NCGNE1028_COMPLETE FILE - HISTORICAL_20161129

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v
DOC TYPE
O -HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ ao/ � ri a 9
YYYYMMDD

Energy, Mineral
and Land Resources
ENVIRONMENTAL QUALITY
Mr. Ken Villani
Pactiv LLC
1447 Enterprise Blvd.
Kinston, NC 28504
Dear Mr. Villani:
PAT MCCRORY
DONALD R. VAN DER VAART
TRACY DAVIS
November 29, 2016
Subject: Name/Ownership Change Request
No Exposure Certification NCGNE1028
Pactiv LLC
Formerly Pactiv Packaging, Inc.
Lenoir County
The Division has reviewed your submittal of the permit name/ownership change form for the
subject No -Exposure Certification. Division personnel have reviewed and approved your
request to transfer the exclusion from NPDES stormwater permitting requirements.
Please note that by our original acceptance of the No -Exposure Certification and by our
approval of your request to transfer it, you are obligated to maintain no -exposure conditions
at your facility. If conditions change such that your facility can no longer qualify for the no -
exposure exclusion, you are obligated to immediately obtain NPDES permit coverage for
your stormwater discharge. Otherwise, the discharge becomes subject to enforcement as an
un-permitted discharge.
Annual re -certification is required, and we have enclosed one blank Annual No Exposure
Exclusion Self Re -Certification form for your use. Your certification of no exposure does
not affect your facility's legal requirements to obtain environmental permits that may be
required under other federal, state, or local regulations or ordinances.
If you have any questions or need further information, please contact the Stormwater
Permitting Program at [phone].
Sincerely,
for Tracy I vis, PM P.E., C, Director
Division of Energy, Mineral and Land
cc: W shmgton Regional Office
VStormwater Permitting File
Siam of Noah Carolina I Environmental Quality I Energy, Mineral and Land Resources
1612 Mail Service Center 1 512 Noah Salisbury Street I Raleigh, North Carolina 27699-1612
919 707 9220 T

PAGT1N/
Pactiv LLC
1447 Enterprise Boulevard
Kinston, NC 28504
October 21, 2016
CERTIFIED MAIL
Stormwater and General Permits Unit Program
Division of Energy, Mineral and Land Resources
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
RE. Name Change Request for Pactiv Warehouse
No Exposure Certification No. NCGNE1028
To Whom It May Concern:
Pactiv Packaging, Inc. (Pactiv) owns and operates a warehouse at 2769 Rouse Road Extension in
Kinston, North Carolina (Pactiv Warehouse). On November 3, 2014, the Pactiv Warehouse was issued
No Exposure Certification No. NCGNE1028 by the North Carolina Department of Environmental Quality
(DEQ). Certification No. NCGNE1028 granted exclusion from the National Pollutant Discharge
Elimination System (NPDES) requirements for industrial stormwater,
Effective November 1, 2016, Pactiv will change its name from 'Pactiv Packaging, Inc." to "Pactiv LLC'.
With this submittal, Pactiv requests that No Exposure Certification No. NCGNE1028 be updated to
change the company name to "Pactiv LLC'. The State Stormwater Permit Name/Ownership Change form
is included as an attachment to this letter.
If you have any questions or comments about the information presented in this submittal, please do not
hesitate to contact Mr. Glenn Rogers at [phone].
Sincerely,
Ken Villani
Plant Manager
Attachment
cc: Mr. Glenn Rogers - Pactiv LLC
Ms. Kim Teofilak - Trinity Consultants, Inc.
io�17k

