NCGNE0864_COMPLETE FILE - HISTORICAL_20120817

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v uc,
DOC TYPE
HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ �' d O � 7
YYYYMMDD

r ��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 NCGNE0864
North Carolina National Guard — Kinston Armory &
FMS #18
Lenoir 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. Samir Dumpor and Mr. Scott Vinson 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 Samir Dumpor at [phone], or at
[e-mail].
Division of Water Quality
cc: Washington Regional Office
vl�`Stormwater Permitting Unit, (Attn —Cory Larsen - No -Exposure Files)
North Carolina Division of Water Quality
Internet: www.ncwalcraualitv.org
943 Washington square Mall
Phone: [phone]
One
Washington, NC 27889
FAX [phone]
NorthCarolina
An Equal Opportunity/Affirmative Action Employer —50%Recycled110%
Post Consumer Paper
Natural&

Permit: NCGNE0864 Effective:
SOC: Effective:
County: Lenoir
Region: Washington
Compliance Inspection Report
Expiration: Owner: NC National Guard
Expiration: Facility: NC National Guard Kinston Armory & SMS #18
2001 Dobbs Farm Rd
Kinston NC 28504
Contact Person: Thomas Morris Title: Phone: [phone]
Directions to Facility:
Facility is approx .75 miles west of the intersection betwen Hap Arnold Blvd & Dobbs Farm Rd
System Classifications:
Primary ORC: Certification:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 08108/2012
Primary Inspector: Samir Dumpor
Secondary Inspector(s):
EntryTime: 11:00 AM Exit Time: 12:00 PM
Phone:
Phone: [phone]
Scott A Vinson Phone: [phone] Ext.208
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 0 Misc
(See attachment summary)
Page: 1

Permit: NCGNE0864 Owner • Facility: NC National Guard
Inspection Date: 08/08/2012 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
NC National Guard requested a No Exposure certification for Kinston Facility. Inspection due to this request was
performed on August 8, 2012 by Mr. Samir Dumpor and Mr. Scott Vinson of the Washington Regional Office of the
Division of Water Quality. Mr. Dumpor and Mr. Vinson met on site with Mr. Thomas Morris of the NC National Guard and
found site to be compliant with the stomrwater permit and to fulfill all of the requirements to received a No Exposure
Certification.
Misc
Is the facility compliant?
Comment:
vow W. ue w=
Page: 2

QUA
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 NCGNE0864
North Carolina National Guard — Kinston Armory &
FMS 918
Lenoir 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. Samir Dumpor and Mr. Scott Vinson 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 Samir Dumpor at [phone], or at
[e-mail].
Division of Water Quality
cc: Washington Regional Office
Stormwater Permitting Unit, (Attu —Cory Larsen - No -Exposure Files)
North Carolina Division of Water Quality Internet: www.ncwaterqualitv.org
943 Washington Square Mall Phone: [phone]�iOne
Washington, NC 27889 FAX [phone] i orth CarQf1nd
An Equal Opportunity/Affirmative Action Employer- 50%Recycled110% Post Consumer Paper Natural&

Permit: NCGNE0864 Effective:
SOC: Effective:
County: Lenoir
Region: Washington
Compliance Inspection Report
Expiration: Owner: NC National Guard
Expiration: Facility: NC National Guard Kinston Armory & SMS #18
2001 Dobbs Farm Rd
Kinston NC 28504
Contact Person: Thomas Morris Title: Phone: [phone]
Directions to Facility:
Facility is approx .75 miles west of the intersection betwen Hap Arnold Blvd & Dobbs Farm Rd
System Classifications:
Primary ORC: Certification:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Phone:
Inspection Date: 08/08/2012 EntryTime: 11:00 AM Exit Time: 12:00 PM
Primary Inspector. Samir Dumpor Phone: [phone]
Secondary Inspector(s):
Scott AVinson Phone: [phone] Ext.208
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 N Misc
(See attachment summary)
Page: 1

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Permit: NCGNE0864 (Tuner - Facility: NC National Guard
Inspection Date: 0810812012 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
NC National Guard requested a No Exposure certification for Kinston Facility. Inspection due to this request was
performed on August 8, 2012 by Mr. Samir Dumpor and Mr. Scott Vinson of the Washington Regional Office of the
Division of Water Quality. Mr. Dumpor and Mr. Vinson met on site with Mr. Thomas Moms of the NC National Guard and
found site to be compliant with the stomrwater permit and to fulfill all of the requirements to received a No Exposure
Certification.
Misc
Is the facility compliant?
Comment:
Yes No NA NE
Page: 2

