NCGNE0624_COMPLETE FILE - HISTORICAL_20110829

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCGNE
DOC TYPE
Q/HISTORICAL FILE
DOC DATE
❑ a 0 110�
YYYYMMDD

0
Turkington
USA[:_4�rr�a'!�
AUG 2 9 2011
Jim Partridge Rr718tG(IVC DEIMi (?ro°rnai{lf;,;E:
8182 US HWY 70 W Bus
Clayton, NC 27520
August 23, 2011
RE: No Exposure Storm Water Permit
Myrl Nisely
NCDENR
1628 Mail Service Center
Raleigh, NC 27699-1628
Dear Mr. Nisely,
Thank you for coming to our plant to review our compliance with the No Exposure Storm Water
Permit. Based on our conversation and your recommendation, we have changed out the scrap bin
to a shorter version to keep the material safety under our loading dock overhang. We have also
turned the container to make it possible to even keep the covered containers under the overhang.
Included with this letter are pictures of the new arrangement. This was the only issue you had
indicated would need to be rectified to obtain our permit.
If you have any questions, please feel free to contact me directly at [phone] or anytime on
my cell phone at [phone].
Thank you,
Lg!e
Facilities Manager
Enclosures: 1
8182 US HWY 70 WEST • CLAYTON, NORTH CAROLINA 27520 • UNITED STATES •T + 1 919-674-3750
A TURKINGTON INDUSTRIES GROUP COMPANY

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Nisely, Myrl
From: Jim Partridge[[e-mail]]
Sent: Wednesday, August 24, 2011 8:28 AM
To: Nisely, Myrl
Subject: Scrap Container Changes 1 of 2
Attachments: P1000921.JPG
Myrl,
First of all, I really enjoyed meeting with you the other day. Your feedback was greatly appreciated. As per our
discussion, we have switched out the scrap metal container the stuck out past the roof line. We actually turned the
new, shorter container and was even able to get the other two covered containers under the overhang as well. They are
all well behind the edge of the roof line as you will see in the attached photos. I have to send them one at a time as our
outboard file size limitation won't allow for more than one. I have sent out a letter to your attention that includes print
outs of these photos as well. If you have any other questions, please feel free to call or stop by our plant. If I don't hear
from you prior to the end of the month, have a great retirement!
Sincerely,
Jim Partridge
Facilities Manager
Turkington USA
8182 US Hwy 70 W Bus
Clayton, NC 27520
919-674-3820 Desk
919-344-7770 Cell

Nisely, Myrl
From:
Jim Partridge [Jim. [e-mail]]
Sent:
Wednesday, August 24, 2011 8:31 AM
To:
Nisely, Myrl
Subject:
2 of 2
Attachments:
P1000920.JPG 1
Here is the other photo. As a reminder, the big container the is only partially under the overhang is our scrap wood
dumpster. It does not contain any pressure treated or otherwise contaminated wood. It is for scrap wood from our
crate building for shipping.
Thanks,
Jim Partridge
Facilities Manager
Turkington USA
8182 US Hwy 70 W Bus
Clayton, NC 27520
919-674-3820 Desk
919-344-7770 Cell

Turkington Pictures Showing Improved Dumpster Locations Out of the Rain - August 2011

