NCGNE0641_COMPLETE FILE - HISTORICAL_20101008

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STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V
DOC TYPE
HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ � b) b I 'V D
YYYYMMDD

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NC®ENR
North Carolina Department of Environment and Natural Resources -
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
October 8, 2010
JOHN W NEWBY, MANAGER EHS
KEIHIN CAROLINA SYSTEM TECHNOLOGY LLC
4047 MCNAIR ROAD
TARBORO NC 27886
Subject:
Dear Mr. Newby:
Dee Freeman
Secretary
1-3 011jO 1HNBI3l72t 8�+13tl�
t + OIOZ
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Name/Ownership Change Request
No Exposure Certification NCGNE0641
Keihin Carolina System Technology, LLC
Formerly Keihin Carolina System Technology, Inc.
4047 McNair Road, Tarboro
Edgecombe County
The Division has reviewed your submittal of the pennit name/ownership change form for the subject No -Exposure
Certification, which we received on October 7, 2010. 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 Perninting Unit at [phone].
Sincerely,
ORIGINAL SIGNED M
KEN PICKLE
for Coleen H. Sullins
cc: Raleigh Regional Office .
Stormwater Permitting Unit Files
Wetlands and Stormwater Branch
1617 Mail Service Center, Ralegh, North Carolina 27699-1617
T. rOne
1 � orta L, l Carol l na
Location: 512 N. Salisbury St. Ralegh, North Carolina 27604
//
Phone: [phone] FAX: [phone] \ Customer Service: 1-877-623-6748 - .
Naturally
Internet: w .nmaterquality.org
i/
An Equal Opportunity { Affirmafive Action Employer

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 conditions.
-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/npdessd-#tab-5

North Carolina
Beverly Eaves Perdue
Governor
r
NCDENR
Department of Environment and
Division of Water Quality
Coleen H. Sullins
Director
October 10, 2009
Mr. John Foster
Keihin Carolina System Technology, Inc.
4047 McNair Road
Tarboro, NC 27886
Natural Resources
Subject: Application for No -Exposure Certification
Permit No. NCGNE0641
Keihin Carolina System Technology
Tarboro
Edgecombe County
Dear Mr. Foster:
Dee Freeman
Secretary
The Division has reviewed your submittal of the No -Exposure Certification for Exclusion from NPDES Stormwater
Permitting form and made a site visit on October 8, 2009 to assess the potential for stormwater pollution. Based on our
observations and your submittal of a 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 expires in five years (October 7, 2014). At that
time you must re -certify with the Division, or obtain NPDES permit coverage for any stormwater discharges from
your facility.
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 Myrl Nisely at (919) 79�-4200 or at
[e-mail]. . /
for Coleen H.
cc., RRO / SW P Files
` stormwater Permitting Unit No -Exposure Files
North Carolina Division of Water Quality 1628 Mail service Center Raleigh, NC 27699-1628 Phone [phone]
Internet: v~v.ncwatercualitv.oro Location: 3800 Barrett Drive Raleigh, NC 27609 Fax [phone]
An Equal Opportunity/Affirmative Action Employer— 50% Recycled/10% Post Consumer Paper
North Carolina
,Vatmrally
Customer Service
1-877-623-6748

r
0 Division of Water Quality
Division of Soil and Water Conservation
❑ Other Agency II --II
Facility Number: Facility Status: Active - Permit: NCGNE0641 IJ Denied Access
Inspection Type: Stormwater . Inactive or Closed Date:
Reason for Visit: Routine County: Edoecombe Region: Raleioh
Date of Visit: 10/08/2009 Entry Time:11715 AM Exit Time: 11:55 AM Incident #:
Farm Name: Keihm Carolina System Technoloay. Inc Owner Email:
Owner: Keihm Carolina System Te hnoloav Inc
Mailing Address: 4047 McNair Rd Tarboro NC 27886
Physical Address: 4047 McNair Rd Tarboro NC 27886
Phone: [phone]
Facility Status: O Compliant ❑ Not Compliant . Integrator:
Location of Farm: Latitude: Longitude:
Question Areas:
Certified Operator: Operator Certification Number:
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name John Foster
Primary Inspector: Myrl Nisely
Inspector Signature:
Secondary Inspector(s):
Phone: [phone] ext 2830
Phone:
Date:
Inspection Summary:
This site visit evaluated the possibility of a No Exposure permit. Manufacturing is done entirely indoors, and there are no potential
stormwater pollutants outside. The company has taken steps to make sure stormwater cannot be polluted, and handles runoff via a
system of three retention ponds. They have placed a tent -like movable structure over a dumpster for empty five gallon epoxy buckets
in order to preclude rainwater. A permanent structure for that purpose is planned in the near future.
The NE is granted.
Page:1

