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NCGNE1168_COMPLETE FILE - HISTORICAL_20161115
� _--'_---____�_------_�.--'__`'-�_--�----- __--_--___-��--__----__--�--___-_---_-_--___- STORMWATER DIVISION CODING SHEET .NCG PERMITS PERMIT NO. NCGNE DOC TYPE 0 HISTORICAL FILE DOC DATE YYYYMMDD 067 � 5 EFORENCY USS ONLY ale ReceivedDivision of Energy, Mineraland Land ResourcesMonlh DaLand Quality Sectioncale0fCDVera a l jp National Pollutant Discharge Elimination System NO EXPOSURE CERTIFICATION for Exclusion Ft].Lagy, Rai our NCGNEooaa ant]. Lcrrrrl ltesouArces EwwRtarrPiswr.cL nirnGIry I 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 forstormwater 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, m eans all industrial materials and activities are protected by a storm resistant shelter (with some exceptions) to prevent exposureto,rain, snow, snowmelt, and/or runoff. For permitted facilities in North Carolina, DEMLR must approve your application for No Exposure Certification before this exclusion is effective. 'Until you are issued a No Exposure Certification and your NPDES permit is rescinded, your facility must continue to abide by the terms and conditions of the current permit. industrial materials or activities Include, but are not limited to: material handling equipment or activities, industrial machinery, raw materials, intermediate products, by-products, final products, or waste products. Material handling activities include the storage, loading and unloading, transportation, or conveyance of any raw material, intermediate product, final product or waste product. A storm resistant shelter is not required for the following Industrial materials and activities: drums, barrels, tanks, and similar containers that are tightly sealed, provided those containers are not deteriorated and do not leak. "Sealed" means banded or otherwise secured and with locked or non -operational taps or valves; adequately maintained vehicles used in material handling; and final products, other than products that would be mobilized in storm wa ter 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). If approved, your conditional No Exposure Exclusion has no expiration date BUT MUST BE self re -certified at least annually. ' Please look for information about re -certification under the No Exposure section on this page: https://deco.nc.goyLbou.t/divIsionsteLiergy-mineral-land-resources/energy-mineral-land-i3ermitslstormwater- For questions, please contact the DEMLR Regional Office for your area. (Seepage 6) (Please print or type) 1) Mailing address of owner/operator (address to which all certiffcati n correspondence will be mailed): Name FedEx Express Contact Chris Galloway, Manager EOS ^� Street Address 3620 Hacks Cross Rd Bldg B, 06 FI City Memphis State TN. ZIP Code 38125 Telephone No. 901-434-8509 Fax: 901-434-9235 Page 1 of 7 ! nat rANicAri nrgnrgmF . i , � 4 i NCGNE0000 No Exposure Certification 2) Location of facility producing discharge: f� ,4 (� } Facility Name _�<(% G t ��'�i�{, s— V Facility Contact car 1rr v !�CQ,� e Street Address V c City lksti Py t Ll State _ ZIP Code O County ; Telephone No. _ gg sa - Fax: j I 3) Physical location Information: I Please provide a narrative description of how to get to the facility (use street names, state road numbers, and' distance and direction trppm a roadway intersection). t - ter- ' taS _\C� S ILLS -a� `71.1S n'S� _� � _ (A copy of a map with the facility clearly located on it should be Included with the certification application.) I 4) Is the facility located on Native American Lands? ❑ Yes U-Mlo �p f _ Q� 5r 4� `, SJ 5) Is this a Federal facility? ❑ Yes ag. 3 �• Q r / v I K�jc..,/ 6) Latitude_�_v Lon itude (deg., min., seconds) 1 7) This NPDES No Exposure Exclusion application applies to which of the following: j ❑ New or Proposed Facility Date operation Is to begin j xisting Date operation began ❑ Renewal of existing No Exposure Certification Certification No.: NCGNE j 8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes C-We- E f If yes, what is the NPDES Permit Number? 9) Standard Industrial Classification: Provide the 4-digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial activity at this facility I SIC Code: L� a,I _ ! 10) Provide a brief description of the types of industrial activities and products produced at this facility,{ 11) Does this facility have any Non -Discharge permits (ex: recycle permits)? G3'N o ❑ Yes If yes, list the permit numbers for all current Non -Discharge permits for this facility: Page 2 of 7 SWU-NCGNE last revised 9/28/2018 NCGNE01}40 No Exposure Certification Exposure Checklists (12. - 14.) 11) 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 ❑ No ❑ NIA 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 p-,No ❑ N/A c. Materials or products from past industrial activity . . ❑ Yes Q-l1(o ❑ NIA d. Material handling equipment (except adequately maintained vehicles) ❑ Yes LAO -❑ NIA e. Materials or products during loading/unloading or transporting activities ❑ Yes QAo ❑ NIA f. Materials or products stored outdoors (except final products intended for outside ❑ Yes `t' W'o ❑ NIA 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 Q I o ❑ NIA and similar containers h. Materials or products handledlstored on roads or railways owned or maintained by ❑ Yes la t( ❑ NIA the discharger i. Waste material (except waste in covered, non -leaking containers [e.g., dumpsters]) ❑ Yes oNIA j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes ::O/pa NIA k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes 04g/o ❑ NIA 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 040 ❑ N/A (i.e., not closed and stored upside down to prevent precipitation accumulation) m. For any exterior ASTs, as well as drums, barrels, tanks, and similar containers ❑ Yes ❑MI6"❑ NIA stored outside, has the facility had any releases in the past three (3) years? 