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NCGNE1440_Application_20201118
Division of Energy, Mineral and Land Resources Land Quality Section i r _ National Pollutant Discharge Elimination System NO EXPOSURE CERTIFICATION for Exclusion Envircnmentah - 7�7 ��--..�7 n /� Quality NCGNEOOOO NCGNE, (Lt y D FOR AGENCY USE ONLY Date Received Year Month Day O tt $ Certificate ot-Coverage N C G N l O 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, 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 Until you are issued a No Exposure Certification and your NPDES permit is rescinded, your facility must continue to abide by the terms and conditions of the current permit.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 requirq#,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: https://deo. nc.gov/about/divisions/energy-mineral-land-resources/energy-mineral-land-permits/stormwater- 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 ail certification correspondence will be mailed): iPy Name PCi of North Carolina, LLC Contact Street Address City Telephone No. Swu-NCGNE Clarence Spurr 100 Falcone Parkway Cary 919 467-5151 Page 1 of 7 State NC Fax: 91& ZIP Code 27511-6712 460-1013 Rrl._AF NED Last revised 9i2fibi 1 4 2020 DENR-LAND QUALITY STORMWATER PERMITTING 7 NCGNE0000'No Exposure Certification 2) Location of facility producing discharge: Facility Name PCI of North Carolina, LLC Facility Contact Clarence Spurr Street Address 100 Falcone Parkway City Cary State NC ZIP Code 27511-6712 County Wake Telephone No. 919 467-6151 Fax: 919 460-1013 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).* On the west side of Falcone Parkway roughly 100 yards from the intersection of Old Apex Road and Falcone Parkway (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 Q No 5) Is this a Federal facility? ❑ Yes ✓❑ No 6) Latitude 35.47.08 Longitude 78,47,41 (deg., min., seconds) 7) This NPDES No Exposure Exclusion application applies to which of the following: Ll New or Proposed Facility Date operation is to begin ✓❑ Existing Date operation began May 28th 1984 ❑ Renewal of existing No Exposure Certification Certification No.: NCGNE 8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes ✓❑ No If yes, what is the NPDES Permit Number? 9) Standard Industrial Classification: Provide the 4-digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial activity at this facility SIC Code: 3 0 8 9 10) Provide a brief description of the types of industrial activities and products produced at this facility: Plastic Injection Molding and Assembly 11) Does this facility have any Non -Discharge permits (ex: recycle permits)? QNo ❑ Yes If yes, list the permit numbers for all current Non -Discharge permits for this facility: Page 2 of 7 SWU-NCGNE Last revised 912812016 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 El Yes 2✓ No 0 N/A residuals from using, storing or cleaning industrial machinery or equipment remain and are exposed to stormwater b. Materials or residuals on the ground or in stormwater inlets from spills/leaks p Yes QNo 13 N/A c. Materials or products from past industrial activity © Yes QNo E3 N/A d. Material handling equipment (except adequately maintained vehicles) In Yes QNo 0 N/A 61 Materials or products during loading/unloading dr transporting activities 0 Yes Q✓ No N/A '-w- E3 f. Materials or products stored outdoors (except final products intended for outside 13 Yes 0✓ No F3 N/A use [e.g., new cars] where exposure to stormwater does not result in the discharge of pollutants) g. Materials contained in open, deteriorated or leaking storage drums, barrels, 13 Yes QNo O N/A tanks, and similar containers h. Materials or products handled/stored on roads or railways owned or maintained p Yes Q No In N/A by the discharger i. Waste material (except waste in covered, non -leaking containers [e.g., E3 Yes ✓❑ No 13 NIA dumpsters]) j. Application or disposal of process wastewater (Hess otherwise permitted) G Yes Z No 13 N/A k. Particulate matter or visible deposits of residuals from roof stacks and/or vents E3Yes Q✓ No O N/A 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 O Yes ONo 13 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 0 Yes M No Z 