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Central Files: APS_ SWP_
Permit Number NCGNE0864 ,� oprrao . }�e9a. 195krmit Tracking Slip 07/16/12
Program Category
NPDES SW
Permit Type
Stormwater Discharge, No Exposure Certificate
Primary Reviewer
al. hodge
Coastal SW Rule
Permitted Flow
Facility Name
NC National Guard Kinston Armory & SMS #18
Location Address
7-87S 20&1-Dobbs Farrn,Rd
Kinston NC
Status Project Type
In review New Project
Version Permit Classification
Individual
Permit Contact Affiliation
Major/Minor Region
Minor Washington
County
Lenoir
28504 Facility Contact Affiliation
Thomas Morris, IZEM - EPAS N+dwag2r —rlc Arm,, Ni
Morris Mr
1636 Gold Star Or
Raleigh NC 27607
Owner Name Owner Type
NC National Guard Government - State
`- Owner Affiliation
Thomas,IMorris'
fN� 7 Morris Mr
Lb4 "6047 1636 Gold Star Dr
C9f1)yfa{ -LIg4 Raleigh NC 27607
Dates/Events
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
07/03/12
Regulated Activities ( Requested/Received Events
3S • io SS — 77• b y3?l �(oeos�c Eor r �,j Region comments on draft received
Region comments on draft requested 07/11/12
Outfall NULL ��5. 3iS 3 — 7ao1�5 �, tde, ha✓O COor6�^w��
Waterbody Name Stream Index Number Current Class Subbasin

?4-�4�r� 01311 a -
Permit Number NCG080556
Program Category
NPDES SW
Permit Type
Transportation w/Vehicle Maintenance/Petroleum Bulk/Oil Water
Separator Stormwater Discharge COC
Primary Reviewer
aisha.lau
Coastal SW Rule
Permitted Flow
0
FacilityName tJt, tjd4e.w) 4",r d �'^S�'•�+
NC Nat Gd- Kinston/Oms # 18 k 5 t-ni A- 18
Location Address
2875 Dobbs Farm Rd
Kinston
NC 28504
Central Files: APS_ SWP_
07/16/12
Permit Tracking Slip
Status
Project Type
Active
Renewal
Version
Permit Classification
3.00
COC
Permit Contact Affiliation
Vickie A. Dudick
4105 Reedy Creek Rd
Raleigh NC 276076410 5
iMajor/Minor Region
Minor Washington
County
Lenoir
Facility Contact Affiliation
Owner Name Owner Type
NC National Guard Government - State
En�•-)Sr(v<rt ►�Y4w��Ic�%�4,Zg0-�O�r Owner Affiliation
t1� (-o n t t� (�^�Spr, ; Christopher Barfield (919 )bI;0 - &°SS
V; LK ;{ Q ,�.*O ; �� �ql� (0(04 (,pQ-7 4105 Reedy Creek Rd
Dates/Events 91 9� 6 (� {�18 (� Raleigh NC 276076410
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
01/30/98 05/21/07 11/01/07 11/01/07 10/31/12
regulated Activities
Oil water separator
Petroleum storage < 1 million gallons
Requested/Received Events
RO staff report received Loord; •„g�{S ,o ^ ��y ��, �.
RO staff report requested P �S, 7o j Sr ,-77. i101=33
Vehicle maintenance ?S- z9S333 -'77. 54,9 �
��
r �' for z87S; Cobb•; «t-.;.., P-a;
Outfall 001 ✓.T k,Rdt<:r LqG� �S• (� •�4 2 , ` 77, 3$.lo
Waterbody Name Stream Index Number Current Class Subbasin
Yadkin Branch (Adkin Branch) 27-79 1 C;Svv,NSW 03-04-05
' r5�•� �IY+r do 312olv?7
• Fn�r7�TL��Cr^`�, fb�cSv a jowc(^ GC-2c`5v1 (Go�.•c5 ?.at-� �(2k52� 52(i -Z
O'^YY P�P( -Lp bL-`Q A (919) �64-ki0$40
7
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131:VERI.Y EAVES PERDUE
GOVERNOR
REUI3EN E. YOUNG
SECRETARY
NGNC- FMO-DEM
STATE OF NORTH CAROLINA
DEPARTMENT OF PUBLIC SAFETY
JOINT FORCE HEADQUARTERS
NORTH CAROLINA NATIONAL GUARD
Stormwater Permitting Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27699-1617
Re: "Total Coverage Exemption Certification
Kinston, North Carolina— FMS 918
NPDES Permit Number NCGO80556
Dear Stormwater Permitting Unit:
NSSSted to Poe
N R-T
CAR(>I. A
NATIONAL
(1 GUARD C�
\, t Y
GREGORY A. LUSK
MAJOR GENERAL, NCNG
ADJUI'AN'I' GENERAL
28 June 2012
The North Carolina Army National Guard (NCARNG) is submitting the attached Total Coverage
Exemption Certification for the above referenced Certificate of Coverage and facility.
Please feel free to contact the undersigned at [phone] with any questions.
Sincerely,
Thomas Morris, REM
EPAS Manager
North Carolina Army National Guard
RECEIVED
J U L 13 2012
DWQ-V'I/.RO
1636 Gold Star Drive, Raleigh, NC 27607-3371, Telephone: [phone], DSN 582-9210
An Equal Opportunity / Affirmative Action Employer

