NCGNE0289_COMPLETE FILE - HISTORICAL_20060725

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO. /V
DOC TYPE HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE ❑
YYYYMMDD

#tl� wo
F W A n Michael F.Easley,Governor
t� RQ William G.Ross Jr.,Secretary
`Q G -R CC1V>D North Carolina Department of Environment and Natural Resources
Cp N.0 �9ot.of cNR
� Alan W.Klimek,P.E.Director
�_ rt qA�► Division of Water Quality
p JUL 2 J LIM Coleen H.Sullins,Deputy Director
yr rs �_z1� Division of Water Quality
July 19, 2006
Mr. Thomas O'Reilly
Matrex Seating
899 East Lindsay Street
Greensboro, NC 27405
Subject: No Exposure Certification NCGNE0289
Matrex Seating
899 East Lindsay Street, Greensboro, NC
Guilford County
Dear Mr. O'Reilly:
The Division has reviewed your submittal of the No-Exposure Certification for Exclusion from NPDES
Stormwater Permitting form, which we received on June 16, 2006. Based on your submittal and signed
certification of no exposure at the above referenced facility, the Division is granting your certification as
provided for under 40 CFR 126.22(g), which is incorporated by reference in North Carolina regulations, and
hereby rescinding your former Certificate of Coverage NCG050337.
Please note that by our acceptance of your no exposure certification, you are obligated to maintain no
exposure conditions at your facility. If conditions change such that your facility can no longer qualify for a no-
exposure exclusion, you are obligated to immediately obtain NPDES permit coverage for your stormwater
discharge. Otherwise, the discharge becomes subject to enforcement as an un-permitted discharge. Your
conditional no-exposure exclusion expires in five years (June 30, 2011). At that time you must re-certify with
the Division, or obtain NPDES permit coverage for any stormwater discharges from your facility.
Your certification of no exposure does not affect your facility's legal requirements to obtain environmental
permits that may be required under other federal, state, or local regulations or ordinances.
If you have any questions or need further information, please contact Sarah Young at(919) 733-5083, ext.
502, or at [e-mail].
Sincerely,
ORIGINAL SIGNED By
KEN PICKLE
for Alan W. Klimek, P.E.
cc: Winston-Salem Regional Office Central Files—wlattachments
Stormwater Permitting Unit Files
NCDENR
N.C.Division of Water Quality 1617 Mail Service Center Raleigh,North Carolina 27699-1617 [phone] Customer Service
1-877-623-6748

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(�v1i A]� Michael F,Easley,Governor
William G.Ross Jr.,Secretary
North Carolina Department of Environment and Natural Resources
Alan W.Klimek,P.E.Director
Division of-Water Quality
p Coleen H.Sullins,Deputy Director
Division of Water Quality
July 19, 2006
Mr. Thomas O'Reilly
Matrex Seating
899 East Lindsay Street
Greensboro, NC 27405
Subject: No Exposure Certification NCGNE0289
Matrex Seating
899 East Lindsay Street, Greensboro, NC
Guilford County
Dear Mr. O'Reilly:
The Division has reviewed your submittal of the No-Exposure Certification for Exclusion from NPDES
Stormwater Permitting form, which we received on ,tune 16, 2006. Based on your submittal and signed
certification of no exposure,at the above referenced facility, the Division is granting your certification as
provided for under 40 CFR 126.22(g), which is incorporated by reference in North Carolina regulations, and
hereby rescinding your former Certificate of Coverage NCG050337.
Please note that by our acceptance of your no exposure certification, you are obligated to maintain no
exposure conditions at your facility. If conditions change such that your facility can no longer qualify for a no-
exposure exclusion, you are obligated to immediately obtain NPDES permit coverage for your stormwater
discharge. Otherwise, the discharge becomes subject to enforcement as an un-permitted discharge. Your
conditional no-exposure exclusion expires in five years(June 30, 2011). At that time you must re-certify with
the Division, or obtain NPDES permit coverage for any stormwater discharges from your facility.
Your certification of no exposure does not affect your facility's legal requirements to obtain environmental
permits that may be required under other federal, state, or local regulations or ordinances.
If you have any questions or need further information, please contact Sarah Young at(919) 733-5083, ext.
502, or at [e-mail].
Sincerely,
for Alan W. Klimek, P.E.
cc: Winston-Salem Regional Office Central Files—wlattachments
Stormwater Permitting Unit Files
NCDENR
N.C.Division of Water Quality 1617 Mail Service Center Raleigh,North Carolina 27699-1617 [phone] Customer Service
1-877-623-6748

