIA
c. Materials or products from past industrial activity
13 Yes
No 13 NIA
d. Material handling equipment (except adequately maintained vehicles)
© Yes
# No El NIA
e. Materials or products during loading/unloading or transporting activities
13 Yes
0 No o NIA
f. Materials or products stored outdoors (except final products intended for outside 13 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, iQ Yes 1ANo C NIA
tanks, and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained ❑ Yes q No In NIA
by the discharger I
i. Waste material (except waste in covered, non -leaking containers [e.g., 13 Yes IANo 13 NIA
dumpsters))
j. Application or disposal of process wastewater (unless otherwise permitted) G Yes I No 13 NIA
k. Particulate matter or visible deposits of residuals from roof statics and/or vents 13 Yes No ❑ NIA
not 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 p 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 it No CI NIA
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 13 Yes IM No JNIA
deterioration, or evidence of leaks?
b. is secondary containment provided for all exterior ASTs? If so, is it free of any ❑ Yes ❑ No tNIA
cracks, holes, or evidence of leaks, and are drain valves maintained locked
shut?
14) Secondary Containment: If you answer "No" to any of the following items, you are not eligible for the
no exposure exclusion.
Page 3 of 7
SWU-NCGNE
1�
Last revised 9/2812016

NCGNE0000 No Exposure Certification
a. Is secondary containment provided for single above ground storage containers 13 Yes El No NIA
(inoiuding drums, borrolc, oto.) with a capacity of more than 660-gallons?
b. Is secondary containment provided for above ground storage containers stored 0 Yes in No J 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 M Yes o No NIA
Amendments and keauthorization Act (SARA) water ray chemicals"?
d. Is secondary containment provided for hazardous substances" designated in p Yes p No NIA
40 CFR §116?
e. Are release valves on all secondary containment structures locked? © Yes n No NIA
IS) Hazardous Waste:
a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? DYes 1� No p NIA
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous © Yes l No CJ NIA
waste generated.per month) of hazardous waste?
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste G Yes 1, No 13 NIA
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 I 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 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.
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.
Page 4 of 7
SWU-NCGNE Last revised 9/28/2016

NCGNE0000 No Exposure Certification
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.?
d. Does your facility have air emissions associated with its industrial activity (e.g.,
degreasing operations, plating, painting and metal finishing)? If so, describe the
industrial activity:
e. If you answered yes to d., are those emissions permitted by an Air Quality
Permit? Please specify:
f. Please list any other environmental program permits (federal, state, etc.) not
specified earlier in this application (such as Hazardous Waste Permits, etc.):
Permit: _ Program:
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
,Yes
In No
© NIA
p Yes
,No
® NIA
El Yes
11 No
I© N/A
©Yes IftNo Cl NIA
10 Yes o No E NIA
Page S of 7
5WU-NCGNE last revised 912812016

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 maintain no exposure conditions and complete a Self-Regertifiggltion form at least once
each year, and if requested, provide this certification to the operator of the local municipal separate storm sewer system
(M54) into which the facility discharges (where applicable). I understand that I must allow the North Carolina Division of
Energy, Mineral, and Land Resources, 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, l understand I
must keep a copy of annual re -certifications on file at the facility.
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: i 1R Ind ! V M Fes?
Title: G Jh i' m a r
&AM'd 2mein4l - - -
(Signature of Applicant) 4r (Date Signed)
Please note: This application for the No Exposure Exclusion is subject to approval by the NCDEQ
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 143-216.6 B(i) provides that:
Any person who knowingly makes ary 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 thls Article shall be guilty of a Class 2 misdemeanor which may include a fine
not to exceed ten thousand dollars ($10,000).
There is currently no fee for a No Exposure Exclusion.
Page 6 of 7
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NCGNEOOOO 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.
p If the site currently has an NPDES Stormwater Permit, be sure to indicate the permit number in Question 8.
Mail the entire package to:
DEMLR - Stormwater Program
Dept. of Environmental Quality
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 Recilonai Office Contact Informatlon:
Asheville Office ......
[phone]
Fayetteville Office ...
[phone]
Mooresville Office_
[phone]
Raleigh Office ........
[phone]
Washington Office ...(252)
946-6481
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office_.. . ...
[phone]
Page 7of7
SWU-NCGNE Last revised 912812016

