NCGNE1477_Application_20210503

FOR AGENCY USE ONLY
Date Received: P5J03/
NCGNE l it 1 —7
Division of Energy, Mineral, and Land Resources MAY 0 j 2021
National Pollutant Discharge Elimination System
No Exposure Certification for Exclusion NR-LAND �RMV�'�
p S7'QR�,�UIfAT� R Fi:RN�' i TiNi'
NCGNE0000
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. Industrial materials or activities include, but are not limited to:
• material handling equipment or activities, • by-products,
• industrial machinery, • final products, or
• raw materials, • waste products.
• intermediate 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 industrial materials stored in the following container types, provided
the containers are not deteriorated and do not leak:
• drums, • tanks, and
• barrels, • similar containers.
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rescinded, your facility must continue to abide by the terms and conditions of the current permit.
A No Exposure Certification must be provided for each facility qualifying forthe no exposure exclusion. Additionally,
the exclusion from NPDES permitting is available on a facility -wide basis only — not for individual outfalls. If any
industrial activities or materials are, orwill be, exposed to precipitation, thefacility is not eligible forthe 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 cond itonal No Exposure Certification has no expiration date but must be self -recertified at least
"i
annually. Please look for information about recertification under the No Exposure section on this page:
https://deg.nc.gov/about/divisions/energy-mineral-land-resources/npdes-no-exposure.
Directions: Print or type all entries on this application form. Send the original, signed application to: NCDEMLR
Stormwater Program, 512 N. Salisbury St., 1612 MSC, Raleigh, NC 27699-1612. The submission of this form does
not guarantee exclusion from NPDES stormwater permitting. Prior to exclusion from NPDES stormwater permitting
a site inspection will be conducted.
Page 1 of 5

1. Owner/Operator (to whom all permit correspondence will be mailed):
Name of legal organizational entity:
Legally responsible person (as signed in Item 7 below):
High Speed Gear
Matt Gadams
Street address:
City:
State and zip code:
�NC
87 old hammocks rd.
swansboro
28584
Telephone number:
Email address:
910 325 1000 x1303
[e-mail]
Type of Ownership:
Government
®County QFederal 0Municipal GState
Non -government
Business (If ownership is business, a copy of NCSOS report must be included with this application)
Individual
2. Industrial Facility (facility requesting exclusion):
Facility name:
Facility environmental contact:
High Speed Gear
Darrell Smith
Street address:
Telephone number:
118 county farm rd.
9103251000 x1304
City:
State and zip code:
�NC
Email address:
Windsor
27983
[e-mail]
Latitude of entrance:
Longitude of entrance: Latitude 35.998492 Longitude-76.946064
Parcel Identification Number (PIN):
Date operation began:
Standard Industrial Classification (SIC) Code:
�2399
3/08/2021
Brief description of the types of industrial activities and products produced at this facility:
Sewing
3. Consultant (if applicable):
Name of consultant:
Consulting firm:
Sophia Gentil
TRC
Street address:
City:
State and zip code:
1 park west circle suite 102
Midlothian
VA . 23114
Telephone number:
Email address:
804.350.5397
�[e-mail]
4. Exposure Checklists
Are any of the following materials or activities exposed to precipitation, now or in the foreseeable future? If you
answer "Yes" to any of these items, you are not eligible for the no exposure exclusion.
Using, storing, or cleaning industrial machinery or equipment, and areas where residuals from using,
storing, or cleaning industrial machinery or equipment remain and are exposed to stormwater
QYesQ
No
Materials or residuals on the ground or in stormwater inlets from spills/leaks
©Yes
No
Materials or products from past industrial activity
OYesONo
Material handling equipment (except adequately maintained vehicles)
©YesQNo
Materials or products during loading/unloading or transporting activities
Oyes(2)No
Page 2 of 5

Materials or products stored outdoors (except final products intended for outside use [e.g., new cars]
where exposure to stormwater does not result in the discharge of pollutants)
�YesQNo
Materials contained in open, deteriorated, non -sealed', or leaking storage drums barrels, tanks, and
similar containers
Yes Q No
Materials or products handled/stored on roads or railways owned or maintained by the discharger
OYesO No
Final products that would be mobilized in stormwater discharges (e.g., rock salt)
0Yes No
Waste material (except waste in covered, non -leaking containers [e.g., dumpsters])
0YesQ No
Application or disposal of process wastewater (unless otherwise permitted)
OYes' No
Particulate matter or visible deposits of residuals from roof stacks and/or vents not otherwise regulated
(i.e. under an air quality control permit) and evident in the stormwater outflow
QYeskv No
Empty containers that previously contained materials that are not properly stored (i.e., not closed and
stored upside down to prevent precipitation accumulation)
QYes (DNo
For any exterior ASTs, as well as drums, barrels, tanks and similar containers stored outside, has the facility
had any releases in the past three (3) years?
©Yes No
'Sealed means banded or otherwise secured and with locked or non -operational taps or valves.
Above Ground Storage Tanks (ASTs) and Secondary Containment
If you answer "No" to any of the following items, you are not eligible for the no exposure exclusion.
Are exterior ASTs or piping free of rust, damaged or weathered waling, pits, or deter ioration, or evidence
QYesNo
of leaks?
Is secondary containment provided for all exterior ASTs? If so, is it free of any cracks, holes, or evidence of
QYesfNo
leaks, and are drain valves maintained locked shut?
Is secondary containment provided for single above ground storage containers (including drums, barrels,
QYesONo
etc.) with a capacity of more than 660-gallons?
Is secondary containment provided for above ground storage containers stored in close proximity to each
QYes�No
other with a combined capacity of more than 1,320 gallons?
Is secondary containment provided for Title III Section 313 Superfund Amendments and Reauthorization
QYesQNo
Act (SARA) water priority chemicals?
is secondary containment provided for hazardous substances designated in 40 CFR §116?
QYes�No
Are release valves on all secondary containment structures locked?
0YesEV"No
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.
Are vehicles used in material handling in disrepair and/or leaking fluid?
QYesQNo
Does this facility store used, recycled, or otherwise reclaimed pallets outside?
0
Yes Q No
Does this facility have coal piles on site?
QYesQ
No
Does this facility store other fuel sources outside in piles, such as wood chips, sawdust, etc.?
QYesQ
No
Does this facility have air emissions associated with industrial activity (e.g., degreasing operations, plating,
OYes(DNo
painting, or metal finishing)?
If yes:
Describe the industrial activity:
Are those emissions permitted by an Air Quality Permit? OYesONo
Please specify:
Page 3 of 5