RECEIVED
N.C.OPM of FNR
I of RAI a L
60 "' " 'F proved
United States Environmental Protection Agency yyirg No.2040-0211
NPDES ;'��� Washington, DC 20460 Real -,
35110--111 `� NO EXPOSURE CERTIFICATION for Exclusion from --
NPDES Storm Water Permitting
Submission of this No Exposure Certification constitutes notice that the entity identified in Section A does not require permit authorization for its storm water
discharges associated with industrial activity in the State identified in Section B under EPA's Storm Water Multi-Sector General Permit due to the existence
of a condition of no exposure.
A condition of no exposure exists at an industrial facility when all industrial materials and activities are protected by a storm resistant shelter to prevent
exposure to rain,snow,snowmelt,andfor runoff. 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 without operational taps or valves;
- adequately maintained vehicles used in material handling;and
- final products,other than products that would be mobilized in storm water discharges(e.g.,rock salt).
A No Exposure Certification must be provided for each facility qualifying for the no exposure exclusion. In addition,the exclusion from NPDES permitting is
available on a facility-wide basis only,not for individual outfails. 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,the entity in Section A is certifying that a condition of no exposure exists at its facility or site,
and is obligated to comply with the terms and conditions of 40 CFR 122.26(g).
ALL INFORMATION MUST BE PROVIDED ON THIS FORM.
Detailed instructions for completing this form and obtaining the no exposure exclusion are provided on pages 3 and 4.
A. Facility Operator Information
1. Name: 'r S E I l iTA6 2.Phone: 131�aL�a I31`1 I 3�
3. Mailing Address: a.Street: IS 19 4y I IC I^U=5I—k r II- I t ItJit IAI Y I.SI"i:z i V-i ErnI I I I I I I I
b.City: IGIRI CIF-I f I Sl�p I I[of I I I I I I I I I I _j c.State: [gLCJ d.Zip Cade: jai]IL 10 1 S- I I I I I
B. Facility/Site Location Information
1.Facility Name: IM1 I�r'IfZI fi&L I tl tl r,. 6,
2.a. Street Address: ITD919 I 11FASrET I L4 finSAhl I;M1_f<1f4E7
b. City: Cj RI'EIF-0151 ad IRI OI I I I I I I I I I I I I ] c.County: I y I i I t1 Ft al RA") I j
d.State: L� a.zip Code: L1am24;d1�1-I I I I I
3. Is the facility located on Indian Lands? Yes No
Ysj
4. Is this a Federal facility? Yes No I
,m v
5.a.Latitude: I��J �5J c} ( b. Longitude: I 1fT6 1 0 IGI V�1 " le+z Innj
ID C iJULf
6. a.Was the facility or site previously covered underan NPDES storm water permit? Yes No
b. If yes,enter f1PDES permit number: IV GG 0-03 S a �_& `
7.SIC/Activity Codes: Primary: `l Seconds if applicable): �X cmD �f
B.Total size of site associated with industrial activity: acres JD
��
9.a.Have you paved or roofed over a formerly exposed,pervious area in order to qualify for the no exposure exclusion? � Rexposure
r [b. If yes,please indicate approximately how much area was paved or roofed over. Completing this question does not disqualify you•foclht.
exclusion, However,your permitting authority may use this information in considering whether storm water discharges from your site are likely to have
an adverse impact on water quality,in which case you could be required to obtain permit coverage.
Less than one acre ❑ One to five acres ❑ More than five acres
EPA Form 3510-11 (10-99) Page 1 of 4

