NCGNE1338_COMPLETE FILE - HISTORICAL_20190314

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... ... ...... .. ... ......
STORMWATER DIVISION CODING SHEET
.NCG PERMITS
PERMIT NO.
NCGNE 17,3
DOC TYPE
Cy HISTORICAL FILE
DOC DATE
❑ D b o
YYYYMMDD

NCCngc3-6$
Environmental
Quality
Division of Energy, Mineral and Land Resources
Land Quality Section
National Pollutant Discharge Elimination System
NO EXPOSURE CERTIFICATION for Exclusion
NCCNEooao
FOR AGENCY USE ONLY
Date Received
Year
44onth
Ra
to
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Certificate of covets c
i INSIA
RECEI 170
MAR 14 2019
MP-0
National Pollutant Discharge Elimination System application for exclusion from ab AROMJINN d
on NO EXPOSURE: III G
Submission of this No Exposure Certification constitutes notification that your facility does not require a
permit for stormwater discharges associated with industrial activity in the State of North Carolina because
it qualifies for a no exposure exclusion. A condition of no exposure at an industrial facility means all
industrial materials and activities are protected by a storm resistant shelter (with some exceptions) to
prevent exposure to rain, snow, snowmelt, and/or runoff.
For permitted facilities in North Carolina, DEMLR must approve your application for No
Exposure Certification before this exclusion is effective. Until you are issued a No
Exposure Certification and your NPDES permit is rescinded, your facility must continue
to abide by the terms and conditions of the current permit.
Industrial materials or activities include, but are not limited to: material handling equipment or activities,
industrial machinery, raw materials, intermediate products, by-products, final products, or waste products.
Material handling activities include the storage, loading and unloading, transportation, or conveyance of
any raw material, intermediate product, final product or waste product. A storm resistant shelter is not
required for the following industrial materials and activities: drums, barrels, tanks, and similar containers
that are tightly sealed, provided those containers are not deteriorated and do not leak. "Sealed" means
banded or otherwise secured and with locked or non -operational taps or valves; adequately maintained
vehicles used in material handling; and final products, other than products that would be mobilized in
stormwater discharges (e.g., rock salt).
A No Exposure Certification must be provided for each facility qualifying for the no exposure exclusion. In
addition, the exclusion from NPDES permitting is available on a facility -wide basis only —not for individual
outfalls. If any industrial activities or materials are, or will be, exposed to precipitation, the facility is not
eligible for the no exposure exclusion. By signing and submitting this No Exposure Certification form, you
certify that a condition of no exposure exists at this facility or site and are obligated to comply with the
terms and conditions of 40 CFR 122.26(g).
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:
httr)s:Hdea. nc.gov/about/divisions/enerov-mineral-land-resources/enerav-mineral-land-r)ermitslstormwater-
permitslnpdes-industrial-sw
For questions, please contact the DEMLR 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 CholOe,,r UJ t r;
Contact
Street Address
City
Telephone No.
Tyler Kiste v
5910 Long Creek Park Drive suite 5 & W _11A j 'C� CDC Ift,Ull
Charlotie State NC 11 ZIP Code 28269
704 499-5329
Page 1 of 7
Fax:
T� -ry leq- o,*-t 749
e k V.0-1 to y"
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NCGNE0000 No Exposure Certification
2) Location of facility producing discharge:
Facility Name Eaton RWDD
Facility Contact Tyler Kiste
Street Address 5910 Long Cree Park drive Suite S & W
City Charlotte
County Mecklenburg
Telephone No. 704 499-5329
State INC ZIP Code 28269
Fax: [phone]
3) Physical location information:
Please provide a narrative description of how to get to the facility (use street names, state road numbers, and
distance and direction from a roadway intersection). 'r interstate 77 mouth take a let on Harris aouleverd proceed to Statesvile road (HNfY 21 BYP}, take m right
on Statesville road, go Approxone quarter mile and take a left onto Long creek park drive. Follow the road through the 4 way stop and tum right. Eaton is approx 2DO yards on the left.
