NCGNE0988_COMPLETE FILE - HISTORICAL_20180924

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STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCGNE ON
DOC TYPE
HISTORICAL FILE
DOC DATE
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YYYYMMDD

ROY COOPER NORTH CAROLINA
Governor Environmental Quality
MICHAEL S. REGAN
Secretary
WILLIAM E. (TOBY) VINSON, JR,
Interim Director
September 24, 2018
Proampac
Attention: Arvel Bailey
159 Broad River Blvd
Forest City, North Carolina 28043
Subject: Compliance Evaluation Inspection
Permit: NCGNE0988
Rutherford County, North Carolina
Dear Mr. Bailey:
Enclosed please find a copy of the Compliance Evaluation Inspection Report for the
inspection I conducted at the subject facility on September 11, 2018.
The report should be self-explanatory; however, should you have any questions
concerning this report, please do not hesitate to contact me at [phone] or by email
at [e-mail].
Sincerely-
Isaiah'Reed,LCX- C1, MS CECI
Environmental Specialist
Land Quality Section
Enclosure: Inspection Report
North Carolina Department of Environmental Quality I Division of Energy, Mineral and Land Resources
Asheviile Regional Office 12090 U.S. Highway 70 I Swannanoa, North Carolina 28778
828.296.4500

Permit: NCGNE0988
SOC:
County: Rutherford
Region: Asheville
Contact Person: Arvel Bailey
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Compliance Inspection Report
Effective: 11/03/14 Expiration: Owner. Proampac
Effective: Expiration: Facility: ProAmpac
159 Broad River Blvd
Inspection Date: 09/11/2018
Primary Inspector: Isaiah L Reed
Secondary lnspector(s):
Forest City NC 28043
Title: Phone: [phone]
Certification: Phone:
Entry Time: 02;45PM Exit Time: 03:45PM
Phone: [phone]
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Stormwater Discharge, No Exposure Certificate
Facility Status: E3 Compliant ❑ Not Compliant
Question Areas:
M Miscellaneous Questions ® Misc
(See attachment summary)
Page: 1

0 0
Permit: NCGNE0958 Owner - Facility:proampac
Inspection Date: 091111201a Inspection Type : Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
On September 11, 2018 this facility was insepcted for compliance. I met with Arvel Bailey on site. No issues were observed
on site.
If you have any questions, please contact this office at [phone]
Page: 2

permit: NCGNE0988 Owner - Facility:Proampac
Inspection Date: 0911112018 Inspection Type : Ccmpliance Evaluation
Misc
Is the facility compliant?
Comment:
Reason for Visit: Routine
Yes No NA NE
® ❑ ❑ ❑
Page: 3

Permit: NCGNE0988
SOC:
County: Rutherford
Region: Asheville
Contact Person: Arvel Bailey
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Compliance Inspection Report
Effective: 11/03/14 Expiration
Effective: Expiration
Title:
Certification:
Owner: Proampac
Facility: ProAmpac
159 Broad River Sivd
Forest City NC 28043
Phone: [phone]
Phone:
Inspection Date: 0911112018 Entry Time: 02:45PM Exit Time: 03:45PM
Primary Inspector: Isaiah L Reed Phone: [phone]
Secondary Inspector(s):
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: 5tormwater Discharge, No Exposure Certificate
Facility Status: Compliant Not Compliant
Question Areas:
Miscellaneous Questions Misc
(See attachment summary)
Page: 1

0 •
Permit: NCGNE0988 Owner - Facility:Proampac
Inspection Date: 09/1112018 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
On September 11, 2018 this facility was insepcted for compliance. I met with Arvel Bailey on site. No issues were observed
on site.
If you have any questions, please contact this office at [phone]
Page: 2

0 0
Permit: NCGNE0988 Owner - Facility: Proampac
Inspection Date: 09/11/2018 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Misc
Is the facility compliant?
Comment!
Yes No NA NE
■❑❑❑
Page: 3

Aq
Ia
HCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory ,John E. Skvarla, III
Governor Secretary
November 3, 2014
Bonita Packaging Products, Inc. dba Bonita Pioneer
ATTN: Mr. Thomas Shaw
7333 S.W. Bonita Road
Tigard, OR 97224
Subject: No Exposure Certification - Approval
NCGNE0988
Bonita Packaging Products, Inc. dba Bonita Pioneer
Rutherford County
Dear Mr. Shaw:
The Division has reviewed your application for a No Exposure Certification for Exclusion (NE) for the
subject facility. Based on the information provided in your application; and a site visit conducted on
October 27, 2014 (see attached inspection report), the NE has been approved.
Please note that you are obligated to maintain no -exposure conditions at your facility. If conditions
change such that your facility can no longer qualify for an NE, you are obligated to immediately
obtain NPDES permit coverage for your stormwater discharge. Otherwise, the discharge becomes
subject to enforcement as an un-permitted discharge. Your NE does not expire. In order to help
assure that your facility stays in compliance with all of the conditions in the Certification, you must
self -recertify your facility at least annually. Please see the attachment for information on self -
recertification.
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 me at [phone], or at
laura.herbert(-ncdenr.gov.
Sincerely,
,74
for Tracy E. Davis, PE, CPM
Director
Attachments
ec: Stormwater Permitting Unit/Ken Pickle, No -Exposure Files
Division of Energy, Mineral, and Land Resources
1612 Mail Service Center, Raleigh, North Carolina 27699-1612.919-707-92001 FAX: [phone]
512 North Salisbury Street, Raleigh, North Carolina 27604 - Internet: ht1 :II ortal,ncdenr.or Iwebllr!
An Equal Opportunity 1 Affirmative Action Employer - 50% Recycled 110% Post Consumer Paper

