NCGNE0054_COMPLETE FILE - HISTORICAL_20100430

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCGNE
DOC TYPE
LR'HISTORICAL FILE
DOC DATE
o aol ooy f)o
YYYYMMDD

,w r
NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
April 30, 2010
JOSEPH PERRY
FACILITIES SUPERVISOR
CAREFUSION MANUFACTURING LLC
1515 IVAC WAY
CREEDMOOR NC 27522
Dear Mr. Perry:
Dee Freeman
Secretary
Subject: Name/Ownership Change
No Exposure Certification NCGNE0054
CareFusion Manufacturing, LLC
Formerly Alaris Medical Systems, Inc
1515 IVAC Way, Creedmoor, NC
Granville County
The Division has reviewed your submittal of the permit name/ownership change form for your No -Exposure
Certification, which we received on March 23, 2010. Division personnel have reviewed and approved your request to
change coverage under your Certificate of No -Exposure.
Please note that by our acceptance of your no exposure certification, you are obligated to maintain no exposure
conditions at your facility. If conditions change such that your facility can no longer qualify for a no -exposure
exclusion, you are obligated to immediately obtain NPDES permit coverage for your stormwater discharge.
Otherwise, the discharge becomes subject to enforcement as an un-permitted discharge. Your conditional no -exposure
exclusion expires on May 30, 2011. At that time you must -re -certify with the Division, or obtain NPDES permit
coverage for any stormwater discharges from your facility.
Your certification of no exposure 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.
Wetlands and Stormwater Branch
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone, 919-807-63001 FAX: 91 M07-64941 Customer Service: 1-877-623-6748
Internet www,ncwaterquatty.org
An Equal Opportunity 1AKmtatwe Action Employer
One
North Carolina
Naturally

No Exposure Certification NCGNE0054
If you have any questions or need further information, please contact the Stormwater Permitting Unit at (919) 807-
6300.
Sincerely,
/ "`
for Coleen H. Sullins
cc: Gentral File - ( Dw 62 SXr6ruxe-- S P(A
Raleigh Regional Office I v n ly)
Stonnwater Permitting Unit Files J

✓S
O�O� WA7F9oG Beverly Caves Perdue, d1lernor
7 Dec Freeman, Secretary
North Carolina Department or Environment and Natural Resources
O 'C
Coleen 11. Sullins, Director
Division of Water Quality
SURFACE,WATER PROTECTION SECTION•-
.. .., _
PERMIT NAME/OWNERSHIP..CHANGE FORM-'
Please enter the permit number for which the change is requested.
NPDES Permit (or) Certificate of Coverage
N I iD I S 10 12 6 8 2 4 N C G N I I O 0 5 4
Permit status prior to requested change.
a. Permit issued to (company name): Alaris Medical Systems Inc.
b. Person legally responsible for permit: Robert Suka
First MI Last
Sr Operations Manager
Tide
1515 IVAC Way
Permit Bolder Mailing Address
Creedmoor NC 27522
City State Zip
[phone] ( )
Phone Fax
c. Facility name (discharge): Alaris Medical Systems Inc.
d. Facility address: 1515 IVAC Way
Address
Creedmoor NC 27522
City State Zip
e. Facility contact person: Robert Suka [phone]
First / MI / Last Phone
Please provide the following for the requested change (revised permit).
a. Request for change is a result of: ® Change in ownership of the facility
® Name change of the facility or owner
If other please explain:
b. Permit issued to (company name):
c. Person legally responsible for permit:
d. Facility name (discharge):
e. Facility address:
F. Facility contact person:
CareFusion Manufacturing, LLC
First MI Last
Facilities Supervisor
'title
1515 IVAC Way
Pcrmit Bolder Mailing Address
Creedmoor NC 27522
City State Zip
(919) 528-53 14 Joseph. Perry(cbcarefusion.com
Phone I mail Address
CareFusion Manufacturing, LLC
1515 IVAC Way
Address
Creedmoor NC 27522
City State Zip
First MI Last
[phone] Joseph.Perry(a,)careftlsion.com
Phone E-mail Address
Revised 812008

PERMIT NAME/OWNERSHIP CHANGE FORM
' -'Page 2 of 2
IV. Permit contact information (if different from the person legally responsible for the permit)
Permit contact:
MI Last
Title
Mailing Address
City State Zip
( )
Phone E-mail Address
V. Will the permitted facility continue to conduct the same industrial activities conducted prior
to this ownership or name change?
® Yes
❑ No (please explain)
VI Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS
ARE INCOMPLETE OR MISSING:
❑ This completed application is required for both name change and/or ownership change
requests.
® Legal documentation of the transfer of ownership (such as relevant pages of a contract deed,
or a bill of sale) is required for an ownership change request. Articles of incorporation are
not sufficient for an ownership change.
.....................................................................................................................
The certifications below must be completed and signed by both the permit holder prior to the change, and
the new applicant in the case of an ownership change request. For a name change request, the signed
Applicant's Certification is sufficient.
PERMITTEE CERTIFICATION (Permit holder prior to ownership change):
I, i attest that this application for a name/ownership change has been reviewed and is accurate and
c replete to the best of my knowledge. I understand that if all required parts of this application are not
completed and that if all required supporting information is not included, this application package will be
returned as incomplete,
/ABC X /bMAJzto
ignature Date
APPLICANT CERTIFICATION
I, attest that this application for a name/ownership change has been reviewed and is accurate and
corhplete to the best of my knowledge. I understand that if all required parts of this application are not
completed and that if all required supporting information is not included, this application package will be
returned as incomplete.
Vr (Y Lie MA tL l O
Signature Date
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Division of Water Quality
Surface Water Protection Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Revised 712008