(A copy of a map with the facility clearly located on it should be included with the certification application.)
4) Is the facility located on Native American Lands?© Yes m No
5) Is this a Federal facility? p Yes a No
6) Latitude 35-19-58 Longitude 80-5-41 (deg., min., seconds)
7) This NPDES No Exposure Exclusion application applies to which of the following:
G New or Proposed Facility
El Existing
Date operation is to begin
Date operation began 1995
El Renewal of existing No Exposure Certification Certification No.: NCGNE
8) Was this facility or site ever covered under an NPDES 5tormwater Permit? ® Yes o No
If yes, what is the NPDES Permit Number? NPDES 3510-11 (see attached submission)
9) Standard Industrial Classification:
Provide the 4-digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: 5 0 6 3
10) Provide a brief description of the types of industrial activities and products produced at this facility:
Eaton Charlotte is a distribution. facility with small Dackaainq department. We distribute
mostly wall plates and outlets and conduct Dackaaina and assembly the same products.
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
0 No
0 Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
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NCGNE0000 No Exposure Certification
Exposure Checklists (12. - 14.)
12) Are any of the following materials or activities exposed to precipitation, now or in the foreseeable
future? (Please check either "Yes" or "No.") If you answer "Yes" to any of these items, you are not
eligible for the no exposure exclusion.
a. Using, storing, or cleaning industrial machinery or equipment, and areas where 13 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 p Yes El No 0 NIA
c. Materials or products from past industrial activity
0 Yes 0 No 17 NIA
d. Material handling equipment (except adequately maintained vehicles)
❑ Yes ® No 0 NIA
e. Materials or products during loading/unloading or transporting activities
❑ Yes EI No G NIA
f. Materials or products stored outdoors (except final products intended for outside
0 Yes 0 No © 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,
0 Yes 0 No 13 NIA
tanks, and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained ❑ Yes EINo ❑ NIA
by the discharger
i. Waste material (except waste in covered, non -leaking containers [e.g., 13 Yes 0 No © NIA
dumpsters])
j. Application or disposal of process wastewater (unless otherwise permitted) 0 Yes © No D NIA
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents © Yes p No ❑ NIA
not 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 0 No p NIA
(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 0 No © NIA
stored outside, has the facility had any releases in the past three (3) years?
13) Above Ground Storage Tanks (ASTs): If you answer "No" to any of the following items, you are not
eligible for the no exposure exclusion.
a. Are exterior ASTs or piping free of rust, damaged or weathered coating, pits, or E1 Yes ❑ No ® NIA
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any C Yes ❑ No a NIA
cracks, holes, or evidence of leaks, and are drain valves maintained locked
shut?
14) Secondary Containment: If you answer "No" to any of the following items, you are not eligible for the
no exposure exclusion.
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NCGNE0000 No Exposure Certification
a. Is secondary containment provided for single above ground storage containers 0 Yes M No 0 NIA
(including drums, barrels, etc.) with a capacity of more than 660-gallons?
b. Is secondary containment provided for above ground storage containers stored EI Yes Ip No El NIA
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 [3 Yes In No ® NIA
Amendments and Reauthorization Act (SARA) water priority chemicals"?
d. Is secondary containment provided for hazardous substances" designated in p Yes p No ® NIA
40 CFR §116?
e. Are release valves on all secondary containment structures locked? 13 Yes G No EI NIA
15) Hazardous Waste:
a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? p Yes C No ® NIA
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous © Yes ® No © NIA
waste generated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste © Yes 0 No 13 NIA
generated per month) of hazardous waste?
If you answered yes to questions b. or c., please provide the following information:
Type(s) of
waste:
vendor:
How is material stored: I
Where is material stored:
How many disposal shipments per year:
Name of transport 1 disposal
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.
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.
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NCGNE0000 No Exposure Certification
a. Does your facility store used, recycled, or otherwise reclaimed pallets outside? [3 Yes ® No t7 NIA
b. Does your facility have coal piles on site?
