NCGNE1587_Application_20230215

FOR AGENCY USE ONLY
NCGNE, C7�
ned to: g• COO
A 0 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
DEMLR 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 Until you are issued a No Exposure Certification and your NPDES permit is rescinded, your facility must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, 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).
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:
httus://deq.n�A.labout _div_isions enerav-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, 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 entity:
Legally responsible person (as signed in Item 7 below):
Master Workholding of GA, INC
David Jackson
Street address:
City:
Stale
Zip Code
315 Burke Drive
Morganton
N.C.
28655
Telephone number:
Email address:
828-437-0011
[e-mail]
Type of Ownership:
Government
❑ County ❑ Federal ❑ Municipal ❑ State
Non -government
R 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:
Master Workholding of GA, INC
Street address:
Telephone number:
315 Burke Drive
828-437-0011
Email address:
[e-mail]
City
County
State
Zip Code
Morganton
Burke
N.C.
28655
Latitude of entrance: 35.7487660-35^ 44'55.55"
Longitude of entrance: 81.6633610-s1^ 39'4M9"
Parcel Identification Number (PIN): 2703987047
Date operation began:
Standard Industrial Classification (SIC) Code:
August 15, 2018
3544
Brief description of the types of industrial activities and products produced at this facility:
Manufacturing any producing Workholding Fixtures
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 forthe 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 IR No ❑ N/A
Materials or residuals on the ground or in stormwater inlets from spills/leaks
❑ Yes IR No ❑ N/A
Materials or products from past industrial activity
❑ Yes 9 No ❑ N/A
Material handling equipment (except adequately maintained vehicles)
❑ Yes IR No ❑ N/A
Page 3 of 6

Materials or products during loading/unloading or transporting activities
❑ Yes IR No ❑ N/A
Materials or products stored outdoors (except final products intended for outside use [e.g., new
El Yes No ❑ N/A
cars] where exposure to stormwater does not result in the discharge of pollutants)
Materials contained in open, deteriorated, non -sealed', or leaking storage drums barrels, tanks,
❑Yes )� No ❑ N/A
and similar containers
Materials or products handled/stored on roads or railways owned or maintained by the discharger
❑ Yes R No ❑ N/A
Final products that would be mobilized in stormwater discharges (e.g., rock salt)
❑ Yes 5R No ❑ N/A
Waste material (except waste in covered, non -leaking containers [e.g., dumpsters])
❑ Yes IR No ❑ N/A
-Application or disposal of process wastewater (unless otherwise permitted)
❑ Yes ❑ No 9 N/A
Particulate matter or visible deposits of residuals from roof stacks and/or vents not otherwise
❑ Yes' No ❑ N/A
regulated (i.e. under an air quality control permit) and evident in the stormwater outflow
Empty containers that previously contained materials that are not properly stored (i.e., not closed
❑ Yes No El N/A
and stored upside down to prevent precipitation accumulation)
For any exterior ASTs, as well as drums, barrels, tanks and similar containers stored outside, has
❑ Yes' No El N/A
the facility had any releases in the past three (3) years?
'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 coating, pits, or deterioration, or
evidence of leaks?
®Yes ❑ No ❑ N/A
Is secondary containment provided for all exterior ASTs? If so, is it free of any cracks, holes, or
evidence of leaks, and are drain valves maintained locked shut?
®Yes El No ❑ N/A
Is secondary containment provided for single above ground storage containers (including drums,
barrels, etc.) with a capacity of more than 660-gallons?
❑ Yes ❑ No IR N/A
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?
❑ Yes ❑ No IR N/A
Is secondary containment provided for Title III Section 313 Superfund Amendments and
Reauthorization Act (SARA) water priority chemicals?
®Yes ❑ No ❑ N/A
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 ❑ 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 2 No ❑ N/A
Does this facility store used, recycled, or otherwise reclaimed pallets outside?
❑ Yes R No ❑ N/A
Does this facility have coal piles on site?
❑ Yes 2 No ❑ N/A
Does this facility store other fuel sources outside in piles, such as wood chips, sawdust, etc.?
❑ Yes R No ❑ N/A
Page 4 of 6

Does this facility have air emissions associated with industrial activity (e.g., degreasing operations, ❑ Yes 9 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
❑ 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 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:
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.
IB I have read and understand the eligibility requirements for claiming a condition of "no exposure' and obtaining an
exclusion from NPDES stormwater permitting.
® 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)).
6.d 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.
1 understand that in the event that the site no longer qualifies for a No Exposure Exclusion that I must obtain coverage
under an NPDES permit prior to any point source discharge of stormwater from the facility.
® 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:
_ 0. JA<4.L3of3 G50 OZ
Sig of Applicant Date Signed
Mail the entire package to: DEMLR —Stormwater Program
Department of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
Page 6 of 6

