NCGNE0856_COMPLETE FILE - HISTORICAL_20120622

STORMWATER DIVISION CODING SHEET
.NCG PERMITS
PERMIT NO.
NCGNE
DOC TYPE
HISTORICAL FILE
DOC DATE
❑ 3 UR O OZ�
YYYYMMDD

i y
�r
NCDENR
North Carolina Department of Environment and
Division of Wafer Qualify
Beverly Eaves Perdue Chuck Wakild, PE
Governor Director
June 22, 2012
Ms. Melanie Proctor
Purdue Pharmaceuticals L. P.
4701 Purdue Drive
Wilson, North Carolina 27893
Natural Resources
Subject: No -Exposure Certification NCGNE0856
Purdue Pharmaceuticals L. P.
Wilson County
Dear Ms. Proctor:
Dee Freeman
Secretary
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. Based on our observations 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 in order 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 Dave Parnell at [phone] or at
david. [e-mail].
/ Si cerely,
/
for Chuc akild, PE
Attachment:
cc: RRO Wilson County No Exposure File
Stormwater Permitting Unit No -Exposure Files
North Carolina Division of Water Quality 1628 Mail Service Center Raleigh, NO 27699-1628 Phone [phone]
Internet: www.ncwateroualitv.ora Location: 3800 Barrett Drive , Raleigh, NO 27609 Fax [phone]
An Equal Opportunity/Affirmative Action Employer— 50% Recycled/10% Post Consumer Paper
Ncone
nhCarolina
�Vntrrrally
Customer Service
1-877-623-6748

Compliance Inspection Report
Permit: NCGNE0856 Effective: Expiration: Owner: Purdue Pharmaceuticals L P
SOC: Effective: Expiration: Facility: Purdue Pharmaceuticals L P
County: Wilson 4701 Purdue Dr
Region: Raleigh
Wilson NC 27893
Contact Person: Susan Kennedy Title: Phone: [phone]
Directions to Facility:
System Classifications: -
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 06/20/2012 Entry Time: 01:30 PM Exit Time: 03:00 PM
Primary Inspector: David R Parnell 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 E Misc
(See attachment summary)
Page:1

S
r _
Permit: NCGNE0856 Owner - Facility: Purdue Pharmaceuticals L P
Inspection Date: 06/20/2012 Inspection Type: Compliance Evaluation
Inspection Summary:
Reason for Visit: Routine
Facility was evaluated for No Exposure Certification approval. Purdue is a solid tablet pharmaceutical production plant.
There are no floor drains within the plant. There is no pollutants that would affect stormwater being emmitted from the
roof exhausts. Gutters are connected to the stormwater system - which has been monitored since the facility was
permitted. The dock are shows no sign of any product or spillage in the vicinity and the individual docks are protected
with storm curtains to prevent any rainfall from coming in contact with materials. All dumpsters were observed and found
to be adequately covered and not exposed to the elements. Curb inlets were observed as well as the Stormwater
Discharge Outfall at the point where it is discharged into the industrial park stormwater pond. The No Exposure
Certification is accepted and approved at the time of this inspection.
Misc
Is the facility compliant?
Comment:
Yes No. NA NE
Page:2

�r
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P.E. Dee Freeman
Governor Director Secretary
August 17, 2012
Mr. Thomas Morris
North Carolina National Guard
1636 Gold Star Drive
Raleigh, NC 27607-6410
Subject: No -Exposure Certification NCGNE0861
North Carolina National Guard — Goldsboro Armory &
FMS #15
Wayne County
Dear Mr. Morris:
The Division has reviewed your submittal for the No -Exposure Certification for Exclusion from NPDES
Stormwater Permitting. Based on your submittal and signed certification of no exposure at the above referenced
facility and on site visit by Mr. Scott Vinson and Mr. Samir Dumpor of the Washington Regional Office of the
Division of Water Quality on August 8, 2012, 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 by self re -certifying your No Exposure Exclusion annually. 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 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 Scott Vinson at [phone], or at
[e-mail].
Wof
k.04t�or
ver Quality
cc: Washington Regional Office
I/Stormwater Permitting Unit, (Attu —Cory Larsen - No -Exposure Files)
North Carolina Division of Water Quality Internet: wwwmcwalerquality.org
943 Washington Square Mall Phone: [phone] One
Washington, NC 27889 FAX [phone] NorthCarolina
An Equal Opportunity/Affirmative Action Employer —50%RegGed110%a Post Consumer Paper Natural&