;r
EXECUTION COPY
40 � 4
SEPARATION AGREEMENT
BY AND BETWEEN
CARDINAL HEALTH, INC.
• AND
CAREFUSION CORPORATION
Dated July 22, 2009
1;
ERROR! NO PROPERTY NAME SUPPLIED.
i,
I
EXECUTION COPY
40 � 4
SEPARATION AGREEMENT
BY AND BETWEEN
CARDINAL HEALTH, INC.
• AND
CAREFUSION CORPORATION
Dated July 22, 2009
1;
ERROR! NO PROPERTY NAME SUPPLIED.
i,
I

® SEPARATION AGREEMENT
This SEPARATION AGREEMENT, dated as of July 22, 2009 (this
"Agreement"), is by and between Cardinal Health, Inc., an Ohio corporation ("Cardinal Health"),
and CareFusion Corporation, a Delaware corporation ("CareFusion"). Certain terms used in this
Agreement are defined in Section 1.1.
W ITNESSETH:
WHEREAS, the board of directors of Cardinal Health has determined that it is in
the best interests of Cardinal Health and its shareholders to create a new publicly traded
company which shall operate the CareFusion Business;
WHEREAS, CareFusion has been incorporated solely for these purposes and has
not engaged in activities except in preparation for its corporate reorganization and the
distribution of its stock;
WHEREAS, the board of directors of Cardinal Health and the board of directors
of CareFusion have approved the transfer of the CareFusion Assets to CareFusion and its
Subsidiaries and the assumption by CareFusion and certain of its Subsidiaries of the CareFusion
Liabilities, all as more fully described in this Agreement and the other Transaction Documents;
WHEREAS, the board of directors of Cardinal Health has further approved the
® distribution to the holders of the issued and outstanding common shares, without par value, of
Cardinal Health (the "Cardinal Health Common Shares") as of the close of business on the
Record Date, by means of a pro rata distribution, of issued and outstanding shares of the
common stock, par value one one -hundredth of one dollar ($0.01) per share, of CareFusion (the
"CareFusion Common Stock" ), on the basis of one-half (1/2) share of CareFusion Common
Stock for every one (1) Cardinal Health Common Share (the "Distribution");
WHEREAS, Cardinal Health and CareFusion have prepared, and CareFusion has
filed with the SEC, the Form 10, which includes the Information Statement, and which sets forth
disclosure concerning CareFusion and the Distribution;
WHEREAS, in connection with the Distribution, Cardinal Health has entered into
the Cardinal Health Credit Facility Amendment;
WHEREAS, for U.S. federal income tax purposes, certain steps of the
Reorganization and the Distribution are intended to qualify for tax-free treatment under Sections
332, 351, 355, 361(c), 368(a) and related provisions of the Code;
WHEREAS, Cardinal Health has received a private letter ruling from the IRS to
the effect that, among other things, (i) certain steps of the Reorganization and the Distribution,
taken together, qualify as a transaction (a) that is described in Sections 355(a) and 368(a)(1)(D)
of the Code, (b) in which the CareFusion Common Stock distributed is "qualified property"
under Section 361(c) of the Code and (c) in which the holders of Cardinal Health Common
Shares recognize no income or gain for U.S. federal income tax purposes under Section 355 of
the Code, (ii) the CareFusion Cash Distribution qualifies as money transferred to Cardinal Health
ERROR! NO PROPERTY NAME SUPPLIED.

® creditors under Section 361(b) of the Code and (iii) certain other steps of the Plan of
Reorganization qualify as transactions that are described in Sections 355(a) and 368(a)(1)(D) of
the Code (the "Private Letter Rulin¢");
WHEREAS, this Agreement is intended to be a "plan of reorganization" within
the meaning of Treas. Reg. 1.368-2(g); and
WHEREAS, it is appropriate and desirable to set forth the principal corporate
transactions required to effect the Reorganization and the Distribution and to set forth certain
other agreements that will, following the Distribution, govern certain matters relating to the
Reorganization and the Distribution and the relationship of Cardinal Health, CareFusion and
their respective Subsidiaries.
NOW, THEREFORE, in consideration of the premises and the representations,
warranties, covenants and agreements contained herein, and for other good and valuable
consideration, the receipt and sufficiency of which are hereby acknowledged, and intending to be
legally bound hereby, the parties hereby agree as follows:
ARTICLE 1
DEFINITIONS
1.1 Certain Definitions. For purposes of this Agreement, the following terns shall
have the meanings specified in this Section 1.1:
"Action' means any demand, action, claim, dispute, suit, countersuit, arbitration,
inquiry, subpoena, proceeding or investigation of any nature (whether criminal, civil, legislative,
administrative, regulatory, prosecutorial or otherwise) by or before any federal, state, local,
foreign or international Governmental Authority or any arbitration or mediation tribunal.
"Affiliate" (including, with a correlative meaning, "affiliated") means, when used
with respect to a specified Person, a Person that directly or indirectly, through one (1) or more
intermediaries, controls, is controlled by or is under common control with such specified Person.
For the purpose of this definition, "control' (including with correlative meanings, "controlled
by" and "under common control with"), when used with respect to any specified Person shall
mean the possession, directly or indirectly, of the power to direct or cause the direction of the
management and policies of such Person, whether through the ownership of voting securities or
other interests, by contract, agreement, obligation, indenture, instrument, lease, promise,
arrangement, release, warranty, commitment, undertaking or otherwise. It is expressly agreed
that, from and after the Effective Time and for purposes of this Agreement and the other
Transaction Documents, no member of the CareFusion Group shall be deemed to be an Affiliate
of any member of the Cardinal Health Group, and no member of the Cardinal Health Group shall
be deemed to be an Affiliate of any member of the CareFusion Group.
"Approvals or Notifications" means any consents, waivers, approvals, permits or
authorizations to be obtained from, notices, registrations or reports to be submitted to, or other
filings to be made with, any third Person, including any Governmental Authority.
ERROR: NO PROPER IN NAME SUPPLIED.

