NCGNE1463_Application_20210210

Division of Energy, Mineral and Land Resources
Land Quality Section
National Pollutant Discharge Elimination Systern
NO EXPOSURE CERTIFICATION for Exclusion
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AGENCY
D.1c Received
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Certificate oCoverage
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14 1-11 � 11-1
FEB 10 2021
National Pollutant Discharge Elimination System application for exclusion from a Stormwater PlaFMIR-LANDdQUALITY
on NO EXPOSURE: STORMWATEM PE_RNfl'FTHNK3
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.
For permitted facilities in North Carolina, DEIVILR 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Exposure Certification and your NPDES permit is rescinded, your facility must continue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 facllit 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 Exocsure section on this page:
V S e M, S m, � son , e - b, !en rg-y-_!­-d,n o rce tormwat r
........ . ...... - .. . ............. :L- M ... . .... ............ I ..... . ................ .
.... . ........ ... . ...
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);
Narne Cardinal CT
Contact Travis Tilley
Street Address 630 Derby Street
City Mount Airy State NC ZIP Code 27030
Telephone No. 336 719-6857 Fax: [phone]
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2) Location of facility producing discharge:
Facility Name Cardinal CT
Facility Contact
Street Address
City
County
Telephone No.
Travis Tilley
630 Derby Street
Mount Airy State NC ZIP Code 27030
Surry
336 719-6857 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).
(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?M Yes 0 No
5) Is this a Federal facility? 13 Yes is No
6) Latitude 36*29'44-5"N Longitude 80'36'58-0"W (deg., min., seconds)
7) This NPDES No Exposure Exclusion application applies to which of the following:
in New or Proposed Facility Date operation is to begin
0 Existing Date operation began tr)O+ 5,rC
El Renewal of existing No Exposure Certification Certification No.: NCGNE
8) Was this facility or site ever covered under an NPDES Stormwater Permit? 0 Yes 0 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:27 ), 3
10) Provide a brief description of the types of industrial activities and products produced at this facility:
Custom tempered Glass production lines, forklifts
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
MNo
E3 Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
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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 Cl Yes 13Wn 0N/A
residuals from using, storing orcleaning industrial machinery urequipment
remain and are exposed to stormwater
tzMaterials orveaidunlsnnthegnoundorinstnrmwaherhnletafnrmupUls/eaks DYee ENo 0N/A
c. Materials orproducts from past industrial activity
DMes 0Noa N/A
d. Material handling equipment (except adequately maintained vehicles)
13Yeo BNo 13N/A
e.Materials orproducts during loading/unloading ortransporting activities
13Yoe E0n C3N/A
f. Materials or products stored outdoors (except final products intended for outside
03Yeo VNn MN/A
use [e.g..new cars] where exposure tomtunnwsterdoes not result inthe
discharge ufpollutants)
g, Materials contained in open, deteriorated or leaking storage drums, barrels,
DYea IN No 13N64
tanks, and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained E3Yea 1INo C3N/A
bythe discharger
iWaste material (except waste incovered, non -leaking containers [e.g, 13 Yes MNu CI N/A
dumpsters])
j. Application or disposal of process wastewater (unless otherwise permitted) 0 Yes 0 No 0 N/A
k. Particulate matter orvisible deposits ofresiduals from roof stacks and/or vents 13 Yes MNu[3 N/A
not otherwise regulated (i.e., under an air quality control permit) and evident in the
stormwater outflow
iEmpty containers that previously contained materials that are not properly stored [3 Yes IMNo13 N/A
(i.e`not closed and stored upside down toprevent precipitation accumulation)
m.For any exterior ASTo.mowell smdrums, barrels, tanks, and similar containers N3Yea MNo CI N/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 ni!sn
eligible for the no exposure exclusion. a
a.Are exterior ASTmorpiping free ofrust, damaged orweathered nootng.pkn.nr MYoo DNo EW/A
deterioration, mrevidence ofleaks?
b.|esecondary containment provided for all exterior ASTo? Ifso, iait free ofany El Yes El No 5N64
cracks, holes, or evidence of leaks, and are drain valves maintained locked
shut?
14) Secondary Containment: Ifyou answer "No" to any of the following items, you are not eligible for the
nmexposure exclusion.
