NCGNE1462_Application_20210204

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OfL r-i,c CIVLI
TssicQlnety,Mineral and Resources DfeReiC av�•
Land Quality Section �_ � A °A
National Pollutant Discharge Elimination System � CcficatraFCo ricer
r NO EXPOSURE C` k id f IFIC"ATION for } xchtSion
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, andlor runoff,
s
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Exposure Certification and your NPDES permit is rescinded, your facility must continue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 teak. "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 of40 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:l/deq.r.c;.ciovlabout/divisioiis/energy-mineral-land-resourc.esinpdos-no-exposure
For questions, please contact the DEMLR Regional Office for your area. (See page 6)
1) Mailing address of ownerloperator
Name ''ilia rive
Contact K-B ,yn
Street Address y .�_g
City 14ie7, f-e
Telephone No. 41 D —
SWU-NCGNE
(Please print or type)
_dress to which all certification correspondence will be mailed):
�v,`I/� alp sr�r vav No>f. Ca vrJ la r•c., E Itild s fn c
State A. -IC ZIP Code z 3©
— 2 73 Fax
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Last revised 9,28.2016
NC GEOLOGICAL SURVEY
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NG FO0OO No Exposure Certification
2) Location of facility producing discharge:
FacilityName�---- .___r_....... .-------- _--------- _._�______.._m._._
Facility Contact
Street Address n'
City t4�/ iflP State tVC SIP Code e g e>6
County _.I'+"Id
Ielephone No. �U ` S(n._._ _ Fax _.._..-,.. w.,..._...._.
3) Physical location information:
Please provide a narrative description of how to get to the facility (use street narnes, state road numbers, anti
distance and direction from a roadway intersection).
(A copy of a map with the facility clearly located on it should be included with the certification application }
4) is the facility located can dative American Lands?O Yes IN No
5) is this a Federal facility? C Yes WA No
N1
Of
6) Latitude f �`� Longitude IL,. i 111-7 ` � (deg., €n., seconds)
7) This N DES No Exposure Exclusion application applies to which of the following:
New or Proposed Facility Dale operation is to begin
Existing Date operation began _ Q 7 7
IM Renewal of existing ilia F_Aposu171= (`,ertsfication Certification No. NCGNE
8) Was this facility or site aver covered under an NFD S Stormwfater Permit? M Yes A No
If yes: what Is the NPDES Pernnit NLimb(--,,r'?
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:
10) Provi0e 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)?
No
0 Yes
If yes; list the permit nurnbers for all current Non -Discharge permits for this facility:
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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 0 Yes 0 No 0 N/A
residuals from using, storing or cleaning industrial machinery or equipment
remain and are exposed to stormwiter
b. Materials or residuals on tile ground or in stormiwater inlets from spills/leaks D Yes &No El N/A
c. Materials or products from past industrial activity 0 Yes a No 0 NiA
d. Material handling equipment (except adequately maintained vehicles) 0 Yes 0 No 0 N/A
e. Materials or products during loading/unloading or transporting activities 0 Yes PNo 0 N/A
f, Materials Or products stored outdoors (except final products intended for outside D Yes No 0 N/A
use [e.g., new cats', where exposure to storn-twater does not result in the
discharge Of pollutants)
g. Materials contained in open, deteriorated or leaking storage drums, barrels, 0 Yes 10 No 0 N/A
tanks, and similar containers
h. Materials or products handledistored on roads or railways owned or maintained 0 Yes 0 No 0 N/A
by the discharger
i. Waste material (except waste in covered, non -leaking containers [e.g., 13 Yes 12 No 0 N/A
dumpsters])
j. Application or disposal of process wastewater (unless otherwise permitted) Yes 0 No 0 NIA
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents 0 Yes 0 No Cj- N/A
not otherwise regulated (Le., Linder an air quality control permit) and evident in the
stormwater outflow
1. Empty containers that previously contained materials that are not properly stored 0 Yes 0 No 0 N/A
(j,o,, not closed and stored upside down to prevent precipitation accumulation)
m. For any exterior ASTs, as well as drums, barrels, tanks, and similar containers OYes CNo ON/A
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 Irep, of rust, damaged or weathered coating, pits, or §2 Yes 0 No M NIA
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any V, Yes El No L19 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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si. Is secondary containment provided for 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 containnient 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 (loss 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:
waste: Type(s) of Pr _- 0 L
How is matemal stored: _�i-,'34,ew -!2 T ., (1 0­ b r Lk ju,-S
Where is material stored:
Now many disposal shi,rprnents per year:
Name of transport / disposal
vendor:
Vendor address:
tuc- Z-760'3
Footnotes to Questions "1 4) c. & d .
It Yes 0 No 0 N/A
0 Yes L-] No § N/A
113 Yes 0 No 0 N/A
E] Yes Of No V N/A
0 Yes 0 No dif MA
0 Yes a No 0 N/A
V, Yes 13 No 0 N/A
M Yes 12 No El 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 minirnis amounts of certain substances,
, Title :11 SARA 313 ii, 40 CFR
indlor other qualifiers, as describedi in tlne fi-onn reporfln,-,
§3723&
—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 §1173.
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 circurnstances may be required.