0 ARTICLE 11
THE REORGANIZATION
2.1 Transfer of Assets; Assumption of Liabilities.
(a) Prior to the Distribution, in accordance with the plan and structure set
forth on Schedule 2.1(a) (such plan and structure being referred to herein as the "Plan of
Reorganization") and to the extent not previously effected pursuant to the steps of the Plan of
Reorganization that have been completed prior to the date hereof:
(i) Cardinal Health shall, and shall cause its applicable Subsidiaries
to, assign, transfer, convey and deliver to CareFusion or certain of CareFusion's Subsidiaries
designated by CareFusion, and CareFusion or such Subsidiaries shall accept from Cardinal
Health and its applicable Subsidiaries, all of Cardinal Health's and such Subsidiaries' respective
direct or indirect right, title and interest in and to all CareFusion Assets;
(ii) subject to Section 2.5(c), CareFusion and certain of its Subsidiaries
designated by CareFusion shall accept, assume and agree faithfully to perform, discharge and
fulfill all the CareFusion Liabilities in accordance with their respective terns. CareFusion and
such Subsidiaries shall be responsible for all CareFusion Liabilities, regardless of when or
where such CareFusion Liabilities arose or arise, or whether the facts on which they are based
occurred prior to or subsequent to the Distribution Date, regardless of where or against whom
such CareFusion Liabilities are asserted or determined (including any CareFusion Liabilities
arising out of claims made by Cardinal Health's or CareFusion's respective directors, officers,
employees, agents, Subsidiaries or Affiliates against any member of the Cardinal Health Group
or the CareFusion Group) or whether asserted or determined prior to the date hereof, and, except
as set forth in Section 2.3(b)(vi), regardless of whether arising from or alleged to arise from
negligence, recklessness, violation of Law, fraud or misrepresentation by any member of the
Cardinal Health Group or the CareFusion Group, or any of their respective directors, officers,
employees, agents, Subsidiaries or Affiliates;
(iii) Cardinal Health shall cause its applicable Subsidiaries to assign,
transfer, convey and deliver to certain of its other Subsidiaries designated by Cardinal Health,
and such other Subsidiaries shall accept from such applicable Subsidiaries, such applicable
Subsidiaries' respective right, title and interest in and to any Excluded Assets specified by
Cardinal Health to be so assigned, transferred, conveyed and delivered; and
(iv) Cardinal Health and certain of its Subsidiaries designated by
Cardinal Health shall accept and assume from certain of its other Subsidiaries designated by
Cardinal Health and agree faithfully to perform, discharge and fulfill certain Excluded
Liabilities of such other Subsidiaries specified by Cardinal Health, and Cardinal Health and its
applicable Subsidiaries shall be responsible for all Excluded Liabilities, regardless of when or
where such Excluded Liabilities arose or arise, or whether the facts on which they are based
occurred prior to or subsequent to the Distribution Date, regardless of where or against whom
such Excluded Liabilities are asserted or determined (including any such Excluded Liabilities
• arising out of claims made by Cardinal Health's or CareFusion's respective directors, officers,
ERROR! NO PROPERTY NATIE SUPPLIED. 14

