NCGNE0292_COMPLETE FILE - HISTORICAL_20081107

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
� V
DOC TYPE HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE ❑ �OUtS I O
YYYYMMDD

FW A TF Michael F.Fasley,Governor
William G.Ross Jr.,Secretary
North Carolina Department of Environment and Natural Resources
Coleen H.Sullins,Director
p Division of Water Quality
November 7, 2008
Mr. Joe McGowan
Harvest Time Bread Company
501 Mountain View Lane
Mount Airy, NC 27030
Subject: Ownership Change
No Exposure Certification NCGNE0292
Harvest Time Bread Co. of NC
Formerly Gerard's Bakery, LLC
501 Mountain View Lane, Mount Airy, NC
Surry County
Dear Mr. McGowan:
The Division has reviewed your submittal of the permit name/ownership change form for your No-Exposure
Certification, which we received on August 10, 2008. Division personnel have reviewed and approved your
request to change coverage under your Certificate of No-Exposure.
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 on May 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 [phone], or at
[e-mail].
Sincerely,
for Coieen H. Sullins
cc: Winston-Salem Regional Office Central Files—wlattachments
Stormwater Permitting Unit Files
N.C.Division of Water Quality 1617 Mail Service Center Raleigh,North Carolina 27699-1617 [phone] Customer Service
1-877-623-6748

,V A rr, Michael F.Easley,Governur
~ Williarn G.Ross Jr.,secretary
North Carolina Department of Environment and Natural Resources
G' Alan W.Klimek.P.E.Director
Division or Water Quality
:SURFACE WATER PROTECTION SECTION
PERMIT:NAME/OWNERSHIP CHANGE FORM
1. Please enter the permit number for which the change is requested.
NPDES Pen-nit (or) Certificate of Coverage
N I C N I C I G N I E 10 12 19 12
11. Permit status prior to status change.
a. Permit issued to(company name): GERARD'S BAKERY, LLC
b. Person legally responsible for permit: JOE McGOWAN
First I MI I Last
PLANT MANAGER
'ritic
501 MOUNTAIN VIEW LANE
Permit holder Mailing Address
MOUNT AIRY, NC 27030
City State Zip
(336 ) 789-3245 (336 ) 789-7635
Phonc Fax
c. Facility name(discharge): GERARD'S BAKERY, LLC-MT AIRY PLANT
d. Facility address: 501 MOUNTAIN VIEW LANE
Address
MOUNT AIRY, NC 27030
City State Zip
e. Facility contact person: TIM VAN ERSTVELDE (336 ) 789-3245
First / M1 / Last Phone
111. Please provide the following for the request change(revised permit).
a, Request for change is a result of: —/Change in ownership of the facility
.I r Namc change of the facility or owner
If other please explain:
b. Permit issued to(company name): HARVEST TIME BREAD COMPANY
c. Person legally responsible for permit: JOE McGOWAN
First / MI / Last
PLANT MANAGER
Title
501 MOUNTAIN VIEW LANE
Permit Holder Mailing Address
MOUNT AIRY, NC 27030
City Statc Zip
( 336) 789-3245 [e-mail]
Phone T-mail Address
d. Facility name(discharge): HARVEST TIME BREAD COMPANY OF NC, LLC
e. Facility address: 501 MOUNTAIN VIEW LANE
Address
MOUNT AIRY, NC 27030
City State Zip
f. Facility contact person: TIM VAN ERSTVELDE
First I MI / bast
(336 ) 789-3245 [e-mail]
Phone E-mail Address
Revised 7/2005