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NCGNEOOOO No Exposure Certification
a. Does YOLK facility store used, recycled, or otherwise reclaimed pallets outside?
b. Does your facility have coal piles on site?
c. Does your facility store other fuel sources outside in piles, such as wood chips.
sawdust, etc.?
d. Does you., facility have air ernissions associated with its industrial activity (e.g,,
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? Please specifyi
f. Please list any other envirortmental program permits (federal, state, etc.) not
specified eadiel in ihus application (such as Hazardous Waste Penmits, etc.):
Permit. Program'
Pernift, Program:
Permit: Program:
Permit Program:
Permit: Program:
Permit Prograrri.
Permit: Program
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IN Yes 10 No 0 N/A
rj Yes !31 No Q RIA
L-1 Yes a No t3 N/A
M Yes 2 No [3 N/A
0 Yes M No 4 N/A
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GNEOO O No Exposure 'Certification
17) Certification:.
1 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 lave 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 Lander 40 CFR 122.26(9)(21',).
I understand that I am obligated to maintain tie exposure conditions and cc, rmplete a 5eif-F ecertif nation form at least once_
pgcn 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 N154 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 file event that the site no longer qualifies fct a No Expos.rr'c. Exclusion, 1 understand that 1 must obtain cove;aga under
an NPDES permit prior to any point source discharge of stormwater from the facility. Additionally, l certify under penalty of
law that this document and all attachments were prepared under tray 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 syste,n, 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 l 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- �� t� h%f � �� A)ct
Title
(Signature of Applicant) ;Date Signed)
Please note: This application for the No Exposure Exclusion is subject to approval by the NCDEQ
Regional Office prier 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 .Ise No Exposure Exclusion.
North Carolina General Statute 43-215.6 B(i) provides that:
Ary person who knovon, % makes any false st rent, rer. rosy ntation or ,:ertr '; n in any aqpLcahon, record, report, plan, or other
document riled or required to be mainiairsed under this Ar`ucle or a rule implementing this Article, or who knowingly makes a false
statement of a matorral fact in a r ulermking proceeding or contested case under this Anic!e' or who falsifies, tampers with, or knowingly
renders inaccurate any recording cr monitonng device or method required to be operateca or maintained under this Article or rules of the
[Environr„ental NIanagementl Corr.rnission implementing this Article shall be guilry of a Class misdemeanor v4ich may indude a fine
not to exceed ten thousand dollars ($I0100ra).
There is currently no fee for a No Exposure Exclusion.
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NCGNEOOOO No Exposure Certification
Final Checklist
This application should includie 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 - Stormv.,ater Program
Dept. of Environmental Quality
1512 Mail Service Center
R,aleigh, North Carolina 27699-1612
Note
The submission of this document does not guarantee the issuance of a No Exposure Exclusion.
For questions, please cont'adt,the D'MLR Regional 0 ffi-ce for y'our area.
DF-MLP, Remonal Office Contact Information:
Asheville Office ......
[phone]
Fayetteville Office
[phone]
Mooresville Office
[phone]
Raleigh Office .....
(919)'791-4200
Washington Office
946-6431
Wilmington Office ...
(9 10) 796-7 215
Winston-Salem ......
[phone]
Central Office ... .... _(919)
707-9220
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North Carolina Secretary of State Search Results
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Filings • Print a Pre -Populated Annual Report form • Print an Amended a Annual Report form
Limited Liability Company
Legal Name - ' -- - -
Fayetteville Observer, LLC b
Information t46
Sosld: 0630610
Status: Dissolved O
Date Formed: 5/9/2002
Citizenship: Domestic
\1' I1115 'Tr�Q
Annual Report Due Date: April 15th 1 kA
Registered Agent: Broadwell, Charles
Addresses
Principal Office Reg Office Mailing
458 Whitfield Street 458 Whitfield Street P.O. box 849
Fayetteville, NC 28306-1614 Fayetteville, NC 28306-1614 Fayetteville, NC 28302-0849
Reg Mailing
P.O. Box 849
Fayetteville, NC 28302-0849
Company Officials
All LLCs are managed by their managers pursuant to N.C.G.S. 57D-3-20.
Manager
Charles W. Broadwell
458 Whitfield Street
Fayetteville NC 28306
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Business Corporation
Legal Name
DB North Carolina Holdings, Inc.
Information
Sosld: 1426536
Status: Current -Active O
Date Formed: 2/6/2015
Citizenship: Foreign
State of Incorporation: DE
Fiscal Month: December
Annual Report Due Date: April 15th
Registered Agent: Corporation Service Company
Addresses
Mailing
Principal Office
Reg Office
Reg Mailing
175 Sully's Trail
175 Sully's Trail
2626 Glenwood Avenue, Suite 550
2626 Glenwood Avenue, Suite 550
Pittsford, NY 14534
Pittsford, NY 14534
Raleigh, NC 27608
Raleigh, NC 27608
Officers
Chief Executive Officer
Treasurer
Executive Director
Secretary
Paul Bascobert
Alison Engel
Michael E. Reed
POLLY GRUNFELD SACK
175 Sully's Trail
175 Sully's Trail
175 Sully's Trail, 3rd Floor
175 SULLY'S TRAIL, 3RD FLOOR
Pittsford NY 14534
Pittsford NY 14534
Pittsford NY 14534
PITTSFORD NY 14534
Stock
https://www.sosnc.gov/online_services/search/Business Registration_Results 2/9/2021