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e. Issecondary containment provided for single above ground storage containers E3 Yes MNo M N/A
(including drums, barrels, mtc.)with acapacity of more than 660-gallons?
b. Is secondary containment provided for above ground storage containers stored MYee EgNo MN/A
in close proximity to each other with a combined capacity of more than 1,320-
gallons?
o./asecondary containment provided for Title ||| Section 313Gupehbnd MYeo 0No MNA\
Amendments and Reauthorization Act (SARA) water priority chemicals*?
d.|osecondary containment provided for hazardous substances"designated in Yea allo MN6A
40CFR §116?
e.Are release valves unall secondary containment structures locked? MYma 0No IN N/A
a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? E3Yeu MNo 0N/&
b.|athis facility aSmall Quantity Generator (less than 1000kg. ofhazardous MYea 13No EjN/A
waste generated per month) ofhazardous waste?
o. |othis facility a Large Quantity Generator (1UO8kg. ormore ofhazardous waste El Yes IN No M N/A
generated per month) ofhazardous waste?
If you answered yes to questions b. or c., please provide the following information:
Type(s)of
waste: 1Al2 AerosolTrackerO(1zCan Box),TSnBattery"rrackeo&(0»gallon Alkaflneftckel)!VMH MercutyTrackea(1ugallon bucket)
How ismaterial stored: Universal waste boxes
Where ismaterial stored: inside the building
How many disposal shipments per year:
�
Name oftransport /disposal
vendor: Waste Management
Vendor address: Winston Salem, wC
~Note that amounts below the 66O-gallon(single) and 1.32O-ga|lon(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.
^1Nut*that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require
secondary containment. However, some exceptions may bnmade for amounts less than the Reportable
Quantities of the hazardous substances listed in 40 CFR §117.3.
1G)Other information. If you answer "Yem"tmany ofthe following items, you might not beeligible for the
nmexposure exclusion. Amore in-depth evaluation mythe site circumstances may barequired.
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a. Does your facility store used, recycled, or otherwise reclaimed pallets outside? C3Yoa MNu 13NV\
b. Does your facility have coal piles on site?
c. Does your facility store other fuel sources outside inpiles, such oawood chips,
sawdust, etc.?
d. Does your facility have air emissions associated with its industrial activity (e.g.,
degreasing operations, plating, painting and metal finiahing)? |fso, describe the
industrial activity:
a.|fyou answered yes hod..are those emissions permitted byanAir Quality
Permit? Please specify:
t Please list any other environmental program permits (federal, otahe, etc.) not
specified earlier in this application (such as Hazardous Waste Permits, etc.):
Permit:
. Program:
Permit:
. Program:
Permit:
Program:
Port -nit:
Program:
Program:
0 Yes IN No 0 NIA
E3 Yes C No El N/A
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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 complete a Self -Recertification form at least once
pach_%tear, 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 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: Travis Tilley
Title: Safety Manager
;'
(Signature of Applicant) (Date Signed)
applicationPlease note: This - No Exposure Exclusion is subjectapproval
RegionalOffice prior to issuance. The RegionalOffice
Exposurewith 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
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
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This completed application and all supporting documentation.
E"" A map with the location of the facility clearly marked.
ice' If the site currently has an NPDES Stormwater Permit, be sure to indicate the permit number in Question 8.
DEMLR - Stormwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
For questions, please contact the DEMLR Regional Office for your area.
Asheville Office ......
[phone]
Fayetteville Office ...
[phone]
Mooresville Office ...
[phone]
Raleigh Office .......
[phone]
Washington Office ...(252)
946-6481
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........(919)
707-9220
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North Carolina Secretary of State Search Results
Page 1 of 1
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Business Corporation
Legal Name
Cardinal CT Company
Information
Sosld: 1382833
Status: Current -Active O
Date Formed: 6/4/2014
Citizenship: Foreign
State of Incorporation: WI
Fiscal. Month: December
Annual Report Due Date: April 15th
Currentgnnual Report Status:
Registered Agent: National Registered Agents, Inc.
Addresses
Reg Office Reg Mailing Mailing
160 Mine Lake Ct Ste 200 160 Mine Lake Ct Ste 200 775 Prairie Center Drive, Suite 200
Raleigh, NC 27615-6417 Raleigh, NC 27615-6417 Eden Prairie, MN 55344-7316
Principal Office
775 Prairie Center Drive, Suite 200
Eden Prairie, MN 55344-7316
Officers
President Chief Financial Officer
TODD FRENCH , SMITH JEFFREY PETERSON
775 PRAIRIE CENTER DRIVE SUITE 200 775 PRAIRIE CENTER DRIVE, STE 200
EDEN PRAIRIE MN 55344 EDEN PRAIRIE MN 55344
Stock
https://www.sosnc.gov/online_services/search/Business_Registration_Results 2/10/2021