5. Other Facility Conditions (check all that apply and explain accordingly):
❑ This facility has other NPDES permits.
If checked, list the permit numbers for all current NPDES permits:
❑ This facility has Non -Discharge permits (e.g. recycle permit).
If checked, list the permit numbers for all current Non -Discharge permits:
❑ This facility stores hazardous waste in the 100-year floodplain.
If checked, describe how the area is protected from flooding:
❑ This facility is a (mark all that apply)
❑ Hazardous Waste Generation Facility
❑ Hazardous Waste Treatment Facility
❑ Hazardous Waste Storage Facility
❑ Hazardous Waste Disposal Facility
If checked, indicate:
• Kilograms of waste generated each month:
• Type(s) of waste:
• How material is stored:
• Where material is stored:
• Number of waste shipments per year:
• Name of transport/disposal vendor:
• Transport/disposal vendor EPA ID:
• Vendor address:
❑ This facility is located on a Brownfield or SUPERFUND site.
If checked, briefly describe the site conditions:
❑ This facility is located on Native American Lands.
6. Required Items (Application will be returned unless all of the following items have been included):
❑ Copy of most recent Annual Report to the NC Secretary of State (if applicable)
❑ This completed application and any supporting documentation
❑ Copy of county map or USGS quad sheet with the location of the facility clearly marked
Page 4 of 5

7. Applicant Certification
North Carolina General Statute 143-215.6E (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 ... shall be guilty of a Class 2 misdemeanor which may include a fine not
to exceed ten thousand dollars ($10,000). 1 hereby request exclusion from NPDES stormwater permitting.
Under penalty of law, I certify that:
0 1 am the person responsible for the industrial activity, for satisfying the requirements of this exclusion, and for any civil
or criminal penalties incurred due to violations of this exclusion.
El I have read and understand the eligibility requirements for claiming a condition of "no exposure" and obtaining an
exclusion from NPDES stormwater permitting.
El 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)).
El I 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 applicable, 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 recertifications on file at the facility.
0 I understand that in the event that the site no longer qualifies for a No Exposure Exclusion that I must obtain coverage
under an NPDES perrnit prior to dny point source discharge of storrnwaler rrorn the facility.
El The information submitted in this N01 is, to the best of my knowledge and belief, true, accurate, and complete based on
my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the
information.
Printed Name of Person Signing:
Title: Darrell Smith (GM)
6. 4a v
izi—
Signature of Applicant
4/28/2021
Date Signed
Mail the entire package to: DEMLR — Stormwater Program
Department of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
Page 5 of 5

b
'► LIMITED LIABILITY COMPANY ANNUAL REPORT
A� F
10/2017
NAME OF LIMITED LIABILITY COMPANY: HSG. LLC
SECRETARY OF STATE ID NUMBER: 1271399 STATE OF FORMATION: NC
REPORT FOR THE CALENDAR YEAR: 2021
SECTION A: REGISTERED AGENT'S INFORMATION
1. NAME OF REGISTERED AGENT: Gadams, Matthew J.
2. SIGNATURE OF THE NEW REGISTERED AGENT:
E - Filed Annual
Report
1271399
Changes
SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT
3. REGISTERED AGENT OFFICE STREET ADDRESS & COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS
2127 Scotland Ridge Road
Charlotte, NC 28211-1620 Mecklenburg County
SECTION B: PRINCIPAL OFFICE INFORMATION
2127 Scotland Ridge Road
Charlotte, NC 28211-1620
1. DESCRIPTION OF NATURE OF BUSINESS: Manufactuer Tactical Nylon Gear
2. PRINCIPAL OFFICE PHONE NUMBER: [phone] x305 3. PRINCIPAL OFFICE EMAIL:
Privacy Redaction
4. PRINCIPAL OFFICE STREET ADDRESS
87 Old Hammocks Road
Swansboro, NC 28584-8661
5. PRINCIPAL OFFICE MAILING ADDRESS
2NE33=1
Swansboro, NC 28584
6. Select one of the following if applicable. (Optional see instructions)
❑ The company is a veteran -owned small business
❑ The company is a service -disabled veteran -owned small business
SECTION C: COMPANY OFFICIALS (Enter additional company officials in Section E.)
NAME: Matthew Gadams NAME:
TITLE: Manager TITLE:
ADDRESS:
2127 Scotland Ridge Road
Charlotte, NC 28211
ADDRESS:
NAME:
TITLE:
ADDRESS:
SECTION D: CERTIFICATION OF ANNUAL REPORT Section D must be completed in its entirety by a person/business entity.
Matthew Gadams, by Chris Hayden Controller
SIGNATURE
Form must be signed by a Company Official listed under Section C of This form.
4/13/2021
DATE
Matthew Gadams, by Chris Hayden Controller Manager
Print or Type Name of Company Official Print or Type Title of Company Official
This Annual Report has been filed electronically.
MAIL TO: Secretary of State, Business Registration Division, Post Office Box 29525, Raleigh, NC 27626-0525