►� 31 r �
NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
August 24, 2011
Mr. Jim Partridge
Turkington USA.
8183 US Hwy 70 West
Clayton, NC 27520-0687
Subject: No -Exposure Stormwater Certification
Permit No. NCGNE0624
Turkington USA
Clayton, NC
Johnston County
Dear Mr. Partridge:
The Division has reviewed your submittal of the No -Exposure Certification for Exclusion from NPDES Stormwater
Permitting form and made a site visit to assess the potential for stormwater pollution. Your facility now qualifies after a
change was made to completely shield the waste dumpster at the end of the truck dock. Based on our observations,
this corrective action and your submittal and signed certification of no exposure at the above referenced facility, the
Division is granting your conditional exclusion from permitting 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 (subject to civil penalties
of up to $25,000 per day). Your conditional no -exposure exclusion does not expire. However, you must self re-
certify annually using the enclosed form, or obtain NPDES permit coverage for any stormwater discharges from
your facility. Please store the completed re -certification forms to have them available during future inspections by
DWQ.
Your conditional exclusion from permitting does not affect your facility's legal requirements to obtain environmental
permits that may be required under other federal, state, or local regulations or ordinances.
If you have any questions or need further information, please contact a staff member in the Raleigh Regional Office at
[phone].
(Since)
�
ly,
12 �✓ /%7d
for Coleen H. Sul'fS
Attachment
cc: RRO County NE File
Stormwater Permitting Unit No -Exposure Files
North Carolina Division of Water Quality 1628 Mail Service Center Raleigh, NC 27699-1628 Phone [phone] Customer Service
Internet: www.ncwatergualitv.orq Location: 3800 Barrett Drive Raleigh, NC 27609 Fax [phone]
One
An Equal Opportunity/Affirmative Action Employer —50% Recycled/10% Post Consumer Paper No hCarolina
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a.
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.orgMebMgMs/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.
-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 above website.

Compliance Inspection Report
Permit: NCGNE0624 Effective: Expiration: Owner: Turkington USA
SOC: Effective: Expiration: Facility: Turkington USA
County: Johnston 8182 Ua Hwy 70 W
Region: Raleigh
Clayton NC 27520
Contact Person: Jim Partridge Title: Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 08/09/2011 Entry Time: 08:00 AM Exit Time: 09:00 AM
Primary Inspector: Myrl Nisely Phone: [phone]
Secondary Inspector(s):
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Stormwater Discharge, No Exposure Certificate
Facility Status: ■ Compliant ❑ Not Compliant
Question Areas:
E Miscellaneous Questions
(See attachment summary)
Page:1

Permit: NCGNE0624 Owner- Facility: Turkington USA
Inspection Date: 08/09/2011 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
This inspection evaluated whether this facility qualified for a No Exposure permit. The nicely landscaped building had one
exposed source of potential pollution at one end of the loading dock. A large dumpster is under roof except for about the
last four feet of its length, but in that end were oily metal shavings. Either a shorter dumpster should be used and emptied
more often, or some way be found to keep rain from entering the few feet that are uncovered. Mr. Partridge agreed to
make an appropriate change and send pictures and a description.
The No Exposure can be granted with this BMP in place.
Page:2

w �
NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Colleen H. Sullins Dee Freeman
Governor Director . Secretary
August 24, 2011
Mr. Jim Partridge
Turkington USA.
8183 US Hwy 70 West cn � V
Clayton, NC 27520-0687 "-'
Subject: No -Exposure Stormwater Certificatio if
Permit No. NCGNE0624
Turkington USA o
Clayton, NC o
Johnston County —�
Dear Mr. Partridge:
0
The Division has reviewed your submittal of the No -Exposure Certification for Exclusion from NPDES Stormwater
Permitting form and made a site visit to assess the potential for stormwater pollution. Your facility now qualifies after a
change was made to completely shield the waste dumpster at the end of the truck dock. Based on our observations,
this corrective action and your submittal and signed certification of no exposure at the above referenced facility, the
Division is granting your conditional exclusion from permitting 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 (subject to civil penalties
of up to $25,000 per day). Your conditional no -exposure exclusion does not expire. However, you must self re-
certify annually using the enclosed form, or obtain NPDES permit coverage for any stormwater discharges from
your facility. Please store the completed re -certification forms to have them available during future inspections by
DWQ.
Your conditional exclusion from permitting does not affect your facility's legal requirements to obtain environmental
permits that may be required under other federal, state, or local regulations or ordinances.
If you have any questions or need further information, please contact a staff member in the Raleigh Regional Office at
[phone].
for Coleen H.
Attachment
cc: RRO County NE File
Stormwater Permitting Unit No -Exposure Files
Suy s
North Carolina Division of Water Quality 1628 Mail service Center Raleigh, NC 27699-1628 Phone [phone] Customer service
Internet: www.ncwatemuality.orc Location: 3800 Barrett Drive Raleigh, NC 27609 Fax [phone]
()IIC
An Equal Opportunity/Affirmative Action Employer —50%Recycled/10% Post Consumer Paper NonhCarolina
A1rrtrrrrr1lj

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.
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/wq/ws/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.
-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 above website.