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State of North Carolina
Department of Environment and Natural Resources vv
Division of Water Quality
STATE STORMWATER PERMIT NAME/OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION
1. Stormwater Management Permit Number: NCGNE1028
2. Project Name: Pactiv Warehouse
3. Current Permit Holder's Company Name/Organization: Pactiv Packaging Inc.
4. Signing Official's Name: Ken Villani Title: Plant Manager
5. Mailing Address: 1447 Enterprise Boulevard
City: Kinston State: NC Zip: 28504
6.Phone: ( 252 ) 520-5020 Fax:( 252 ) 527-0379
II. PROPOSED PERMITTEE / OWNER / PROJECT / ADDRESS INFORMATION
This request is for: (please check all that apply)
❑X Name change of the owner (Please complete Items 1, 2 and 3 below)
❑ Name change of project (Please complete Item 5 below)
❑ Change in ownership of the property/company (Please complete Items 1, 2, 3, and 4 below)
❑ Mailing address / phone number change. (Please complete Item 4 below)
❑ Other (please explain):
1. Proposed permittee's company name/organization: Pactiv LLC
2. Proposed permittee's signing official's name: Ken Villani
3. Proposed permittee's title: Plant Manager 0rT `
4. Mailing Address: Of6
City: State: Zip:
Phone:( ) Fax:(
5. New Project Name to be placed on permit:
Please check the appropriate box. The proposed permittee listed above is:
❑ HOA or POA (Attach documentation showing that the HOA or POA owns, controls, or has a
recorded easement for all areas that contain stormwater system features. Print name of HOA or
POA in #1 above and provide name of HOA/POA's authorized representative in #2 above)
® The property owner
❑ Lessee (Attach a copy of the lease agreement and complete Property Owner Information on
page 4)
❑ Purchaser (Attach a copy of the pending sales agreement. Final approval of this transfer will be
granted upon receipt of a copy of the recorded deed)
❑ Developer (Complete Property Owner Information on page 4)
SSW N/O Change Rev24Sept2012 Page 1 of 4

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111. , -REQUIRED ITEMS
A request to transfer a permit will not be approved by the Division of Water Quality (DWQ) unless all
of the applicable required items listed below are included with the submittal. Failure to provide the
listed items may result in processing delays or denial of the transfer.
1. This completed and signed form. This certification must be completed and signed by both the
current permit holder and the new applicant if this is a change of ownership.
2. Legal documentation of the property transfer to a new owner.
3. A copy of any recorded deed restrictions, covenants, or easements, if required by the permit.
4. The designer's certification (DWQ Engineer and Designer Certification Forms are available from
each DWQ Regional office), if required by the permit and if not already submitted to DWQ.
5. If the proposed permittee is a firm, partnership, association, institution, corporation, limited liability
company, or other corporate entity, provide documentation showing the authority of the named
representative to act on behalf of the proposed permittee.
6. The $40.00 processing fee. If this is an initial transfer from the original permittee the processing
fee is not required. Subsequent ownership transfers will require the $40.00 processing fee.
IV. CURRENT PERMITTEE'S CERTIFICATION
Please check one of the following statements and fill out the certification below that statement:
® Check here if the current permittee is only changing his/her/its name, the project name, or mailing
address, but will retain the permit. I, Ken Villani , the current
permittee, hereby notify the DWQ that I am changing my name and/or I am changing my mailing
address and/or I am changing the name of the permitted project. I further attest that this application
for a name/ownership change is accurate and complete to the best of my knowledge. I understand
that if all required parts of this application are not completed or if all required supporting information
and attachments listed above are not included, this application package will be returned as
incomplete.
❑ Check here if current permittee is transferring the property to a new owner and will not retain
ownership of the permit.
I, , the current permittee, am submitting this application
for a transfer of ownership for permit # . I hereby notify DWQ of the sale or
other legal transfer of the stormwater system associated with this permit. I have provided a copy of
the most recent permit, the designer's certification for each BMP, any recorded deed restrictions,
covenants, or easements, the DWQ approved plans and/or approved as -built plans, the approved
operation and maintenance agreement, past maintenance records, and the most recent DWQ
stormwater inspection report to the proposed permittee named in Sections II and V of this form. I
further attest that this application for a name/ownership change is accurate and complete to the best
of my knowledge. I understand that if all required parts of this application are not completed or if all
required supporting information and attachments listed above are not included, this application
package will be returned as incomplete. I assign all rights and obligations as permittee to the
proposed permittee named in Sections II and V of this form. I understand that this transfer of
ownership cannot be approved by the DWQ unless and until the facility is in compliance with the
permit.
Signature: Ci 1� Date: Iuta 1,201G
I, ?CLWelc� Qtzir A `YtlilliPC a Notary Public for the State of
Nof�ti ea�,n j, iNa County of i _enn!r , do hereby certify that
yw U� It010i personally appeared before me this the
a S 4"4` day of Ur 6o6r , 20 110 , and
forgoing instrument. Witness my hand and official seal,
Notary Signature
auguso19
SSW N/O Change Rev24Sept2012 Page 2 of 4
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execution of the

MCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
November 3, 2014
Pactiv Packaging Warehouse
ATTN: Mike Russell
1447 Enterprise Road
Kinston, North Carolina 28504
Subject: No Exposure Certification NCGNE1028
Facility Name: Pactiv Packaging Warehouse
Location: 2769 Rouse Road Extension
County: Lenoir
Dear Sir or Madam:
John E. Skvarla, III
Secretary
On September 17, 2014, this office received your Application for Certification of No Exposure requesting
exclusion from NPDES stormwater permitting at Pactiv Packaging Warehouse facility located near the GTP
Jetport (Location coordinates: 35.320152,-77,611330). Based on both the information provided in the
application and a site inspection by Mr. Thom Edgerton on October 17, 2014, the Division hereby grants
conditional exclusion from the NPDES permitting as provided for under 40 CFR 122.26(g), which is
incorporated by reference in North Carolina regulations.
Please note that by granting the No Exposure Certification, you become liable for maintaining "no exposure'
conditions at this facility. Be advised that you are required to immediately apply for and obtain NPDES permit
coverage should conditions and/or activities change such that the site no longer qualifies for the "no
exposure" exclusion. Failure to have NPDES permit coverage, if needed, makes an unpermitted discharge
subject to appropriate legal action. An unpermitted discharge could include a civil penalty of up to $25,000
per day.
Using the included form, you must re -certify the "no exposure" status at this facility annually. (Note: NPDES
permit coverage is required for any "yes" response.) A copy of the re -certification must be maintained on
site. The re -certification form does not need to be submitted to DEMLR, unless so requested. Please note
this conditional exclusion from permitting does not supercede requirements to obtain other permits that may
be required under other govemental regulations or ordinances.
If you have any questions or need further information, please contact Mr. Thom Edgerton or me at (252) 946-
6481.
Sincer ly, �
,.�
X lam/
Patrick H. McClain,"PE
Regional Engineer
Enclosure: Annual Self -Recertification Form
CC: Bradley Bennett, Stormwater Permitting Program — No Exposure Files Inc rr131 r4
entral Files - DWR
,/WaRO Files — Land Quality
Division of Energy, Mineral, and Land Resources . Land Quality Section
Washington Regional Office
943 Washington Square Mall, Washington, North Carolina 27889 • Phone: [phone] FAX: [phone]
Internet: http://portal//portal.ncdenr.orq/webilriland-guality/webilriland-quality
An Equal Opportunity 1 Affirmative Action Employer - 50% Recycled 110% Post Consumer Paper

0
Division of Water Quality / Surface Water Protection
NC®ENR
Na � D[v MENT OF
E_RONMFM u b NUW.u. PL FCES
National Pollutant Discharge Elimination System
ANNUAL NO EXPOSURE EXCLUSION SELF RE -CERTIFICATION
NCGNE0000
Do not submit this form to DWQ unless requested.
For questions, please contact the DWQ Regional Office for your area or the Central Office.
(Please print or type)
Facility's No Exposure Exclusion No. Date Completed (MM/DD/YYYY)
f N C G N E I 0 Z$
1) Has the facility name or owner changed? ❑ Yes ❑ No
(if yes, please submit a separate Name/Ownership Change Form to DWQ located at
http://portal. ncdenr.org/web/wq/ws/su/npdessw#Application_Forms_NPDES)
2) 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 to maintain your no exposure exclusion, and must immediately apply for a permit from DWQ.
a. Using, storing, or cleaning industrial machinery or equipment, and areas where ❑ Yes ❑ 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 ❑ No
c. Materials or products from past industrial activity
❑ Yes
❑ No
d. Material handling equipment (except adequately maintained vehicles)
❑ Yes
❑ No
e. Materials or products during loading/unloading or transporting activities
❑ Yes
❑ No
f. Materials or products stored outdoors (except final products intended for outside
❑ Yes
❑ 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
❑ No
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by
❑ Yes
❑ No
the discharger
i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters])
❑ Yes
❑ No
j. Application or disposal of process wastewater (unless otherwise permitted)
❑ Yes
❑ No
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes ❑ 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 ❑ No
(i.e., not closed and stored upside down to prevent precipitation accumulation)
Page 1 of 3
SWU-NESR-29M2010