(]Yes ® No G NIA
c. Does your facility store other fuel sources outside in piles, such as wood chips,
C] Yes 0 No ID NIA
sawdust, etc.?
d. Does your facility have air emissions associated with its industrial activity (e.g.,
E3 Yes ® No 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 G No ® NIA
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:
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NCGNE0000 No Exposure Certification
17) Certification:
I certify under penalty of law that I have read and understand the eligibility requirements for claiming a condition of "no
exposure" and obtaining an exclusion from NPDES stormwater permitting.
I certify under penalty of law that there are no discharges of stormwater contaminated by exposure to industrial activities or
materials from the industrial facility or site identified in this document (except as allowed under 40 CFR 122.26(g)(2)),
understand that I am obligated to maintain no exposure conditions and complete a Self -Recertification 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. 1 understand I
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, 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; Tyler Kiste
Title: Operations Manager
of
3 /
(Date Signed)
Please note: This application for the No Exposure Exclusion is subject to approval by the NCDEQ
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
lEnvironmental 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.
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NCGNE0000 No Exposure Certification
Final Checklist
This_application should include the following items:
❑ This completed application and all supporting documentation.
❑ A map with the location of the facility clearly marked.
❑ If the site currently has an NPDES Stormwater Permit, be sure to indicate the permit number in Question 8.
Mail the entire package to:
DEMLR - Stormwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Note
The submission of this document does not guarantee the issuance of a No Exposure Exclusion.
For questions, please contact the DEMLR Regional Office for your area.
DEMLR Regional Office Contact Information:
Asheville Office ......
[phone]
Fayetteville Office ...
[phone]
Mooresville Office...
[phone]
Raleigh Office ........
[phone]
Washington Office ...
[phone]
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........
[phone]
Page 7of7
SWU-NCGNE last revised 9/28/2016

Biron, Sherry
From: Biron, Sherry
Sent: Thursday, March 7, 2019 9:15 AM
To: Biron, Sherry
Subject: Sent from Snipping Too!
https://www.google.com/maps/place/5910+Long+Creek+Park+Dr,+Charlotte,+NC+282691@35.3363239,-
80.8493704,6832m/data=!3m 1 ! 1 e3!4m5!3m4! 1 sOx8856a715fee73519:Ox2ebe8fO465359c84!8m2!3d35.3276406!4d-80.8374457

Eaton Charlotte RWDD provided this notification to EPA in 2015, but we have not located a copy in your
records of any forms submitted to NC, so we are providing the NC forms now.

t
NPDES UNITED STATES ENVIRONMENTAL PROTECTION AGENCY Form Approved
FORM .in EPA NO EXPOSURE CERTIFICWASHINGTON, DC 20460 OMB No. 2040-0211
3510-11 ATION FOR EXCLUSION FROM NPDES STORMWATER
PERMITTING
Submission of this No Exposure Certification constitutes notice that the entity identified in Section A does not require permit authorization for its
stormwater discharges associated with industrial activity In the State Identified In Section B under EPA's Stormwater Multi Sector General Permit
due to the existence of a condition of no exposure.
A condition of no exposure exists at an industrial facility when all industrial materials and activities are protected by a storm resistant shelter to
prevent exposure to rain, snow, snowmelt, and/or runoff. Industrial materials or activities Include, but are not limited to, material handling equipment
or activitles, 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 activltles:
- drums, barrels, tanks, and slmllar containers that are tightly sealed, provided those containers are not deteriorated and do not leak. 'Sealed'
means banded or otherwise secured and without operational laps or valves;
- adequately maintained vehicles used in malarial handling; and
- final products, other then products that would be mobilized in stormwater discharges (e.g., rock salt).
A No Exposure Certlficatfon must be provided for each faculty qualifying for the no exposure exclusion. In addltlon, 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 Cerliflcatlon form, the entity in Section A is certifying that a condition of no exposure exists at its facility
or site, and is obligated to comply with the terms and conditions of 40 ('FR 122.26(g).
