NCGNE0190_COMPLETE FILE - HISTORICAL_20150331

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCGNE
DOC TYPE
EAHISTORICAL FILE
DOC DATE
❑
YYYYMMDD

NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory Donald R. van der Vaart
Governor ta"�ry
March 23, 2015 i� , •&^."'.
MAR 3 1 2015
Mr. Carlos E. Simon j
Liebel-Flarsheim Company, LLC j
8800 Durant Road NC DENR Raleigh Regional Office .
Raleigh, NC 27616
Subject: Name/Ownership Change Request
No Exposure Certification NCGNE0190
Liebel-Flarsheim Company, LLC
Formerly Tyco Healthcare/Mallinckrodt
Wake County
Dear Mr. Simon:
The Division has reviewed your submittal of the permit name/ownership change form for the
subject No -Exposure Certification, which we received on March 4, 2015. Division personnel
have reviewed and approved your request to transfer the exclusion from NPDES stormwater
permitting requirements.
Please note that by our original acceptance of the No -Exposure Certification and by our
approval of your request to transfer it, 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 un-
permitted discharge.
Annual re -certification is required, and we have enclosed one blank Annual No Exposure
Exclusion Self Re -Certification form for your use. 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.
Division of Energy, Mineral, and Land Resources
Energy Section • Geological Survey Section • Land Quality Section
1612 Mail Service Center, Raleigh, North Carolina 27699-1612.919-707-9200 / FAX: [phone]
512 North Salisbury Street, Raleigh, North Carolina 27604 • Internet: http://portal.ncdenr.org/web/ir/
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper

If you have any questions or need further information, please contact the Stormwater Permitting
Program at [phone].
Sincerely,
ORIGINAL SIGNED W
KEN PICKLE
.for Tracy E. Davis, P.E., CPM, Director
Division of Energy, Mineral and Land Resources
cc:%Raleigh Regional Office
Stormwater Permitting Program Files
Central Files

Q��
,.
A
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Mr. Carlos E. Simon
Liebel-Flarsheim Company, LLC
8800 Durant Road
Raleigh, NC 27616
Dear Mr. Simon:
Donald R. van der Vaart
Secretary
March 23, 2015
Subject: Name/Ownership Change Request
No Exposure Certification NCGNE0190
Liebel-Flarsheim Company, LLC
Formerly Tyco Healthcare/Mallinckrodt
Wake County
The Division has reviewed your submittal of the permit name/ownership change form for the
subject No -Exposure Certification, which we received on March 4, 2015. Division personnel
have reviewed and approved your request to transfer the exclusion from NPDES stormwater
permitting requirements.
Please note that by our original acceptance of the No -Exposure Certification and by our
approval of your request to transfer it, 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 un-
permitted discharge.
Annual re -certification is required, and we have enclosed one blank Annual No Exposure
Exclusion Self Re -Certification form for your use. 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.
Division of Energy, Mineral, and Land Resources
Energy Section • Geological Survey Section • Land Quality Section
1612 Mail Service Center, Raleigh, North Carolina 27699-1612.919-707-9200 / FAX: [phone]
512 North Salisbury Street, Raleigh, North Carolina 27604 • Internet: http://Portal.ncdenr.org/web/Ir/
An Equal Opportunity 1 Affirmative Action Employer- 50% Recycled 110% Post Consumer Paper

If you have any questions or need further information, please contact the Stormwater Permitting
Program at [phone].
Sincerely,
ORIGINAL SIGNED B`
for Tracy N Davis; Y.E., CPM, Director
Division of Energy, Mineral and Land Resources
cc: Raleigh Regional Office
Stormwater Permitting Program Files
Central Files

WAM
NCDENit
W7
Division of Energy, Mineral & Land Resources
Land Quality Section/Stormwater Permitting
National Pollutant Discharge Elimination System
PERMIT NAME/OWNERSHIP CHANGE FORM
FOR AGENCY USE ONLY
Date Received
Year
Month
Day
I. Please enter the pennit number for which the change is requested.
NPDl-S Pennit (or) Certificate of Coverage
N
C
S
O
N
C
G
N
E
O
I
9
0
11. Permit status IMiaE to requested change.
a. Permit issued to (company name):
'Tyco Flea] hcare/Mallinckrodt
b. Person legally responsible for permit:
Carlos L' Simon
First MI Last
Plant Manager
Title
8800 Durant Road
Permit Holder Mailing Address
Raleigh NC 27616
City State Zip
[phone] (9 19) 713-2439
Phone Fax
c. Facility name (discharge):
Tyco [lea lthcare/Mallinckrodt
d. Facility address:
8800 Durant Road
Address
Raleigh NC 27616
City State Zip
c. Facility contact person:
Maria J. Longcore [phone]
First / MI / Last Phone
III. 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 otter please explain: 'Transfer of ownership of facility from one corporate subsidiary to
another; see attached cover letter.
b. Permit issued to (company name):
Liebe I-Flarsheim Company LLC
c. Person legally responsible for penniC
Carlos H Simon
First MI Last
Plant Manager
RECEIVED
hr
8800 Duraa nt Road
MAR
tt ii L d
Q 4 2015
Permit Holder Mailing Address
Raleigh NC 27616
DENR-LAND QUALITY
City State Zip
STORMWATER PERMITTING
[phone] carlos.simon a mallinckrodt.com
Phone &mail Address
d. Facility name (discharge):
Licbel-Flarsheim Company LLC
c. Facility address:
8800 Durant Road
Address
Raleigh NC 27616
City State Zip
f. Facility contact person:
Maria .1. Longcore
First MI Last
[phone] marialongcoreamallinckrodt.com
Revised Jan. 27. 2014

PDES PERMIT NAME/OWNERSHIP CHANGE FORM
Page 2 of 2
Phone F-mail Address
IV. Permit contact information (if different from the person legally responsible for the permit)
Permit contact: Maria J Longcore
First MI Last
1-1-IS Manager
Title
8800 Durant Road
Mailing Address
Raleigh NC 27616
City State Zip
[phone] maria.longcore n,mallinckrodt.com
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:
❑ "hhis 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 (Ieed,
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 pennit 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, [Carlos Simon, attest that this application for a name/ownership change has been reviewed and is accurate
and complete 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 incor lete.
t
February 25, 2015
Signature Date
APPLICANT C . TIFICATION
I, Carlos Simon, attest that this application for a name/ownership change has been reviewed and is accurate
and complete 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.
0-y\ February 25, 2015
Signature Date
PLEASE SEND TIIE COMPLETE APPLICATION PACKAGE TO:
Division of Energy, Mineral and Land Resources
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Revised Jan. 27, 2014

