NCGNE0930_COMPLETE FILE - HISTORICAL_20130425

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCGNE
DOC TYPE
P'HISTORICAL FILE
DOC DATE
❑ 5 013 N
YYYYMMDD

,l
NCDENR
North Carolina Department of Environment and
Division of Water Quality
Pat McCrory III Charles Wakild, PE
Governor Director
April 23, 2013
Dennis J. Osborne, Ph.D., J.D.
Supervisor
Wake County Public School System
1551 Rock Quarry Road
Raleigh, NC 27610
Natural Resources
John E. Skvarla
Secretary
�r F4
APR - o H13
Subject: No -Exposure Certification NCGNE0930
Wake County Public School System Fuel Port and
Shop - 1551 Rock Quarry Road
Wake County
Dear Mr. Osborne:
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 fora
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 retain 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].
PCIhar'19e
tsW
akild,iPiEr
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]
Internet: www.ncwaterqualay.orq Location: 3800 Barrett Drive Raleigh, NC 27609 Fax [phone]
An Equal Opportunity/Affirmative Action Employer— 50% Recycled/10% Post Consumer Paper
NorihCarol i na
Customer Natimallf
1-877-623-6748

)14
No -Exposure Self Re -Certification Information:
You are obligated to maintain no -exposure* conditions at your facility. If conditions change such that your facility
can no longer qualify for a no -exposure exclusion, you are obligated to immediately obtain NPDES permit
coverage for your stormwater discharge. Otherwise, the discharge becomes subject to enforcement as an un-
permitted discharge. State statute provides for fines of up to $25,000 per day for un-permitted discharges.
Your conditional no -exposure exclusion must be self re -certified at least annually as follows:
- Complete the re -certification at a minimum of once per year using the included Self Re -
Certification Form.
(additional copies can be downloaded from http://portal.ncdenr.org/web/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 website at:
http://Portal.ncdenr.org/web/wq/ws/su/npdessw#tab-5

Compliance Inspection Report
Permit: NCGNE0930 Effective: Expiration: Owner: Wcpss Environmental & Grounds Dept
SOC: Effective: Expiration: Facility Wake County Public School System
Maintenance and Operations Location
County: Wake 1551 Raock Quarry Rd
Region: Raleigh
Raleigh NC 27610
Contact Person: Sneha Atwal Title: Phone: [phone]
Directions to Facility:
Directly east of watson poultry plant on rock quarry rd occupies se corner of intersection of 1-440 and rock quarry rd.
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 04/10/2012 Entry Time: 01:00 PM Exit Time: 02:30 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 Q Not Compliant
Question Areas:
. Miscellaneous Questions ■ Misc
(See attachment summary)
Page: 1

Permit: NCGNE0930 Owner -Facility: Wcpss Environmental &'Grounds Dept
tr
Inspection Date: 04/10/2012 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
Misc
Is the facility compliant?
Comment: The shop areas were inspected as were the fueling locations. All inside
drains are reported to go to the sanitary sewer. The fuel locations are undercover and
in the event of a spill of petroleum, the fuel would go to a oil and water separator - which
discharges to the sanitary sewer, acording to Dr. Osbourne. Dumpsters on site were for
the function of disposing of office waste. There were no pallets exposed to
precipitation. There is a staging area where mulch is placed temporarily during the
spring months for the use of contractors - Dr. Osbourne states that the mulch is
unloaded and used during planting season and is not there long enough to produce any
leachate. The Certificate of No Exposure is approved.
Yes No NA NE
Page:2

Pat McCrory II I
Governor
;Aw'FA 4 tI
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Charles Wakild, PE John E. Skvarla
Dennis J. Osborne, Ph.D., J.D.
Supervisor
Wake County Public School System
1551 Rock Quarry Road
Raleigh, NC 27610
Dear Mr. Osborne:
Director
April 23, 2013
Secretary
Subject: No -Exposure Certification NCGNE0930
Wake County Public School System Fuel Port and
Shop - 1551 Rock Quarry Road
Wake County
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 retain 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].
OSincrely,
�/ iyrs
for Charles Wakild, PE
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]
Internet: www.ncwaterqualfty.orq Location: 3800 Barrett Drive Raleigh, NC 27609 Fax [phone]
An Equal Opportunity/Affirmative Action Employer— 50% Recycled/10% Post Consumer Paper
North Carolina
Customer 11VII&MIlf
1-877-623-6748

No -Exposure Self Re -Certification Information:
You are obligated to maintain no -exposure* conditions at your facility. If conditions change such that your facility
can no longer qualify for a no -exposure exclusion, you are obligated to immediately obtain NPDES permit
coverage for your stormwater discharge. Otherwise, the discharge becomes subject to enforcement as an un-
permitted discharge. State statute provides for fines of up to $25,000 per day for un-permitted discharges.
Your conditional no -exposure exclusion must be self re -certified at least annually as follows:
- Complete the re -certification at a minimum of once per year using the included Self Re -
Certification Form.
(additional copies can be downloaded from http://portal.ncdenr.org/web/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 website at:
http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-5