2/22/2019
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Permit: NCGNE1334 Effective:
SOC: Effective:
County: Catawba
Region: Mooresville
Contact Person: David Tumey
Compliance Inspection Report
Expiration: Owner : Sonoco Products
Expiration: Facility: Sonoco Products
1214 Highland Ave
Title:
Hiclwry NC 28601
Phone: [phone]
Directions to Facility:
40 West. Right on Lenoir Ryhne Blvd Exit 125 go 1.5 mile to Highland Ave. turn right - 0.5 mile - Sonoco on right.
System Ciassifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 03/13/2019 Entry Time: 09:30AM Exit Time: 10:30AM
Primary Inspector: Christopher Graybeal Phone. [phone]
Secondary Inspector(s):
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)
Page 1 of 3

permit: NCGNE1334 Owner - Facility: Sonoco Products
Inspection pate: 03113/2019 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
This was a no exposure inspection. Based on the site conditions I recomend that no exposure be granted.
Page 2 of 3

s
Environmental
Quality
Division of Energy, Mineral and Land Resources
Land Quality Section
National Pollutant Discharge Elimination System
NO EXPOSURE CERTIFICATION for Exclusion
NCGNEaooa
kZ6-&Vr:��Lf
FOR
Year
WVZ-Z&
Zpl�
Certificate oE'Covcrage
RFff:1Vr7r,) A+l"
FEB 2 6 2013 , I_ f
National Pollutant Discharge Elimination System application for exclusion from a Storv�r-e1rIP�FmLu�ed
on NO EXPOSURE: STORIAWATER PERT ill i ING
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, 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 922.26(g).
If approved, your conditional No Exposure Exclusion has no expiration date
BUT MUST BE self re -certified at least annually.
Please look for information about re -certification under the No Exposure section on this page:
httos:/Idea. nc.cov/about/d ivisions/enerov-m ineral-land-resources/enerav-mineral-land-perm itslstormwater-
permitslnodes-industrial-sw
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 mailed):
Name Pr1_i44Z*
Contact
Street Address
City
Telephone No,
Z 14 1-k r k
Ztf
State_ ZIP Code
Fax: 21 b 3 �z
b)
Page 1 of 7
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NCGNEOOOO No Exposure Certification
2) Location of facility producing discharge:
Facility Name _ So r7 o CIO
Facility Contact �Yrd y s
Street Address /2 r (-1 _
City t &v,
County w
Telephone No.
3) Physical location information:
State ZIP Code
Fax:
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). R wt ad [ �.�c, : l 7A,-, +3i q P.� a-r
tf/i �
(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?0 Yes 900
5) Is this a Federal facility? © Yes y No
6) Latitude 35 73933s" Longitude —Y4 31YIVO (deg., min., seconds)
7) This NPDES No Exposure Exclusion application applies to which of the following:
in New or Proposed Facility Date operation is to begin
IA Existing Date operation began L141
© Renewal of existing No Exposure Certification Certification No.: NCGNE
8) Was this facility or site ever covered under an NPDES Stormwater Permit? 0 Yes YNo
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 � -7 6
10) Provide a brief description of the types of industrial activities and products produced at this facility:
4/ j T"
.4 : W ✓ 1'fA , iL l
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
of No
0 Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
Page 2 of 7
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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 E3 Yes 4No © 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
[3 Yes
No
El NIA
c. Materials or products from past industrial activity
0 Yes
No
E3 NIA
d. Material handling equipment (except adequately maintained vehicles)
© Yes
t�l No
D NIA
e. Materials or products during loading/unloading or transporting activities
© Yes
No
E3 NIA
f. Materials or products stored outdoors (except final products intended for outside
0 Yes
No
13 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,
13 Yes
1ANo
G NIA
tanks, and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained
© Yes
I$ No
0 NIA
by the discharger
i. Waste material (except waste in covered, non -leaking containers [e.g.,
E3 Yes
IANo
0 NIA
dumpsters])
j. Application or disposal of process wastewater (unless otherwise permitted)
© Yes
0 No
0 NIA
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents 0 Yes 0 No 0 NIA
not 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 0 No p NIA
(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 INo ❑ NIA
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 E3 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 0 No N/A
cracks, holes, or evidence of leaks, and are drain valves maintained locked
shut?
14) Secondary Containment: If you answer "No" to any of the following items, you are not eligible for the
no exposure exclusion.
Page 3 of 7
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NCGNE0000 No Exposure Certification
a. Is secondary containment provided for single above ground storage containers ❑ Yes 0 No NIA
(including drums, barrels, etc.) with a capacity of more than 660-gallons?
b. Is secondary containment provided for above ground storage containers stored E3 Yes Ip 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 0 No NIA
Amendments and Reauthorization Act (SARA) water priority chemicals"?
d. Is secondary containment provided for hazardous substances— designated in ❑ Yes p No T� NIA
40 CFR §116?
e. Are release valves on all secondary containment structures locked? a Yes in No NIA
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:
waste:
Type(s) of
How is material stored:
Where is material stored:
How many disposal shipments per year:
Name of transport / disposal
vendor:
Vendor address:
Footnotes to Questions 14) c. & d.
❑ Yes
No
p NIA
© Yes
>� No
Ell NIA
G Yes
1, 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.
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.
Page 4 of 7
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NCGNE0000 No Exposure Certification
a. Does your facility store used, recycled, or otherwise reclaimed pallets outside? *Yes El No © NIA
b. Does your facility have coal piles on site?
p Yes No 0 NIA
c. Does your facility store other fuel sources outside in piles, such as wood chips,
El Yes 1P No O NIA
sawdust, etc.?
d. Does your facility have air emissions associated with its industrial activity (e.g.,
® Yes *LNo 0 NIA
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
In Yes © No 0 NIA
Permit? Please specify:
f. Please list any other environmental program permits (federal, state, etc.) not
specified earlier in this application (such as Hazardous Waste Permits, etc.):
Permit: Program. -
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
Page 5 of 7
SWv-NCGNE Last revised 9/28/2016