Mallinckrodt
Pharmaceuticals
February 25, 2015
Division of Energy, Mineral and Land Resources
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Re: Notification regarding Mallinckrodt LLC facility
located at 8800 Durant Rd., Raleigh, NC
No Exposure Certification # NCGNE0190
Dear Sir or Madam:
As you know, Mallinckrodt LLC has owned and operated a manufacturing facility at
8800 Durant Rd., Raleigh, North Carolina, for some time. Mallinckrodt LLC is an indirect
subsidiary of Mallinckrodt plc, which is publicly traded on the New York Stock Exchange. This
letter is to notify you that as part of an internal corporate restructuring, effective June 30, 2014,
ownership of the property and assets at that location was transferred from Mallinckrodt LLC to
Liebel-Flarsheim Company, LLC, which is another, existing indirect subsidiary of Mallinckrodt
plc. This movement of assets and ownership is entirely within the group of companies all wholly
owned directly or indirectly by Mallinckrodt plc.
Contact information, used for the Certification listed above, including telephone
number(s) and names, will remain the same; there are no associated changes in personnel having
control over the permit. All records retained in connection with the permit will be maintained at
the current location. No changes are currently planned that would impact the permit. We are
merely providing this notification to you so that you may update your database of permit
information.
Thank you for your attention. If you have any questions, please contact Eric Berry, Vice -
President — Environmental Law, at our St. Louis, Missouri, U.S. headquarters, at 314-654-6878.
Again, thank you.
Very Truly Yours,
RECEIVED
-��-� t i% R 04 2015
Maria Longeore
DFNR-LA.P1D QUALITY
STORIVI'VI1ATER PERMUTING
cc: Eric Berry
8800 Durant Road • Raleigh, NC 27616 • 919.878.2930 T • mallinckrodt.com

BKO15789PGO1571
Prepared by: Bryan Cave LLP
211 N. Broadway, Suite 3600
St. Louis, MO 63102
Return after recording to: Commonwealth Land Title Company
421 Fayetteville Street, Suite 215
Raleigh, NC 27601
Attn:
Tax Parcel No.:
Excise Tax:
1728917216
$0.00
WAKE COUNTY, NC 65
LAURA M RIDDICK
REGISTER OF DEEDS
PRESENTED & RECORDED ON
0W24/2014 AT 11:20:02
BOOK:015789 PAGE:01S71 — 0157S
RECEIVED
1`1.QR Q 41015
DENR-LAND QUALITY
STORMNIATER PERMITTING
NORTH CAROLINA SPECIAL WARRANTY DEED
THIS DEED is made effective as of the 30th day of June, 2014, by and between
MALLINCKRODT LLC, a Delaware limited liability company (successor by merger to Mallinckrodt
Inc., a Delaware corporation) ("Grantor''), having a mailing address of 675 McDonnell Boulevard,
Hazelwood, Missouri 63042, and LIEBEL-PLARSHEIM COMPANY LLC, a Delaware limited liability
company ("Grantee"), having a mailing address of 675 McDonnell Boulevard, Hazelwood, Missouri
63042. The designation Grantor and Grantee as used herein shall include said parties, their heirs,
successors and assigns, and shall include singular, plural, masculine, feminine or neuter as required by
context.
WITNESSETH, that the Grantor has and by these presents does GRANT and CONVEY unto the
Grantee in fee simple all that certain lot or parcel of land situated in Wake County, North Carolina and
more particularly described on Exhibit A attached hereto and incorporated herein (the "Property").
The Property hereinabove described was acquired by Grantor by instrument recorded in Book
8529 at Page 944 of the Wake County Official Records.
TO HAVE AND TO HOLD the aforesaid Property, subject to the exceptions listed on Exhibit B
attached hereto and incorporated herein (the "Permitted Exceptions"), and all privileges and
appurtenances thereto belonging to the Grantee in fee simple.
AND THE, GRANTOR will, subject to the Permitted Exceptions, warrant and defend the title
against the lawful claims of all persons claiming by, under or through Grantor, but not further or
otherwise.
4401824J

BK015789PG01572
Grantee has paid no consideration in property or money to Grantor in connection with the transfer
of the Property and owes no such consideration to Grantor in connection therewith.
[REMAINDER OF PAGE INTENTIONALLY LEFT BLANK]

8KO157SOPGO1573
IN WITNESS WIIEREOF, Grantor has caused this instrument to be signed the day and year
first above written.
MALLINCKRODT LLC,
a Delaware limited liability company
Title: L�2—,
STATE OF 1 t SSo �e
COUNTY OF
I, the undersigned, a notary public of the state and county aforesaid certify that C • FN tee� E7�H
personally carte before me this day and said that s/he is thcVP1 &Srj. 643�of MAL,LINCKRODT
LLC, a Delaware limited liability company, and that s/he, in such capacity and being authorized to do so,
voluntarily executed to the foregoing on behalf of such limited liability company.
TAMMY D. WESEA
Nary Wblic - Notary Seal
Smta 01 Mlssoull
Commissioireo tar st cW5s 000
MymE.)res: Me15, 2095
Number.1185741
(Official Seal)
icia 'i of Notary
`Tafr,nY, y Is_ I%V:44{
Notary's printdd or typed name
My commission expires: d-�s-�-1—