iA� Division of Water Quality / Surface Water Protection
NC®ENR National Pollutant Discharge Elimination System
A wry no. NO EXPOSURE CERTIFICATION for Exclusion
NCGNE0000
FOR AGENCY USE. ONLY
Dme Received
Ycar
I Month
I Dav
Ceroeea,e of C.,e.
e
NjCjQlNlEnIf
NO EXPOSURE CERTIFICATION Please check here if this is a renewal: ❑ RENEWAL
National Pollutant Discharge Elimination System application for exclusion from a Stormwater Permit based
on NO EXPOSURE:
Submission of this No Exposure Certification constitutes notification that your facility does not require a
permit for stormwater discharges associated with industrial activity in the State of North Carolina because
it qualifies for a no exposure exclusion. A condition of no exposure at an industrial facility means all
industrial materials and activities are protected by a storm resistant shelter (with some exceptions) to
prevent exposure to rain, snow, 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 cor—ptVllh Tom"
terms and conditions of 40 CFR 122.26(g). —T
For questions, please contact the DWO Regional Office for your area. (Seepage 6)_ n-
-{
(Please print or type)
1) Mailing address of owner/operator (address to which all certification correspondence Juifl:bema leeai 1:
Name /`e,4b CQrahne. 5!jskrn red. k.sX me J
Contact r)r, �n Fos der
Street Address YOL/7 /NCAA*f2 AP
City %qR Brio State All- ZIP Code e2?"-4
Telephone No. as.1 GN/ -6?0 6.wo d830 Fax: a51 8.2-/- /y3o
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NCGNE0000 No Exposure Certification
2) Location of facility producing discharge:
Facility Name tirerirrrr LAro/1124L .SVJ&. Teor:m45 y Z.rc
Facility Contact
Street Address
City
County
Telephone No.
3) Physical location information:
State Air_ ZIP Code -1 7d'�K
-67So E.cF d8,30 Fax: e?S'A /.H/-/'/JQ
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): Fre.n 6'i eas f fttkc Er. f `/81/, lap o
(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 Ukiqo
5) Is this a Federal facility? ❑ Yes VNo
6) Latitude 3S.53' /• 04gj* Longitude -770 3S' i3.81W(deg., min., seconds)
7) This NPDES No Exposure Exclusion application applies to which of the following:
❑ New or Proposed Facility
Existing
Date operation is to begin
Date operation began 'V'/- /7Y8
❑ Renewal of existing No Exposure Certification Certification No.: NCGNE
8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes ]r _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: 3 ? / `L
10) Provide 8Z brief description of the types of industrial activities and products produced at this facility:
/tc T/f/nrc A33eln6ty
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
9<0
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
Page 2 of 7
S W U-N E-021309
Last revised 2/13/2009