® employees, agents, Subsidiaries or Affiliates against any member of the Cardinal Health Group
or the CareFusion Group) or whether asserted or determined prior to the date hereof, and
regardless of whether arising from or alleged to arise from negligence, recklessness, violation of
Law, fraud or misrepresentation by any member of the Cardinal Health Group or the CareFusion
Group, or any of their respective directors, officers, employees, agents, Subsidiaries or
Affiliates.
(b) In furtherance of the assignment, transfer, conveyance and delivery of the
CareFusion Assets and the assumption of the CareFusion Liabilities in accordance with
Sections 2.1(a)(i) and 2. I a ii , on the date that such CareFusion Assets are assigned,
transferred, conveyed or delivered or such CareFusion Liabilities are assumed (i) Cardinal
Health shall execute and deliver, and shall cause its Subsidiaries to execute and deliver, such
bills of sale, quitclaim deeds, stock powers, certificates of title, assignments of contracts and
other instruments of transfer, conveyance and assignment as and to the extent necessary to
evidence the transfer, conveyance and assignment of all of Cardinal Health's and its .
Subsidiaries' (other than CareFusion and its Subsidiaries) right, title and interest in and to the
CareFusion Assets to CareFusion and its Subsidiaries, and (ii) CareFusion shall execute and
deliver, and shall cause its Subsidiaries to execute and deliver, such assumptions of contracts and
other instruments of assumption as and to the extent necessary to evidence the valid and effective
assumption of the CareFusion Liabilities by CareFusion and its Subsidiaries. All of the
foregoing documents contemplated by this Section 2.1(b) shall be referred to collectively herein
as the "Cardinal Health Transfer Documents."
(c) If at any time or from time to time (whether prior to or after the Effective
Time), any party hereto (or any member of such party's respective Group), shall receive or
otherwise possess any Asset or Liability (including any Intellectual Property or Technology) that
is allocated to any other Person pursuant to this Agreement or any other Transaction Document,
such party shall promptly transfer, or cause to be transferred, such Asset or Liability, as the case
may be, to the Person entitled to such Asset or responsible for such Liability, as the case may be.
Prior to any such transfer, the Person receiving, possessing or responsible for such Asset or
Liability shall be deemed to be holding such Asset or Liability, as the case may be, in trust for
any such other Person.
(d) CareFusion hereby waives compliance by each and every member of the
Cardinal Health Group with the requirements and provisions of any "bulk -sale" or "bulk -
transfer" Laws of any jurisdiction that may otherwise be applicable with respect to the transfer or
sale of any or all of the CareFusion Assets to any member of the CareFusion Group.
(e) Cardinal Health hereby waives compliance by each and every member of
the CareFusion Group with the requirements and provisions of any "bulk -sale" or "bulk -transfer'
Laws of any jurisdiction that may otherwise be applicable with respect to the transfer or sale of
any or all of the Excluded Assets to any member of the Cardinal Health Group.
2.2 CareFusion Assets.
(a) For purposes of this Agreement, "CareFusion Assets" shall mean (without
duplication):
ERROR! NO PROPERTY NAME SUPPLIED. 15

® 8.1 1 Specific Performance. Subject to the provisions of Article VII, in the event of any
actual or threatened default in, or breach of, any of the terms, conditions and provisions of this
Agreement, the Employee Matters Agreement or any of the Intellectual Property Agreements,
the party or parties who are or are to be thereby aggrieved shall have the right to specific
performance and injunctive or other equitable relief (on an interim or permanent basis) of its
rights under this Agreement, the Employee Matters Agreement or any of the Intellectual Property
Agreements, in addition to any and all other rights and remedies at law or in equity, and all such
rights and remedies shall be cumulative. The parties agree that the remedies at law for any
breach or threatened breach, including monetary damages, may be inadequate compensation for
any loss and that any defense in any action for specific performance that a remedy at law would
be adequate is waived. Any requirements for the securing or posting of any bond with such
remedy are waived by each of the parties to this Agreement.
8.12 Amendment. No provision of this Agreement may be amended or modified
except by a written instrument signed by all the parties to this Agreement. No waiver by any
party of any provision of this Agreement shall be effective unless explicitly set forth in writing
and executed by the party so waiving. The waiver by any party of a breach of any provision of
this Agreement shall not operate or be construed as a waiver of any other subsequent breach.
8.13 Rules of Construction. Interpretation of this Agreement shall be governed by the
following rules of construction: (i) words in the singular shall be held to include the plural and
vice versa and words of one gender shall be held to include the other gender as the context
• requires, (ii) references to the terms Article, Section, paragraph, clause, Exhibit and Schedule are
references to the Articles, Sections, paragraphs, clauses, Exhibits and Schedules of this
Agreement unless otherwise specified, (iii) the terms "hereof," "herein," `hereby," "hereto," and
derivative or similar words refer to this entire Agreement, including the Schedules and Exhibits
hereto, (iv) references to "$" shall mean U.S. dollars, (v) the word "including" and words of
similar import when used in this Agreement shall mean "including without limitation," unless
otherwise specified, (vi) the word "or" shall not be exclusive, (vii) references to "written' or "in
writing" include in electronic form, (viii) unless the context requires otherwise, references to
"party" shall mean Cardinal Health or CareFusion, as appropriate, and references to "parties"
shall mean Cardinal Health and CareFusion, (ix) provisions shall apply, when appropriate, to
successive events and transactions, (x) the table of contents and headings contained in this
Agreement are for reference purposes only and shall not affect in any way the meaning or
interpretation of this Agreement, (xi) Cardinal Health and CareFusion have each participated in
the negotiation and drafting of this Agreement and if an ambiguity or question of interpretation'
should arise, this Agreement shall be construed as if drafted jointly by the parties hereto and no
presumption or burden of proof shall arise favoring or burdening either party by virtue of the
authorship of any of the provisions in this Agreement or any interim drafts of this Agreement,
and (xii) a reference to any Person includes such Person's successors and permitted assigns.
8.14 Counterparts. This Agreement may be executed in one (1) or more counterparts,
and by the different parties to each such agreement in separate counterparts, each of which when
executed shall be deemed to be an original but all of which taken together shall constitute one
and the same agreement. Delivery of an executed counterpart of a signature page to this
Agreement by facsimile or portable document format (PDF) shall be as effective as delivery of a
• manually executed counterpart of any such Agreement.
ERROR! NO PROPERTY NAME SUPPLIED. 67

© [The remainder of this page is intentionally left blank.]
•
ERROR! NO PROPERTY NAME SUPPLIED. 68