Permit: NCGNE0988 Effective:
SOC: Effective:
County: Rutherford
Region: Asheville
Contact Person; Thomas A Shaw
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Re prose ntative(sl:
Related Permits:
Comoliance Inspection Resort
Expiration: Owner : Bonita Packaging Products Inc
Expiration: Facility: Bonita Pioneer- Forrest City
159 Broad River Blvd
Forest City NC 28043
Title: Phone: [phone] Ext.238
Certification:
Phone:
Inspection Date: 10/27/2014 Entry Time: 10:30AM Exit Time: 12:OOPM
Primary Inspector: Darlene J Kucken Phone:
Secondary Inspector(s):
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Stormwater Discharge, No Exposure Certificate
Facility Status: Compliant Not Compliant
Question Areas:
M Miscellaneous Questions
(See attachment summary)
Page: 1

Permit: NCGNE0988 Owner - Facility: Bonita Packaging Products Inc
Inspection Date: 1012712014 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
Comment: Site visit on 10/27/14 confirmed that facility qualifies for no exposure
certification. Granting NEC with letter dated 10/2812014.
Page: 2

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 -ex osure 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.nedenr.org/web/wqi'Ws/sui'npdessw#tab-5
Rev. 30Aug2010

F5WA
NCDENR
NO C AOu oEP. -E-T or
EwV RONMENT mo NATURAL RESOURCES
Division of Water Quality / Surface Water Protection
National Pollutant Discharge Elimination System
ANNUAL NO EXPOSURE EXCLUSION SELF RE -CERTIFICATION
NCGNEQ000
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)
N I C I G N I E
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#Aoplication—Forms_N PDES)
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
1. 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-29Ju12010

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 ❑ NIA
deterioration, or evidence of leaks?
b. is secondary containment provided for all exterior ASTs? If so, is it free of any ❑Yes❑ No ❑ NIA
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-
galfons?
c. Is secondary containment provided for Title III Section 313 Superfund
Amendments and Reauthorization Act (SARA) water priority chemicals*?
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. & d.
[]Yes[:] No ❑ NIA
[:]Yes[:] No ❑ NIA
[:]Yes[:] No ❑ NIA
[:]Yes[:] No ❑ NIA
❑Yes❑ No ❑ NIA
*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. 1f you answered yes to d., are those emissions permitted by an Air Quality Permit? ❑Yes❑ No❑NIA
Please specify:
Page 2 of 3
SWU-NESR-29Ju12010

NCGNE0000 No Exposure Self Re -Certification
6) Certification:
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.
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; of 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-29jul2olo

Herbert, Laura C
From: Kucken, Darlene
Sent: Monday, November 03, 2014 1:07 PM
To: Herbert, Laura C
Cc: Georgoulias, Bethany; Pickle, Ken
Subject: RE: Bonita Packaging Products, dba Bonita Pioneer Forest City Rutherford County
All, I did a site inspection of this facility on Oct 27 and believe that this is a "no exposure" facility. There are no interior
stormdrains and all fluids are stored indoors.
There is a wash up area for the confined printing press area, which is hosed down and drains to a submersible pump and
a 1600 gallon tank. The liquids are run through an equalization process and a treatment tank and then to the Forest City
WWTP.
There is no vehicle maintenance and no outdoor storage.
Let me know if you need anything else from me.
Darlene Kucken - [e-mail]
North Carolina Dept. of Environment and Natural Resources
Asheville Regional Office
Division of Energy, Mineral, and Land Resources
2090 U.S. 70 Highway
Swannanoa, NC 28778
Tel: [phone]
Fax: [phone]
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and
may be disclosed to third parties.
`Aj Go Green! Print this email only when necessary. Thank you for helping NCDENR be environmentally responsible.
From: Tom Shaw [mailto:[e-mail]]
Sent: Wednesday, October 15, 2014 12:47 PM
To: Herbert, Laura C
Cc: Kucken, Darlene; Georgoulias, Bethany; Pickle, Ken
Subject: Re: Bonita Packaging Products, dba Bonita Pioneer Forest City Rutherford County
Laura,
We are up and running on two machines at this time, with two more to add in the
next 60-90 days. I will be at the facility the week of the 27th of October if that is
a good time for you to visit. Let me know when you have a moment.
Torn Shaw
----- Original Message -----
From: Herbert. Laura C
To: Tom Shaw
Cc: Kucken Darlene ; Georgoulias, Bethany ; Pickle, Ken
Sent: Wednesday, October 15, 2014 5:47 AM
Subject: RE: Bonita Packaging Products, dba Bonita Pioneer Forest City Rutherford County
Tom,