ALL INFORMATION MUST BE PROVIDED ON THIS FORM.
Detailed Instructions for completing this form and obtaining the no exposure exclusion are provided on pages 3 and 4.
A. Facility Operator Information
Name:
WIAIYID144 ILIuICW4161 ISIAINICWEIz I I I I 1 I I 2. Phone: y y $ o R
3.Email: lblAIL(IDICIEl�C14AIVI0104E Il OM, ICOd I I I I I Ll
4. Maiiing Address: a. Street fig a D N, R K Q A R k V
b. City: kIwIAIR1L1c,1 I W I I I I I I I I I I I I I c. State LNA d. zip Code: g a y _LLLU
B. Facility/Site Location Information
1. Facility Name: 161A 4I IRIWIDID1 I0TISM RI=1610 4141 ICIFMEi ki I I 1 1 1
2, a. Street Address;h1`111141 loolliold C 2 AJRJ� R V�Jujttgrb
b. City: cN p R t o County:IICIKI�.IcfNIgI�IRIr,I I I I I I I I I
d. Stale: WC1 a. Zip Code: 141,21419 - 1111�
3. is the facility located on Indian Lands? ❑ YES ® NO
4. Is this a Federal facility? ❑ YES ® NO
5. a. Latitude: lslL . b. Longitude: L-o * 1 151 q 11,
6. a. Was She facility or site previously covered under an NPDES stormwater permit? ❑ YES In NO
b. If yes, enter NPDES permit number or tracking number:
7. SIC/Activity Codes: Primary: Secondary
5 a 3 (if applicable): t I I I I
6. Total size of site associated with Industrial activity: lDoo (A FT acres V0 ov> SVCII Ope4R{:otMS e►tsecA PAc.
9. a. Have you paved or roofed over a formerly exposed, pervious area In order to qualify for the no exposure exclusion? ❑ YES ❑ NO
b. If yes, please indicate approximately how much area was paved or roofed over. Completing this question does not disqualify you for the no
exposure exclusion. However, your permitting authority may use this Information in considering whether stormwatef discharges from your site
are likely to have an adverse impact on water quality, in which case you could be required to obtain permit coverage.
Less than one acre ❑ One to five acres ❑ More then five acres ❑
EPA Form 3510-11 (09-08) Page 1 of 4
r f, j J

C. Exposure Checklist
Are any of the following materials or activities exposed to precipitation, now or in the foreseeable future?
(Please check either "Yes" or "No" in the appropriate box.) If you answer "Yes" to any of these questions
(1) through (11), you are p2l eligible for the no exposure exclusion.
Yes
No
1. Using, storing or cleaning Industrial machinery or equipment, and areas where residuals from using, storing or cleaning
El
IR
Industrial machinery of equipment remain and are exposed to stormwater
2. Materials or residuals on the ground or in stormwater inlets from spills/leeks
3. Materials or pfoducls from past industrial activity
i
❑
4. Material handling equipment (except adequately maintained vehicles)
El
X
S. Materials or products during loading/unloading or transporting activities
8. Materials or products stored outdoors (except final products Intended for outside use (e.g., now cars] where
exposure to stormwater does net result in the discharge of pollutants)
7. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, and similar containers
8. Materials or products handled/stored on roads or railways owned or maintained by the discharger
54
9. Waste material {except waste in covered, non leaking containers [e.g., dumpstersp
❑
10. Application or disposal of process wastewater (unless otherwise permitted)
11. Particulate matter or visible deposits of residuals from roof stacks andfor vents not otherwise regulated
(i.e., under an air quality control permit) and evident In the stormwater outflow
Certification Statement
I certify under penalty of law that I have read and understand the eligibility requirements for claiming a condition of "no exposure' and obtaining
an exclusion from NPDES stormwater permitting.