II
•
II1 WITNESS WHEREOF, the pvtos heacto have caused this Agcerucnt to be
=ruted on the date first written above by their respective duly authorized officers,
CARDINAL REALM, )N
By: --
Name: George S. Barrett
Title: Vice Chairman and Chief Exocutive
OCCtcec, Hcalthcnc Supply Chaia
Services
CARPTIMON CORPORATION
By:
Name: David I.. Schlottcrbork
Title: Chaimian and Chief Executive Officer
S?jMONN?-Vr*SeylnnonA I« Q.r

0 IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be
executed on the date first written above by their respective duly authorized officers.
•
CARDINAL HEALTH, INC.
M
Name: George S. Barrett
Title: Vice Chairman and Chief Executive
Officer, Healthcare Supply Chain
Services
CAREFUSION CORPORATION
/Name: David L. Schlotterbeck
Title: Chairman and Chief Executive Officer
ftiw— PMe!oSga-jt%pn Agr —em

\09 CareFusion
1515IVAC Way
Creedmoor, NC. 27522
[phone]
March 16, 2010
Division of Water Quality
Attention: Sarah Young
Surface Water Protection Section
1617 Mail Service Center
Raleigh, North Carolina 27699
Dear Sarah Younq,
As of September 1, 2009, the Cardinal Health, Inc., facility located at 1515 IVAC
Way, Creedmoor, NC., 27522 transferred operational control to CareFusion
Manufacturing, LLC, a separate legal entity. Enclosed, please find the required form
to transfer the North Carolina Department of Environment and Natural Resources
conditional no -exposure exclusion NPDES permit currently held by Cardinal Health,
Inc., Permit No. NCS026824 to CareFusion Manufacturing, LLC.
CareFusion Manufacturinq, LLC certifies there are no operational changes that
warrant a permit modification. Please contact me if you have question relatinq to this
permit transfer request. I have also enclosed a copy of the separation agreement
between Cardinal Health, Inc., and CareFusion Manufacturinq_, LLC. Thank you for
your assistance.
Sincerely,
�' �lZ�
Joseph Perry
Facilities Supervisor
CareFusion
1515IVAC Way
Creedmoor, NC. 27522
919-528-5314
Enclosure
1�kvl
MAR 2 i 9010
DENR WA7FH'L]71AUTY
We'Janda & Skxnmatar Branch

Michael P. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, 1'. H. Director
Division of Water Quality
Coleen 11. Sullins, Deputy Director
Division of Water Quality
April 20, 2005
Robert Suka
Alaris Medical Systems Inc
1515 Ivac Way
Creedmoor. NC 27522-8113
Subject: No Exposure Certification NCGNE0054
Alaris Medical Systems Inc - 515 Ivac Way
Granville County
Dear Permittee:
The Division has reviewed your submittal of the No -Exposure Certification for Exclusion from NPDES
Stormwater Permitting form, which we received on May 18, 2004. We apologize for the extended period it has
taken us to get back to you on this request and we appreciate your patience as we have worked through this
process. Based on your submittal and signed certification of no exposure at the above referenced facility the
Division is granting your certification as provided for under 40 CFR 126.22(g) which is incorporated by
reference in North Carolina regulations.
Please note that by our acceptance of your no exposure certification, you are obligated to maintain no
exposure conditions at your facility. If conditions change such that your facility can no longer qualify for a no -
exposure exclusion, you are obligated to immediately obtain NPDES permit coverage for your stormwater
discharge. Otherwise, the discharge becomes subject to enforcement as an un-permitted discharge. Your
conditional no -exposure exclusion expires in five years (April 30, 2010). At that time you must re -certify with
the Division, or obtain NPDES'permit coverage for any stormwater discharges from your facility.
Your certification of no exposure 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 Jonathan Diggs at [phone] ext.
537, or at [e-mail].
Sincerely,
for Alan W. Klimek, P.E.
cc: Raleigh Regional Office Central Files —w/attachments
Slormwater Permitting Unit Files
N. C. Division of Water Quality 1617 Mail Service Center Raleigh, North Carolina 27699-I617 [phone]
ASA
NCDENR
Customer Service
1-877-623-6748

ATF
Michael F. Easley, Govemor
William G. Ross Jr., Secretary
�1`90
G
North Carolina Department of Environment and Natural Resources
rAlan
W. Klimek, P. E. Director
-..(
Division of Water Quality
Coleen 11. Sullins, Deputy Director
Division of Water Quality
April 20, 2005
Robert Suka
Alaris Medical Systems Inc
1515 Ivac Way
Creedmoor. NC 27522-8113
Subject: No Exposure Certification NCGNE0054
Alaris Medical Systems Inc - 515 Ivac Way
Granville County
Dear Permittee:
The Division has reviewed your submittal of the No -Exposure Certification for Exclusion from NPDES
Stormwater Permitting form, which we received on May 18, 2004. We apologize for the extended period it has
taken us to get back to you on this request and we appreciate your patience as we have worked through this
process. Based on your submittal and signed certification of no exposure at the above referenced facility the
Division is granting your certification as provided for under 40 CFR 126.22(g) which is incorporated by
reference in North Carolina regulations.
Please note that by our acceptance of your no exposure certification, you are obligated to maintain no
exposure conditions at your facility. If conditions change such that your facility can no longer qualify for a no -
exposure exclusion, you are obligated to immediately obtain NPDES permit coverage for your stormwater
discharge. Otherwise, the discharge becomes subject to enforcement as an un-permitted discharge. Your
conditional no -exposure exclusion expires in five years (April 30, 2010). At that time you must re -certify with
the Division, or obtain NPDES permit coverage for any stormwater discharges from your facility.
Your certification of no exposure 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 Jonathan Diggs at [phone] ext.'
537, or at [e-mail].
Sincerely,
for Alan W. Klimek. P.E.
cc: Raleigh Regional Office Central Files — w/attachments
Stormwater Permitting Unit Files
N. C. Division of Water Quality 1617 Mail Service Center Raleigh, Nonh Carolina 27699-1617 [phone]
dMy
AW
NCDENR
Customer Service
1-877-623-6748

