NCGNE1574_Application_20221228

FOR AGENCY USE ONLY
NCGNE151Gf
Assigned to: - COOA
ARO FRO MRO RRO WARO WIRO WSRO
Division of Energy, Mineral, and Land Resources
National Pollutant Discharge Elimination System
No Exposure Certification for Exclusion
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 new facilities, applicants should apply no earlier than 60 days before the start of operation This will allow
DEMUR staff to verify conditions during active operation. For facilities that already have an industrial stormwater
permit 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 Until you are issued a No Exposure Certification and your NPDES permit is rescinded, your facility must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 for the 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, the facility 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).
For new facilities, applicants should not apply more than 60 days before the start of operation date. This
If approved, your conditional No Exposure Certification has no expiration date but must be self -recertified at least
annually. Please look for information about recertification under the No Exposure section on this page:
httDs•//decinc 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: NCDEMI R
Stormwater Program, 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 6

1. Owner/Operator (to whom all permit correspondence will be mailed):
Name of legal organizational en 'I :
P"r- nv,, r r-eij
Legally re onsible person (as signed in Item 7 below):
%CMv�iL Oe
Street address:
l 6 `{ �a Alta e Sa.!% J`.
City: n
/ 0 —S) e
Statg ,G
Zip Code
Telephone number:
33;-1145'
Email address:
14A`e. 'r�'4
Type of Ownership:
Government
❑ County ❑ Federal ❑ Municipal ❑ State
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: n 1))
P0./�k.C� ._. Ir_ay.�fle�9✓1
Facility environmental contact:
/�Jl
Street address: `6 u PO , ,4 So.. `
Telephone number:
4 _ S 22
_
Email address: / n
City n
Couptys!y�`( �;;W. ,.,
State Aky
Zlp CodeYZ 7 31
Q
Latitude of entrance: 0543
Longitude of entrance
Parcel Identification Number -(PIN)
Date operatio66egan:.
Industrial Classificatwn (SIC) Code: �'"
Brief descriptia o(f�the1typesof industrial actrv)ties_andproducts`prod'u"ced a
r
his facility: `_
p��G��
ah� ty o
s ca vG
_ 'irv�oecv.
3. Consultant (if applicable):
Name of consultant:
Consulting firm:
Street address:
City:
State and zip code:
Telephone number:
Email address:
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
❑ Yes ® No ❑ N/A
Materials or residuals on the ground or in stormwater inlets from spills/leaks
❑ Yes ® No ❑ N/A
Materials or products from past industrial activity
❑ Yes 0 No ❑ N/A
Material handling equipment (except adequately maintained vehicles)
❑ Yes ® No ❑ N/A
S-
Page 3 of 6

Materials or products during loading/unloading or transporting activities
❑ Yes ErNo ❑ N/A
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)
❑ Yes ® No ❑ N/A
Materials contained in open, deteriorated, non -sealed', or leaking storage drums barrels, tanks,
and similar containers
❑ Yes X No ❑ N/A
Materials or products handled/stored on roads or railways owned or maintained by the discharger
❑ Yes R3 No ❑ N/A
Final products that would be mobilized in stormwater discharges (e.g., rock salt)
❑ Yes a No ❑ N/A
Waste material (except waste in covered, non -leaking containers [e.g., dumpsters])
❑ Yes $J No ❑ N/A
Application or disposal of process wastewater (unless otherwise permitted)
❑ Yes 9 No ❑ N/A
Particulate matter or visible deposits of residuals from roof stacks and/or vents not otherwise
regulated (i.e. under an air quality control permit) and evident in the stormwater outflow
❑ Yes 0 No ❑ N/A
Empty containers that previously contained materials that are not properly stored (i.e., not closed
and stored upside down to prevent precipitation accumulation)
❑ Yes KI No ❑ N/A
For any exterior ASTs, as well as drums, barrels, tanks and similar containers stored outside, has
the facility had any releases in the past three (3) years?
❑ Yes 0 No ❑ N/A
'Sealed means banded or otherwise secured and with locked or non -operational taps or valves.
Above Ground Storage Tanks (ASTs) and Secondary Containment
If you answer No to an of the followln items �ou are not eli Ible for tP* -no-.ex os e-ex&" ..,.
„„ Y g Y g P
Are exterior ASTs or piping free of rust, damaged or'_weatF erect coating„pits or deterioration, or
❑ �N/A
evidence of leaks?
N
Is secondary cont ain[pert provided for all exterior ASTs?:If
so is it free ofany cracks, `boles, or
� � "'
d 1
� ❑ye§'❑ No ® N/A
evidence of leaks, and are drain val_ves•maintainedlocked
shut?
Is secondary contamment.p owded for si1.ngle ab_ove.ground.storage containers (including drums; , ti
❑Yes ❑'No 9N/A
barrels, etc.) -,with a capacity of,more than 660-gallons? `f '7 '-
Is secondaN,contammentprovifded foriab6v6 ground storage containers stored inclose proximity "r
of 1,320'gallons?Y
❑Yes ❑ No ®N/A
to each other with a combined capacity more than
Is secondary containment provided for Title III Section 313 Superfund Amendments .and
❑Yes ❑ No [$ N/A
Reauthorization Act (SARA) water priority chemicals?
Is secondary containment provided for hazardous substances designated in 40 CFR §116?
❑ Yes ❑ No ® N/A
Are release valves on all secondary containment structures locked?
❑ Yes ❑ No 9 N/A
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?
❑ Yes IFI No ❑ N/A
Does this facility store used, recycled, or otherwise reclaimed pallets outside? LJ° V) k rf
-9 Yes ❑ No ❑ N/A
Does this facility have coal piles on site?
❑ Yes ® No ❑ N/A
Does this facility store other fuel sources outside in piles, such as wood chips, sawdust, etc.?
❑ Yeses No ❑ N/A
Page 4 of 6