BKO15789PGO1574
Exhibit A
Legal Description
Lying and being in Wake County, North Carolina, and more particularly described as follows:
Being more particularly described as that 27.81 acre parcel depicted on plat entitled "Property Survey
Mallinckrodt, Inc. Parenteral Plant" dated June 5, 1990, prepared by Michael P. Griffin, Land Surveyor
(Registration No. L-3331) and recorded in Book of Maps 1990, Page 779 of Wake County Register of
Deeds, as follows:
BEGINNING at an iron pipe located near the intersection of Durant Road and US Highway I North in
Wake County, North Carolina; said iron pipe being in the northern right of way of Durant Road (S.R.
2006) and having N.C. Grid Coordinates of N = 780,473.48 feet and E = 2,130,203.97 feet and located N
49037'34" W 471.14 feet from N.C. Grid monument "Ken" (N = 780,168.295 feet and E = 2,130,562.894
feet); thence with northern right of way of Durant Road N 63°57'53" W 1004.00 feet to an iron pipe at the
intersection of the northern right of way of Durant Road and the eastern edge of a 100 foot CP& L
transmission right of way; thence with the eastern line of said right of way N 21 °50'30" W 805.90 feet to
an iron pipe; thence continuing with said right of way N 13°47'41" E 129.81 feet to an iron pipe; thence
leaving the CP & L right of way, S 85°43'22" E 605.68 feet to a fence comer; thence with the fence line N
7405211' E 194.46 feet to a fence comer; thence with the fence line S 70°25'42" E 69.79 feet to a fence
comer; thence with the fence line S 34°35'54" E 28.40 feet to a fence comer; thence with the fence line S
05000'07" W 42.37 feet to a fence comer; thence with the fence line S 86°42'25" E 137.23 feet to a fence
corner; thence with the fence line N 11 *50'46" E 37.26 feet to a fence corner; thence with the fence line S
81004'25" E 178.31 feet to a fence comer; thence with the fence line S 73°15'57" E 122.23 feet to a fence
corner; thence S 05°45'39" W 80.63 feet to an existing iron pipe, being the northwest comer of the now of
formerly Holdcn property; thence S 16°27'52" W 198.23 feet to an existing iron pipe; thence S 09°29'00"
E 151.19 feet to an existing axle, being the northwest comer of the now or formerly Joyner property;
thence S 10°05'04" W 92.34 feet to an existing iron pipe; thence S 09°58'26" E 100.19 feet to an existing
iron pipe, being the northwest corner of the now or formerly Perry property; thence S 10050'56" E 94.95
feet to an existing iron pipe; thence S 09058'26" W 119.51 feet to an existing iron pipe; thence S
14048'00" W 112.34 feet to an existing iron pipe; thence S 249I'00" W 125.37 feet to an existing iron
pipe; thence S 21°47'00" W 167.05 feet to the point and place of BEGINNING, containing 27.81 acres.
-7-

BKO15789PGO1575
Exhibit B
Permitted Exceptions
I. Covenants, conditions, limitations, restrictions, rights, rights of way, encumbrances,
encroachments, reservations, easements, agreements and other matters of fact or record.
2. Present and future zoning, subdivision, building, land use, and environmental laws, ordinances,
restrictions, resolutions, orders and regulations and all present and future ordinances, laws,
regulations and orders of all federal, state, county, municipal or other governments, agencies,
boards, bureaus, commissions, authorities and bodies now or hereafter having or acquiring
jurisdiction of the property and the use and improvement thereof.
3. Any state of facts or exception which an accurate survey or an inspection of the Property would
show.
4. Special assessments now or hereafter becoming a lien.
5. General property taxes for the current tax fiscal year and subsequent tax fiscal years.

BKO15789PGO1576
BOOK:015789 PAGE:01571 - 01576
WAKE
COUNTY
NORTH CAROLINA
Please retain yellow trailer page
It is part of the recorded document and must be submitted with the original for re-
recording.
Laura M. Riddick
Register of Deeds
Wake County Justice Center
300 South Salisbury Street, Suite 1700
Raleigh, NC 27601
❑ New Time Stamp
❑ Additional 'Document Fee
This Customer Group
_# of Time Stamps Needed
❑ $25 Non -Standard Fee
❑ Additional Reference Fee
This Document
# of Pages

Mallinckrodt
May 15, 2013
Mr. Bradley Bennett
Stormwater Permitting Unit
NC DENR
512 N. Salisbury Street
Raleigh, NC 27604
COVIDIEN
Re: Corporate Reorganization Notification—Mallinckrodt plc Spin Off from Covidien plc
Mallinckrodt LLC Raleigh, No Exposure Certification, # NCGNE0190
Dear Mr. Bennett:
I am sending this letter to formally notify you that Mallinckrodt plc will be a new public company
effective after receipt of government approvals anticipated in June 2013. Mallinckrodt LLC will
continue to conduct its US operations and is the current legal entity holding all existing
environmental permits, general permits, licenses and registrations applicable to our facility located
at 8800 Durant Road in Raleigh. The direct parent company of Mallinckrodt LLC is Mallinckrodt
Enterprises LLC, a Delaware limited liability corporation. Both companies are ultimately owned by
Mallinckrodt plc.
Mallinckrodt plc will formally become a publicly traded entity upon approval of the Form 10
Registration statement filed with the US Securities and Exchange Commission (SEC) on February
1, 2013. The anticipated date for the completion of this process is June 28, 2013. This notification
is to inform you of the new independent status of Mallinckrodt LLC's ultimate parent company.
This action does not involve any transfer of property or change to the corporate structure of
Mallinckrodt LLC and all permits and licenses will remain in the name of Mallinckrodt LLC. Please
note that the ownership of the property remains the same.
If you have any further questions or require any additional information please contact me at
314/654-2131 or by email at [e-mail].
Sincerely,
0 e5�W;104e�
Laura Andrew
Principal EHS Engineer
cc: Eric Berry, Mallinckrodt
Maria Longcore, Mallinckrodt
MALLINCKRODILLC
675 MCDONNELLBLVD.
I1AZELWOOD, MO 63042
IN
z0113 i

NC®ENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
MARIA LONGCORE
MALLINCKRODT, LI.0
SHOO DURANT ROAD
RALEIGH, NC 27616
Dear Ms. Longcore:
Division of Water Quality
Coleen H. Sullins
Director
September 6, 2011
Dee Freeman
Secretary
Subject: Name/Ownership Change Request
No Exposure Certification NCGNE0190
Mallinckrodt, LLC
Formerly Tyco Healthcare - Mallinckrodt
8800 Durant Road
Wake County
The Division has reviewed your submittal of the permit name/ownership change form for the subject No -Exposure
Certification, which we received on July 13, 2011. Division personnel have reviewed and approved your request to transfer
the exclusion from NPDES stormwater permitting requirements.
Please note that by our original acceptance of the no exposure certification and by our approval of your request to
transfer it, 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 un-permitted discharge.
Annual re -certification is required, and we have enclosed one blank Annual No Exposure Exclusion Self Re -Certification
form for your use. 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 the Stormwater Permitting Unit at (919),807-6300.
Sincerely,
for Coleen H. Sullins
cc: Raleigh Regional Office
Stormwater Permitting Unit Files
Wetlands and Stonnwater Branch 7�7One
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 i O hCarolina
Phone:: 9-8 N. Salisbury St. Rale19.807, North Carolina r Service:
NaturalllJ
Phone: 919�0783001 FAX: 919�807&i921 Customer Service: 1�877$23-6748
Internet w .ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer

COL :

No -Exposure Self Re -Certification Information:
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. State statute provides for fines of up to $25,000 per day for un-permitted'
discharges.
Your conditional no -exposure exclusion must be self re -certified at least annually as follows:
- Complete the re -certification at a minimum of once per year using the included Self Re -
Certification Form.
(additional copies can be downloaded from http://portal.ncdenr.org/web/wgtws/su/npdessw#tab-5 )
- Maintain a record of re -certifications on file at the facility. Do not submit the re -certification to DWQ
unless requested. If requested, submit a copy of the re -certification to the Division and/or the
municipality in which the facility is located.
-During an inspection by DWQ or local government, provide the re -certifications immediately upon
request.
- Notify the Division of any changes in ownership, significant facility and/or activity changes, or if the
facility can no longer maintain no -exposure conditions.
-Allow the NPDES permitting authority or, if discharging into a municipal separate storm sewer system, the operator
of the system, to: (1) inspect the facility; and (2) make such inspection reports publicly available upon request.
* "No exposure" means that all industrial materials and activities are protected by a storm resistant shelter to prevent
exposure to rain, snow, snowmelt, 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. (40 CFR 122.26(g))
Information and forms related No -Exposure Certifications can be accessed on the website at:
http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-5

�0
NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
September 6, 2011
MARIA LONGCORE
MAIJ.INCKRODT, LLC
8800 DURANT ROAD
RALEIGH, NC 27616
Dee Freeman
Secretary
Subject: Name/Ownership Change Request
No Exposure Certification NCGNE0190
Mallinckrodt, LLC
Formerly Tyco Healthcare - Mallinckrodt
8800 Durant Road
Wake County
Dear Ms. Longcore:
The Division has reviewed your submittal of the permit name/ownership change form for the subject No -Exposure
Certification, which we received on July 13, 2011. Division personnel have reviewed and approved your request to transfer
the exclusion from NPDES stormwater permitting requirements.
Please note that by our original acceptance of the no exposure certification and by our approval of your request to
transfer it, 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 un-permitted discharge.
Annual re -certification is required, and we have enclosed one blank Annual No Exposure Exclusion Self Re -Certification
form for your use. 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 the Stormwater Permitting Unit at [phone].
Sincerely,
ORIGINAL SIGNED M
KEN PICKLE
for Coleen H. Sullins
cc: Raleigh. Regional Office
Stormwater Permitting Unit Files
Wetlands and Stormwater Branch One
1617 Mail Service Center, Ralegh, North Carolina 27699-1617 NOrthCarOliria
Phone:
6-8 N. Salisbury St. Raleigh, North Carolina 27604 Naturally
Phone: 919�07-63001FAX: 919�07&1921 Customer Service: l-877$23-6748 fi !fi
Internet: www.ncwalerquality.org
An Equal Opportunity 1 ARrmarve Action Employer

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No -Exposure Self Re -Certification Information:
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. State statute provides for fines of up to $26,000 per day for un-permitted
discharges.
Your conditional no -exposure exclusion must be self re -certified at least annually as follows:
- Complete the re -certification at a minimum of once per year using the included Self Re -
Certification Form.
(additional copies can be downloaded from http://portal.ncdenr.org/webtwgtws/su/npdessw#tab-5 )
- Maintain a record of re -certifications on file at the facility. Do not submit the re -certification to DWQ
unless requested. If requested, submit a copy of the re -certification to the Division and/or the
municipality in which the facility is located.
-During an inspection by DWQ or local government, provide the re -certifications immediately upon
request.
- Notify the Division of any changes in ownership, significant facility and/or activity changes, or if the
facility can no longer maintain no -exposure conditions.
-Allow the NPDES permitting authority or, if discharging into a municipal separate storm sewer system, the operator
of the system, to: (1) inspect the facility; and (2) make such inspection reports publicly available upon request.
* "No exposure" means that all industrial materials and activities are protected by a storm resistant shelter to prevent
exposure to rain, snow, snowmelt, 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. (40 CFR 122.26(g))
Information and forms related No -Exposure Certifications can be accessed on the website at:
http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-5

o�oF \NA7F919
> 1 ✓ w v.� —I
,. JV1lLHl.l
PERMIT N
Beverly Eaves Perdue, Governor
Dce Freeman, Secretary
North Carolina Department of Environment and Natural Resources
Coleen If. Sullins, Director
Division of Water Quality
please enter the permit number for which the change is requested.
NPDES Permit (or) Certificate of Coverage
N C I S 1 .0 1 1 1 1 1 1 N. I C I G. I N IE 0 1 9 0
Permit status prior to requested change.
a. Permit issued to (company name): Tyco Healthcare - Mallinekrodt
b. Person legally responsible for permit:
c. Facility name (discharge):
d. Facility address:
First MI
Title
8800 Durant Road
Permit Bolder Mailing Address
Raleigh NC 27616
City State Zip
Phone Fax
Mallinekrodt Inc.
8800 Durant Road
Address
Raleigh NC 27616
City State Zip
e. Facility contact person: Maria Longcore [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
/f 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:
Mallinekrodt LLC
First
MI Last
Title
8800 Durant Road
Permit
Raleigh
Fielder Mailing Address
NC 27616
City
[phone]
State Zip
Phone
F.-mail Address
Address
City
Maria
State Zip
Longcore
First
[phone]
MI Last
maria.longcore a,covidien.com
Phone
E-nail 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: Maria Longo
First MI Last
Senior HSE Engineer
'title
8800 Durant Road
Mailing Address
Raleigh NC 27616
City State Zip
(919-878-2980)
maria.longcorc 0acovidien.corn
Phone Grnail 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 13E 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 most 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, , attest that this application for a name/ownership change has been reviewed and is accurate and
complete 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.
Signature Date
APPLICANT CERTIFICATION
I M4 r' attest {�>'at�t its application tot- a name/ownership change has been reviewed and is accurate and
complete 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.
h n.4 e 6112Z&
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