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 D Yes EI No F✓ 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 ✓QN/A 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. Page 3 of 7 SWU-NCGNE Last revised 9/2812016 NCGNE0000 No Exposure Certification a. Is secondary containment provided for single above ground storage containers E3 Yes M No ✓� N/A (including drums, barrels, etc.) with a capacity of more than 660-gallons? b. Is secondary containment provided for above ground storage containers stored 13 Yes El No Q✓ N/A 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 E3Yes 13 No FV N/A Amendments and Reauthorization Act (SARA) water priority chemicals'? f Is secondary containment provided for hazardous substances— designated in p Yes p No R] N/A 40 CFR'§116? e. Are release valves on all secondary containment structures locked? 13 Yes 13 No F/IN/A 16) Hazardous Waste: a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? pYes Q✓ No p N/A b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous 0 Yes QNo I] N/A waste generated per month) of hazardous waste? c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste In Yes Q✓ No p N/A 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 / disposal vendor:_ 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. 1, Page 4of7 swu-NCGNE-- Last revised 9/2812016 NCGNE0O0O No Exposure Certification a. Does your facility store used, recycled, or otherwise reclaimed pallets outside? O Yes QNo 0 N/A b. Does your facility have coal piles on site? 13 Yes QNo 0 N/A c. Does your facility store other fuel sources outside in piles, such as wood chips, p Yes QNo ID NIA sawdust, etc.? d. Does your facility have air emissions associated with its industrial activity (e.g., 0 Yes QNo O N/A 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 0 Yes ® No 0 N/A 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 SWU-NCGNE Last revised 9/2812016 NCGNE0000 No Exposure Certification 17) Certlf[catidW 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 maintain no exposure conditions and com lete Self-Recertificabon 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 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 'Mrir`('y 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: / L6 C A ca 0— Title: C. h e,� �� n c; a M 0 f il s A 1020 (Signature of Applicant) (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 143-216.6 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 Gass 2 misdemeanor which may include a fine rpt to exceed ten thousand dollars ($10,000). There is currently no fee for a No Exposure Exclusion. Page 6of7 SWU-NCGNE Last revised 9/28/2016 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 ...... (828) 296-4500 Fayetteville Office ... (910) 433-3300 Mooresville Office ... (704) 663-1699 Raleigh Office ........ (919) 791-4200 Washington Office ... (252) 946-6481 Wilmington Office ... (910) 796-7215 Winston-Salem ...... (336) 776-9800 Central Office ......... (919) 707-9220 t, Page 7of7 SWU-NCGNE Last revised W28l2016 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 Limited Liability Company Legal Name PCI of North Carolina, LLC Prev Legal Name SPNC, LLC Prev Home State Name PCI of North Carolina, LLC Information SOS I d: 1810648 Status: Current -Active O Date Formed: 2/26/2019 Citizenship: Foreign State of Incorporation: DE Annual Report Due Date: April 15th Registered Agent: CT Corporation System Addresses Principal Office 100 Falcone Parkway Cary, NC 27511 Company Officials Reg Office 160 Mine Lake Ct Ste 200 Raleigh, NC 27615 Reg Mailing 160 Mine Lake Ct Ste 200 Raleigh, NC 27615 Mailing N116 W18271 Morse Drive Germantown, WI 53022 All LLCs are managed by their managers pursuant to N.C.G.S. 57D-3-20. Chief Financial Officer Chief Executive Officer President Michael Molling James Derrill Rice Peter Taft N116 W18271 Morse Drive N116 W18271 MORSE DRIVE 600 SUPERIOR AVENUE EAST, STE 2500 Germantown WI 53022 GERMANTOWN WI 53022 CLEVELAND OH 44114 Vice President Vice President Karen Tuleta Matt Yohe 600 SUPERIOR AVENUE EAST, SUITE 2500 600 SUPERIOR AVENUE EAST, STE 2500 CLEVELAND OH 44114 CLEVELAND OH 44114 https://www.sosnc.gov/online_services/search/Business_Registration_Results 11 /18/2020