NCGNE0000 No Exposure Certification
Exposure Checklists (12. - 14.)
12) Are any of the following materials or activities exposed to precipitation, now or in the foreseeable
future? (Please check either "Yes" or "No.") If you answer "Yes" to any of these items, you are not
eligible for the no exposure exclusion.
a. Using, storing, or cleaning industrial machinery or equipment, and areas where ❑ Yes 2-<o ❑ 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 C1 No ❑ N/A
c. Materials or products from past industrial activity
❑ Yes
&-go
❑ N/A
d. Material handling equipment (except adequately maintained vehicles)
❑ Yes
_N'o
❑ N/A
e. Materials or products during loading/unloading or transporting activities
❑ Yes
9?"No
❑ N/A
I. Materials or products stored outdoors (except final products intended for outside ❑ Yes R"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 2- o ❑ N/A
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by
❑ Yes ❑-No ❑ N/A
the discharger
i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters])
❑ Yes 19-No ❑ N/A
j. Application or disposal of process wastewater (unless otherwise permitted)
❑ Yes lrfo ❑ N/A
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not
❑ Yes 0,11o' 17 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 "o ❑ 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 la�o ❑ N/A
stored outside, has the facility had any releases in the past three (3) years?
13) Above Ground Storage Tanks (ASTs): It 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 vlyle�s ❑ No ❑ N/A
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any V�es ❑ No ❑ N/A
cracks, holes, or evidence of leaks, and are drain valves maintained locked shut?
Page 3 of 7
SWU-NE-021309 Last revised 2/13/2009

NCGNE0000 No Exposure Certification
14) Secondary Containment: If you answer "No" to any of the following items, you are not eligible for the
no exposure exclusion.
a. Is secondary containment provided for single above ground storage containers
(including drums, barrels, etc.) with a capacity of more than 660-gallons?
b. Is secondary containment provided for above ground storage containers stored
in close proximity to each other with a combined capacity of more than 1,320-
gallons?
c. Is secondary containment provided for Title III Section 313 Superfund
Amendments and Reauthorization Act (SARA) water priority chemicals'?
d. Is secondary containment provided for hazardous substances— designated in 40
CFR §116?
e. Are release valves on all secondary containment structures locked?
15) Hazardous Waste:
a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste
generated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste
generated per month) of hazardous waste?
If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste:
How is material st(
Where is material
How many disposal shipments per year: 42 er
Name of transport / disposal vendor: {it"4..dy
Vendor address:
Footnotes to Questions 14) c. & d.
E!rYes ❑ No ❑ N/A
❑ Yes ❑ No H N/A
Cl Yes ❑ No dN/A
❑ Yes ❑ No f7 N/A
/Yes ❑ No ❑ N/A
❑ Yes M-I10 ❑ N/A
❑ Yes w,<o ❑ N/A
Vfes ❑ 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? Fr" es ❑ No ❑ N/A
b. Does your facility have coal piles on site? ❑ Yes B No ❑ N/A
c. Does your facility store other fuel sources outside in piles, such as wood chips, ❑ Yes "o Cl N/A
sawdust, etc.?
d. Does your facility have air emissions associated with its industrial activity (e.g., 6eYes ❑ No ❑ N/A
degreasing operations, plating, painting and metal finishing)? If so, describe the
industrial activity: Res... %a,»4
e. If you answered yes to d., are those emissions permitted by an Air Quality Permit? M*`Yes ❑ No ❑ N/A
Please specify: To/ucnf-
f. Please list any other environmental program permits (federal, state, etc.) not
specified earlier in this application (such as Hazardous Waste Permits, etc.):
Permit: Aitt Pcr....0012199oS' , Program: At it Qerp,4-
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
Page 5 of 7
SWU-NE-021309 Last revised 2J13/2009

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 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: d64r fac kr-
Title:
of Applicant)
9--3- 09
(Date Signed)
Please note: This application for the No Exposure Exclusion is subject to approval by the
NCDENR Regional Office prior to issuance. The Regional Office may inspect your facility for
compliance with no exposure conditions prior to that approval. The Regional Office may also
inspect your facility at any time in the future for compliance with the No Exposure Exclusion.
North Carolina General Statute 143-215.6 B(i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan, or other
document filed or required to be maintained under this Article or a rule implementing this Article; or who knowingly makes a false
statement of a material fact in a rulemaking proceeding or contested case under this Article; or who falsifies, tampers with, or knowingly
renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
[Environmental Management) Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine
not to exceed ten thousand dollars ($10,000).
There is currently no fee for a No Exposure Exclusion.
Page 6 of 7
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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 this is a renewal, indicated current NCGNE number in Question 7.
❑ If the site currently has an NPDES Stormwater Permit, be sure to indicate the permit number in Question 8.
Mail the entire package to:
Stormwater Permitting Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Note
The submission of this document does not guarantee the issuance of a No Exposure Exclusion.
For questions, please contact the DWO Regional Office for your area.
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-021309 Last revised 2/13/2009