Via Federal Express
June 14, 2011
Mr. Bradley Bennett
Stormwater Permitting Unit
NC DENR
512 N. Salisbury Street
Raleigh, NC 27604
RE: Notification of Conversion of Mallinckrodt Inc. to Mallinckrodt LLC
Dear Mr. Bennett:
This letter is to notify you that on or about June 24, 2011, Mallinckrodt Inc., an indirect
subsidiary of Covidien plc, intends to complete an intercompany reorganization that will result in
Mallinckrodt Inc. being converted into a limited liability company, Mallinckrodt LLC. This
conversion is being done in accordance with Delaware corporate law and is tentatively scheduled
to be completed on .tune 24, 2011. Mallinckrodt Inc. owns legal title to property, plant and
equipment subject to the licenses or permits described on "Exhibit A" to this notification.
The following is a simplified summary of the proposed steps: (1) Mallinckrodt Inc. will file a
certificate of conversion under Delaware law to convert the company into a limited liability
company; (2) after the conversion to a limited liability company, the entity will be renamed as
Mallinckrodt LLC; and (3) the ownership of Mallinckrodt LLC will be transferred to
Mallinckrodt Enterprises LLC, a Delaware limited liability company that is also wholly owned
by indirect subsidiaries of Covidien plc. None of these transactions involve any legal entities
which are not affiliated with Mallinckrodt Inc. All of the movement of assets and ownership is
within the group of companies all wholly owned directly or indirectly by Covidien plc. Please
note, Mallinckrodt LLC is the same company, Mallinckrodt Inc., that is currently permitted.
By this letter, Mallinckrodt Inc. is notifying the North Carolina Department of Environment and
Natural Resources that the above referenced transaction will occur on or about June 24, 2011.
On the date the transaction is completed, an additional correspondence will be sent to your
office, confirming that the conversion of Mallinckrodt Inc. to Mallinckrodt LLC has been
finalized. Mallinckrodt is providing the following information to assist you in your review of the
transaction.
Page 1

1. The new name of the organization will be Mallinckrodt I.I.C. Their headquarters address
will remain at the current location.
Mallinckrodt LLC
675 McDonnell Blvd
Hazelwood, MO 63042
2. All contact information used for the existing permit including telephone number(s) and
names will remain the same.
3. There will be no changes in personnel having control over the permit and all officers and
managers of Mallinckrodt LLC will be the same as Mallinckrodt Inc.
4. At this time, Mallinckrodt Inc. does not plan any specific changes to the organization,
location, facility, equipment or procedures. If Mallinckrodt does intend to modify or change
the organizational structure which may impact the permit, Mallinckrodt will notify your
agency as necessary.
5. All records retained in connection with the permit will be maintained at the current location.
6. Mallinckrodt LLC will continue to abide by all commitments and representations within the
permit and will maintain all permit terms, conditions, and requirements upon conversion to
Mallinckrodt LLC.
Please note that we would appreciate your expeditious review of this notice and provide a
response if you need any additional information. If you have any questions regarding the
foregoing, please contact the undersigned at 919-878-2980, or, Patricia Duft, Mallinckrodt's
Chief EHS Counsel at 314-654-6314.
Sincerely,
-"L
Maria Longcore
Eric:
Exhibit "A"-Pennit List
Cc: file
Kay Yoder (Mallinckrodt)
Patricia Duft (Mallinckrodt)
Page 2

Exhibit A
Facility Location License "Cypc License Number
Raleigh, NC No Exposure Certification NCGNE0190
Page 3

July 7, 2011
Mr. Bradley Bennett
Stormwatcr Permitting Unit
NC DENR
512 N. Salisbury Street
Raleigh, NC 27604
RE: Notification of Conversion of Mallinckrodt Inc. to Mallinckrodt LLC
Permit # NCS000136
Dear Mr. Bennett:
COVIDIEN
JUL 1 3 2011
In a letter to your office dated June 14, 2011, our facility notified you of a pending name change.
On .tune 23, 2011, the name of the company was changed from Mallinckrodt Inc. to Mallinckrodt
LLC as described in our previous letter.
If you have any questions regarding the name change, please contact me at 919-878-2895, or
Patricia Duft, Mallinckrodt's Chief EHS Counsel at 314-654-6314.
Sincerely,
Mallinckrodt LLC
Tim Roberts
Environmental Coordinator
cc: Patricia Duft (Mallinckrodt-Corporate)
Sarah Scott (Mallinckrodt-Raleigh)
Kay Yoder (Mallinckrodt-Corporate)
Via Certified Mail 7010 3090 0000 0351 1596
iMALLINC 6HOM INC. 919-N78-28110 I'�
8801 CAPI'1'n1, MINI' 919-878-2823 1
Itn 1.1!1n u, NC
27616-3116