Compliance Inspection Report
Permit: NCGNE0861 Effective: Expiration: Owner:
NC National Guard
SOC: Effective: Expiration: Facility:
NC National Guard Goldsboro Armory &
FMS #15
County: Wayne
700 US Hwy 117 Bypass S
Region: Washington
Goldsboro NC 27530
Contact Person: Thomas Morris Title:
Phone: [phone]
Directions to Facility:
facility is located on the south west corner of intersection of US 17 & Canal St
System Classifications:
,
Primary ORC: Certification:
Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 08/08/2012 Entry Time: 09:30 AM Exit Time: 10:00 AM
Primary Inspector: Scott A Vinson Phone: [phone]
Secondary Inspector(s): Ext.208
Samir Dumpor Phone:
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Stormwater Discharge, No Exposure Certificate
Facility Status: ■ Compliant ❑ Not Compliant
Question Areas:
0 Miscellaneous Questions E Misc
(See attachment summary)
Page: 1

Permit: NCGNE0861 Owner - Facility: NC National Guard
Inspection Date: 08/08/2012 Inspection Type: Compliance Evaluation
Inspection Summary:
Reason for Visit: Routine
No Exposure Certification requested by the North Carolina Army national Guard. The inspection to determine if facility
qualifies for a No Exposure performed on August 8, 2012 by Mr. Scott Vinson and Mr. Samir Dumper of the Washington
Regional Office of DWQ. Mr Vinson and Mr Dumper met on site with Mr. Thomas Morris of National Guard and inspected
the facility. Facility found to be compliant and met all of the requirements to qualify for the No Exposure.
Misc
Is the facility compliant?
Comment: Permitee requested No Exposure certification. The facility compliant and
approved for No Exposure
Vea N. NA NF
Page: 2

V
North Carolina
Beverly Eaves Perdue
Governor
Ms. Melanie Proctor
Purdue Pharmaceuticals L. P.
4701 Purdue Drive
Wilson, North Carolina 27893
Dear Ms. Proctor:
_A_ ,
NCDENR
Department of Environment and Natural Resources
Division of Water Quality
Chuck Wakild, PE
Director
June 22,2012
Subject: No -Exposure Certification NCGNE0856
Purdue Pharmaceuticals L. P.
Wilson County
Dee Freeman
Secretary
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. Based on our observations 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 in order 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 Dave Parnell at [phone] or at
[e-mail].
Si cerely,
lily%� �%'✓�
for Chuc akild, PE
Attachment:
cc: RRO Wilson County No Exposure File
Stormwater Permitting Unit NO -Exposure Files
NorthCaroline
)Vaturallif
North Carolina Division of Water Quality 1628 Mail Service Center Raleigh, NC 27699-1628 Phone [phone] Customer Service
Internet: v .ncwatergualitv.org Location: 3800 Barrett Drive Raleigh, NC 27609 Fax [phone]
An Equal Opportunity/Affirmative Action Employer —50% Recycled/10% Post Consumer Paper

e
Compliance Inspection Report
Permit: NCGNE0856 Effective: Expiration: Owner: Purdue Pharmaceuticals L P
SOC: Effective: Expiration: Facility: Purdue Pharmaceuticals L P
County: Wilson 4701 Purdue Dr
Region: Raleigh
Wilson NC 27893
Contact Person: Susan Kennedy Title: Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 06/2012012
Primary Inspector: David R Parnell
Secondary Inspector(s):
Certification:
Entry Time: 01:30 PM Exit Time: 03:00 PM
Phone:
Phone: [phone]
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Stormwater Discharge, No Exposure Certificate
Facility Status: ® Compliant C) Not Compliant
Question Areas:
® Miscellaneous Questions ® Misc
(See attachment summary)
I
Page: 1

4
w r
NCDENR
North Carolina Department of Environment and
Beverly Eaves Perdue
Governor
Ms. Melanie Proctor
Purdue Pharmaceuticals L. P.
4701 Purdue Drive
Wilson, North Carolina 27893
Dear Ms. Proctor:
Division of Water Quality
Chuck Wakild, PE
Director
June 22, 2012
NAM
Natural Resources
Subject: No -Exposure Certification NCGNE0856
Purdue Pharmaceuticals L. P.
Wilson County
Dee Freeman
Secretary
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. Based on our observations 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 quality 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 in order 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 Dave Parnell at [phone] or at
[e-mail]. /
cerely,
l> //// �
for Chucl akild, PE
Attachment:
cc: RRO Wilson County No Exposure File
Stormwater Permitting Unit No -Exposure Files
N, OnethC mlina
/l �rturrr!!y
North Carolina Division of Water Quality 1628 Mad Service Center Raleigh, NC 27699-1628 Phone [phone] Customer Service
Internet: .vww.ncwatemuality. ora Location: 3800 Barrett Drive Raleigh, NC 27609 Fax [phone] 623-6748
An Equal Opportunity/Affirmative Action Employer - 50% Recycled/10 % Post Consumer Paper