0 0
Hope all is going well at Bonita. Just a follow up on the status of operation of the new facility. Are you all up and
running yet? If so, we would like to schedule a "no exposure" inspection at your convenience.
Thanks,
Laura
Laura Herbert, P.E.
Regional Engineer
Division of Energy, Mineral, and Land Resources - Land Quality Section
NCDENR-Asheville Regional Office
2090 US Highway 70
Swannanoa, NC 28778
Tel:[phone] Fax:[phone]
http://Portal.ncdenr.org/web/Ir
Notice: l;-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and therefore may be disclosed to
third parties unless the content is exempt by statute or other regulation.
From: Tom Shaw [mailto:toms,bonitapioneer.com] T
Sent: Wednesday, March 05, 2014 11:46 AM
To: Herbert, Laura C
Cc: Kucken, Darlene; Georgoulias, Bethany; Pickle, Ken
Subject: Re: Bonita Packaging Products, dba Bonita Pioneer Forest City Rutherford County
We're about 5 months away from that but I will definitely be in touch as we get closer.
Thanks!
Tom
----- Original Message -----
From: Herbert, Laura C
To: Tom Shaw
Cc: Kucken Darlene ; Georgoulias, Bethany ; Pickle, Ken
Sent: Monday, March 03, 2014 9:44 AM
Subject: Bonita Packaging Products, dba Bonita Pioneer Forest City Rutherford County
Tom,
We received your No Exposure Certification last Friday. Please let us know when the facility is up and running and we
will schedule an inspection with you as part of the No Exposure review. We look forward to meeting you and working
with you on this No Exposure Certification.
Thanks,
Laura
Laura Herbert, P.E.
Regional Engineer
Division of Energy, Mineral, and Land Resources - Land Quality Section
NCDENR-Asheville Regional Office
2090 US Highway 70
Swannanoa, NC 28778
Tel:[phone] Fax:[phone]
http://portal.ncdenr.org/web/Ir

10 0
Compliance Inspection Report
Permit: NCGNE0988 Effective: Expiration: Owner : Bonita Packaging Products Inc
SOC: Effective: Expiration: Facility: Bonita Pioneer- Forrest City
County: Rutherford 159 Broad River Blvd
Region: Asheville
Forest City NC 28043
Contact Person: Thomas A Shaw Title: Phone: [phone] Ext.238
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 10/27/2014
Primary Inspector: Darlene J Kucken
Secondary Inspector(s):
Certification:
Phone:
Entry Time: 10:30AM Exit Time: 12:OOPM
Phone:
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Stormwater Discharge, No Exposure Certificate
Facility Status: Compliant Not Compliant
Question Areas:
Miscellaneous Questions
(See attachment summary)
Page: 1

permit: NCGNE0988 owner- Facflfty: Bonita Packaging Products Inc
Inspection date: 10/2712014 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
Comment: Site visit on 10/27/14 confirmed that facility qualifies for no exposure
certification. Granting NEC with letter dated 10/28/2014.
Page: 2

Kucken, Darlene
From: Tom Shaw <[e-mail]>
Sent: Monday, October 20, 2014 5:31 PM
To: Kucken, Darlene
Subject: Re: "No exposure" inspection
Darlene,
That time will work fine. My cell number is 503-329-5031. We do not have phone service at the building yet.
We are so new we don't always come up on Google Earth or Mapquest. Here's some directions to asisst
you. Take US 74 East from Asheville to exit 178 and get on 221 S. Go about 8 miles and look for the
Riverstone Business Park on the right side. Turn right into the park, go to the bottom of the hill and turn left.
We're the only building. Hope that helps.
Tom
----- Original Message From: Kucken, Darlene
To: Tom Shaw
Sent: Monday, October 20, 2014 2:04 PM
Subject: RE: "No exposure" inspection
Hi Tom,
Let's go for the morning. I'm still coming into this discussion, so I'm not sure where you're located. Please give me an
address. I can likely get there by about 10:00. We should be done within an hour or two at most.
Please also send me your phone number.
Darlene Kucken - [e-mail]
North Carolina Dept. of Environment and Natural Resources
Asheville Regional Office
Division of Energy, Mineral, and Land Resources
2090 U.S. 70 Highway
Swannanoa, NC 28778
Tel: [phone]
Fax: [phone]
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and
may be disclosed to third parties.
`A Go Green! Print this email only when necessary. Thank you for helping NCDENR be environmentally responsible.
From: Tom Shaw [ma llto:toms@bon itapioneer.com]
Sent: Monday, October 20, 2014 4:40 PM
To: Kucken, Darlene
Subject: Re: "No exposure" inspection
Hi Darlene,
Let's go with the 27th. Pick a time between 9 and 2 that works for you
and let me know. Thanks!
Tom Shaw
----- Original Message -----
From: Kucken,- Darlene
To: [e-mail]