Compliance Inspection Report
Permit: NCGNE0624 Effective: Expiration: Owner: Turkington USA
SOC: Effective: Expiration: Facility: Turkington USA
County: Johnston 8182 Ua Hwy 70 W
Region: Raleigh
Clayton NC 27520
Contact Person: Jim Partridge Title: Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 08/09/2011 Entry Time: 08:00 AM Exit Time: 09:00 AM
Primary Inspector: Myrl Nisely Phone: [phone]
Secondary Inspector(s):
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Stormwater Discharge, No Exposure Certificate
Facility Status: ■ Compliant ❑ Not Compliant
Question Areas:
Miscellaneous Questions
(See attachment summary)
Paget

Permit: NCGNE0624 Owner - Facility: Turkington USA
Inspection Date: 08/09/2011 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
This inspection evaluated whether this facility qualified for a No Exposure permit. The nicely landscaped building had one
exposed source of potential pollution at one end of the loading dock. A large dumpster is under roof except for about the
last four feet of its length, but in that end were oily metal shavings. Either a shorter dumpster should be used and emptied
more often, or some way be found to keep rain from entering the few feet that are uncovered. Mr. Partridge agreed to
make an appropriate change and send pictures and a description.
The No Exposure can be granted with this BMP in place.
Page:2

q1 -Pq --7770
Division of Water Quality / Surface Water Protection
NC®ENR National Pollutant Discharge Elimination System
NO EXPOSURE CERTIFICATION for Exclusion
NCGNE0000
P-0
FOR AGENCY USE ONLY
Dute Received
Ymr Mumh
Duy
O
crtificate nl'Coverage
N N E 7-
Please check here if this is a renewal: ❑ 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, snowmeft, 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).
✓sy
A No Exposure Certification must be provided for each facility qualifying for the no exposure excl ion --In „J
addition, the exclusion from NPDES permitting is available on a facility -wide basis only —not for i �i'�. ualXi
itU
outfalls. if any industrial activities or materials are, or will be, exposed to precipitation, the facilit `s,not z
eligible for the no exposure exclusion. By signing and submitting this No Exposure Certification , yo u_
certify that a condition of no exposure exists at this facility or site and are obligated to comply wi ;the
terms and conditions of 40 CFR 122.26(g). o I e91
cl c�
You are required to reapply for the No Exposure Exclusion once every five (5 a s:
For questions, please contact the DWO Regional Office for your area. (See page 6)
(Please print or type)
1) Mailing address of ewaertoperator (address to which all certification correspondence will be mailed):
Name I(Ark „4-ovn U54
Contact h.,+}A/: T m tea ./ ­ ; d 4 e-
Street Address ti (R 3 i.1 SH w4 7 d L)e S L"
City State A>C ZIP Code
Tel No. 9197 Fax:
ytEi" - 0 `1 3 70 a7�
Page 1 of 7
SWU-NE-021309 Last revised 2/1312009