PERMIT NAME/OWNERSHIP CHANGE FORM
Page 2 of 2
IV. Permit contact information: (if different from the person legally responsible for the permit)
Permit contact: SAME
First / MI / Last
Title
Mailing Address
City State Zip
(
Phonc E-mail Address
V. Will the permitted facility continue to conduct the same industrial activities conducted prior to
this ownership or name change?
z Yes
❑ No(please explain)
VI. Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS ARE
INCOMPLETE OR MISSING.
aLhis completed application is required for both name change and/or ownership change requests.
egal documentation of the transfer of ownership (such as relevant pages of a contract deed, or a bill
of sale) is required for an ownership change request. Articles of incorporation are not sufficient for
an ownership change.
...................................................................................................
The certifications below must be completed and signed by both the permit holder prior to the change, and the new
applicant in the case of an ownership change request. For a name change request,the signed Applicant's Certification
is sufficient.
PERMITTEF.CERTIFICATION(Permit holderprior to ownership change):
1, , attest that this application for a name/ownership
change has been reviewed and is accurate and complete to the best of my knowledge. 1 understand that if all required
parts of this application are not completed and that if all required supporting information is not included, this
application package will be returned as incomplete.
Signature Date
APPLICANT CERTIFICATION:
c
1, / attest that this application for a name/ownership
change has been reviewed and is accurate and complete to the best of my knowledge. I understand that if all required
parts of this application are not completed and that if all required supporting information is not included, this
application package will be returned as incornpletc.
t —46i
Signature Date
...................
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Division of Water Quality
Surface Water Protection Section
1617 Mail Service Center
Raleigh,North Carolina 27699-1617
Revised 7/2005

Harvest Time Bread of North Carolina, LLC
501 Mountain View Lane
Mt. Airy, NC 27030
August 7, 2008 AUG
Division of Water Quality j uuu
GUA �!Surface Water Protection Section --� tfl,%N.7';,
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
RE: CHANGE OF OWNERSHIP AND NAME REQUEST
HARVEST TIME BREAD OF NORTH CAROLINA, LLC ,
CERTIFICATE OF COVERAGE NCGNE0292
Dear Sir or Madame:
In a letter dated June 23, 2006, Alan Klimek of DWQ provided Gerard's Bakery, LLC - Mt.
Airy Plant a No-Exposure Certification for Exclusion from NPDES for Storm Water Dis-
charge. On July 24, 2008, Gerard's Bakery, LLC closed two of its plants located in
Longmont, Colorado and Livermore, California pending possible bankruptcy proceed-
ings. The third plant, located in Mount Airy, North Carolina has been leased to Harvest
Time Bread of North Carolina, LLC and will operate as Harvest Time Bread of North
Carolina, LLC.
The Mount Airy Plant will continue to operate as a commercial bakery and continues to
qualify for the No-Exposure Certification for storm water discharge.
Attached to this letter you will a completed Surface Water Protection Section's Permit
Name/Ownership Change Form. Please note that because the change is recent, some
legal documents requested in Section VI may not be available.
You may address any questions you have either to me or Tim Van Erstvelde. We both
may be reached at [phone].
Sincerely yours,
�C 1,6`
Joe McGowan 4
Plant Manager
Attachment

1 :i�j�R
� � -�., e
.-' ._J

HARVEST TIME BREAD OF NORTH CAROLINA, LLC
c/o Harvest Time Bread Company
One Amboy Avenue
Woodbridge,New Jersey 07095
August 7, 2008
Division of Water Quality
Surface Water Protection Section
1617 Mail Service Center
Raleigh,North Carolina 27699-1617
Dear Sir or Madame:
As you may have heard in news reports, it is our understanding that on July 24,2008,
Gerard's Bakery LI,C ceased all of its operations and terminated all of its employees. Harvest
Time Bread of North Carolina, LLC ("Harvest Time"),which is not affiliated with Gerard's,
leased Gerard's Mt Airy,N.C. manufacturing facility and will be operating the plant for its own
account starting July 25th.
If you have claims against Gerard's you will need to pursue those claims against that
company. Going forward, Harvest Time will be purchasing inventory and manufacturing
products out of the Mt. Airy facility for its own account. Operating expenses of the Mt. Airy
facility starting July 25,2008 are the responsibility of Harvest Time. While customer orders
placed before July 25th are not the responsibility of Harvest Time,we intend to purchase
Gerard's inventory located at the Mt. Airy facility, and will be endeavoring to make
arrangements to fulfill such existing customers to the extent desired.
Please be aware that any trade liabilities or other operating expenses of the Mt. Airy plant
through July 24, 2008 have not been assumed by Harvest Time and remain the sole obligation of
Gerard's.
Sincerely,
HARVEST TIME BREAD OF NORTH
CAROLINA 7
By:1/109
Icy J. Il�er -
Sr. Vice President
3653682 2.f)OC