Compliance Inspection Report
Permit: NCGNE0856 Effective: Expiration: Owner: Purdue Pharmaceuticals L P
SOC: Effective: Expiration: Facility: Purdue Pharmaceuticals LP
County: Wilson 4701 Purdue Or
Region: Raleigh
Wilson NC 27893
Contact Person: Susan Kennedy Title: Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 06/20/2012 Entry Time: 01:30 PM Exit Time: 03:00 PM
Primary Inspector: David R Parnell 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:
N Miscellaneous Questions M Misc
(See attachment summary)
Page:1

Permit: NCGNE0856 Owner - Facility: Purdue Pharmaceuticals L P
Inspection Date: 06/20/2012 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary
Facility was evaluated for No Exposure Certification approval. Purdue is a solid tablet pharmaceutical production plant.
There are no floor drains within the plant. There is no pollutants that would affect stormwater being emmitted from the
roof exhausts. Gutters are connected to the stormwater system - which has been monitored since the facility was
permitted. The dock are shows no sign of any product or spillage in the vicinity and the individual docks are protected
with storm curtains to prevent any rainfall from coming in contact with materials. All dumpsters were observed and found
to be adequately covered and not exposed to the elements. Curb inlets were observed as well as the Stormwater
Discharge Outfall at the point where it is discharged into the industrial park stormwater pond. The No Exposure
Certification is accepted and approved at the time of this inspection.
Misc
Is the facility compliant?
Comment:
Yes No NA NE
Page:2

(((\°���/)ry^ A ` Division of Water Quality / Surface Water Protection
MCip ENR National Pollutant Discharge Elimination System
NO EXPOSURE CER-FIF1CATION for Exclusion
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NCGNE-0000
NO EXPOSURE CERTIFICATION
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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 ornon-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
of40 CFR 122.26(g).
You are required to self re -certify your No Exposure Exclusion annually.
For questions, please contact the DWQ 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 Purdue Pharmaceuticals L.P.
Contact Melanie Proctor
Street Address 4701 Purdue Drive
City Wilson State NC ZIP Code 27893 O
Telephone No. I252) 265-1680 Fax: [phone]
Email melanie.proctor(o)pharma.coo l/
vU�
SWU-NE-12Au92010
MAY 3 1 2012

NCGNE0000 No Exposure Certification
2) Location of facility producing discharge:
Facility Name Purdue Pharmaceuticals L.P
Facility Contact
Melanie Proctor
Facility Street Address 4701 Purdue Drive
City
Wilson Slate NC ZIP Code 27893
County
Wilson County
Telephone No.
[phone] Fax: [phone]
Email
melanie.proctor(o),pharma.com
3) Physical location information:
Please provide a narrative description of how to gel to the facility (use street names, state road numbers, and
distance and direction from a roadway intersection). From Raleigh take 64 East to 264 East in approximately 20
miles take Exit 36B (Wilson). This is 264 Business/Raleigh Road. Cross over 1-95 and take a right at the light onto
Merck Road. Follow Merck Road 2 miles to International Boulevard. Turn right on International Boulevard, Purdue
Pharmaceuticals will be immediately on the left (see attached map).
(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 X No
5) Is this a Federal facility? ❑ Yes X No
6) Latitude N 35' 44' 06 Longitude W 77° 59' 22" (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
X Existing
Date operation began April 2001
❑ Renewal of existing No Exposure Certification Certification No.: NCGNE
8) Was this facility or site ever covered under an NPDES Stormwater Permit? X Yes ❑ No
If yes, what is the NPDES Permit Number? NPDES General Permit No. NCGO60000,
Certificate of Coverage No. NCGO60239
9) Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial activity at
this facility
SIC Code:2834
10) Provide a brief description of the types of industrial activities and products produced at this facility:
The industrial activities performed at the facility involve the production of solid dose pharmaceuticals
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
X No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
Page 2 of 7
SWU-NE-12Aug2010

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
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
c. Materials or products from past industrial activity
❑ Yes X No
J. Material handling equipment (except adequately maintained vehicles)
❑ Yes X No
e. Materials or products during loading/unloading or transporting activities
❑ Yes X No
f. Materials or products stored outdoors (except final products intended for outside
❑ Yes X No
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
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by O Yes X No
the discharger
i. Waste material (except waste in covered, non -leaking containers [e.g,, dumpsters]) ❑ Yes X No
j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes X No
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes X No
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 X No
(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 X No
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 and piping free of rust, damaged or weathered coating, pits, or []Yes D No X N/A
deterioration, or evidence of leaks? Note: Site does not have exterior ASTs
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any ❑ Yes ❑ No X N/A
cracks, holes, or evidence of leaks, and are drain valves maintained locked shut?
Page 3 of 7
Sw1J-NE-12Au92o10