AEPA
NCDENR
,rvmunw�.ri wn N.mnu. P/9p).�E,e
Division of Water Quality / Surface Water Protection
National Pollutant Discharge Elimination System
NO EXPOSURE CERTIFICATION for Exclusion
NCGNE0000
NO EXPOSURE CERTIFICATION
FOR AGENCY USE ONLY
Date RCRIved
year nm�a�
oay
Certificate of Cavemp
NICIGINJE1
Please check here if this is a renewal: i& RENEWAL
National Pollutant Discharge Elimination System application for exclusion from a Stormwater Permit based
on NO EXPOSURE:
Submission of this No Exposure Certification constitutes notification that your facility does not require a
permit for stormwater discharges associated with industrial activity in the State of North Carolina because
it qualifies for a no exposure exclusion. A condition of no exposure at an industrial facility means all
industrial materials and activities are protected by a storm resistant shelter (with some exceptions) to
prevent exposure to rain, snow, snowmelt, and/or runoff.
For permitted facilities in North Carolina, DWQ must approve your application for No
Exposure Certification before this exclusion is effective. Until you are issued a No
Exposure Certification and your NPDES permit is rescinded, your facility must continue
to abide by the terms and conditions of the current permit.
Industrial materials or activities include, but are not limited to: material handling equipment or activities,
industrial machinery, raw materials, intermediate products, by-products, final products, or waste products.
Material handling activities include the storage, loading and unloading, transportation, or conveyance of
any raw material, intermediate product, final product or waste product. A storm resistant shelter is not
required for the following industrial materials and activities: drums, barrels, tanks, and similar containers
that are tightly sealed, provided those containers are not deteriorated and do not leak. "Sealed" means
banded or otherwise secured and with locked or non -operational taps or valves; adequately maintained
vehicles used in material handling; and final products, other than products that would be mobilized in
stormwater discharges (e.g., rock salt).
A No Exposure Certification must be provided for each facility qualifying for the no exposure exclusion. In
addition, the exclusion from NPDES permitting is available on a facility -wide basis only —not for individual
outfalls. If any industrial activities or materials are, or will be, exposed to precipitation, the facility is not
eligible for the no exposure exclusion. By signing and submitting this No Exposure Certification form, you
certify that a condition of no exposure exists at this facility or site and are obligated to comply with the
terms and conditions of 40 CFR 122.26(g).
You are required to reapply for the No Exposure Exclusion once every five (5) years.
For questions, please contact the DWO 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 Mallinckrodt, Inc. (Imaging Plant)
Contact Maria Longcore
Street Address 8800 Durant Road
City Raleigh State NC ZIP Code 27616
Telephone No. 919 878-2994, ext. 2980 Fax: [phone]
Page 1 of 7
SWU-NE-021309 Last revised 2/13/2009'

NCGNE0000 No Exposure Certification
2) Location of facility producing discharge:
Facility Name Same as Question 1
Facility Contact
Street Address
City
County
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). The facility is on the north side of
Durant Road, approximately 800 feet west of Capital Blvd/US 1. See attached
(A copy of a map with the facility clearly located on it should be included with the certification application.)
4) Is the facility located on Native American Lands? ❑ Yes IN No
5) Is this a Federal facility? ❑ Yes DO No
6) Latitude 35 53' 44" Longitude 78 33' 38" (deg., min., seconds)
7) This NPDES No Exposure Exclusion application applies to which of the following:
❑ New or Proposed Facility Date operation is to begin
❑ Existing Date operation began
IN Renewal of existing No Exposure Certification Certification No.: NCGNE 0190
8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes M No
If yes, what is the NPDES Permit Number?
9) Standard Industrial Classification:
NA
map.
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: 2 8 3 5
10) Provide a brief description of the types of industrial activities and products produced at this facility:
The facilitv manufactures a wide —ranee of contrast media Droducts used in the
sis or diseases.
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
IN No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility: NA
Page 2 of 7
SWU-NE-021309 Last revised 2/13/2009

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 ❑ Yes M No ❑ N/A
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 X No ❑ N/A
c. Materials or products from past industrial activity
❑ Yes KI No ❑ N/A
d. Material handling equipment (except adequately maintained vehicles)
❑ Yes IN No ❑ N/A
e. Materials or products during loading/unloading or transporting activities
❑ Yes N No ❑ N/A
f. Materials or products stored outdoors (except final products intended for outside
❑ Yes W No ❑ N/A
use [e.g., new cars] where exposure to stormwater does not result in the discharge
of pollutants)
g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks,
❑ Yes M No ❑ N/A
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes M No ❑ N/A
the discharger
i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters]) ❑ Yes N No ❑ N/A
j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes W No ❑ N/A
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes ® No ❑ N/A
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 M No ❑ N/A
(i.e., not closed and stored upside down to prevent precipitation accumulation)
m. For any exterior ASTs, as well as drums, barrels, tanks, and similar containers ❑ Yes M No ❑ N/A
stored outside, has the facility had any releases in the past three (3) years?
13) Above Ground Storage Tanks (ASTs): If you answer "No" to any of the following items, you are not
eligible for the no exposure exclusion.
a. Are exterior ASTs or piping free of rust, damaged or weathered coating, pits, or
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any
cracks, holes, or evidence of leaks, and are drain valves maintained locked shut?
M Yes ❑ No ❑ N/A
® Yes ❑ No ❑ N/A
Page 3 of 7
SWU-NE-021309 Last revised 2/13/2009

NCGNE0000 No Exposure Certification
14) Secondary Containment: If you answer "No" to any of the following items, you are not eligible for the
no exposure exclusion.
a. Is secondary containment provided for single above ground storage containers
(including drums, barrels, etc.) with a capacity of more than 660-gallons?
b. Is secondary containment provided for above ground storage containers stored
in close proximity to each other with a combined capacity of more than 1,320-
gallons?
c. Is secondary containment provided for Title III Section 313 Superfund
Amendments and Reauthorization Act (SARA) water priority chemicals*?
d. Is secondary containment provided for hazardous substances** designated in 40
CFR §116?
e. Are release valves on all secondary containment structures locked?
15) Hazardous Waste:
a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
M Yes ❑ No ❑ N/A
❑ Yes ❑ No IN N/A
❑ Yes ❑ No E N/A
❑ Yes []No Kl N/A
M Yes []No ❑ N/A
❑ Yes El No ❑ N/A
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste [-]Yes W No ❑ N/A
generated per month) of hazardous waste?
(THE FACILITY IS A CONDITIONALLY EXCEMPT SMALL QUANITITY GENERATOR OF HAZ. WASTE.
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste ❑ Yes K1 No ❑ N/A
generated per month) of hazardous waste?
If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste: NA
How is material stored:_
Where is material stored:
How many disposal shipments per year:
Name of transport / disposal vendor: _
Vendor address:
Footnotes to Questions 14) c. & d.
*Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require
secondary containment. However, some exceptions may 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.
Page 4 of 7
SWU-NE-021309 Last revised 2/13/2009