I certify under penalty of law that there are no discharges of slofmwatar contaminated by exposure to industrial activities of materials from the
industrial facility or site identified in this document (except as allowed under 40 CFR 122.28(g)(2)).
I understand that I am obligated to submit a no exposure certificat€on form once every five years to the NPDES permitting authority and. If
requested, to the operator of the local municipal separate storm sewer system (MS4) into which the facility discharges (where applicable). I
understand that I must allow the NPDES permitting authority, or MS4 operator where the discharge is into the local MS4, to perform Inspections
to confirm the condition of no exposure and to make such Inspection reports publicly available upon request. I understand that I must obtain
coverage under an NPDES permit prior to any point source discharge of stormwater from the facility.
Additionally, I certify under penalty of law that this document and all attachments were prepared under my direcden or supervision In accordance
with a system designed to assure that qualified personnel property gathered and evaluated the information submitted. Based on my Inquiry of the
person or persons who manage the system, or those persons directly responsible for gathering the Information, the Information submitted Is to
the best of my knowledge and belief true, accurate and complete. I am aware that'there are significant penalties for submitting false information,
Including the possibility of fine and Imprisonment for knowing violations.
Print Name: [AjA -Dj O .1 _J�V 4 41A J M" b JAIf CI I EE LI l I I I I L 1 I 11
PrintTltle: AJAHAF71CJRI $JE-� IRJTIUI-rJXJOW jdPjFjXjAjTJ "4 11
Signature:
Date: 0 U4f1014la0j
Me Day Year
Email:
EPA Form 3610-11 (09-08) age 2 of 4

Instructions for the NO EXPOSURE CERTIFICATION for Exclusion from NPDES Stormwater Permitting
Who May File a No Exposure Certification
Federal law at 40 CFR Part 122.26 prohibits point source
discharges of stormwater associated with industrial activity to waters
of the U.S. without a National Pollutant Discharge Eilmination
System (NPDES) permit. However, NPDES permit coverage is not
required for discharges of stormwater associated with industrial
activities Identified at 40CFR 122.26(b)(14)(1)-(ix) and (xi) if the
discharger ran certify that a condition of "no exposure' exists at the
industrial facility or site.
Stormwater discharges from construction activities identified in
40 CFR 122.26(b)(14)(x) and (b)(15) are not eligible for the no
exposure exclusion.
Obtaining and Maintaining the No Exposure Exclusion
This form is used to certify that a condition of no exposure exists at
the industrial facility or site described herein. This certification is only
applicable in jurisdictions where EPA is the NPDES permitting
authority and must be re -submitted at least once every five years.
Section B. Facility/Site Location Information
1. Enter the official or legal name of the facility or site.
2. Enter the complete street address (if no street address exists,
provide a geographic description [e.g., Intersection of Routes 9
and 551}, city, county, state, and zip code. Do not use a P.O.
Box number.
3. Indicate whether the facility Is located on Indian Lands,
4. Indicate whether the Industrial facility is operated by a
department or agency of the Federal Government (see also
Section 313 of the Clean Water Act).
5. Enter the latitude and longitude of the approximate center of
the facility or site in deg reeslminuteslseconds. Latitude and
longitude can be obtained from United States Geological
Survey (USGS) quadrangle or topographic maps, by calling
1-(888) ASK-USCS, or by accessing the Census Bureau at
www.census._govlcoi-binloazetteer
The industrial facility operator must maintain a condition of no
Latitude and longitude for a facility In decimal form must be
converted to degrees (°), minutes ('), and seconds ('I for proper
exposure at its facility or site in order for the no exposure exclusion
to remain applicable. If conditions change resulting in the exposure
entry on the certification form. To convert decimal latitude or
of materials and activities to stormwater, the facility operator must
longitude to degrees/minuteslseconds, follow the steps in the
obtain coverage under an NPDES stormwater permit immediately,
following example.