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 all single above ground storage
O Yes O No X N/A
containers (including drums, barrels, etc.) with a capacity of more than 660-
gallons? Note: Site does not have any exterior above ground storage containers
greater than 660 gallons. 3,000 gallon fuel lank inside containment building has
secondary containment.
b. is secondary containment provided for above ground storage containers stored
X Yes ❑ No ❑ N/A
in close proximity to each other with a combined capacity of more than 1,320-
gallons? 3,000 gallon fuel tank inside containment building has secondary
containment. Secondary containment for other inside containers consists of
containment double walled tanks and storage of drums on spill pallets.
c. Is secondary containment provided for Title III Section 313 Superfund
X Yes O No ❑ N/A
Amendments and Reauthorization Act (SARA) water priority chemicals'?
d. Is secondary containment provided for hazardous substances" designated in 40
X Yes 0 No ❑ N/A
CFR §116?
e. Are release valves on all secondary containment structures locked? Note: Site
❑ Yes O No X N/A
does not have any outside secondary containment structures requiring the
release of precipitation. Secondary containment for inside containers consists of
containment without release valves double walled tanks and storage of drums
on spill pallets.
15) Hazardous Waste:
a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? ❑ Yes X No
In. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste ❑ Yes X No
generated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste X Yes ❑ No
generated per month) of hazardous waste?
If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste: Various laboratory waste from QC lab and Isopropyl Alcohol waste
How is material stored: In closed containers in containment building with secondary containment
Where is material stored: In a containment building attached to the buildinq with secondary containment
How many disposal shipments per year: 6 on average
Name of transport / disposal vendor: Veolia Environmental Services
Vendor address: 2176 Will Suitt Road, Creedmore NC 27522
Page 4 of 7
SW U-NE-12Aug2010

NCGNED000 No Exposure Certification
Footnotes to Questions 14) c. & d.
'Note that amounts below the 660-gallon (single) and 1.320-gallon (combined) bulk storage minimums require
secondary containment. However, some exceptions may be made for de minimis amounts of certain substances, and/or
other qualifiers, as described in the exemptions from reporting requirements of Title III SARA 313 in 40 CFR §372.38.
"Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require
secondary containment. However, some exceptions may be made for amounts less than the Reportable Quantities of
the hazardous substances listed in 40 CFR §117.3.
16) Other information: If you answer "Yes" to any of the following items, you might not be eligible for the no
exposure exclusion. A more in-depth evaluation of the site circumstances may be required.
a. Does your facility store used, recycled, or otherwise reclaimed pallets outside? ❑ Yes X No
b. Does your facility have coal piles on site? ❑ Yes X No
c. Does your facility store other fuel sources outside in piles, such as wood chips, ❑ Yes X No
sawdust, etc.?
d. Does your facility have air emissions associated with its industrial activity (e.g., X Yes 0 No
degreasing operations, plating, painting and metal finishing)? If so, describe the
industrial activity: Facility has synthetic minor air permit for process equipment
with bag filters and diesel fired electric generator. Air permit also lists a number of
exempt equipment including boilers.
e. If you answered yes to d., are those emissions permitted by an Air Quality X Yes 0 No ❑ N/A
Permit? Please specify: Yes, air emission sources are covered by facility's air
permit (permit # 08820R05).
f. Please list any other environmental program permits (federal, slate, etc.) not
specified earlier in this application (such as Hazardous Waste Permits, etc.):
Permit: # 0882OR05 Program: Air Permit
Permit: # 2000-001 Program: Wastewater Discharge Permit
Permit: ID # NCR000135285 Program: Hazardous Waste Generator ID
Permit: # 2011031910 Program: UST Operating Permit
Permit: Program:
Permit: Program:
Permit Program:
Page 5 of 7
S W U-N&12Aug2010

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 penally 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 annually self re -certify, No Exposure and, if requested, submit the re -certification to DWQ or
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 ooin[ source discharoe of stormwater from the facility. Additionally, I certify under penalty of law that
this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or
persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is
to the best of my knowledge and belief true, accurate and complete. I am aware that there are significant penalties for submitting
false information, including the possibility of fine and imprisonment for knowing violations.
I certify that I am familiar with the information contained in this application and that to the best of my knowledge and belief such
information,is true, complete, and accurate.
Printed Name of Person Signing: _r�/(V LD Ll7NDt t
Title: 1 ")�Z 1->F r SEC i.ikeA
Z
(Signature ol1 pplic (t) (Date Signed)
Please note: This application for the No Exposure Exclusion is subject to approval by the NCOENR
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 Anice; 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-12Au92010

NCGNE000O No Exposure Certification
Final Checklist
This application should include the following items:
X This completed application and all supporting documentation.
X A map with the location of the facility clearly marked.
X 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 DWQ Regional Office for your area.
DWQ Regional Office Contact Information:
Asheville Office ......
[phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
[phone]
Washington Office ...
[phone]
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office ........,
[phone]
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Page 7 of 7
SWU-NE-12Aug2010

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