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
October 8, 2010
JOHN W NEWBY, MANAGER EHS
KEIHIN CAROLINA SYSTEM TECHNOLOGY LLC
4047 MCNAIR ROAD
TARBORO NC 27886
Dear Mr. Newby:
Dee Freeman
Secretary
Subject: Name/Ownership Change Request
No Exposure Certification NCGNE0641
Keihin Carolina System Technology, LLC
Formerly Keihin Carolina System Technology, Inc.
4047 McNair Road, Tarboro
Edgecombe County
The Division has reviewed your submittal of the permit name/ownership change form for the subject No -Exposure
Certification, which we received on October 7, 2010. 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 pen -nit 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 Unit at [phone].
Sincerely,
far Coleen H. Sullins
cc: Raleigh Regional Office
Stormwater Permitting Unit Files
Wetlands and Stormwater Branch
1617 Mail Service Center, Ralegh, North Carolina 27699-1617
1�rOne 7
1.� Qlth Carcifi na
Location: 512 Salisbury St. Ralegh, North Carolina 27604
9-8N.
Phone: 91o759A 3D01 FAX: [phone] Customer Service: 1-877-623-6748
Naturally
Internet: w .navaterquality.org
An Equal Opportunity, 1 Affirmative Action Employer

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 conditions.
-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:
littp://por(al.ncdeiir.org/wcl)/wq/ws/su/iipdessw#tab-5

wATF9OG
\O�OF
Beverly Eaves Perdue, Governor
y
Dee Freeman, Secretary
North Carolina Department of Environment and Natural Resources
O Y
Coleen H. Sullins. Director
Division of Water Quality
SURFACE WATER PROTECTION SECTION
PERMIT NAME/OWNERSHIP CHANGE FORM
I. Please enter the permit number for which the change is requested.
NPDES Permit
(or) Certificate of Coverage
N G S 1 0 1
1 N I G G N I E 0 6 4 1
II. Permit status rior to requested change.
a. Permit issued to (company name):
Keihin Carolina System Technology, Inc
b. Person legally responsible for permit:
John W. Newby
First MI Last
Manager EHS
1
Title
4047 McNair Road
®C II�7 p 9151
Permit Holder Mailing Address
Tarboro NC 27886
9€l'I
City State Zip
(
) ( )
Phone Fax
c. Facility name (discharge):
Keihin Carolina System Technology, Inc
d. Facility address:
4047 McNair Road
Address
Tarboro NC 27886
City State Zip
e. Facility contact person:
Roy Baker 252 641-6750
First / MI / Last Phone
1II. Please provide the following for the requested change (revised permit).
a. Request for change is a result of:
❑ Change in ownership of the facility
X Name change of the facility or owner
If other please explain:
b. Permit issued to (company name):
Keihin Carolina System Technology, LLC
c. Person legally responsible for permit:
John W Newby
First MI Last
Manager EHS
Title
4047 McNair Road
Permit Holder Mailing Address
Tarboro
NC
27886
City
State
Zip
_(252) 641-6750
[e-mail]
Phone
E-mail Address
d. Facility name (discharge):
Keihin Carolina System Technology,
LLC
e. Facility address:
4047 McNair Rd
Address
Tarboro
NC
27886
City
State
Zip
f. Facility contact person:
Roy
Baker
First
MI
Last
[phone]
[e-mail]
Phone
E-mail Address
Revised 812008