Sent: Monday, October 20, 2014 1:22 PM
Subject: "No exposure" inspection
Hi Tom,
Laura Herbert has been forwarding your information on to me as the inspector for Rutherford County. I understand
that you will be at the facility the week of Oct 27 and that this would be a good time to conduct a potential no
exposure inspection.
I am available on Oct 27 and 31.
Please send me your preferred date and time and your facility location and we will set up the inspection. My dates fill
in very quickly, so the sooner we can get this on the calendar the better.
look forward to meeting you.
Darlene Kucken - [e-mail]
North Carolina Dept. of Environment and Natural Resources
Asheville Regional Office
Division of Energy, Mineral, and Land Resources
2090 U.S. 70 Highway
Swannanoa, NC 28778
Tel: [phone]
Fax: [phone]
E-mail correspondence to and from this address may be subject to the North Carolina (Public Records Law and
may be disclosed to third parties.
`Aj Go Green! Print this email only when necessary. Thank you for helping NCDENR be environmentally responsible.

Herbert, Laura C
From: Tom Shaw <[e-mail]>
Sent: Wednesday, March 05, 2014 11:46 AM
To: Herbert, Laura C
Cc: Kucken, Darlene; Georgoulias, Bethany; Pickle, Ken
Subject: Re: Bonita Packaging Products, dba Bonita Pioneer Forest City Rutherford County
We're about 5 months away from that but I will definitely be in touch as we get closer.
Thanks!
Tom
----- Original Message -----
From: Herbert, Laura C
To: Tom Shaw
Cc: Kucken, Darlene; Georgoulias, Bethany ; Pickle, Ken
Sent: Monday, March 03, 2014 9:44 AM
Subject: Bonita Packaging Products, dba Bonita Pioneer Forest City Rutherford County
Tom,
We received your No Exposure Certification last Friday. Please let us know when the facility is up and running and we
will schedule an inspection with you as part of the No Exposure review. We look forward to meeting you and working
with you on this No Exposure Certification.
Thanks,
Laura
Laura Herbert, P.E.
Regional Engineer
Division of Energy, Mineral, and Land Resources - Land Quality Section
NCDENR-Asheville Regional Office
2090 US Highway 70
Swannanoa, NC 28778
Tel:[phone] Fax:[phone]
http://Portal.ncdenr.org/web/i
Notice: E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and therefore may he disclosed to
third panics unless the content is exempt by statute or other regulation.
From: Herbert, Laura C
Sent: Wednesday, January 29, 2014 1:00 PM
To: Tom Shaw'
Cc: Watkins, Wayne; Kucken, Darlene; Georgoulias, Bethany; Pickle, Ken
Subject: RE: New Printing Facility in Rutherford or Caldwell County
Tom,
Thank you for the application. Once the facility is operating, we will schedule an inspection to confirm the "no
exposure" status. Please send the original to the following address:
North Carolina Division of Energy, Mineral, and Land Resource
Stormwater Permitting Section
1

so a
ATTN: Bethany Georgoulias or Ken Pickle (NPDES Industrial Stormwater)
1612 Mail Service Center
Raleigh, NC 27699-1612
Thanks,
Laura
Laura Herbert, P.E.
Regional Engineer
Division of Energy, Mineral, and Land Resources - Land Quality Section
NCDENR-Asheville Regional Office
2090 US Highway 70
Swannanoa, NC 28778
Tel:[phone] Fax:[phone]
http://Portal.ncdenr.org/web/Ir
Notice: E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and therefore may he disclosed to
third parties unless the content is exempt by statute or other regulation.
From: Tom Shaw[ma.ilto:[e-mail]]
Sent: Wednesday, January 29, 2014 12:45 PM
To: Herbert, Laura C
Cc: Watkins, Wayne; Kucken, Darlene
Subject: Re: New Printing Facility in Rutherford or Caldwell County
Ms. Herbert,
Attached you will find a copy of our completed application. I plan to send the original
to you via mail at the address shown below, as opposed to the Division of Water Quality
address shown on the application. I will wait until I hear back from you confirming that
address, and I'm aware that, given the weather conditions in the southeast, you may
not receive this until tomorrow. Please let me know if there is anything further needed
when you have had time to review the application. Thanks for all of your assistance!
Best regards,
Tom
----- Original Message ---
From: Herbert Laura C
To: tomspbonitapioneer.com
Cc: Watkins, Wayne ; Kucken, Darlene
Sent: Monday, January 27, 2014 12:34 PM
Subject: New Printing Facility in Rutherford or Caldwell County
Mr. Shaw,
Thank you for your inquiry regarding stormwater permitting requirements for a proposed new printing/folding bag
facility (SIC 2759)in either Caldwell or Rutherford County. As we discussed this type of operation would be subject to a
general stormwater permitting requirement as handled by our General Permit NCG050000 (see attached). You
indicated that the facility will probably not store anything outside, and may qualify for a no exposure exclusion. If this
is the case, please complete the attached request for no exposure and submit to our division. Note that if this facility
will have a vehicle maintenance area that uses more than 55 gallons of new motor oil and/or hydraulic oil per month
when averaged over the calendar year, this facility will be subject to the monitoring requirements for on -site vehicle
and equipment maintenance and cannot qualify for no exposure. If this is the case, you should complete the NOI form
to apply for the general permit.