NCGNE0000 No Exposure Certification
2) Location of facility producing discharge:
Facility Name
Facility Contact
Street Address
City
County
Telephone No.
3) Physical location information:
State JVC_- ZIP Code J7$)d-
3ci4 -77'7 d 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). 7 ru C/a l u , cti- b u � ,-na -s
Ju5) ems! 'f2/<<";5 (A3 e-) P�e, +
(A copy of ap with the facility clearly located on it should be included with the certification application.)
4) is the facility located on Native American Lands? ❑ Yes kNo
5) Is this a Federal facility? ❑ Yes )d No
0
6) Latitude 35 � 57" Longitude -78 ,s Ol ° (deg., min., seconds)
7) This NPDES No Exposure Exclusion application applies to which of the following::
X New or Proposed Facility Date operation is to begin 5/ -e " 6e, , ; c'
❑ Existing
Date operation began
❑ Renewal of existing No Exposure Certification Certification No.: NCGNE
8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes ❑ No
If yes, what is the NPDES Permit Number? q0 ko U cJ V1
9) Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility r1
SIC Code: 3 5 6 9
10) Provide a brief description of the types of industrial activities and products produced at this facility:
I M,"u' -r;•I, &X I"N of n.F
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
J(No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
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 X 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 K No ❑ N/A
c. Materials or products from past industrial activity
❑ Yes
No
❑ N/A
d. Material handling equipment (except adequately maintained vehicles)
❑ Yes
No
❑ N/A
e. Materials or products during loading/unloading or transporting activities
❑ Yes
)(No
❑ N/A
f. Materials or products stored outdoors (except final products intended for outside ❑ Yes i` 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 X No ❑ N/A
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by
❑ Yes No ❑ N/A
the discharger
I. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters])
Cl Yes No ❑ N/A
j. Application or disposal of process wastewater (unless otherwise permitted)
❑ Yes No ❑ N/A
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not
❑ Yes W 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 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 V No KN/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 ❑ Yes ❑ No N/A
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any [:]Yes ❑ No N/A
cracks, holes, or evidence of leaks, and are drain valves maintained locked shut?
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?
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste
generated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste
generated per month) of hazardous waste?
If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste: U- ik r4', Al
How is material stored: f f os.z-c( d
Where is material stored: Gc -
How many disposal shipments per year:
Name of transport / disposal vendor: _
Vendor address: 7SS
Footnotes to Questions 14) c. & d.
❑ Yes ❑ No X N/A
❑ Yes ❑ No � N/A
❑ Yes ❑ No )9 N/A
❑ Yes ❑ No X N/A
❑ Yes ❑ No )(N/A
❑ Yes %I No ❑ N/A
N Yes ❑ No ❑ N/A
❑ Yes 'W No ❑ N/A
`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

NCGNEOOOO No Exposure Certification
16) Other information: If you answer "Yes" to any of the following items, you might not be eligible for the
no exposure exclusion. A more in-depth evaluation of the site circumstances may be required.
a. Does your facility store used, recycled, or otherwise reclaimed pallets outside?
❑ Yes
PQ No
❑ N/A
b. Does your facility have coal piles on site?
❑ Yes
X No
❑ N/A
c. Does your facility store other fuel sources outside in piles, such as wood chips,
❑ Yes
% No
❑ N/A
sawdust, etc.?
d. Does your facility have air emissions associated with its industrial activity (e.g.,
k1 Yes
❑ No
❑ N/A
degreasing operations, plating, painting and metal finishing)? If so, describe the
industrial activity: e x 3 v 4 �� f�i nq a C. 1; ✓: l y
e. If you answered yes tot d., are those emissions permitted by an Air Quality Permit?
❑ Yes
,rj No
❑ N/A
Please specify: / yd 4 s s 1-f .,„ 5 +,,, Iti si L d
f. Please list any other environmental program permits (federal, state, etc.) not
specified earlier in this application
(such as Hazardous Waste Permits, etc.):
Permit:
Program:
Permit:
Program:
Permit:
Program:
Permit:
Program:
Permit:
Program:
Permit:
Program:
Permit:
Program:
Page 5 of 7
SWU-NE-021309 Last revised 2/13/2009

NCGNEO000 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 o
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: �dH„ �uCe,-.s
Title: -Pt4 S'; 000014—
(Signature of Applicant) (Date Signed)
Please note: This application for the No Exposure Exclusion is subject to approval by the
NCDENR Regional Office prior to issuance. The Regional Office may inspect your facility for
compliance with no exposure conditions prior to that approval. The Regional Office may also
inspect your facility at any time in the future for compliance with the No Exposure Exclusion.
North Carolina General Statute 143-215.6 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

NCGNE0000 No Exposure Certification
Final Checklist
This application should include the following items:
❑ This completed application and all supporting documentation.
❑ A map with the location of the facility clearly marked.
❑ If this is a renewal, indicated current NCGNE number in Question 7.
❑ 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.
DWO 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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