NCGNE0053_COMPLETE FILE - HISTORICAL_20050420

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STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCGNE On5 3
DOC TYPE
HISTORICAL FILE
DOC DATE
oyO-D
YYYYMMDD

F W A j F Michael F. Easley, Governor
RQ�i William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P. Ei: Director
Division of Water Quality
p Coleen H. Sullins, Deputy Director
Division of Water Quality
April 20, 2005
Kenneth D Neves
AGI Industries Inc
PO Box 7929
High Point, NC 27264
Subject: No Exposure Certification NCGNE0053
AGI Industries Inc - 217 Feld Ave
Guilford County
Dear Permittee:
The Division has reviewed your submittal of the No -Exposure Certification for Exclusion from NPDES
Stormwater Permitting form, which we received on June 1, 2004. We apologize for the extended period it has
taken us to get back to you on this request and we appreciate your patience as we have worked through this
process. Based on your submittal and signed certification of no exposure at the above referenced facility the
Division is granting your certification 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 NPDE=S permit coverage for your stormwater
discharge. Otherwise, the discharge becomes subject to enforcement as an un-permitted discharge. Your
conditional no -exposure exclusion expires in five years (April 30, 2010). At that time you must re -certify with
the Division, or obtain NPDES permit coverage for any stormwater discharges from your facility.
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 Jonathan Diggs at [phone] ext.
537, or at [e-mail].
cc: Winston-Salem Regional Office
Stormwater Permitting Unit Files
Sincerely,
for Alan W. Klimek, P.E.
Central Files — wlattachments
N. C. Division of Water Quality 1617 Mail Service Center Raleigh, North Carolina 27699-1617 [phone]
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Customer Service
1-877-623-6748

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United States Environmental Protection Agency Form Approved
A"C
511
NPDES A Washington, DC 20460 OMB No.2040-0211
FORMA `MW Epq NO EXPOSURE CERTIFICATION for Exclusion froLI
35t 0-4 7
NPDES Storm Water Permitting
Submission of this No Exposure Certification constitutes notice that the entity identified in Section A does not require permit authorization for its storm water
discharges associated with industrial activity in the State identified in Section 8 under EPA's Storm Water Multi -Sector General Permit due to the existence
of a condition of no exposure.
A condition of no exposure exists at an industrial facility when all industrial materials and activities are protected by a storm resistant shelter to prevent
exposure to rain, snow, snowmett, 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 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 without operational taps or valves;
- adequately maintained vehicles used in material handling; and
- final products, other than products that would be mobilized in storm water` 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, the entity in Section A is certifying that a condition of no exposure exists at Its facility or site,
and is obligated to comply with the terms and conditions of 40 CFR 122.26(g).
ALL INFORMATION MUST BE PROVIDED ON THIS FORM.
Detailed instructions for completing this form and obtaining the no exposure exclusion are provided on pages 3 and 4.
A. Facility Operator Information
1. Name: 10161- 12iNibilUjSiTIQ11 FJSi I-1,4ICl I I I I I I t I I 1 1 2. Phone: I1j3 16I 1/1311/ 161 11 I
3. Mailing Address: a. Street: IP_t IQ l SI QIY I l l k/ Iral 21 l I I I I l I I l l 1 1 1 _L_ 1 I II I
b. City. IItILI GIN 1 I PIy I i-IN I! 1 I I I I I I I I I I I I C. State: &Cj d. Zlp Code: i2I Q J- l %I -I I I I
B. Facility/Site Location information
1. Facility Name: /
2. a. Street Address: 111191
b. City: (,- c. County: Irrl 11 L 1101r21 n i I
d. State: " e_ Zip Code: I A 91 di 6 1- L 1 1
3. Is the facility located on Indian Lands? Yes ❑ No 0—
4. Is this a Federal facility? Yes ❑ No B-
5. a. Latitude: l .71J 1 a IJ I J I 1 I 1 11 " b. Longitude: 1=L_i.io Lid iJ I -z "
6. a. Was the facility or site previously covered under an NPDES storm water permit? Yes ❑ No t
b. If yes, enter NPDES permit number: _
7. SIClActivity Codes: Primary: 11 611alJ Secondary (if applicable): I I I
8. Total size of site associated with industrial activity: __ L / � acres
9. a. Have you paved or roofed over a formerly exposed, pervious area in order to qualify for the no exposure exclusion? Yes ❑ No
b. If yes, please indicate approximately how much area was paved or roofed over. Completing this question does not disquattfy you for the no exposure
exclusion. However, your permitting authority may use this information In considering whether storm water discharges from your site are likely to have
an adverse impact on water quality, in which case you could be required to obtain permit coverage.
Less than one acre ❑ One to five acres ❑ More than five acres ❑ Q
EPA Form 3510-11 (10-99) �l Page 1 of 4