NCGNE0000 No Exposure Self Re -Certification
m. For any exterior ASTs, as well as drums, barrels, tanks, and similar containers ❑ Yes ❑ No
stored outside, has the facility had any releases in the past three (3) years?
3) Above Ground Storage Tanks (ASTs): If you answer "No" to any of the following items, you are not
eligible to maintain your no exposure exclusion, and must immediately apply for a permit from DWQ.
a. Are exterior ASTs and piping free of rust, damaged or weathered coating, pits, or ❑Yes❑ No ❑ N/A
deterioration, or evidence of leaks?
b. Is secondary containment provided'for all exterior ASTs? If so, is it free of any ❑Yes❑ No ❑ N/A
cracks, holes, or evidence of leaks, and are drain valves maintained locked shut?
4) Secondary Containment: If you answer "No" to any of the following items, you are not eligible to
maintain your no exposure exclusion, and must immediately apply for a permit from DWQ.
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?
Footnotes to Questions 4) c. 8 d.
[]Yes[] No ❑ N/A
[:]Yes[:] No ❑ N/A
[:]Yes[:] No ❑ N/A
❑Yes❑ No ❑ N/A
❑Yes❑ No ❑ N/A
'Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require secondary containment.
However, some exceptions may be made for de minimis amounts of certain substances, and/or other qualifiers, as described in the
exemptions from reporting requirements of Title III SARA 313 in 40 CFR §372.38.
"Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require secondary containment.
However, some exceptions may be made for amounts less than the Reportable Quantities of the hazardous substances listed in 40 CFR
§117.3.
5) Other information: If you answer "Yes" to any of the following items, and the answer if different from
how it was answered when originally applying, you might not be eligible to maintain your no exposure
exclusion. Please contact the Division if this is the case.
a. Does your facility store used, recycled, or otherwise reclaimed pallets outside? ❑ Yes ❑ No
b. Does your facility have coal piles on site? ❑ Yes ❑ No
c. Does your facility store other fuel sources outside in piles, such as wood chips, ❑ Yes ❑No
sawdust, etc.?
d. Does your facility have air emissions associated with its industrial activity (e.g., ❑ Yes ❑ No
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? ❑Yes❑ No❑N/A
Please specify:
Page 2 of 3
SWU-NESR-29Ju12010

NCGNE00O0 No Exposure Self Re -Certification
6) 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/maintaining 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 this 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 provided. Based on my
inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the
information, the information provided is to the best of my knowledge and belief true, accurate and complete. I am aware
that there are significant penalties for providing false information, including the possibility of fine and imprisonment for
knowing violations.
I certify that I am familiar with the information contained in this document and that to the best of my knowledge and belief
such information is true, complete, and accurate.
Printed Name of Person Signing:
Title:
(Signature)
(Date Signed)
Please note: The Regional Office may 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).
This completed form must be kept on file at the facility for at least 5 years. Do not submit this
form to DWQ unless requested.
Page 3 of 3
SWU-NESR-29Jul2010

