NCGNE1317_Self Recertification Form_20231220

Division of Energy, Mineral and Land Resources
Land Quality Section—Stormwater Permitting
National Pollutant Discharge Elimination System
Energy,Mineral ANNUAL NO EXPOSURE EXCLUSION SELF RE-CERTIFICATION
and Land Resources NCGNE0000
ENVIRONMENTAL QUALITY
Do not submit this form to DEMLR unless requested.
For questions,please contact the DEMLR Regional Office for your area or the Central Office.
(Please print or type)
Facility's No Exposure Exclusion No. Date Completed (MM/DD/YYYY)
N C G N E 1 12 / 11 5 / 12 10 12 3
1) Has the facility name or owner changed? 11 Yes �✓ No
(if yes, please submit a separate Name/Ownership Change Form to DEMLR located at:
http://deg.nc.gov/about/divisions/energy-mineral-land-resources/energy-mineral-land-permits/stormwater-permits/npdes
Industrial-sw)
2) 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 to maintain your no exposure exclusion, and must immediately apply for a permit from DEMLR.
a. Using, storing, or cleaning industrial machinery or equipment, and areas where ❑ Yes ❑✓ No
residuals from using, storing or cleaning industrial machinery or equipment
remain and are exposed to stormwater
b. Materials or residuals on the ground or in stormwater inlets from spills/leaks ❑ Yes ✓0 No
c. Materials or products from past industrial activity Yes Fv No
d. Material handling equipment(except adequately maintained vehicles) Yes 21 No
e. Materials or products during loading/unloading or transporting activities ❑ Yes ❑✓ No
f. Materials or products stored outdoors (except final products intended for outside ❑ Yes ❑✓ No
use [e.g., new cars] where exposure to stormwater does not result in the
discharge of pollutants)
g. Materials contained in open, deteriorated or leaking storage drums, barrels, ❑ Yes 21 No
tanks, and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained ❑ Yes �✓ No
by the discharger
i. Waste material (except waste in covered, non-leaking containers [e.g., FJYes ✓❑ No
dumpsters])
j. Application or disposal of process wastewater(unless otherwise permitted) ❑Yes ❑✓ No
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents n Yes �✓ No
not otherwise regulated (i.e., under an air quality control permit)and evident in the
stormwater outflow
I. Empty containers that previously contained materials that are not properly stored ® Yes ✓❑ No
(i.e., not closed and stored upside down to prevent precipitation accumulation)
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SWU-NESR-3May2016