12) Above Ground Storage Tanks (ASTs): If you answer "No" to any of the following items, you are not eligible for the no exposure exclusion. a. Are exterior ASTs or piping free of rust, damaged or weathered coating, pits, or 04es ❑ No ❑ NIA deterioration, or evidence of teaks? / b. Is secondary containment provided for all exterior ASTs? If so, is It free of any U 9es ❑ No ❑ NIA cracks, holes, or evidence of teaks, and are drain valves maintained locked shut? 13) Secondary Containment: if you answer "No" to any of the following items, you are not eligible for the no exposure exclusion. a, is secondary containment provided for single above ground storage containers ❑ Yes ❑ No i�IA (including drums, barrels, etc.) with a capacity of more than 660-gallons? Page 3 of 7 1 Art mviRaa AOWMc NCGNE0000 No Exposure Certification b. Is secondary containment provided for above ground storage containers stored ❑ Yes (]No 04A in close proximity to each other with a combined capacity of more than 1,320- g gallons? c. Is secondary containment provided for Title 111 Section 313 Superfund ❑ Yes a No q)tlA Amendments and Reauthorization Act (SARA) water priority chemicals*? d. Is secondary containment provided for hazardous substances_** designated in 40 ❑ Yes ©No 01A CFR §116? e. Arc release valves on all secondary containment structures locked? C/yes []No ❑ NIA 14) Hazardous Waste: a. Is this facility a Hazardous Waste Treatment, Storage,'or Disposal Facility? ❑ Yes ❑40 ❑ NIA b. is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste ❑ Yes ry1 tlo ❑ NIA generated per month) of hazardous waste? . c. Is this facility a Large Quantity Generator (1000 kg, or more of hazardous waste ❑ Yes l Ao ❑ NIA generated per month) of hazardous waste? If you answered yes to questions b. or c., please provide the following information: I Type(s) of waste: i How is material stored: _ Where is material stored: How many disposal shipments per year: Name of transport I disposal vendor: i Vendor address: Footnotes to Questions 14) c. & d. *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. • f 15) 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? 0 Yes M-No , ❑ NIA b. Does your facility have coal piles on site? ❑ Yes 'a/c ❑ NIA Page 4of7 ! I ari rRviFwrl Ar>Pj9n9fi r NCGNE0000 No Exposure Certification c. Does your facility store other fuel sources outside in piles, such as wood chips, ❑ Yes VNo 0 NIA sawdust, etc.? / d. Does your facility have air emissions associated with its industrial activity (e.g., ❑ Yes "0 ❑ NIA ' 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 ❑ Yes Ci No qN/R Permit? Please specify: f. Please list any other environmental program permits -(federal, state, etc.) not specified earlier in this application (such as Hazardous.Waste Permits, etc.): Permit: Program: Permit: Program: Permit: Program: Permit: Program: Permit: _ _ Program: Permit: Program: _ Permit: Program: Page 5 of 7 NCGNEOOOO No Exposure Certification M 16) Certification: I certify under penalty of law that I have read and understand the eligibility requirements for claiming a condition of "no i exposure" and obtaining an exclusion from NPDES stormwater permitting. I I certify under penalty of law that there are no discharges of stormwater contaminated by exposure to industrial activitios 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 1 am obligated to maintain no exposure conditions and complete a Self-Recertifcation form at least once each year, and if requested, provide this certification to the operator of the local municipal separate storm sewer system (MS4) into which the facility discharges (where applicable), i understand that I must allow the North Carolina Division of Energy, Mineral, and Land Resources, or MS4 operator where the discharge is Into the local MS4, to perform inspections to confirm the condition of no exposure and to make such inspection reports publicly available upon request. I understand must keep a copy of annual re -certifications on file at the facility, 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, 1 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 Wing: _Karen Ellis Title: —Asst Tres r nAng Director (Signature of 10/7116 (Date Signed) ~� ' Env. Ops. Support Please note: This application for the No ,Exposure Exclusion Is subject to approval by the L } NCDE4 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 fnspect your facility at anv time in the future for compliance with the No Exposure Exclusion. North Carolina General Statuto 143-215.6 B(i) provides that: Any person who knowingly makes any false statement, representatlon, or certification in any application, record, report, plan, or other documenl 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 fora No Exposure Exclusion. Page 6 of 7 NCGNE0000 No Exposure Certification Final Checklist This application should include the following items: ? p//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 Program Division of Energy, Mineral and Land Resources 1612 Mail Service Center Raleigh, North Carolina 27699-1612 Note The submission of this document does not guarantee the issuance of a No Exposure Exclusion. For questions, please contact the DEMLR Regional Office for your area. DEMLR Recional Office Contact Information: Asheville Office ...... (828) 296-4500 Fayetteville Office ... (910) 433-3300 Mooresville Office ... (704) 663-1699 Raleigh Office ........ (919) 791-4200 J Washington Office ...(252) 946-6481 Wilmington Office ... (910) 796-7215 Winston-Salem ...... 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