NCGNE0000 No Exposure Certification
16) Other information: It you answer "Yes" to any of the following items, you might not be eligible for the
no exposure exclusion. A more in-depth evaluation of the site circumstances may be required.
a. Does your facility store used, recycled, or otherwise reclaimed pallets outside?
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: See note I below
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.):
❑ Yes M No ❑ N/A
❑ Yes %] No ❑ N/A
❑ Yes 0 No ❑ N/A
❑ Yes NJ No ❑ N/A
❑ Yes ❑ No ® N/A
Permit: No. 01479R44 Program: NCDF.NR Division of Air Quality
Permit: No. MED 1 Program:City of Raliegh, Industrial Discharge
Permit
Permit:
Program:
Permit:
Program:
Permit:
Program:
Permit:
Program:
Permit:
Program:
Note 1: The facility does not have air emissions associated with the industrial
activity. The air emissions are from the operation of three boilers and one
backup generator. The facility air permit is jointly held with the adjacent
Mallinckrodt, Inc. (Pharmaceutical Plant located at 8801 Capital Blvd.).
Except for a jointly held air permit, the Mallinckrodt, Inc. facilities are
completly separate businesses.
Page 5 of 7
SWU-NE-021309 Last revised 2/13/2009

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 submit a no exposure certification form once every five (5)years to the North Carolina
Division of Water Quality and, if requested, to the operator of the local municipal separate storm sewer system (MS4) into
which the facility discharges (where applicable). I understand that I must allow the North Carolina Division of Water
Quality, or MS4 operator where the discharge is into the local MS4, to perform inspections to confirm the condition of no
exposure and to make such inspection reports publicly available upon request.
In the event that the site no longer qualifies for a No Exposure Exclusion, I understand that I must obtain coverage under
an NPDES permit prior to any point source discharge of stormwater from the facility. Additionally, I certify under penalty of
law that this document and all attachments were prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on my
inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the
information, the information submitted is to the best of my knowledge and belief true, accurate and complete. I am aware
that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for
knowing violations.
I certify that I am familiar with the information contained in this application and that to the best of my knowledge and belief
such information is true, complete, and accurate.
Printed Name of Person Signing: CiiAI-ICSICCLS'
Title: FAGjwnEt MAw/A,SA1—
(Signature of Applicant)
Please note: This application for the No Exposure Exclusion is subject to approval by the
NCDENR Regional Office prior to issuance. The Regional Office may inspect your facility for
compliance with no exposure conditions prior to that approval. The Regional Office may also
inspect your facility at any time in the future for compliance with the No Exposure Exclusion.
North Carolina General Statute 143-215.6 B(i) provides that;
Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan, or other
document filed or required to be maintained under this Article or a rule implementing this Article; or who knowingly makes a false
statement of a material fact in a rulemaking proceeding or contested case under this Article; or who falsifies, tampers with, or knowingly
renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
[Environmental Management] Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine
not to exceed ten thousand dollars ($10,000).
There is currently no fee for a No Exposure Exclusion.
Page 6 of 7
SWU-NE-021309 Last revised 2/13/2009

NCGNEO000 No Exposure Certification
Final Checklist
This application should include the following items:
W This completed application and all supporting documentation.
® A map with the location of the facility clearly marked.
® If this is a renewal, indicated current NCGNE number in Question 7.
❑ NA If the site currently has an NPDES Stormwater Permit, be sure to indicate the permit number in Question 8.
Mail the entire package to:
Stormwater Permitting Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Note
The submission of this document does not guarantee the issuance of a No Exposure Exclusion.
For questions, please contact the DWO Regional Office for your area.
DWQ 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)
807-6300
Page 7 of 7
SWU-NE-021309 Last revised 2/13/2009

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C_3 COVIDIEN
November 9, 2009
Mr. Myrl Nisely
North Carolina Department of Environment
and Natural Resources
Division of Water Quality
Raleigh Regional Office
3800 Barrett Drive
Raleigh, North Carolina 27609
RE: No Exposure Certification for Exclusion
from NPDES Storm Water Permitting
Renewal — Certification # NCGNE0190
Dear Mr. Nisely:
Mallinckrodt, Inc. (Imaging Plant) at 8800 Durant Road, Raleigh, North Carolina is
submitting a No Exposure Certification for Exclusion from NPDES Storm Water
Permitting (renewal of Certification # NCGNE0190). The completed No Exposure
Certification application form is attached.
Please call me at [phone] if you have any questions or require additional
information.
Sincerely,
Maria J. Longcore
Environmental, Health & Safety Coordinator
Attachment
IMAGwe SOLL1'I'1UN5 919-878-2931) � I
8800 DURAN'I RUgU 919-713-2.09 11:1
RA1.eua1, NC
27616
T,, NOV 1 02009

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, 1'. E. Director
Division of Water Quality
COleen Fl. Sullins, Deputy Director
Division of Water Quality
April 20, 2005
Christopher L Guerdan, Dir Operati
Tyco Healthcare-Mallinckrodt
675 McDonnell Blvd
Hazelwood, MO 63042
Subject: No Exposure Certification NCGNE0190
Tyco Healthcare- Mallinckrodt - 8800 Durant Rd
Wake 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 March 25, 2003. 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,
b-,,'tell
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, North Carolina 27699-1617 [phone]
awn
NCDENH
Customer Service
1-877-623-6748

Michael F. Easley, Govemor
William G. Ross Jr., Secretary
QG North Carolina Department of Rnvironment and Natural Resources
1 r Alan W. Klimek, F. E. Director
—� Division or Water Quality
'C Coleco H. Sullins, Deputy Director
Division of Water Quality
April 20, 2005
Christopher L Guerdan, Dir Operati
Tyco Healthcare-Mallinckrodt
675 McDonnell Blvd
Hazelwood. MO 63042
Subject: No Exposure Certification NCGNE0190
Tyco Healthcare- Mallinckrodt - 8800 Durant Rd
Wake 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 March 25, 2003. 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, North Carolina 27699-1617 [phone]
eNA
NCO ENR
Customer Service
1-977-623-6748

tgco
Healthcare
Mallinckrodt
March 20, 2003
Mr. Bradley Bennett
North Carolina Department of Environmental
and Natural Resources
Storm Water & General Permits Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
RE: No Exposure Certification for Exclusion
from NPDES Storm Water Permitting
Tyco Heal thcare/MalIinckrodt
Dear Mr. Bennett:
Mallinckrodt Inc
8800 Durant Road
Raleigh, NC 27616
Tele. 919 878-2930
Fax. [phone]
1, £OOZ S Z 1jdW I
Tyco Healthcare/Mallinckrodt at 8800 Durant Road, Raleigh, North Carolina is
submitting a No Exposure Certification for Exclusion from NPDES Storm Water
Permitting. EPA Form 3510-1 1 has been completed and is attached.
It is my understanding from talking with you today that submittal of this information to
the EPA is not required, even though EPA Form 3510-11 indicates that the form should
be mailed to the EPA. The North Carolina Storm Water & General Permits Unit allows
use of this form.
Please call me at [phone] if you have any questions or require additional
information.
Sincerely,
Maria J. Longcore
Environmental, Health & Safety Coordinator
Attachment