a
i,
Permit:
NCGNE1028
SOC:
County:
Lenoir
Region:
Washington
Contact Person: Mike Russell
Compliance Inspection Report
Effective: Expiration: Owner: - Pactiv Packaging Inc
Effective: Expiration: Facility: Pactiv Packaging Warehouse
2769 Rouse Rd Extension
Title:
Kinston NC 28504
Phone: [phone] Ext.264
Directions to Facility:
from us hwy 70 west exit onto cf hervey pkwy, follow pkwy for 6.5 miles and turn left onto hap arnold blvd/rouse road extension, in 1
mile turn right onto airport road, take the second right onto county road 1610 - just before rr tracks - site on right.
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Penn Its:
Inspection Date: 10/17/2014 Entry Time: 08:45AM Exit Time: 09:15AM
Primary Inspector: Thom Edgerton Phone: [phone]
Secondary Inspector(s):
Reason for Inspection: Other Inspection Type: Compliance Evaluation
Permit Inspection Type: Stormwater Discharge, No Exposure Certificate
Facility Status: ❑ Compliant ❑ Not Compliant
Question Areas:
■ Miscellaneous Questions Misc
(See attachment summary)
Page: 1

,.
•1t
permit: NCGNE1028 Ownar• Facility: Pactiv Packaging Inc
Inspection Dab: 10/1712014 Inspection Typo : Compliance Evaluation Reason for Visit: Other
Inspection Summary:
OK to issue the No Exposure Certification to this GTP jetport warehouse located at 2769 Rouse Road (35.320152,
-77.611330).
Page: 2

Permit: NCGNE1028 Owner- Faolllty:Pacgv Packaging Inc
Inspection Date: 10/17/2014 Inspection Type : Compliance Evaluation Ronson for Visit: Other
Misc
Voa No NA NE
Is the facility compliant? M ❑ ❑
Comment. This inspection was to determine if the warehouse location at the GTP ietport was no exposure.
The week prior I had visited 1447 Enterprise Road and had questions if the site qualified. After
speaking with Brenden Bowers [phone], 1 received clarification to the location. (The NE
application coordinates are at even another location?)
I found the warehouse location to be clean with loading docks and truck traffic.
I recommend to issue the No Exposure Certification to this location.
Page: 3

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NCGNE1028
Program Category
NPDES SW
Permit Type
Stormwater Discharge, No Exposure Certificate
Primary Reviewer
thom.edgerton
Coastal SWRule
Permitted Flow
Facility Name
Pactiv Packaging Warehouse
Location Address
2769 Rouse Rd Extension
Kinston
NC 28504
Central Files: APS _ SWP _
10/2/2014
Permit Tracking Slip
Status Project Type
In review New Project
Version Permit Classification
Individual
Permit Contact Affiliation
Major/Minor Region
Minor Washington
County
Lenoir
Facility Contact Affiliation
Mike Russell (ZS L) 57,Z7 - /.30 o elll' 74+
ehs mgr
1447 Enterprise Blvd
Kinston NC 28504
Owner Name Owner Type
Pactiv Packaging Inc Non -Government
Owner Affiliation
Mike Russell
ehs mgr
1447 Enterprise Blvd
Kinston NC 28504
Scheduled
Ong Issue App Received Draft Initiated Issuance
8/28/2014
Public Notice Issue Effective
Waterbody Name Streamindex Number Current Class Subbasin
Expiration

