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HomeMy WebLinkAboutNCGNE1334_COMPLETE FILE - HISTORICAL_20190327STORMWATER 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 christopher.graybeal@ncdenr.gov. 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: 828-322-8844 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: 704-663-1699 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 SWU-NCGNE Last revised 9/28/2016 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 SWU-NCGNE Last revised 9/28/2016 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 ...... (828) 296-4500 Fayetteville Office ... (910) 433-3300 Mooresville Office_ (704) 663-1699 Raleigh Office ........ (919) 791-4200 Washington Office ...(252) 946-6481 Wilmington Office ... (910) 796-7215 Winston-Salem ...... (336) 776-9800 Central Office_.. . ... (919) 707-9220 Page 7of7 SWU-NCGNE Last revised 912812016 2/22/2019 Hickory - Googfe Maps oogle MapS Hickory [ + a1pRTP LAY ma's h r <,>•r t V„ w+ I _� v f �j ' � , '�=+t ie ,' �.• � z � >p%.� -t,;r� - . nia ;,�„�rsra rFe»�i z.. � .., - s r � 1 h� °� d , ra ,fix - ` ' ' 4;, ` _ E : "��i6.�w3mis - �� g. �`� d•a. - yG, i w r �. i �. . . , ' �CIO �, �qq 1 _ ,�i x ; � E v .w ; � C t►>•.+ v� ^�;=.�C} � � . �' r � � -iE e „�� ;. 0EF 1 s— f 1GOa -W a. r L 3 3 �rt� .�: n �.:a:i:n.raEa ._�.,....a"t 'ti rt. �Ir��*-` `.` ,. +�.,. .;" S° �-e.r •:. ,. .Fr'yai.,.».::E.:..ie..`:� Map data 02019 Google 2000 ft r https://www.gGogle.com/maps/place/Hickory,+NC1@35.7422315,-81.3494651,14zidata=!r-m5!3m4!1 sOx88512fd236gd4903:Ox85da1fb0049334a3!6m2!3d35,7344538!4d-81.3444573 113 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: 828-322-8844 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. 704-663-1699 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 SWU-NCGNI- Last revised 9/28/2016 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 SWU-NCGNE Last revised 9128/2016 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 SWU-NCGNE Last revised 9/28/2016 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 SWU-NCGNE Last revised 9/28/2016 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 ...... (828) 296-4500 Fayetteville Office ... (910) 433-3300 Mooresville Office ... (704) 663-1699 Raleigh Office ........ (919) 791-4200 Washington Office ...(252) 946-6481 Wilmington Office ... (910) 796-7215 Winston-Salem ...... 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