NCGNE0000 No Exposure Self Re-Certification
m. For any exterior ASTs, as well as drums, barrels, tanks, and similar containers []Yes ✓❑ No
stored outside, has the facility had any releases in the past three (3)years?
3) Above Ground Storage Tanks (ASTs): If you answer"No" to any of the following items, you are not
eligible to maintain your no exposure exclusion, and must immediately apply for a permit from DEMLR.
a. Are exterior ASTs and piping free of rust, damaged or weathered coating, pits, ✓❑Yes❑ No❑
or deterioration, or evidence of leaks? N/A
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any ❑✓ Yes❑No ❑
cracks, holes, or evidence of leaks, and are drain valves maintained locked N/A
shut?
4) Secondary Containment: If you answer"No" to any of the following items, you are not eligible to
maintain your no exposure exclusion, and must immediately apply for a permit from DEMLR.
a. Is secondary containment provided for all single above ground storage ✓❑Yes❑No ❑
containers (including drums, barrels, etc.)with a capacity of more than 660- N/A
gallons?
b. Is secondary containment provided for above ground storage containers stored ❑✓ Yes❑No❑
in close proximity to each other with a combined capacity of more than 1,320- N/A
gallons?
c. Is secondary containment provided for Title III Section 313 Superfund ✓❑Yes❑ No ❑
Amendments and Reauthorization Act(SARA)water priority chemicals'? N/A
d. Is secondary containment provided for hazardous substances" designated in ❑✓Yes❑No ❑
40 CFR§116? N/A
e. Are release valves on all secondary containment structures locked? ✓❑Yes❑ No ❑
N/A
Footnotes to Questions 4)c.&d.
"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 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.
'"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
§117.3.
5) Other information: If you answer"Yes" to any of the following items, and the answer if different from
how it was answered when originally applying, you might not be eligible to maintain your no exposure
exclusion. Please contact the Division if this is the case.
a. Does your facility store used, recycled, or otherwise reclaimed pallets outside? ❑ Yes ❑✓ No
b. Does your facility have coal piles on site? ❑ Yes ❑✓ No
c. Does your facility store other fuel sources outside in piles, such as wood chips, ❑Yes ❑✓ No
sawdust, etc.?
d. Does your facility have air emissions associated with its industrial activity(e.g., ❑✓ Yes ❑ No
degreasing operations, plating, painting and metal finishing)? If so, describe the
Industrial activity: Inks,coatings,and solvents used in Printing presses,all inside building
e. If you answered yes to d., are those emissions permitted by an Air Quality ❑✓ Yes❑ No❑
Permit? Please specify: Minor Air Permit* 13-096-068 N/A
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NCGNE0000 No Exposure Self Re-Certification
6) Certification:
I certify under penalty of law that I have read and understand the eligibility requirements for claiming a condition of"no
exposure"and obtaining/maintaining 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 annually self re-certify No Exposure and, if requested, submit this re-certification to
DEMLR or 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 Water Quality,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.
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 provided. Based on my
inquiry of the person or persons who manage the system,or those persons directly responsible for gathering the
information,the information provided is to the best of my knowledge and belief true, accurate and complete. I am aware
that there are significant penalties for providing false information, including the possibility of fine and imprisonment for
knowing violations.
I certify that I am familiar with the information contained in this document and that to the best of my knowledge and belief
such information is true, complete, and accurate.
Printed Name of Person Signing: Enrico Rendleman
Title:
12/15/2023
( gnature) (Date Signed)
Please note: The Regional Office may inspect your facility at any time in the future for compliance
with the No Exposure Exclusion.
North Carolina General Statute 143-215.6 B(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;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).
This completed form must be kept on file at the facility for at least 5 years. Do not submit this
form to DEMLR unless requested.
Page 3 of 3
SW U-NESR-3May2016

Caraustar-Randleman Carton Plant
to 217 W Jones St
1 hr 26 min
IRS reimbursement: $62.19
94.9 miles
THead southeast. Go for 92 ft.
Then 0.02 miles
1 Turn left toward US Highway 311/US-311. Go for 112 ft.
Then 0.02 miles
r+ Turn right onto US Highway 311 (US-311). Go for 0.5 mi.
Then 0.5 miles
TContinue on US-311. Go for 0.3 mi.
Then 0.3 miles
RAMP
Turn right and take ramp onto 1-73 N toward US-220 N. Go for 13.9 mi.
Then 13.9 miles
EXIT
7 Take exit 95A toward US-421 S/Durham/1-40 E/Raleigh onto I-85 N. Go for 42.2 mi.
Then 42.2 miles
VKeep right onto 1-40 E (Harriet Morehead Berry Fwy) toward 1-40/Raleigh. Go for 30.3 mi.
Then 30.3 miles
v

Keep right onto Wade Ave toward 1-440/US-1 N/Wade Ave. Go for 6.4 mi.
Then 6.4 miles
RAMP
Take ramp onto Capital Blvd (US-70 ENS-401 S) toward Capital Blvd South/Downtown. Go for 1.2
mi.
Then 1.2 miles
Turn left onto Hillsborough St (NC-54). Go for 489 ft.
Then 0.09 miles
Turn left onto N McDowell St (US-70 W/US-401 N). Go for 0.1 mi.
Then 0.1 miles
Turn left. Go for 236 ft.
Then 0.04 miles
Q 217 W Jones St
Raleigh, NC 27603-2396

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