NPDES rA United States Environmental Protection Agency Form
�W. EPA Washington, DC 20460 OMB No.:
FORM `�'
3510-11 NO EXPOSURE CERTIFICATION for Exclusion from
NPDES Storm Water Permitting
Submission of this No Exposure Certification constitutes notice that the entity Identified in Section A does not require permit authorization for Its storm water
discharges associated with Industrial activity in the Stale identified in Section B under EPA's Storm Water Multi -Sector General Permit due to the existence
of a wridlUon of no exposure.
A condition of no exposure exists at an Industrial facility when all industrial materials and activities are protected by a storm resistant shelter to prevent
exposure to rain, snow, snowmell, and/or runoff. 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 without operational taps or valves;
— adequately maintained vehicles used in material handling; and
— final Products, other than products that would be mobilized in stone water discharges (e.g., rock salt).
A No Exposure Certiflcalion 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, the entity In Section A is certifying that a condition of no exposure exists at Its facilior site,
and is obligated to comply with the forms and conditions of 40 CFR 122.26(g). ty
ALL INFORMATION MUST BE PROVIDED ON THIS FORM.
Detailed Instructions for completing this form and obtaining the no exposure exclusion are provided on pages 3 and 4.
A. Facility Operator Information
1. Name: 161LARIIISI ImjjrQITICIAILI j!;jY15IrIcIr4I5I IjINIrI,2.Phone: dil i916iliRlSi21ol01
3. Mailing Address: a.Streol:LI6115I ll-IYIAICI IHAlyl I I I I I I I I 1 I I I 1 1 1 I 1 1 1
4 Gty: ICIQICIE0)IMI0IOIQI I I I I I I 1 1 1 I1 1
I c.State: INICI d.Zip Code: 1217I.5-12121—I II it 131
B. FacllltylSlte Location Information
1. Facility Name: IRILA21IIS1 Ira CiASigAi Ll J50h5iTIEIMISi Tnfr
11
2. a. Street Address: 1_I 1 5I III Y AI LI N
jAI YI I I I 1 1 1 1
b. City: h..AICIEllilmlo l dial 1 'I I I I I I I I I I I I I c.Counly: IVI&IAINIV1.TILILICI I
d. State: V C-1 o. zip Code: I Zf716*I 2121-1 & I f I 1 131
3. Is the facility located on Indian Lands? Yes ❑ No
4. Is this a Federal facility? Yes ❑ No
CK
5. a. Latitude: O {pl " L=Lfy ' LU " b. Longitude:
6. a. Was the facility or site previously covered under an NODES storm water permit? Yes ❑ No
1
b. If yes, enter NPDES permit number: A
7. SIC/Activity Codes: Primary: 3 91 L111 f Secondar
y (if applicable):
8. Total size of site associated with industrial activity: 39 , 6 ,s
acres
9. a. Have you paved or roofed over a formerly exposed, pervious area in order to qualify for the no exposure exclusion? Yes ❑
No
b. If yes, please Indicate approximately how much area was paved or roofed over. Completing this question does not disqualify you for the no exposure
exclusion. However, your permitting authority may use this Information In considering whether storm water discharges from your site am likely to have
an advorse impact on water quality in which use you could be required to obtain permit coverage.
Less than one acre ❑ One to five acres
❑ Moro than five acres
EPA Form 3510-11 (10.99)
Page 1 of 4