Where to File the No Exposure Certification Form
No Exposure Forms sent regular mail: Forms sent ovemightlexpress:
SW No Exposure Certification (4203M) SW No Exposure Certification
USEPA US EPA East Building, Rm. 7420
1200 Pennsylvania Avenue, NW 1201 Constitution Avenue, NW
Washington, D.C. 20460 Washington, D.C. 20004
[phone]
Completing the Form
You mus type or print, using uppercase letters. In appropriate areas
only. Enter only one character per space (i.e., between the marks).
Abbreviate if necessary to stay within the number of characters
allowed for each item. Use one space for breaks between words,
One form must be completed for each facility or site for which you
are seeking, -to certify a condition of no exposure. Additional
guidance on completing this form can be accessed at EPA's
website: www.epa.gov/npd!2s/slormwate . Please make sure you
have addressed all applicable questions and have made a
photocopy for your records before sending the completed form to
the above address.
Section A. Facility Operator Information
1. Provide the legal name of the person, firm, public organization, or
any other entity that operates the facility or site described in this
certification. The name of the operator may or may not be the
same as the name of the facility. The operator Is the legal entity
that controls the facility's operation, rather than the plant or site
manager.
2. Provide the telephone number of the facility operator
3. Provide the email address of the facility operator.
4. Provide the mailing address of the operator (P.O. Box numbers
may be used). Include the city, state, and zip code. All
correspondence will be sent to this address.
Example: Convert decimal latitude 45.1234507 to degrees (')
minutes ('), and seconds C).
a) The numbers to the left of the decimal point are the degrees:
45°
b) To obtain minutes, multiply the first four numbers to the right
of the decimal point by 0,006: 1234 x 0.006 = 7,404.
c) The numbers to the left of the decimal point in the result
obtained in (b) are the minutes: 7'.
d) To obtain seconds, multiply the remaining three numbers to
the right of the decimal from the result obtained in (b) by
0.06: 404 x 0,06 = 24.24. Since the numbers to the fight of
the decimal point are not used, the result is 24".
e) The conversion for 45.1234567 = 45' 7' 24".
6. Indicate whether the facility was previously covered under an
NPDES stormwater permit. if so, include the permit number or
permit tracking number.
7. Enter the 4-digit SIC code which identifies the facility's primary
activity and second 4-digit SIC code identifying the facility's
secondary activity, if applicable. SIC codes can be obtained
from the Standard Industrial Classification Manual, 1987.
S. Enter the total size of the site associated with industrial activity
in acres. Acreage may be determined by dividing square
footage by 43,550, as demonstrated in the following example.
Example: Convert 54,450 ft2 to acres
Divide 54,450 ft2 by 43,450 square feet per acre:
54,450 ft2 43,560 ft2lacre = 1,25 acres.
9. Check "Yes" or 'No' as appropriate to Indicate whether you have
paved or roofed over a formerly exposed, pervious area (i.e..
lawn, meadow, dirt or gravel roadlparking lot) in order to qualify
for no exposure. if yes, also indicate approximately how much
area was paved or roofed over and is now impervious area.
EPA Form 3510-11 (09-08) Page 3 of 4

Instructions for the NO EXPOSURE CERTIFICATION for Exclusion from NPDES Stormwater Permitting
Section C, Exposure Checklist
Check "Yes" or "No" as appropriate to describe the exposure
condition at your facility. If you answer "Yes" to ANY of the
questions (1) through (11) in this section, a potential for exposure
exists at your site and you cannot certify to a condition of no
exposure. You must obtain (or already have) coverage under an
NPDES stormwater permit. After obtaining permit coverage, you
can institute modifications to eliminate the potential for a discharge
of stormwater exposed to industrial activity, and then certify to a
condition of no exposure.