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NCDENR
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Division of Energy, Mineral and Land Resources
Land Quality Section
National Pollutant Discharge Elimination System
FOR AGENCY USE ONL
Date Re ed
Year
Mw_ Day
7
Crnificatc
o V
NCGNIII a
NO EXPOSURE CERTIFICATION for Exclusion o
NCGNE0000 m D
NO EXPOSURE CERTIFICATION
RENEWAL
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Please check here if this is a renewal— Ei I
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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, DEMLR must approve your application for No
Exposure Certification before this exclusion is effective. Until you are issued a No
Exposure Certification and your NPDES permit is rescinded, your facility must continue
to abide by the terms and conditions of the current permit.
Industrial materials or activities include, but are not limited to: material handling equipment or activities,
industrial machinery, raw materials, intermediate products, by-products, final products, or waste products.
Material handling activities include the storage, loading and unloading, transportation, or conveyance of
any raw material, intermediate product, final product or waste product. A storm resistant shelter is not
required for the following industrial materials and activities: drums, barrels, tanks, and similar containers
that are tightly sealed, provided those containers are not deteriorated and do not leak. "Sealed" means
banded or otherwise secured and with locked or non -operational taps or valves; adequately maintained
vehicles used in material handling; and final products, other than products that would be mobilized in
stormwater discharges (e.g., rock salt).
A No Exposure Certification must be provided for each facility qualifying for the no exposure exclusion. In
addition, the exclusion from NPDES permitting is available on a facility -wide basis only —not for individual
outfalls. If any industrial activities or materials are, or will be, exposed to precipitation, the facility is not
eligible for the no exposure exclusion. By signing and submitting this No Exposure Certification form, you
certify that a condition of no exposure exists at this facility or site and are obligated to comply with the
terms and conditions of 40 CFR 122.26(g).
You are required to reapply for the No Exposure Exclusion once every five (5) years.
For questions, please contact the DEMLR Regional Office for your arep44k e,P6ge.gh rr— r..,
(Please print or type)
1) Mailing address of ownerioperator address to which all certification corres ondence willIThe mailed):
Name Pactiv Packaging, Inc
Contact
Street Address
City
Telephone No.
Mike Russell
1447 Enterprise Road
Kinston State: NC _ ZIF
252-527-6300 Fax:[phone]
Page 1 of 7
SWU-NE-021309 Last revised 6/24114