Does this facility have air emissions associated with industrial activity (e.g., degreasing operations, ❑ Yes E No ❑ N/A
plating, painting, or metal finishing)?
If yes:
Describe the industrial activity:
Are those emissions permitted by an Air Quality Permit? ❑ Yes ❑ No
Please specify:
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
lk-
❑ Hazardous Waste Disposal Facd(#y�'
IPZ
If checked, indicate
• Kilograms of waste gehefated each month:, t
,.
Types) of wasteevm
�
rf ���
• Howmatenalisstored ,� d -ate
'�''»� t`
• Where matenal �s stored y
�# °d
• Number of wa"ste shipments peryear. � � -
�" � '
• Name 4ftranspoit/disposalvendor �'iEl, ,:�f-,r ��Iii#;t,z7s �;��
��,�
`�,
• 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)
,&EAThis completed application and any supporting documentation
9Copy of county map or USGS quad sheet with the location of the facility clearly marked
Page 5 of 6

7. Applicant Certification
North Carolina General Statute 143-215.68 (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:
K I 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.
19 1 have read and understand the eligibility requirements for claiming a condition of "no exposure" and obtaining an
exclusion from NPDES stormwater permitting.
'91 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)).
05 1 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.
9 I understand that in the event that the site no longerFqual'fes for a,No Exposure fxclusion.that must,obtain coverage
under an NPDES permit prior to any.p6oint ou&& drs'cha ge of st rmwater from "the facility
® The information submitted inOWN01 is tv,t bestfrif,my knowledge;and beI true accurate,Anii complete based on
#a
my inquiry of the persofi'%r persons whom age the system totk#hose persons directly resp ns ble"fo ga#hlenng the
information
4 _,�u
j, to { i a
Printed Nam6 f Person Sigm
Title:
Z
Mail the entire package to: DEMLR'— Stormwater Program
Department of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
Page 6 of 6

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Parker Nycoil Corporation
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Manufacturer • Floor 1 Directions
Open • Closes 513M

To: Brittany Carson (DEQRegional)
Subject: No Exposure Certification Request
Company: Parker Hannifin Corp —Randleman, NC
From: Stephen Cernava (Randleman EHS Representative)
Brittany,
Parker Hannifin Corp is a large corporation with dozens of locations throughout the world
manufacturing many products used in aircraft, machines, and services. The Randleman North Carolina
facility is a total of 50 people working Monday -Friday only 2 shifts manufacturing air tubing for the
general public and assembling some thermoplastic hoses.
We would like our site to continue to be certified as "No Exposure Storm Water" classification as
per previous requests approval going back to 2000. 1 am the EHS representative working in the
Randleman facility. I also am the manufacturing engineer. I am submitting this request and look forward
to work with your team to keep up our certification.
Thank You,
Stephen Cernava
Parker Hannifin Corp —Randleman, NC
dote
Stephen Cernava
Engineer
Manufacturing Poc.EnOe,,,r
Parker Hannifin Corporation
Fluid Connectors Group
Padiex Division
direct 33649538,
cell 3345 799430,
tDnv
164 Pointe �h 7317 USA
Randleman,
8
fax 336495:55ex[ 1Y.
33C 495 i3C ,
stephen.oemavaOperker. CO1A�Pa*ece°rn
ISO 9001:21108