Section D. Certification Statement
Federal statutes provide for severe penalties for submitting false
Information on this application form, Federal regulations require
this application to be signed as follows:
For a corporation: by a responsible corporate officer, which
means;
(i) president, secretary, treasurer, or vice-president of the
corporation in charge of a principal business function,
or any other person who performs similar policy or
decision making functions for the corporation, or
(ii) the manager of one or more manufacturing, production,
or operating facilities, provided the manager is
authorized to make management decisions which
govern the operation of the regulated facility Including
having the explicit or Implicit duty of making major
capital investment recommendations, and initiating and
directing other comprehensive measures to assure long
term environmental compliance with environmental laws
and regulations; the manager can ensure that the
necessary systems are established or actions taken to
gather complete and accurate Information for permit
application requirements; and where authority to sign
documents has been assigned or delegated to the
manager In accordance with corporate procedures;
For a partnership or sole proprietorship: by a general partner
or the proprietor, or
For a municipal, State, Federal, or other public facility: by
either a principal executive or ranking elected official.
Paperwork Reduction Act Notice
Public reporting burden for this certification is estimated to average
1.0 hour per certification, including time for reviewing instructions,
searching existing data sources, gathering and maintaining the
data needed, and completing and reviewing the collection of
Information. Burden means the total time, effort, or financial
resources expended by persons to generate, maintain, retain, or
disclose to provide information to or for a Federal agency. This
Includes the time needed to review instructions; develop, acquire,
Install, and utilize technology and systems for the purposes of
collecting, validating, and verifying Information, processing and
maintaining information, and disclosing and providing information;
adjust the existing ways to comply with any previously applicable
instructions and requirements; train personnel to be able to
respond to a collection of information; search data sources;
complete and review the collection of information; and transmit or
otherwise disclose the information. An agency may not conduct or
sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number.
Send comments regarding the burden estimate, any other aspect
of the collection of information, or suggestions for improving this
form, including any suggestions which may increase or reduce this
burden to: Director, OPPE Regulatory Information Division (2137),
USEPA, 401 M Street, SW, Washington, D,C. 20460. include the
OMB control number of this form on any correspondence. Do not
send the completed No Exposure Certification form to this address.
EPA Form 3610-11 (09-08) Page 4 of 4

North Carolina Secretary of State Search Results
page 1 of 1
• File an Annual Report/Amend an Annual Report • Upload a PDF Filing • Order a Document Online • Add Entity to My Email
Notification List - View Filings - Print a Pre -Populated Annual Report form • Print an Amended a Annual Report form
Business Corporation
Legal Name
Cooper Wiring Devices, Inc.
Prev Legal Name
Eagle Electric Manufacturing Co., Inc.
Information
Sosld: 0094130
Status: Current -Active
Annual Report Status: Current
Citizenship: Foreign
Date Formed: 12/17/1984
Fiscal Month: December
State of Incorporation:
NY
Registered Agent: CT Corporation System
Addresses
Mailing
Principal Office
Reg Office
Reg Mailing
1000 Eaton Blvd.
1000 Eaton Blvd.
160 Mine Lake Ct Ste 200
160 Mine Lake Ct Ste 200
Cleveland, OH 44122-6058
Cleveland, OH 44122-6058
Raleigh, NC 27615-6417
Raleigh, NC 27615-6417
Officers
President
Vice President
Treasurer
General Counsel
REVAITHI ADVAITHI
RICHARD H FEARON
TRENT M MEYERHOEFER
HEATH B MONESMITH
1000 Eaton Blvd
1000 EATON BLVD
1000 EATON BLVD
1000 EATON BLVD
Cleveland OH 44122
CLEVELAND OH 44122
CLEVELAND OH 44122
CLEVELAND OH 44122
Controller
KEN D SEMELSBERGER
1000 EATON BLVD.
CLEVELAND OH 44122
Stock
Glass: 99 SEE CERT
Shares: 0
Par Value 0
Assistant Secretary
TARAS G SZMAGALA
1000 EATON BLVD.
CLEVELAND OH 44122
Secretary
LIZBETH L WRIGHT
1000 EATON BLVD
CLEVELAND OH 44122
https://www.sosnc,gov/oniine_services/search/Business_Registration_Results 3/27/2019