•
® R Ro- Lwna. 1_HXf4_
NCDENR
NORTH C ACUNA MCP TMER
E_RONRERT ARP NoUR, RE�,
Division of Water Quality / Surface Water Protection
National Pollutant Discharge Elimination System
NO EXPOSURE CER11FICATION for Exclusion
NCG N E0000
RI)
�- f
ITI
-�
FOR AGENCY USH ONLY
Date Received
Year
Moth
Day
03
Ccrlificate of Coverage
NO EXPOSURE CERTIFICATION
DENR-WER
National Pollutant Discharge Elimination System application for exclusion fror WOftgyq��� ed
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. Ir
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 self re -certify your No Exposu
For questions, please contact the DWQ 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 �oni"f ci �a��caq,►�q rracQrc�f5 r 'rvtiG, dbct�3ov►rj-a
Contact Vko rv►a6 A "" 51%�a
Street Address 7 �3 33 5 LJ Bon � t0L ;?oct
City E;�ard State t' K ZIP Code 17 Z2 4
Telephone No. So- Jv 8 `f ` S 4 2_ x 2-S 6 Fax: 503 59 S - 76 , 2-
Email te,&J6 CC 60n i {-ra p i U n eel-, C.OtAn
Page 1 of 7 F E 8 2 8 2014
SWU-NE-12Aug2010
i, rznCl Quality Section
Asheville

NCGNE0000 No Exposure Certification
2) Location of facility producing discharge:
Facility Name b npi 1+a f 4iiee- f Uvv { G'
Facility Contact T 0 A 1 tic ,M a s S eLcA J 15 eol
Facility Street Address 1 5 R �rauct' e.'ve,, 61 u .
CityState A!G ZIP Code 2- el DL� 3
County --or
Telephone No. T-6 A T3 5o3 - 3- -?6 8 Z
Email rF A treeeo" as f F 1 p),Vd) U4it,' I a ✓�"_z
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). F_roivi 145 -1' ,-take U5 -ZZ) 5­f4, %ur j
ri� r f on 3i✓d, . `T'w,,o ier-4 nofv t3road R;ury Cjf✓,Q. y s nee
(A copy of a map with the facility clearly located on it should be included with the certification application.) rl- (-e4
4) Is the facility located on Native American Lands? ❑ Yes XNo
5) Is this a Federal facility? ❑ Yes %No
6) Latitude 35d, 12 m, 4 7-5 Longitude ~ S d, 60N', 3OS(deg., min., seconds)
7) This NPDES No Exposure Exclusion application applies to which of the following:
)9[ New or Proposed Facility Date operation is to begin -Tu"c 1, 2014
❑ Existing Date operation began
© Renewal of existing No Exposure Certification Certification No.: NCGNE
8) Was this facility or site ever covered under an NPDES Stormwater Permit? 39: Yes ❑ No
If yes, what is the NPDES Permit Number? r vwt $iv,,Mw'4kr ('"r ro i P"r4' 4
GfOsG� 0Ue-r In ✓S r-?o • d rlv- Adai la61L
9) Standard Industrial Classification: i
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: 2— 7 5
10) Provide a brief description of the types of industrial activities and products produced at this facility:
Papar p/i�t�'n9 avid 1-o cManr�fc�{t,r�' >7Ar r Sl�on/>r'ciA
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
XNo
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
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 XNo
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 IS[ No
c. Materials or products from past industrial activity ❑ Yes )R( 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 1K 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 ffi( No
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes 9 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 KNo
(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 XNo
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 irYes ❑ 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 XN/A
cracks, holes, or evidence of leaks, and are drain valves maintained locked shut?
Page 3 of 7
SWU-NE-12Aug2010

0
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 1 disposal vendor: _
Vendor address:
Footnotes to Questions 14) c. & d.
0 Yes ❑ No XNIA
0 Yes ❑ No XNIA
❑ Yes ❑ No XN/A
❑ Yes ❑ No jK NIA
❑ Yes ❑ No (NIA
0 Yes ->(No
❑ Yes X No
❑ Yes XNo
'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.
Rage 4 of 7
SWU-NE-12Aug2010

0
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 XNo
b. Does your facility have coal piles on site?
❑ Yes g No
c. Does your facility store other fuel sources outside in piles, such as wood chips, ❑ Yes JK 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? P(Yes ❑ No ❑ NIA
Please specify: Ar, A;r (VLAa('&i e,,i"04- alitiutfi'o✓i j6 r'n
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:
Page 5 of 7
SWU-ME-12Aug2010

0 0
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:
Title:
(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 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
SWU-NE-12Au92010

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: �7C trVl A • bct W
Title: i G . Ere51 dC,t4� anK]La C-f-Ltri vA
(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 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
SWU-NE-12Aug2010