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 maintain no exposure conditions and complete a Self -Recertification form at least once
each year, and if requested, provide this certification 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
Energy, Mineral, and Land Resources, 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. I understand
must keep a copy of annual re -certifications on file at the facility.
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: r IGyiI C 1 d M__ C 1
Title: at, rviG i
Z Z7i i
(Signature of Applicant) er (Date Signed)
Please note: This application for the No Exposure Exclusion is subject to approval by the NCDEQ
Regional Office prior to issuance. The Regional Office may inspect your facility for compliance
with no exposure conditions prior to that approval. The Regional Office may also inspect your
facility at any time in the future for compliance with the No Exposure Exclusion.
North Carolina General Statute 143-215.6 B(i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan, or other
document filed or required to be maintained under this Article or a rule implementing this Article; or who knowingly makes a false
statement of a material fact in a rulemaking proceeding or contested case under this Article; or who falsifies, tampers with, or knowingly
renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
[Environmental Management] Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine
not to exceed ten thousand dollars ($10,000).
There is currently no fee for a No Exposure Exclusion.
Page 6 of 7
SWU-NCGNE Last revised 912812016

r
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.
El If the site currently has an NPDES Stormwater Permit, be sure to indicate the permit number in Question 8.
Mail the entire package to:
DEMLR - Stormwater Program
Dept. of Environmental Quality
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 ...(252)
946-6481
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........(919)
707-9220
Page 7 of 7
SWU-NCGNE Last revised 9/28/2016

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