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NPDES �,, NO EXPOSURE CERTIFICATION for Exclusion from Form Approved
3510�11 �sEPA OMB No. 2040-0211
NPDES Storm Water Permitting
C. Exposure Checklist
Are any of the following materials or activities exposed to precipitation, now or in the foreseeable future?
(Please check either "Yes" or "No" in the appropriate box.) if you answer "Yes" to any of these questions
(1) through (11), you are not eligible for the no exposure exclusion.
Yes
No
1. Using, storing or cleaning industrial machinery or equipment, and areas where residuals from using, storing
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or cleaning industrial machinery or equipment remain and are exposed to storm water
2. Materials or residuals on the ground or in storm water inlets from spillsReaks
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3. Materials or products from past industrial activity
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4. Material handling equipment (except adequately maintained vehicles)
5. Materials or products during loadinglunloading or transporting activities
6. Materials or products stored outdoors (except final products intended for outside use [e.g., new cars] where
exposure to storm water does not result in the discharge of pollutants)
7_ Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, and similar containers
8. Materials or products handled/stored on roads or railways owned or maintained by the discharger
9. Waste material (except waste in covered, nonaeaking containers [e.g., dumpsters])
10. Application or disposal of process wastewater (unless otherwise permitted)
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11. Particulate matter or visible deposits of residuals from roof stacks and/or vents not otherwise regulated
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(i.e.. under an air quality control permit) and evident in the storm water outflow
D. Certification Statement
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 storm water permitting.
certify under penalty of law that there are no discharges of storm water 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(9)j2)).
understand that I am obligated to submit a no exposure certification form once every five years to the NPDES permitting authority 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 NPDES permitting authority, 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. I understand that I must obtain coverage under an NPDES permit prior
to any point source discharge of storm water 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.
Print Name: IK if� IN IN t Li rLHi A IN iLi Ui ChSiL. j i I I I i_ i_ j .j __i I i i i i ..i i I
Print Title:
Signature:
Date: &&II i5lbigJ
EPA Form 3510-11 (10-99) Page 2 of 4

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"Corey Basinger" To: [e-mail]
1 <Corey. Basi nger@ncm cc:
ail.net> Subject: Stormwater form
06/14/2004 03:28 PM
Sherry,
Attached is the link for the non exposure exemption form. By this
email, I verify on behalf of the Winston-Salem Regional Office that the
AGI facility at 217 Feld Avenue, High Point,NC meets the criteria for
the exemption. Should you have any questions or comments, please do not
hesitate to contact me!
Thanks?
Corey
http://h2o.enr.state.nc.us/su/PDF_Files/SW—Documents/NoExpoForm app4.pdf
Corey Basinger
NC DENR Winston-Salem Regional Office
Division of Water Quality, Water Quality Section
585 Waughtown Street
Winston-Salem, NC 27107
Voice: [phone] ext 263
FAX: [phone]

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July 9, 2004
Permitting authority
N. C. Dept of Environment
.Division of Water Quality
Attn_ Bradley Bennett
1617 Mail Service Center
Raleigh, NC 27699-1617
Dear Mr. Bennett:
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! J U L l 2 2004
L`NR - WhTER QUALITY
POINT SOURCE BRANCH
Enclosed is an "Application for No Exposure Certification for Exclusion
from NPDES Storm Water Permitting'_ In June we had mailed it to the incorrect
address. If you have any questions relating to this, please do not hesitate to call
336-434-0972.
Sincerely,
Sherry J_ IZ Kye
Human Resources Manager
AG
217 Feld A%enue Tel [phone]
PO Box 7929 Fax [phone]
4eh Fbim, NC 27264 Nrwwagi-inczom