Compliance Inspection Report
Permit: NCGNE0930 Effective: Expiration: Owner: Wcpss Environmental & Grounds Dept
SOC: Effective: Expiration: Facility:Wake County Public School System
Maintenance and Operations Location
County: Wake 1551 Raock Quarry Rd
Region: Raleigh
Raleigh NC 27610
Contact Person: Sneha Atwal Title: Phone: [phone]
Directions to Facility:
Directly east of watson poultry plant on rock quarry rd occupies se corner of intersection of 1-440 and rock quarry rd.
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 04/10/2012 Entry Time: 01:00 PM Exit Time: 02:30 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 0 Not Compliant
Question Areas:
N Miscellaneous Questions E Misc
(See attachment summary)
Page: 1

Permit: NCGNE0930 Owner - Facility: Wcpss Environmental & Grounds Dept
Inspection Date: 04/10/2012 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
Misc
Is the facility compliant?
Comment: The shop areas were inspected as were the fueling locations. All inside
drains are reported to go to the sanitary sewer. The fuel locations are undercover and
in the event of a spill of petroleum, the fuel would go to a oil and water separator - which
discharges to the sanitary sewer, acording to Dr. Osbourne. Dumpsters on site were for
the function of disposing of office waste. There were no pallets exposed to
precipitation. There is a staging area where mulch is placed temporarily during the
spring months for the use of contractors - Dr. Osbourne states that the mulch is
unloaded and used during planting season and is not there long enough to produce any
leachate. The Certificate of No Exposure is approved.
Yes No NA NE
Page:2

SMARTER TODAY
GREENER TOMORROW
Raleigh Regional Office
3800 Barrett Drive
Raleigh NC 27609
March 12, 2013
Subject: DMR Summary Report
S. T. Wooten Corporation
Princeton Asphalt Plant
Permit # NC6160049
Dear Sir or Madam,
Princeton Asphalt contained the storm water for 2011, 2012 year 3.
Should you require further information, please give me a call
Office 252-291-5165
Cell 252-290-5912
Email lames.washbumQstwcorp.com
Sincerely,
Corporation
5ames Washburn
Environmental Compliance Manager

hys ) 1 son

SMARTER TODAY
e #
GREENERTOMORROK'
March 12, 2013
I
MAR 13 0 � i
Raleigh Regional Office
3800 Barrett Drive
Raleigh NC 27609
Subject: DMR Summary Report
S. T. Wooten Corporation
Sims Asphalt Plant
Permit 9 NCG 1600053
Dear Sir or Madam,
Sims Asphalt contained the Storm Water for 2011, 2012 year 3.
Should you require further information, please give me a call
Office 252-291-5165
Cell 252-290-5912
Email [e-mail]
Sincerely,
S. T. Wooten
�Corporatio
v
.lames Washburn
Environmental Compliance Manager

I SMARTER TODAY
March 12, 2013
; MAR 13 2013
Raleigh Regional Office
3800 Barrett Drive
Raleigh NC 27609
Subject: DMR Summary Report
S. T. Wooten Corporation
Benson, Asphalt Plant
Permit # NCG 160052
Dear Sir or Madam,
S. T. Wooten did not have an Asphalt Plant or Stockpiles on our site in Johnston County
for the year 3 sampling period.
Should you require further information, please give me a call
Office 252-291-5165
Cell 252-290-5912
Email james.washburngstwcorp.com
Sincerely,
S. T. Wooten�iCorporatop
James Washburn
Environmental Compliance Manager

Division of Water Quality / Surface Water Protection
A
I C®EMR National Pollutant Discharge Elimination System
va U o. N9 EXPOSURE CERTLFICATION for Exclusion
L•L�L �- O t �. f i D NCGNE0000
NO EXPOSURE CERTIFICATION
F AGAGENCY USE ONLY
Uum Rcc<ivcd
Y,.,
Month
Day
r0111ECilc
ui coVI. `c
National Pollutant Discharge Elimination System application for exclusion from a Stormwater Permit based
on NO EXPOSURE:
Submission of this No Exposure Certification constitutes notification that your facility does not require a
permit for stormwater discharges associated with industrial activity in the State of North Carolina because
it qualifies for a no exposure exclusion. A condition of no exposure at an industrial facility means all
industrial materials and activities are protected by a storm resistant shelter (with some exceptions) to
prevent exposure to rain, snow, snowmelt, and/or runoff.
For permitted facilities in North Carolina, DWQ must approve your application for No
Exposure Certification before this exclusion is effective. Until you are issued a No
Exposure Certification and your NPDES permit is rescinded, your facility must continue
to abide by the terms and conditions of the current permit.
Industrial materials or activities include, but are not limited to: material handling equipment or activities,
industrial machinery, raw materials, Intermediate products, by-products, final products, or waste products.
Material handling activities include the storage, loading and unloading, transportation, or conveyance of
any raw material, Intermediate product, final product or waste product. A storm resistant shelter Is not
required for the following industrial materials and activities: drums, barrels, tanks, and similar containers
that are tightly sealed, provided those containers are not deteriorated and do not leak. "Sealed" means
banded or otherwise secured and with locked or non -operational taps or valves; adequately maintained
vehicles used in material handling; and final products, other than products that would be mobilized in
stormwater discharges (e.g., rock salt).
A No Exposure Certification must be provided for each facility qualifying for the no exposure exclusion. In
addition, the exclusion from NPDES permitting is available on a facility -wide basis only —not for individual
outfalls. If any industrial activities or materials are, or will be, exposed to precipitation, the facility is not
eligible for the no exposure exclusion. By signing and submitting this No Exposure Certification form, you
certify that a condition of no exposure exists at this facility or site and are obligated to comply with the
terms and conditions of 40 CFR 122.26(g).
For questions, please contact the DWO Regional Office for your area. (See page 6)
(Please print or type)
1) Mailing address of owner/operator (address to which all certification correspondence will be mailed):
Name �5.1'— ��—Ehl I(7r mo, frQ 4,- CN rids,
Contact —� l�
Street Address
_(`iLCi�t4Cn—
City 0e. M State
Telephone No. _ �S"(a�� Fax
Email _ {-,.rt4 0� uicpSS_ no,I
Page 1 of 7
SW U-NE-12Aug2010
ZIP Code
SrJG- cog 31
FEP 2 i
'.0 CCr
P