W A TF Michael F.Easley,Govemor
`O�O 9p+!i William G.Ross Jr.,Secretary
North Carolina Department of Environment and Natural Resources
Coleen H,Sullins,Director
p Division of Water Quality
November 7, 2008
Mr. Joe McGowan
Harvest Time Bread Company
501 Mountain View Lane
Mount Airy, NC 27030
Subject: Ownership Change
No Exposure Certification NCGNE0292 .
Harvest Time Bread Co. of NC
Formerly Gerard's Bakery, LLC
501 Mountain View Lane, Mount Airy, NC
Surry County
Dear Mr, McGowan:
The Division has reviewed your submittal of the permit name/ownership change form for your No-Exposure
Certification, which we received on August 10, 2008. Division personnel have reviewed and approved your
request to change coverage under your Certificate of No-Exposure.
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 on May 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 [phone], or at
[e-mail].
Sincerely,
ORIGINAL SIGNED BY
KEN PICKLE
for Coleen H. Sullins
cc: Winston-Salem Regional Office Central Files—wlattachments
Stormwater Permitting Unit Files
6ENR
N.C.Division of water Quality 1617 Mail Service Center Raleigh,North Carolina 27699-1617 [phone] Customer Service
1-877-623-6748

(C \J f A 7'F Michael F.Easley,Govemor
William G.Ross Jr.,Secretary
North Carolina Department of Environment and Natural Resources
Alan W.Klimek,P.E.Director
> Division of Water Quality
Coleen H.Sullins,Deputy Director
Divisionof Water Quality
June 23, 2006 - --,
N.0 nary .
Mr. Joe McGowan
Gerard's Bakery, LLC ,UN 2006
501 Mountain View Lane Regional Office
Regional efitice
Mount Airy, NC 27030-8396
Subject: No Exposure Certification NCGNE0292
Gerard's Bakery, LLC
501 Mountain View Lane, Mount Airy, NC
Surry County
Dear Mr. McGowan:
The Division has reviewed your submittal of the No-Exposure Certification for Exclusion from NPDES
Stormwater Permitting form, which we received on June 13, 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.
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 (May 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
NL�7ENR
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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All rights reserved. Use Subject to License/Copyright
This map is informational only. No representation is made or warranty given as to its content. User assumes all risk
of use. MapQuest and its suppliers assume no responsibility for any loss or delay resulting from such use.
http:llwww.mapquest.com/maps/map.adp?formtype=address&addtohistory=&address=%5... 6/22/2006

r FIW A rk Michael F,Easley,Governor
`O�� 9QG William G.Ross Jr.,Secretary
North Carolina Department of Environment and Natural Resources
Alan W.Klimek,P.E.Director
Division of Water Quality
Q -� Coleen H.Sullins,Deputy Director
Division of Water Quality
June 23, 2006
Mr. Joe McGowan
Gerard's Bakery, LLC
501 Mountain View Lane
Mount Airy, NC 27030-8396
Subject: No Exposure Certification NCGNE0292
Gerard's Bakery, LLC
501 Mountain View Lane, Mount Airy, NC
Surry County
Dear Mr. McGowan:
The Division has reviewed your submittal of the No-Exposure Certification for Exclusion from NPDES
Stormwater Permitting form, which we received on June 13, 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.
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 (May 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,
4,J PD
for Alan W. Klimek, P.E.
cc: Winston-Salem Regional Office Central Files—w/attachments
Stormwater Permitting Unit Files
V"
fJL6'ENR
N.C.Division of Water Quality 1617 Mail Service Center Raleigh,North Carolina 27699-1617 [phone] Customer Service
1-877-623-6748