NCGNE0000 No Exposure Certification
Final Checklist
This application should include the following items:
El This completed application and all supporting documentation.
0 A map with the location of the facility clearly marked.
❑ 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...
[phone]
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........
[phone]
Page 7 of 7
SWU-NE-12Aug2010

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Division of Water Quality 1 Surface Water Protection
U'"C®ENR National Pollutant Discharge Elimination System
Z0' NO EXPOSURE CI R,rIFICATiON for Exclusion
ENYIRO.��CvT .vO NRL'RK RCSOURCC]
NCGNE0000
NO EXPOSURE CERTIFICATION
FOR AGENCY USE ONLY
Dale Received
Year
R1ow Dad
Cali Rciltc of Ccveraga
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).
You are required to self re -certify your No Exposure Exclusion annual
For questions, please contact the DWQ Regional Office for your area. (See page 6)
(Please print or type)
1) Mailing address of ownerloperator (address to which all certification correspondence will be mailed):
Name BC111"i-61 eick-as"bz�i �'c�G +�t- 5-roeIG. Ant j���.� Ems,c��Lc•
Contact all 6
Street Address 7 33' -S i.-`
City
Telephone No. 5� Y r ` T
I `J`q-(o� tZx?.7f
Email 5 F' (JC,ianeipr, C�,ol-v
Page 1 of 7
State C' (L ZIP Code S -7._Z7_ `l
Fax: 150 3 Sol F3--7 & c L
SWU-NE-12Aug2010

® 0 r ,
NCGNE0000 No Exposure Certification
2) Location of facility producing discharge:
Facility Name 50"I [ fa f "r i) e G-r-
Facility Contact T 0 A ( II I,-- J" a s
Facility Street Address 150 5110&:d' ,2rVer
City
County
-h-
�i��,..1
State ZIP Code Z� D
Telephone No. -r6 A 5L 3 547- tAn4,A v1,1"'`Vax: 713 4 [ So;S - 5°1f 7GS'2--
�� Lr�,�1-rf7,'0 r,,1:67y� r,}��, 1 u,,t,
Email f6A (+-P i �.. �•'S
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)• r'ro,i u 5 -7 -ra k e Gt 5 - 27i .5c;­ tl, , T-&r"
r[l_1,_t r2, _v,?,- -.5 +-oei e 6iVd,. 14 e(-oee! iC ,,e,- ' ;s '41
(A copy of a map with the facility clearly located on it should be included with the certification application.) rl.P
4) Is the facility located on Native American Lands? 0 Yes ;<No
5) Is this a Federal facility? 0 Yes gNo
6) Latitude 35df 17 n.1 '# ZS^ Longitude - 8604", ?OS (deg., min., seconds)
7) This NPDES No Exposure Exclusion application applies to which of the following:
)K New or Proposed Facility Date operation is to begin -Tu"e 1, ) C i q
❑ Existing
Date operation began
❑ Renewal of existing No Exposure Certification Certification No.: NCGNE
S) Was this facility or site ever covered under an NPDES Stormwater Permit?'V. Yes ❑ No
If yes, what is the NPDES Permit Number? 5a�<«�E�, )r.�'�'�^ cc0,1 SiV(A-rc0nkr
9) Standard Industrial Classification: ov,;r 10 y.'s e-Ill. 4 na•f.fe-
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: 2- 7 5 T
10) Provide a brief description of the types 1of industrial activities and products produced) at this facility:
%�te�¢.,' pr,•n-rlvti� C.lnlJ[ GG'lr.'�!•-'! f v[Cf _ tv i•VlAo,K.7-cL�ter'[.'_ �n,2d,' .�6Iy/r-'r��11
ac; s i,_ , t"�� y i7A rler +L, 1 i 54 1"A,nZ� Ies -1 7
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
XNo
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
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 XNo
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 spillstleaks ❑ Yes D� No
c. Materials or products from past industrial activity ❑ Yes 0 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 1[ 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 DK No
j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes 9 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
1. Empty containers that previously contained materials that are not properly stored ❑ Yes 1KNo
(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 XNo
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 ❑' Yes ❑ No N(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 XN/A
cracks, holes, or evidence of leaks, and are drain valves maintained locked shut?
Page 3 of 7
SWLi-NE-12Aug2o10

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-
gailons?
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 (BABA) 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 1 disposal vendor:
Vendor address:
Footnotes to Questions 14) c. & d.
❑ Yes ❑ No XNIA
❑ Yes ❑ No IXN/A
❑ Yes ❑ No .X NIA
❑ Yes Q No X NIA
❑ Yes ❑ No XNIA
❑ Yes '-KNo
❑ Yes )( No
❑ Yes >(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 ill 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
SWU-NE-12Au92010

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 $( No
b. Does your facility have coal piles on site? 0 Yes No
c, floes 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., OYes ❑ 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 lI NIA
Please specify: An ;r -S iI V1 PrOL(2.s
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:
Page 5 of 7
SWU-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. l 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:
Title:
(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 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 6of7
SWU-NE-12Aug2010