NCGNE0O00 No Exposure Certification
2) Location of facility producing discharge:
Facility Name Wake County Public School System Maintenance and Operations Location
Facility Contact Sneha Atwal, Environmental and Grounds Department Director
Facility Street Address 1551 Rock Quarry Road
City Raleigh
State NC ZIP Code 27610
County Wake
Telephone No. 919 856 3720 Fax: [phone]
Email satwal(o)wcpss.net
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). Directly east of old Watson Poultry Plant on Rock
Quarry Road; Occupies SE corner of intersection of 1440 and Rock Quarry Road: Street Address is
1551 Rock Quarry Road, Raleigh, NC 27610
(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 XNo
5) Is this a Federal facility? ❑ Yes X No
6) Latitude 35N 45' 37.983" Longitude-78 36' 34.7796" (deg., min., seconds)
7) This NPDES No Exposure Exclusion application applies to which of the following:
❑ New or Proposed Facility
X Existing
Date operation is to begin
Date operation began Nov 1, 1997
❑ 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? NCG080026
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: 7 3 8 0
10) Provide a brief description of the types of industrial activities and products produced at this facility:
None
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
ONo EDP=@
X Yes Stormwater Permit
If yes, list the permit numbers for all current Non -Discharge permits for this facility: NCC 08 02EBB 1 8 Z013
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
d. 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 ❑ 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 X 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 X Yes ❑ No ❑ N/A
cracks, holes, or evidence of leaks, and are drain valves maintained locked shut?
Page 3 of 7
SWU-NE-12Aug2010

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
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:
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.
X Yes Cl No ❑ N/A
X Yes ❑ No ❑ N/A
❑ Yes ❑ No X N/A
❑ Yes ❑ No X N/A
❑Yes ❑ No X N/A
❑ Yes X No
❑ Yes X No
❑ Yes X No
*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
S W U-NE-12Aug2010

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 X No
b. Does your facility have coal piles on site?
c. Does your facility store other fuel sources outside in piles, such as wood chips,
sawdust, etc.?
d. Does your facility have air emissions associated with its industrial activity (e.g.,
degreasing operations, plating, painting and metal finishing)? If so, describe the
industrial activity:
e. If you answered yes to d., are those emissions permitted by an Air Quality
Permit? Please specify:
f. Please list any other environmental program permits (federal, state, etc.) not
specified earlier in this application (such as Hazardous Waste Permits, etc.):
Permit:
Program:
Permit:
Program:
Permit:
Program:
Permit:
Program:
Permit:
Program:
Permit:
Program:
Permit:
Program:
❑ Yes X No
❑ Yes X No
❑ Yes X No
❑ Yes ❑ No X N/A
Page 5 of 7
S W U-NE-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 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: Sneha Atwal, P.E.
Title: Environmental and Grounds Department Director
(Signature of Applicant) (D to igned)
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 fled 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-12Aug2010

NCGNE0000 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 ...(252)
946-6481
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........(919)
807-6300
Page 7 of 7
SWU-NE-12Aug2010

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NORTH
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RALIIGH EA8'P, NORTH CAROLTNA
SE/4 RALEIGH 15' QUADRANGLE
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PHOTOREVISED 1987
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RALEIGH, NORTH CAROLINA
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RALEIGH. NORTH cmuNA--CHARLOTTE. NORTH CAROLINA
DRAW DATE: JUNE 1998
OFT CHE SCALE: 1 "=2,000'
ENG CHECK: D JOB: MAA-98R-647
APPROVAL: >MP'1 DWG: 3.1

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REFERENCE:
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DRAWN: D1) DATE: JUNE 1998
OFF CHECK: SCALE: 1-=150'
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APPROVAL: r W" DWG: 3.2