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NPDES �, NO EXPOSURE CERTIFICATION for Exclusion from Form Approved
FORM �-,EPA OMB No.2040-0211
3510-11 NPDES Storm Water Permitting
C. Exposure Checklist
Are any of the following materials or activities exposed to precipitation,now or in the foreseeable future?
(Please check either"Yes"or"No"in the appropriate box.) If you answer"Yes"to any of these questions
(1)through(11),you are not eligible for the no exposure exclusion.
Yes No
1, 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 storm water
2, Materials or residuals on the ground or in storm water inlets from spills/leaks
3. Materials or products from past industrial activity ❑ 91
4. Material handling equipment(except adequately maintained vehicles) ❑
5. Materials or products during loading/unloading or scnsperting activities ❑• S
6. Materials or products stored outdoors(except final products intended for outside use[e.g.,new cars]where ❑
exposure to storm water does not result in the discharge of pollutants)
7, Materials contained in open,deteriorated or leaking storage drums,barrels,tanks,and similar containers
8. Materials or products handled/stored on roads or railways owned or maintained by the discharger
9. Waste material(except waste in covered,non-leaking containers(e.g.,dumpsters])
10. Application or disposal of process wastewater(unless otherwise permitted) LJ
11. 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 storm water outflow
D. Certification Statement
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 storm water permitting.
I certify under penalty of law that there are no discharges of storm water 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 submit a no exposure certification form once every five years to the NPDES permitting authority and,if requested,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 NPDES permitting authority,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 that I must obtain coverage under an NPDES permit prior
to any point source discharge of storm water 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.
Print Name: I r ih I D I MI A is 11 OI 1?I 91 /I I I t I Yl I I I I I I I I I I I I I I I I I I _
Print Title: ISIA091016#1 lAAVL/lRl6lFjzt
Signature:
Date: 10 1 b 1112 1016
EPA Form 3510-11 (10-99)

RECEIygp Michael F,Easley,Governor
�i i
C of ENR Wiiiiam G.Ross Jr.,Secretary
SPNorth Carolina Department of Environment and Natural Resources
16
Q �[ `7 Alan W.Klimek,P.E.Director
nvtonsalem Division of Water Quality
Reglonar office
September 14, 2005
Mr. Thomas O'Reilly
Matrex Seating
899 E. Lindsay St.
Greensboro,NC 27405
Subject: General Permit No. NCGO50000
Matrex Seating
COC No. NCG050337
Guilford County
Dear Mr. O'Reilly:
In accordance with your application for a discharge permit received on March 3,2005 we
are forwarding herewith the subject certificate of coverage (COC) to discharge under the subject
state—NPDES general permit. This permit is issued pursuant to the requirements of North
Carolina General Statute 143-215.1 and the Memorandum of Agreement between North Carolina
and the US Environmental Protection Agency dated May 9, 1994 (or as subsequently amended).
If any parts, measurement frequencies, or sampling requirements contained in this permit
are unacceptable to you, you have the right to request an individual permit by submitting an
individual permit application. Unless such demand is made,this certificate of coverage shall be
final and binding.
Please take notice that this certificate of coverage is not transferable except after notice to
the Division of Water Quality. The Division of Water Quality may require modification or
revocation and reissuance of the certificate of coverage. This permit does not affect the legal
requirements to obtain other permits which may be required by the Division of Water Quality or
permits required by the Division of Land Resources, Coastal Area Management Act or any other .
federal or local governmental permit that may be required-
If you have any questions concerning this permit please contact Aisha Lau at telephone
number(919) 733-5083 ext. 578.
Sincerely,
INL SIGNED BY
"PADLEY BENNETT
A11lan W. Klimek, P.E.
cc: ' Winston-Salem Regional Office
Central Files
Stormwater Permitting Unit Files
Attachments
NNao Carolina
turally
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh,NC 27699-1617 Phone[phone] Customer Service
Internet. h2o.enr.state.nc.us 512 N. Salisbury St. Raleigh,NC 27604 FAX [phone] 1-877-623-6748
An Equal OpportunitylAlfirmaliYe Action Employer—50%Recycled110%Post Consumer Paper

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STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG050000
CERTIFICATE OF COVERAGE No. NCG050337
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act,as amended,
Matrex Seating
is hereby authorized to discharge stormwater from a facility located at
Matrex Seating
899 East Lindsay Street
Greensboro
Guilford County
to receiving waters designated as the Greensboro municipal storm sewer system to Muddy Creek, a class C,NSW
stream in the Cape Fear River Basin in accordance with the effluent limitations, monitoring requirements, and other
conditions set forth in Parts 1,I1, 111,IV,V and VI of General Permit No.NCG050000 as attached.
This Certificate of Coverage shall become effective September 14,2005.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day September 14, 2005.
ORIGINAL SIGNED BY
BRADLEY SENNETT
Alan W. Klimek,P.E. Director
Division of Water Quality
By Authority of the Environmental Management Commission

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