NCGNEOOOO 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 facslity clearly marked.
❑ 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 Reaional Office Contact Information:
Wins
Asheville Office ......
[phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office ........
Washington Office ...(252)
[phone]
946-6461
.1
_ .! • _..�';4"she�ilEc Mt�orusvfllc } . r.�l ` ...,.-' i
Wilmington Office...
[phone]
Winston-Salem ......
[phone]
Central Office .........
[phone]
%—Wtfrning! on
Page 7 of 7
SWU-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
0WQ 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_s_tormwater 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
Title:
/ lk tica
(Signature of Applicant)
-Thctvt 5 A. 'Skek
v,-r„ I�ri aiL'1 �L Tci GTLi r' i r
0
t 2: r y
(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 io 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).
1
There is currently no fee for a No Exposure Exclusion.
Page 6 of 7
SWU-NE-12Au92010

Herbert, Laura C
From: Herbert, Laura C
Sent: Wednesday, January 29, 2014 1:00 PM
To: 'Tom Shaw'
Cc: Watkins, Wayne; Kucken, Darlene; Georgoulias, Bethany; Pickle, Ken
Subject: RE: New Printing Facility in Rutherford or Caldwell County
Tom,
Thank you for the application. Once the facility is operating, we will schedule an inspection to confirm the "no
exposure" status. Please send the original to the following address:
North Carolina Division of Energy, Mineral, and Land Resource
Stormwater Permitting Section
ATTN: Bethany Georgoulias or Ken Pickle (NPDES industrial Stormwater)
1612 Mail Service Center
Raleigh, NC 27699-1612
Thanks,
Laura
Laura Herbert, P.E.
Regional Engineer
Division of Energy, Mineral, and Land Resources - Land Quality Section
NCDENR-Asheville Regional Office
2090 US Highway 70
Swannanoa, NC 28778
Tel:[phone] Fax:[phone]
http://portal.ncdenr.org/web/Ir
Notice: E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and theretbre may be disclosed to
third parties unless the content is exempt by statute or other regulation.
From: Tom Shaw [mailto:[e-mail]]
Sent: Wednesday, January 29, 2014 12:45 PM
To: Herbert:, Laura C
Cc: Watkins, Wayne; Kucken, Darlene
Subject: Re: New Printing Facility in Rutherford or Caldwell County
MS.Herbert,
Attached you will find a copy of our completed application. I plan to send the original
to you via mail at the address shown below, as opposed to the Division of Water Quality
address shown on the application. I will wait until I hear back from you confirming that
address, and I'm aware that, given the weather conditions in the southeast, you may
not receive this until tomorrow, Please let me know if there is anything further needed
when you have had time to review the application. Thanks for all of your assistance!
Best regards,
Tom
Original Message

From: Herbert, Laura C
To: toms(ftonitapioneer.com
Cc: Watkins, Wayne; Kucken, Darlene
Sent: Monday, January 27, 2014 12:34 PM
Subject: New Printing Facility in Rutherford or Caldwell County
Mr. Shaw,
Thank you for your inquiry regarding stormwater permitting requirements for a proposed new printing/folding bag
facility (SIC 2759)in either Caldwell or Rutherford County. As we discussed this type of operation would be subject to a
general stormwater permitting requirement as handled by our General Permit NCG050000 (see attached). You
indicated that the facility will probably not store anything outside, and may qualify for a no exposure exclusion. If this is
the case, please complete the attached request for no exposure and submit to our division. Note that if this facility will
have a vehicle maintenance area that uses more than 55 gallons of new motor oil and/or hydraulic oil per month when
averaged over the calendar year, this facility will be subject to the monitoring requirements for on -site vehicle and
equipment maintenance and cannot qualify for no exposure. If this is the case, you should complete the NO1 form to
apply for the general permit.
You also indicated that this operation will move into an existing building, so land disturbance of more than 1 acre is not
expected. However, you will mention to the building owner the requirement of an approved erosion and sediment
control plan from our office if more than 1 acre is disturbed as part of this project. If you or the owner has any
questions concerning and of these requirements, please give us a call.
For additional information, you may want to review our stormwater website at the following url:
http://portal.ncdenr.org/web/wq/ws/sujnpdessw
Note that our stormwater program has recently moved from our Division of Water Quality to our Division of Energy,
Mineral, and Land Resources. Some of the forms do not reflect this.
Regards,
Laura
Laura Herbert, P.E.
Regional Engineer
Division of Energy, Mineral, and Land Resources - Land Quality Section
NCDENR-Asheville Regional Office
2090 US Highway 70
Swannanoa, NC 28778
Tel:[phone] Fax:[phone]
http://portal.ncdenr.org/web/ir
Notice: E-mail correspondence to and from this address may he subject to the North Carolina Public Records Law and therefore may he disclosed to
third parties unless the content is exempt by statute or other regulation.