l\JC;��I_))::7nIGI D - I tir.
United States Environmental Protection Agency Form Approved
NPDES A Washington, DC 20460 OMB No. 2040-0211
FORM \�, EPA
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 State identified in Section B under EPA's Storm Water Multi -Sector General Permit due to the existence
of a condition 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, snowmelt, 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 storm water discharges (e.g., rock salt).
A No Exposure Certification must be provided for each facility qualifying for the no exposure exclusion. In addition, the exclusion from NPDES permitting is
available on a facility -wide basis only, not for individual outfalls. If any industrial activities or materials are or will be exposed to precipitation, the facility is
not eligible for the no exposure exclusion.
By signing and submitting this No Exposure Certification form, the entity in Section A is certifying that a condition of no exposure exists at its facility or site,
and is obligated to comply with the terms and conditions of 40 CFR 122.26(g).
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: I_TIYIC101 IHIEIAILITIHICIAIR IEl—IMIAILILIIiNfCIKIRIOID ITI 12.Phone: [phone] to 1010 1
3. Mailing Address: a. Street: 1617151 IMICID 101 NIN1 EIL I L I I B 101U I L I E IV IAIR ID I I 1
b. City: I HI Al Z I E I L I W10101 D I 11 I 1 1 1 1 1 I I 1 1 1 c. State: Lu d.Zip Code: 1613'P 14.Tl-14'�I
B. Facility/Site Location Information
1.Facility Name: ITIYICIGI IH IEIA ILI TIHIC IAIRIEI—IMIAILILIT INIC 1KIRIOIDIT
2. a. Street Address: 181810101 1DIUIRIAINITI IRIOIAiDi i i i , . . , . , ,
b. City: RIAILIEITIGIHI I III I 11 1 1 1 1 I 1 1 I c.County: W IA IK I E I I
d. State: IN I Q 1 e. Zip Code: 120 1 6 1 1 16 1-1 1 1
3. Is the facility located on Indian Lands? Yes 0 No [ "
4. Is this a Federal facility? Yes I] No
5. a. Latitude: 1 3151 1501 14141' b. Longitude: LQ 17 18 1313 3 18
6. a. Was the facility or site previously covered under an NPDES storm water permit? Yes No XD
to. If yes, enter NPDES permit number:
7. SIC/Activity Codes: Primary: 1218 15 Secondary (if applicable): I I 1 I
8. Total size of site associated with industrial activity: 2 V • 8 1acres
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 are likely to have
an adverse impact on water quality, in which case you could be required to obtain permit coverage.
Less than one acre ❑ One to five acres ❑ More than five acres ❑
con v....., oo. — I——
Page 1 of 4

rt�
NPDES NO EXPOSURE CERTIFICATION for Exclusion from Form Approved
FORM OMB OMB No. 2040-0211
3510-11 NPDES Storm Water Permitting
C. Exposure Checklist
Are any of the following materials or activities exposed to precipitation, 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 (11), you are not eligible for the no exposure exclusion.
Yes
No
1. Using, storing or cleaning industrial machinery or equipment, and areas where residuals from using, storing
or cleaning industrial machinery or equipment remain and are exposed to storm water
2. Materials or residuals on the ground or in storm water inlets from spills/leaks
X�
3. Materials or products from past industrial activity
❑
X❑
4. Material handling equipment (except adequately maintained vehicles)
❑
X❑
5. Materials or products during loading/unloading or transporting activities
❑
X❑
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)
7. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, and similar containers
XN
8. Materials or products handled/stored on roads or railways owned or maintained by the discharger
X❑
9. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters])
10. Application or disposal of process wastewater (unless otherwise permitted)
K1
11. Particulate matter or visible deposits of residuals from roof stacks and/or vents not otherwise regulated
XQ
(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 "no exposure" and obtaining an
exclusion from NPDES storm water permitting.
I certify under penalty of law that there are 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)).
I 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. I 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 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.
Print Name:ICIHIRIIISITIOIPIHIEIRI ILI IGIUIEIRIDIAINI I I I I I I I I I I I I
Print Title:
Signature:
Date: 10, 31 a o 119131
EPA Form 3510-11 (10-99) Page 2 of 4

NPDES Instructions for the NO EXPOSURE CERTIFICATION for Form Approved
FORM -,EPA OMB No. 2040-0211
3510-11 Exclusion from NPDES Storm Water Permitting
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)-
(ix) 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 (i.e., between the marks). Abbreviate
if necessary to stay within the number of characters allowed for each item.
Use one 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/owMsw. 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 entity that operates the facility or site 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, state, and zip code. All correspondence will
be sent to this address.
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, state, 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 degrees/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 site at http://www.epa.gov/ownVsw/industry/index.him and
selecting Latitude and Longitude Finders under the Resources/Permit
section.
Latitude and longitude for a facility in decimal form must be converted
to degrees (°), minutes I'), and seconds (") for proper entry on
the certification form. To convert decimal latitude or longitude to
degrees/minutes/seconds, follow the steps in the following example.
Example: Convert decimal latitude 45.1234567 to degrees (0), minutes
I), and seconds I').
a) The numbers to the left of the decimal point are the degrees: 450.
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 result 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 Manual, 1987.
8. Enter the total size of the site associated with industrial activity in acres.
Acreage may be determined by dividing square footage by 43,560, as
demonstrated in the following example.
Example: Convert 54,450 ft2 to acres
Divide 54,450 ft2 by 43,560 square feet per acre:
54,450 h2 - 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.
EPA Form 3510-11 (10-99) Page 3 of 4

NPDES Form Approved
FORM ,EPA Instructions for the NO EXPOSURE CERTIFICATION for OMB No. 2040-0211
3510-11 Exclusion from NPDES Storm Water Permitting
Section C. Exposure Checklist
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:
(i) 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
authority to sign documents has been 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, State, 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.
EPA Form 3510-11 (10-99) Page,4 of 4