NPDES A
FORM
-EPA NO EXPOSURE CERTIFICATION for Exclusion from
Form Approved
1
NPDES Storm Water Permitting
OMB No. 2040-0211
C. Exposure Checklist
Are any of the following materials or activities exposed to preclpltallon, now or in the foreseeable future?
(Please check either "Yes" or'No' In the appropriate box.)
If you answer "Yes,, to any of these questions
(1) through 01), you are not eligible for the no
exposure exclusion.
1. Using, storing or cleaning industrial machinery or equipment, and areas where residuals from using, storing
or cleaning Industrial machinery or equipment
Yes
El
No
D9
remain and are exposed to storm water
2. Materials or residuals on the ground or in storm water inlets from spills/leaks
EJ
3. Materials or products from past Industrial activity
O
4. Material handling equipment (except adequately maintained vehicles)
❑
Ip�I
5. Materials or products during loading/unloading or transporling activities
❑
14
6. Materials or products stored outdoors (except final products Intended for outside use [e.g., new cars) where
exposure to storm water does not result in the discharge of pollutants)
El
IR
7. Materials contained In open, deteriorated or leaking storage drums, barrels, tanks, and similar containers
❑
B. Materials or products handled/stored on roads or railways owned or maintained by the discharger
❑
9. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters))
El
10, Application or disposal of process wastewater (unless otherwise permitted)
11. Particulate matter or visible deposits of residuals from roof stacks and/or vents not otherwise regulated
(i.e., under an air quality control permit) and evident in the
storm water outflow
D. Certification Statement
I certify under penalty of law that I have read and understand the eligibility requirements for claiming a condition of exposure' and obtaining an
exclusion from NPDES storm water permitting.
1 certify under penalty of few that there am no discharges of storm water 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)).
1 understand that I am obligated to submit a no exposure certification form once every five years to the NPDES permitting authority and, if requested, to
the operator of the local municipal separate storm sewer system (MS4) into which the facility discharges (where applicable). I understand that I must
allow the NPDES permitting authority, 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. 1 understand that I must obtain coverage under an NPDES permit prior
to any point source discharge of storm water from the facility.
Additionally, I certify under penally 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.
Print Name:
Print Title: L51KI 101914.IRIArrll Io INIS I IM141NIAIGIEIRI
Signature: 7�kyXyk� \,.ern
Date: IC214 It 13 16 I LI �
EPA Form 3510-11 (10-99)
Page 2 of 4

NPDE
FORM Instructions for the NO EXPOSURE CERTIFICATION for 35jp jj OEM Form Approved
Exclusion from NPDES Storm Water Permitting OMB No. 2040-0211
Who May File a No Exposure certification Section B. Facility/Site Location Information
Federal law at 40 CFR Part 122.26 prohibits point source discharges of
storm water associated with Industrial activity to waters of the U.S. without
a National Pollutant Discharge Elimination System (NPDES) permit. However,
NPDES permit coverage is not required for discharges of storm water
associated with industrial activities identified at 40 CFR 122.26(b)(14)(I)-
fix) and (xi) If the discharger can certify that a condition of "no exposure"
exists at the industrial facility or site.
Storm water discharges from construction activities Identified in 40 CFR
122.26(b)(14)(x) and (b)(15) are not eligible for the no exposure exclusion.
Obtaining and Maintaining the No Exposure Exclusion
This form Is used to certify that a condition of no exposure exists at the
industrial facility or site described herein. This certification is only applicable
in jurisdictions where EPA Is the NPDES permitting authority and must be
re -submitted at least once every five years.
The Industrial facility operator must maintain a condition of no exposure at
Its facility or site In order for the no exposure exclusion to remain applicable.
If conditions change resulting in the exposure of materials and activities to
storm water, the facility operator must obtain coverage under an NPDES
storm water permit immediately.
Where to File the No Exposure Certification Form
Mail the completed no exposure certification form to:
Storm Water No Exposure Certification (4203)
USEPA
401 M Street, SW
Washington, D.C. 20460
Completing the Form
You must type or print, using uppercase letters, in appropriate areas only,
Enter only one character per space (Le., between the marks). Abbreviate
If necessary to stay within the number of characters allowed for each Item.
Use ono space for breaks between words. One form must be completed
for each facility or site for which you are seeking to certify a condition of no
exposure. Additional guidance on completing this form can be accessed
through EPA's web site at www.epa.gov/owm/sw. Please make sure you
have addressed all applicable questions and have made a photocopy for
your records before sending the completed form to the above address.
Section A. Facility Operator Information
1. Provide the legal name of the person, firm, public organization, or any
other endly that operates the facility Walla described in this certification.
The name of the operator may or may not be the same as the name of
the facility. The operator is the legal entity that controls the facility's
operation, rather than the plant or site manager.
2. Provide the telephone number of the facility, operator.
3. Provide the mailing address of the operator (P.O. Box numbers may be
used). Include the city, stale, and zip code. All correspondence will
be sent to this address.
EPA Form 3510-11(10-99)
1. Enter the official or legal name of the facility or site.
2. Enter the complete street address (if no street address exists, provide
a geographic description (e.g., Intersection of Routes 9 and 55)), city,
county, stale, and zip code. Do not use a P.O. Box number.
3. Indicate whether the facility Is located on Indian Lands.
4. Indicate whether the industrial facility Is operated by a department or
agency of the Federal Government (see also Section 313 of the Clean
Water Act).
5. Enter the latitude and longitude of the approximate center of the facility
or site in degreos/minutes/seconds. Latitude and longitude can
be obtained from United States Geological Survey (USGS) quadrangle
or topographic maps, by calling 1 {888) ASK-USGS, or by accessing
EPA's web she at http://www.epa.eov/owm/sw/Industry/index htm and
selecting Latitude and Longitude Finders under the Resources/Pormh
section.
Latitude and longitude for a facility in decimal form must be converted
to degrees I'), minutes ('), and seconds (") for proper entry on
the certification form. To convert decimal latitude or longitude to
degrees/minutes/seconds, follow Oro steps in the following example.
Example: Convert decimal latitude 45.1234567 to degrees (°), minutes
('), and seconds (").
a) The numbers to the left of the decimal point are the degrees: 45-.
b) To obtain minutes, multiply the first four numbers to the right of the
decimal point by 0.006: 1234 x 0.006 = 7.404.
c) The numbers to the left of the decimal point In the resull obtained
in (b) are the minutes: 7'... .. .... .. -
d) To obtain seconds, multiply the remaining three numbers to the
right of the decimal from the result obtained in (b) by 0.06:
404 x 0.06 = 24.24. Since the numbers to the right of the decimal
point are not used, the result Is 24".
e) The conversion for 45.1234567 = 45° 7' 24".
6. Indicate whether the facility was previously covered under an NPDES
storm water permit. If so, Include the permit number.
7. Enter the 4-digit SIC code which identifies the facility's primary activity,
and second 4-digit SIC code Identifying the facility's secondary activity.
If applicable. SIC codes can be obtained from the Standard Industrial
Classification Manua_ 1, 1987
8. Enter the total size of the site associated with industrial activity In acres.
Acreage may he determined by dividing square footage by 43.560, as
demonstrated in the following example.
Example: Convert 54,450 112 to acres
Divide 54,450 ft2 by 43,560 square feet per aae:
54,450 ft2 - 43.560 ft2/acre = 1.25 acres.
9. Check 'Yes" or'No- as appropriate to indicate whether you have paved
or roofed over a formerly exposed, pervious area (i.e., lawn, meadow,
dirt or gravel road/parking lot) in order to qualify for no exposure. If yes,
also Indicate approximately how much area was paved or roofed over
and Is now Impervious area.
Page 3 of 4