Division of Water Quality 1 Surface Water Protection
HCDENRNational
Pollutant Discharge Elimination System
rOI CPo.-DC­Tal
NO EXPOSURE CERTIFICATION for Exclusion
,_n�.Ew — N�PK RE�RCE,
NCGNEOOQO
NO EXPOSURE CERTIFICATION
FOR AGENCY USE ONLY
Dale Received
Year
Nlonrh
Day
Certireare of co%crage
NICIGINI
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 922.26(g).
For questions, please contact the DWQ Regional Office for your area. (See page 6)
(Please print or type)
1) Mailing address of ownerloperator (address to which all certification correspondence will be mailed);
Name 60(%(fa eicka l;tiIq �.-r, 7�c.c_fS r i�G. dbct
Contact -d 1 r, riz r, 5 L roc J
Street Address - _3 3 3 -SLi
City i' � rk Irk
Telephone No. I? `LfZ 'K?. 7
Email 5 C, LIJrM
Page 1 of 7
State 0' (< ZIP Code 5 -7 Z", �t
Fax: �5() 3 S 1 F- It- c 2-
SWV-NE-12Aug2010

NCGNE0000 No Exposure Certification
2) Location of facility producing discharge:
Facility Name _ bo.-i l' fa f "0;1 e (?.t_ FL,r&_:5 {- e
Facility Contact _
Facility Street Address
City _
County _
TOA
i 5pr &0ad 9;ve'
Fore 5 f C. f- i
State N16 ZIP Code Z 0- Ott 5
Telephone No. raik Tl3 4 ( tTo - 516 -7G P 7-
Email 113f} r-t-'rOn, Pa "r,I'le"Llf c10" <<<?d+I dv4ed)
I
3) Physical location information:
Please provide a narrative description of how to get to the facility (use street names, state road numbers, and
distanceanddirection from a roadway intersection). r-om u 5 -7-t�/k�e U5 ZZ7I •5^y�=�Gl�, 7c.r.,
rl'Ll 1, I O,� K�'L�'.'✓�a,1C� OIL-'d. iwv✓i le-(-42,7�Jiodd 4'I'vcv- 13(irt, fCi�;�,rt�..`5- °,.,
(A copy of a map with the facility clearly located on it should be included with the certification application.) rt-
4) Is the facility located on Native American Lands? ❑ Yes XNo
5) Is this a Federal facility? ❑ Yes gNo
6) Latitude 45d 1 12 r1ti.X 4 2 S Longitude - S i d, t Or", Ms (deg., min., seconds)
7) This NPDES No Exposure Exclusion application applies to which of the following:
)K New or Proposed Facility Date operation is to begin -Tu"e 1, 2-GI q
0 Existing Date operation began
❑ Renewal of existing No Exposure Certification Certification No.: NCGNE
8) Was this facility or site ever covered under an NPDES Stormwater Permit? 0 Yes ❑ No
if yes, what is the NPDES Permit Number?
GiE.�•�� �✓U'r I� ✓S c,�ja. i# y�s•f r�a�l,i��e✓
9) Standard Industrial Classification: i
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: 2- 7 5 7
10) Provide a brief description of the types lof industrial activities and products produced/ at this facility:
Pr,per pl,'ofoog c;t-e/tU
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
XNo
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
Page 2 of 7
SVVU-NE-12Aug2010

is
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 XNo
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 to 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 X 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 >K 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 9 No
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes 0 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 XNo
(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 XNo
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 V Yes ❑ No JKN/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?
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 riority 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 / disposai vendor: _
Vendor address:
Footnotes to Questions 14) c. & d.
❑ Yes []No XNIA
❑ Yes ❑ No X NIA
❑ Yes ❑ No _X NIA
❑ Yes ❑ No X NIA
❑ Yes ❑ No (NIA
❑ Yes -KNo
❑ Yes X No
❑ Yes )<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
SWU-NE-12Aug2010

NCGNE00O0 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. floes your facility store used, recycled, or otherwise reclaimed pallets outside? ❑ Yes j9. No
b. Does your facility have coal piles on site?
❑ Yes gNo
c. Does your facility store other fuel sources outside in piles, such as wood chips,
❑ Yes XNo
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?
P(Yes ❑ No ❑ NIA
Please specify: _A « L;- �xi,�al",��o t��r �ti� ,'f cx r �c�z�,'�>., ; i i' n
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. -
Page 5 of 7
sWU-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 f 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:
Title:
(Signature ofApplicant)
(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
SWU-NE-12Aug2o10

NCGNE0000 No Exposure Certification
Final Checklist
This application should include the following items:
❑ This completed application and all supporting documentation.
❑ A map with the location of the facility clearly marked.
❑ If the site currently has an 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:
Wino.n.5nlcm
'
Asheville Office ......
828) 296-4500
F Vill fF
ayette e 0 ce ...
1
(9 0) 433-3300
1 r"
; '
=` I .Raleighi
�, r �
Mooresville Office ...
[phone]
Raleigh Office ........
(919) 791 -4200
Washington Office ...(252)
946-6481
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
F.dyattevilic .
Central Office .........
[phone]
Page 7 of 7
5WU-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 Signffing:. I 1, 1C Ovl_a :!� / ` • vlei w
Title: Via- i,'iv 5 ;
(Signature of Applicant)
vi.TciCrtLr i v
(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 6of7
SWU-NE-12Aug2010

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