Map of[100-199] Mountain View Dr Mount Airy,NC by MapQuest Page 1 of l
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All rights reserved. Use Sub}ect to License/Copyright
This map is informational only. No representation is made or warranty given as to its content. User assumes all risk
of use. MapQuest and its suppliers assume no responsibility for any loss or delay resulting from such use.
hitp://www.mapquest.com/maps/map.adp?formtype=address&addtohistory=&address=%5... 6/22/2006

Form Approved
United States Environmental Protection Agency OMB No.2040-0211
NPDES a<1 Washington,DC 20460
FORM
351 Q-11 `•r'Epq NO EXPOSURE CERTIFICATION for Exclusion from
NPDES Storm Water Permitting
Submission of this No Exposure Certification constitutes notice that the entity identified inSection 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,andlor 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 fallowing 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 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,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.
Debited instructions for completing this form and obtaining the no exposure exclusion are provided on pages 3 and 4.
A. Facility Operator Information
1,Name: 16 1 E if IA19101 '151 .ISIRIKii19iJ I I ILILICi I I I I I I I I 12.Phone: 1313 I)o1�1�1�131�I�IS1
3. Mailing Address: a.Street: l�I61I1 I0IIa1ttIN11'AI11N1 I4I11ENl ILIAIN1E1 I I I I I I I I 1 1
b.City: I jA 10 I IA I lu I;I I fA 11 1�I j 1 I I I I I I Jill I I c,State: I d.Zip Code: I a 1­7 I d 13 I U I—I g 13 19 1 6 1
8. FacilltylSlte Location Information
1.FacilityNamw IGiEiRAIZA' i�i igiRiKitlAil1—AiT 1 Al iklll iPiLiAiNtrl I
2.a.Street Address: ISI6111 ImlQl)LINITIAII INI I� l ) Ii -IWl LIIME) i i l I I I I I I
b.City: IM161LkIHIT1 I A I I Iglyl I I I I L j j l 1 1 1 1 1 c.County: 1S41RANI I I I I
d.State: INIC-1 e.zip Code: I Z t j la l3 1 U 1—1 21 �19 161
3.Is the facility located on Indian Lands? Yes ❑ No
LAO
4.Is this a Federal facility? Yes ❑ No
5.a.Latitude: LILO "ad] I I L F
b.Longitude: i! j O I�j o I i o i I T 1 'r"
6.a.Was the facility or site previously covered under an NPDES storm water permit? Yes ❑ No
b. If yes,enter NPDES permit number:
7.SICIActMty Codes: Primary: I I 10 1 S I Secondary(if applicable): I t _t t I
8.Total size of site associated with industrial activity: lb, -Y acres
9.a.Have you paved or roofed over a formerly exposed,pervious area in order to qualify for the no exposure exclusion? Yes ❑ No
b. If yes,please indicate approximately how much area was paved or roofed over. Completing this question does not disqualify you for the no exposure
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

NPDES �, NO EXPOSURE CERTIFICATION for Exclusion from Form Approved
FORM OMB 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.) tf 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 Q
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 ❑ ❑X
4. Material handling equipment(except adequately maintained vehicles)
5. Materials or products during loadinglunloading or transporting activities ❑
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 awned 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)
11, Particulate matter or visible deposits of residuals from roof stacks and/or vents not otherwise regulated El Y
(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 10 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.IIbIEI I1 iciaingiAiNi I I 1 I__1 11 I I I I I. .I. 1 i .LI i I i i
Print Title: IPILIAINITI IMlAftal&lElR4 I I I ll l_ II I II I 1__1 1- 1 1 1 I_I
Signature: _ a�d"f✓ GY.�Li/'`�
Date: Id 1AA ZIa1.4
oe_
EPA Form 3510-11(14-99) Pa
0 V
7"