`t11 BUSINESS CORPORATION ANNUAL REPORT
io 2017
NAME OF BUSINESS CORPORATION: Master Workholding of Georgia Inc.
SECRETARY OF STATE ID NUMBER: 2082591 STATE OF FORMATION: NC
REPORT FOR THE FISCAL YEAR END: 12/31/2022
SECTION A: REGISTERED AGENT'S INFORMATION
1. NAME OF REGISTERED AGENT: Tate, Wendi
2. SIGNATURE OF THE NEW REGISTERED AGENT:
review
Changes
SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT
3. REGISTERED AGENT OFFICE STREET ADDRESS & COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS
315 Burke Drive
315 Burke Drive
Morganton, NC 28655 Burke County Morganton, NC 28655
SECTION B: PRINCIPAL OFFICE INFORMATION
1. DESCRIPTION OF NATURE OF BUSINESS: design and manufacture of custom workholding for production machining industries
2. PRINCIPAL OFFICE PHONE NUMBER: [phone] 3. PRINCIPAL OFFICE EMAIL: Privacy Redaction
4. PRINCIPAL OFFICE STREET ADDRESS
2500 Northlake Drive
Suwanee, GA 30024
5. PRINCIPAL OFFICE MAILING ADDRESS
2500 Northlake Drive
Suwanee, GA 30024
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: OFFICERS (Enter additional officers in Section E.)
NAME: David Jackson
TITLE: Chief Executive Officer
ADDRESS:
2500 Northlake Drive
Suwanee, GA 30024
NAME: Erwin Mock
TITLE: Chief Financial Officer
ADDRESS:
2500 Northlake Drive
Suwanee, GA 30024
NAME: Anne Mackh
TITLE: Secretary
ADDRESS:
2500 Nortlake Dr
SUWANEE, GA 30024
SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business
entit .
Dyavid Jackson 2/8/2023
SIGNATURE
Form must be signed by an officer listed under Section C of this form.
David Jackson
Print or Type Name of Officer
Chief Executive Officer
Print or Type Title of Officer
MAIL TO: Secretary of State. Business Registration Division, Post Office Box 29525, Raleigh, NC 27626-0525

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N, Morganton North, 2019, 7.5-minute
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SITE NAME: Project Hermes
ADDRESS: 315 Burke Drive
Morganton, NC 28655
CLIENT: Ramboll
N-
7068681 - 4 page 5

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7068681 - 4 page 6

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following map sheet(s).
TP, Morganton South, 2013, 7.5-minute
N, Morganton North, 2013, 7.5-minute
0 Miles 0.25 0.5 1 1.5
SITE NAME: Project Hermes
ADDRESS: 315 Burke Drive
Morganton, NC 28655
CLIENT: Ramboll
N-
7068681 - 4 page 7

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This report includes information from the
following map sheet(s).
N, Morganton North, 2002, 7.5-minute
0 Miles 0.25 0.5 1 1.5
SITE NAME: Project Hermes
ADDRESS: 315 Burke Drive
Morganton, NC 28655
CLIENT: Ramboll I
N•
7068681 - 4 page 8

OEDR' Historical Topo Map gg
This report includes Information from the
following map sheet(s).
TP, Morganton South, 1996, 7.5-minute
N, Morganton North, 1996, 7.5-minute
0 Miles 0.25 0.5 1 1.5
SITE NAME: Project Hermes
ADDRESS: 315 Burke Drive
Morganton, NC 28655 _
CLIENT. Ramboll `
N,
7068681 - 4 page 9

(FIE DR` Historical Topo Map 1956
This report includes information from the
following map sheet(s).
0 Miles 0.25 0.5 1 1.5
TP, Morganton South, 1956, 7.5-minute
N, Morganton North, 1956, 7.5-minute
SITE NAME: Project Hermes
ADDRESS: 315 Burke Drive
Morganton, NC 28655
CLIENT: Ramboll
7068681 - 4 page 10

CEDR' Historical Topo Map is
This report includes information from the
following map sheet(s).
TP, Morganton, 1905, 30-minute
0 Miles 0.25 0.5 1 1.5
SITE NAME: Project Hermes
ADDRESS: 315 Burke Drive
Morganton, NC 28655
CLIENT: Ramboll
7068681 - 4 page 11

(ee0R° Historical Topo Map 1892
x
This report includes information from the
following map sheet(s).
TP, MORGANTON, 1892, 30-minute
0 Miles 0,25 0.5 1 1.5
SITE NAME: Project Hermes
ADDRESS: 315 Burke Drive
Morganton, NC 28655
CLIENT: Ramboll
N.
7068681 - 4 page 12

EDR Aerial Photo Decade Package 07/28/22
Site Name: Client Name:
Project Hermes
315 Burke Drive
Morganton, NC 28655
EDR Inquiry# 7068681.8
Ramboll
1600 Parkwood Circle
Atlanta, GA 30339
Contact: Alexandra Piuta
Environmental Data Resources, Inc. (EDR) Aerial Photo Decade Package is a screening tool designed to assist
environmental professionals in evaluating potential liability on a target property resulting from past activities. EDR's
professional researchers provide digitally reproduced historical aerial photographs, and when available, provide one photo
perdecade.
Search Results:
Year
Scale
Details
Source
2016
1"=500'
Flight Year:2016
USDAINAIP
2012
1"=500'
Flight Year:2012
USDA/NAIP
2009
1"=500'
Flight Year:2009
USDA/NAIP
2006
1"=500'
Flight Year:2006
USDA/NAIP
1998
1"=500'
Acquisition Date: January 01, 1998
USGS/DOQQ
1993
1"=500'
Acquisition Date: March 06, 1993
USGS/DOQQ
1984
1 "=500'
Flight Date: February 02, 1984
USDA
1976
1"=500'
Flight Date: April 01, 1976
USGS
1964
1 "=500'
Flight Date: October 22, 1964
USGS
1961
1 "=500'
Flight Date: August 29, 1961
USGS
1954
t"=500'
Flight Date: January 01, 1954
FirstSearch
1950
1 "=500'
Flight Date: November 14, 1950
USGS
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7068681 - 8 page 2

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