510„ I EPA
FORM
Section C. Exposure Checklist
Instructions for the NO EXPOSURE CERTIFICATION for Form Approved
Exclusion from NPDES Storm Water Permitting OMB No. 2040-0211
Check *Yes" or `No' as appropriate to describe the exposure conditions at
your facility. If you answer "Yes" to ANY of the questions (1) through (11)
in this section, a potential for exposure exists at your site and you cannot
certify to a condition of no exposure. You must obtain (or already have)
coverage under an NPDES storm water permit. After obtaining permit
coverage, you can Institute modifications to eliminate the potential for a
discharge of storm water exposed to industrial activity, and then certify to
a condition of no exposure.
Section D. Certification Statement
Federal statutes provide for severe penalties for submitting false Information
on this application form. Federal regulations require this application to be
signed as follows:
For a corporation: by a responsible corporate officer, which means
(t) president, secretary, treasurer, or vice-president of the corporation
In charge of a principal business function, or any other person
who performs similar policy or decision making functions for the
corporation, or
(ii) the manager of one or more manufacturing, production, or
Operating facilities, provided the manager is authorized to make
management decisions which govern the operation of the
regulated facility Including having the explicit or Implicit duty of
making major capital Investment recommendations, and initiating
and directing other comprehensive measures to assure long
term environmental compliance with environmental laws and
regulations; the manager can ensure that the necessary systems
are established or actions taken to gather complete and accurate
information for permit application requirements; and where
EPA Form 3510-11 (10-99)
authority to sign documents has boon assigned or delegated to
the manager In accordance with corporate procedures;
For a partnership or sole proprietorship: by a general partner or the
proprietor; or
For a municipal, Slate, Federal, or other public facility: by either a
principal executive or ranking elected official.
Paperwork Reduction Act Notice
Public reporting burden for this certification Is estimated to average 1.0 hour
per certification, including time for reviewing instructions, searching existing
data sources, gathering and maintaining the data needed, and completing
and reviewing the collection of Information. Burden means the total time,
effort, or financial resources expended by persons to generate, maintain,
retain, or disclose to provide Information to or for a Federal agency. This
includes the time needed to review instructions; develop, acquire, Install,
and utilize technology and systems for the purposes of collecting, validating,
and verifying information, processing and maintaining Information, and
disclosing and providing information; adjust the existing ways to comply with
any previously applicable instructions and requirements; train personnel to
be able to respond to a collection of information; search data sources;
complete and review the collection of information; and transmit or otherwise
disclose the Information. An agency may not conduct or sponsor, and a
person is not required to respond to, a collection of information unless it
displays a currently valid OMB control number. Send comments regarding
the burden estimate, any other aspect of the collection of information, or
suggestions for Improving this form, Including any suggestions which may
Increase or reduce this burden to: Director, OPPE Regulatory Information
Division (2137), USEPA, 401 M Street, SW, Washington, D.C. 20460,
Include the OMB control number of this form on any correspondence. Do
not send the completed No Exposure Certification form to this address.
Page 4 of 4

ALARIS
I7 (:DICAL SYSTEMS
May 11, 2004
Medication Safety
Ft the Point of Care'
ALARIS Medical Systems, Inc.
1515 IVAC Way
Creedmoor, NC 27522
[phone]
Fax [phone]
Via UPS
North Carolina Department of Environment and Natural
Division of Water Quality - Storm Water Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Re: NPDES Form 3510-11/No Exposure Certification
Dear Sir or Madam:
)A g 2004
I DENR-`NATERpUALITY
pptNT SOURCE. BRANCH
Enclosed please find a completed NPDES Form 3510-11/No Exposure
Certification for Exclusion from NPDES Storm Water Permitting on behalf of
ALARIS Medical Systems, Inc.
Pursuant to Federal Regulation 40 CFR 122.26(b) (14) (xi), ALARIS
Medical Systems, Inc. certifies that a condition of no exposure exists at our
Creedmoor, North Carolina facility.
Should you have any questions, please contact me.
Sincerely,
David Strickland
Senior Quality Supervisor
Phone [phone]