CD b

NGGNE0000 No Exposure Certification
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2) Location of facility producing discharge:
Facility Name
Facility Contact
Street Address
City
County
Telephone No.
Pactiv Packaging Warehouse
Mike Russell
2769 Rouse Road Extension
Kinston
Lenoir
State: NC _ ZIP Code: 28504
252-775-6003 Fax:[phone]
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). From US Hwy 70 W exit onto CIF Harvey Parkway.
Follow Parkway for 6.5 miles and turn left onto Hap Arnold Blvd/Rouse Road Extension. In 1 mile turn
right onto Airport Rd. Take the second right onto County Road 1610 Gust before RR tracks). The site
will be on the right.
(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 Now
31,3zotSv, �1'1.b►139° r
6) Latitude Longitude ii-deg;36-r irr41-seo-W (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: 6/1/2014
❑ Renewal of existing No Exposure Certification Certification No.: NCGNE
8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes X No
If yes, what is the NPDES Permit Number?
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 2 2 5
10) Provide a brief description of the types of industrial activities and products produced at this facility:
Finished goods storage and distribution of plastic and paper disposable foodservice containers.
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:
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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 X No ❑ N/A
residuals from using, storing or cleaning industrial machinery or equipment remain
and are exposed to stormwater
b. Materials or residuals on the ground or in stormwater inlets from spills/leaks ❑ Yes X No ❑ N/A
c. Materials or products from past industrial activity
❑ Yes
X No
❑ N/A
d. Material handling equipment (except adequately maintained vehicles)
❑ Yes
X No
❑ N/A
e. Materials or products during loading/unloading or transporting activities
❑ Yes
X No
❑ N/A
f. Materials or products stored outdoors (except final products intended for outside ❑ Yes X No ❑ N/A
use (e.g., new cars] where exposure to stormwater does not result in the discharge
of pollutants)
g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, ❑ Yes X No ❑ N/A
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes X No ❑ N/A
the discharger
i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters])
❑ Yes
X No
0 N/A
j. Application or disposal of process wastewater (unless otherwise permitted)
❑ Yes
❑ No
X N/A
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes X No ❑ N/A
otherwise regulated (i.e., under an air quality control permit) and evident in the
stormwater outflow
I. Empty containers that previously contained materials that are not properly stored ❑ Yes X No ❑ N/A
(i.e., not closed and stored upside down to prevent precipitation accumulation)
m. For any exterior ASTs, as well as drums, barrels, tanks, and similar containers ❑ Yes X No ❑ N/A
stored outside, has the facility had any releases in the past three (3) years?
13) Above Ground Storage Tanks (ASTs): If you answer "No" to any of the following items, you are not
eligible for the no exposure exclusion.
a. Are exterior ASTs or piping free of rust, damaged or weathered coating, pits, or ❑ Yes ❑ No X N/A
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any ❑ Yes ❑ No X N/A
cracks, holes, or evidence of leaks, and are drain valves maintained locked shut?
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NCGNE0000 No Exposure Certification
14) Secondary Containment: If you answer "No" to any of the following items, you are not eligible for the
no exposure exclusion.
a. Is secondary containment provided for single above ground storage containers
(including drums, barrels, etc.) with a capacity of more than 660-gallons?
b. Is secondary containment provided for above ground storage containers stored
in close proximity to each other with a combined capacity of more than 1,320-
gallons?
c. Is secondary containment provided for Title III Section 313 Superfund
Amendments and Reauthorization Act (SARA) water priority chemicals'?
d. Is secondary containment provided for hazardous substances" designated in 40
CFR §116?
e. Are release valves on all secondary containment structures locked?
15) Hazardous Waste:
a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
b. Is this facility a Small Quantity Generator (less than 1000 kg, of hazardous waste
generated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste
generated per month) of hazardous waste?
If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste: _
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.
❑ Yes ❑ No X N/A
❑ Yes ❑ No X N/A
❑ Yes ❑ No X N/A
❑ Yes ❑ No X N/A
❑ Yes ❑ No X N/A
❑ Yes X No ❑ N/A
❑ Yes X No 0 N/A
❑ Yes X No ❑ N/A
'Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require
secondary containment. However, some exceptions may be made for de minimis amounts of certain substances,
and/or other qualifiers, as described in the exemptions from reporting requirements of Title III SARA 313 in 40 CFR
§372.38.
"Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require
secondary containment. However, some exceptions may be made for amounts less than the Reportable
Quantities of the hazardous substances listed in 40 CFR §117.3.
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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 X No ❑ N/A
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 ❑ N/A
❑ Yes X No ❑ N/A
❑ Yes X No ❑ N/A
❑ Yes ❑ No X N/A
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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 submit a no exposure certification form once every five (5) years to the North Carolina
Division of Water Quality and, if requested, to the operator of the local municipal separate storm sewer system (MS4) into
which the facility discharges (where applicable). I understand that I must allow the North Carolina Division of Water
Quality, or MS4 operator where the discharge is into the local MS4, to perform inspections to confirm the condition of no
exposure and to make such inspection reports publicly available upon request.
In the event that the site no longer qualifies for a No Exposure Exclusion, I understand that I must obtain coverage under
an NPDES permit prior to any point source discharge of stormwater from the facility. Additionally, I certify under penalty of
law that this document and all attachments were prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel property 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: _Ron Walls
Title: Plant Manager
a*-Y"Y
(Signature of Applicant) (Date Signed)
Please note: This application for the No Exposure Exclusion is subject to approval by the
NCDENR Regional Office prior to issuance. The Regional Office may inspect your facility for
compliance with no exposure conditions prior to that approval. The Regional Office may also
inspect your facility at anytime 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 Artide 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:
0 This completed application and all supporting documentation.
0 A map with the location of the facility clearly marked.
❑ If this is a renewal, indicated current NCGNE number in Question 7.
❑ If the site currently has an NPDES Stormwater Permit, be sure to indicate the permit number in Question 8.
Mail the entire package to:
Stormwater Permitting Unit Program
Division of Energy, Mineral and Land Resources
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Note
The submission of this document does not guarantee the issuance of a No Exposure Exclusion.
For questions, please contact the DEMLR Regional Office for your area.
DEMLR Regional Office Contact Information:
Asheville Office ......
[phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
[phone]
Washington Office ...(252)
946-6481
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........(919)
807-6300
Page 7 of 7
SWU-NE-021309 Last revised 6124114

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