b"-` O p . .4 n
�415
LIECEIAED

WA
A0 Division of Water Quality / Surface Water Protection
NCDENRNational Pollutant Discharge Elimination System
NO EXPOSURE CERTIFICATION for Exclusion
NCGNE0000
NO EXPOSURE CERTIFICATION
FOR AGENCY USE ONLY
D.w Rcccircd-
Yc.r
Momh
Da
I
I
Ccnific.w of Corc�agc
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; DWO 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).
For questions, please contact the DINO 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 North Carolina National Guard
Contact Thomas Morris
Street Address 1636 Gold Star Drive
City Raleigh State NCB ZIP Code 27607-6410
Telephone No. 919-664-6047 Fax: None
Email Thomas. S.Morris I a�,us.armv.miI
Page 1 of 7
SW U-NE-12Aug2010

NCGNE0000 No Exposure Certification
2) Location of facility producing discharge:
Facility Name North Carolina National Guard -'Kinston Armory & FMS #18
Facility Contact 2875
Facility Street Address 200t Dobbs Farm Road
City Kinston state NC ZIP Code 28504
County
Telephone No. Fax:
Email
3) Physical location Information:
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 located approx..75 miles west of the
(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' M No
5) Is this a ' ? ® Federa gcil;Yes ❑ No
�SS�aI�-7'1.riti�j' 1
6) Latitude N 35=12' 3'1 Longitude W 7S-00!715° (deg., min., seconds) 6aldJooros Coords.
7) This NPDES No.Exp6sure Exclusion application applies to which of the following:
❑ New & Proposed Facility Date operation is to begin
® Existing. Date operation began 1994
❑, Renewal of existing No Exposure Certification, Certification No.: NCGNE
8) Was this facility or site ever covered under an NPDES Stormwater Permit? N Yes ❑ No
If yes, what is the NPDES Permit Number? NCG080556
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: 4 1 7 3
10) Provide a brief description of the types of industrial activities and products produced at this.facility:
11) Does this facility have any Non -Discharge permits (ex: recy6te permits)?
* No
❑ Yes •.
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
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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 %I 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 DI No
c. Materials or products from past industrial activity
❑ Yes ]$I No
d. Material handling equipment (except adequately maintained vehicles)
❑ Yes X No
e. Materials or products during loading/unloading or transporting activities
❑ Yes N No
f. Materials or products stored outdoors (except final products intended for outside
❑ Yes N 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 N No
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes N No
the discharger
Waste material (except waste in covered, non -leaking containers [e.g., dumpsters]) ❑ Yes (K No
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 IN 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 N 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 EX Yes ❑ No ❑ N/A
cracks, holes, or evidence of leaks, and are drain valves maintained locked shut?
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NCGNE0000 No Exposure Certification I'
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'
]@ Yes ❑ No ❑ N/A
containers (including drums, barrels, etc.) with a capacity of more than 660-
gallons?
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?
c. Is secondary containment provided for Title III Section 313 Superfund
O Yes ❑ No M N/A
Amendments and Reauthorization Act (SARA) water priority chemicals'?
d. Is secondary containment provided for hazardous substances" designated in 40
❑ Yes ❑ No N N/A
CFR §116?
. .
e. Are release valves on all secondary containment structures locked?
M Yes ❑ No ❑ N/A
15) Hazardous Waste:
a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? ❑ Yes M No
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste ❑ Yes N No
generated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste ❑ 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:
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-gallori (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.
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NCGNE0000 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 IX No
b. Does your facility have coal piles on site?
❑ Yes M No
C. Does your facility store other fuel sources outside in piles, such as wood chips,
❑ Yes M No
sawdust, etc.?
d. Does your facility have air emissions associated'with its industrial activity (e.g.,
❑ Yes I,Q No
degreasing operations, plating, painting and metal finishing)? It so, describe the
industrial activity:
e. If you answered yes to d., are those emissions permitted by an Air Quality Permit?
❑ Yes ❑ No M N/A
Please specify:
I. 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:
re) n
0
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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 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 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: Vickie Dudick
Title:-Dirrector_of Environmental Manaeement__
(Signature of Applicant)
JUN 2 2 2012
(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.
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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 the site currently has an NPOES Stormwater Permit, be sure to indicate the permit number in Question 8.
Mail the entire package to:
Stormwater,Permitling 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
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Location Map of FMS #18