PERMIT NAME/OWNERSHIP CHANGE FORM
Page 2 of 2
IV. Permit contact information (if different from the person legally responsible for the permit)
Permit contact: Roy Baker
First MI Last
Facilities Lead Coordinator
Title
4047 McNair Road
Mailing Address
Tarboro NC 27886
City State Zip
[phone] [e-mail]
Phone E-mail Address
V. Will the permitted facility continue to conduct the same industrial activities conducted prior
to this ownership or name change?
X Yes
❑ No (please explain)
VI. Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS
ARE INCOMPLETE OR MISSING:
X This completed application is required for both name change and/or ownership change
requests.
❑ Legal documentation of the transfer of ownership (such as relevant pages of a contract deed,
or a bill of sale) is required for an ownership change request. Articles of incorporation are
not sufficient for an ownership change.
The certifications below must be completed and signed by both the permit holder prior to the change, and
the new applicant in the case of an ownership change request. For a name change request, the signed
Applicant's Certification is sufficient.
PERMITTEE CERTIFICATION (Permit holder prior to ownership change):
1, , attest that this application for a name/ownership change has been reviewed and is accurate and
complete to the best of my knowledge. I understand that if all required parts of this application are not
completed and that if all required supporting information is not included, this application package will be
returned as incomplete.
Signature Date
APPLICANT CERTIFICATION
1, John Newbv, attest that this application for a name/ownership change has been reviewed and is accurate
and complete to the best of my knowledge. I understand that if all required parts of this application are not
completed and that if al red sup information is not included, this application package will be
retumed as incemnl e. 7
Signature
10/4/10
Date
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Division of Water Quality
Surface Water Protection Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Revised 7/2008

North Carolina
Beverly Eaves Perdue
Governor
NCDENR
Department of Environment and
Division of Water Quality
Coleen H. Sullins
Director
Mr. John Foster
Keihin Carolina System Technology, Inc.
4047 McNair Road
Tarboro, NC 27886
Dear Mr. Foster:
October 10, 2009
Natural Resources
Freeman
l/ eSecretary
OCT 16 2009
Subject: Application for No -Exposure Certification
Permit No. NCGNE0641
Keihin Carolina System Technology
Tarboro
Edgecombe County
The Division has reviewed your submittal of the No -Exposure Certification for Exclusion from NPDES Stormwater
Permitting form and made a site visit on October 8, 2009 to assess the potential for stormwater pollution. Based on our
observations and your submittal of a 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 expires in five years (October 7, 2014). At that
time you must re -certify with the Division, or obtain NPDES permit coverage for any stormwater discharges from
your facility.
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 Myrl Nisely at (919) 79J-4200 or at
[e-mail].
for Coleen H.
cc: RRO / SWP Files
'Stormwater Permitting Unit No -Exposure Files
North Carolina Division of Water Quality 1628 Mail Service Center Raleigh, NC 27699-1628 Phone [phone]
Internet: www.ncwatercualitv.ora Location: 3800 Barrett Drive Raleigh, NC 27609 Fax [phone]
An Equal Opportunity/Affirmative Action Employer— 50% Recycled/10°/ Post Consumer Paper
One
North Carolina
AVatura!!y
Customer Service
1-877-623-6748

Division of Water Quality
Division of Soil and Water Conservation
❑ Other Agency
Facility Number: -
Facility Status: Active Permit: NCGNE0641 El Denied Access
Inspection Type: Stormwater
Inactive or Closed Date:
Reason for Visit: Routine
County: Edoecombe Region: Raleiah
Date of Visit: 10/08/2009
Entry Time:11:15 AM Exit Time: 11:55 AM Incident #:
Farm Name: Keihm Carolina
System Technology Inc Owner Email:
Owner: Keihm Carolina
System Technoloav Inc Phone: [phone]
Mailing Address: 4047 McNair Rd Tarboro NC 27886
Physical Address: 4047 McNair Rd
Tarboro NC 27886
Facility Status: Compliant
❑ Not Compliant Integrator:
Location of Farm:
Latitude: Longitude:
Question Areas:
Certified Operator:
Operator Certification Number:
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name
John Foster Phone: [phone] ext 2830
Primary Inspector: Myrl Nisely
Phone:
Inspector Signature:
_.. Date:
Secondary Inspector(s)
Inspection Summary:
This site visit evaluated the possibility of a No Exposure permit. Manufacturing is done entirely indoors, and there are no potential
stormwater pollutants outside. The company has taken steps to make sure stormwater cannot be polluted, and handles runoff via a
system of three retention ponds. They have placed a tent -like movable structure over a dumpster for empty five gallon epoxy buckets
in order to preclude rainwater. A permanent structure for that purpose is planned in the near future.
The NE is granted.
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