NCGNE0304_COMPLETE FILE - HISTORICAL_20061114

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO. /V CCU NF030y
DOC TYPE VHISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE ❑ �UUI� I�
YYYYMMDD

f,q Michael F.Easley,Governor
`O�O 9OG William G.Ross Jr.,Secretary
North Carol ina Department of Environment and Natural Resources
Alan W.Klimek,P.E.Director
Division of Water Quality
p C Coleen H.Sullins,Deputy Director
Division of Water Quality
November 13, 2006 RECEIVED
N.C.Dept.of ENR
Ms. Bessie Williams 1 NOV !96
Dell, Inc. Winston-Salem
3200 Temple School Regional Office
Winston-Salem, NC 27107
Subject: No Exposure Certification NCGNE0304
Dell, Inc.
3200 Temple School Road
Forsyth County
Dear Ms. Williams:
The Division has reviewed your submittal of the No-Exposure Certification for Exclusion from NPDES
Stormwater Permitting form, which we received on September 19, 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(October 31, 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 [e-mail].
Sincerely,
ORIGINAL SIGNED BY
KEN FICKLE
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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F WA Michael R Easley,Governor
`O�� R pG William G.Ross Jr.,Secretary
North Carolina Department of Environment and Natural Resources
7 Alan W.Klimek,P.E.Director
Division of Water Quality
Coleen H.Sullins,Deputy Director
Division of Water Quality
November 13, 2006
Ms. Bessie Williams
Dell, Inc.
3200 Temple School
Winston-Salem, NC 27107
Subject: No Exposure Certification NCGNE0304.
Dell, Inc.
3200 Temple School Road
Forsyth County
Dear Ms.Williams:
The Division has reviewed your submittal of the No-Exposure Certification for Exclusion from NPDES
Stormwater Permitting form, which we received on September 19, 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 (October 31, 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], 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
&M
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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Copyright(C)1998,Maptech,Inc,

VE Cert
Subject:NE Cert
From:Rose Pruitt<Rose.Pruitt©ncmai1.net>
Date:Thu,26 Oct 2006 14:31:33-0400
To:Sarah Young<[e-mail]>
Hi Sarah
Corey asked me to email you with my recommendations for NE Cert for the following facilities.
Dell NCGNE0304-OK to issue.
Recycle America NCG 130005 -Not recommened for NE Cert. Exposed piles of materials. See attached pics
Rose Pruitt
NC DENR Winston-Salem Regional Office
Division of Water Quality, Water Quality Section
585 Waughtown Street
Winston-Salem, NC 27107 '
Voice: [phone]
FAX: [phone]
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United States Environmental Protection Agency
Form Approved
g Y �€vu 040 0211
NPDES A Washington, DC 20460 � t�
FORM EPA
NO EXPOSURE CERTIFICATION for Exclusion
3510-11 NPDES Storm Water Permitting zQQQ
Submission of this No Exposure Certification constitutes notice that the entity identified in Section A does not require perm�itiauthorization for its storm wat r
discharges associated with industrial activity in the State identified in Section B under EPA's Storm Water Multi-Sector eG�`n`eral-PLrmit due t3-.tl =axis e
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 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 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.
Detailed instructions for completing this form and obtaining the no exposure exclusion are provided on pages 3 and 4.
A. Facility Operator Informations
1. Name: Pell)11 I Ilr Icl • l 11 I I II I I I I I I I I I I II 1 1 2.Phone: 13,3,61213,1101111,1�
3. Mailing Address: a.Street: 13,210101 ITllel"l��pppllq ISl`-��--++hggll IpNn` cl 4 1 1 1 I, I I II I
b.City W i S t _ S 1 �V
c.State: IUI d.Zip Code: 2227 10 I�7 -
13. Facility/Site Location Information
1. Facility Name: ptelllll I IInIC1 • I 1 1 1 1 1 1 i 1 1 1 1 I 1 1 1 1 f 1 1 1
2.a. Street Address: 3 2 0 0 T e p l leS c 1
b. City: W 1 s t 0 - S �17 e �7 c.County: IFIOirlslYlt .-1 1 1
d.State: RC- e.Zip Code: 2 / 1 / - �
3. Is the facility located on Indian Lands? Yes ❑ Im
No ❑✓
LJ FJI J
4. Is this a Federal facility? Yes ❑ H f I�Na © � , � ^.
5. a. Latitude: 3L61 OL3i L3 1 b. Longitude: 1_18i 0�31 3]81 >rn
6.a.Was the facility or site previously covered under an NPDES storm water permit? Yes ❑ No ❑✓ If X ✓
> ^�
b. If yes,enter NPDES permit number: m c
7.SIC/Activity Codes: Primary: �1517 il Secondary(if applicable): I I I I � g
8.Total size of site associated with industrial activity: _'-1-8J—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 Farm 3510-11 (10-99) , /�j,�� /1'1 (OS
� �� Page 1 of 4

14PDES NO EXPOSURE CERTIFICATION for Exclusion from Form Approved
FORM �r,EPA OMB No.2040-0211
3510-17 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 spill0eaks �✓
3. Materials or products from past industrial activity �✓
4. Material handling equipment(except adequately maintained vehicles) Q
5. Materials or products during loading/unloading 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 handledistored on roads or railways owned or maintained by the discharger
9. Waste material(except waste in covered,non-leaking containers[e.g.,dumpsters]) 0✓
10. Application or disposal of process wastewater(unless otherwise permitted) Z
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
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: ge,ccgig w u a p cI Print Title: i 0 I S r
Signature: APA.4 I 1z
Date: V,1 10
EPA Form 3510-11 (10-99) Page 2 of 4

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Copyright(C)1998.Maptech,Inc.

4
ECS CAROLINAS, LLP
Geotechnicai • Construction Materials • Environmental
CAROLiNAS .
.1uly 20, 2006
Storm Water No Exposure Certification (4203)
USEPA
401 M Street, SW
Washington, DC 20406
Subject: Dell, Inc.
3200 Temple School Road
Winston-Salem,NC
Dear Sir or Madam:
In the interest of maintaining an atmosphere of trust and fostering future business relationships
with Dell this letter is an addendum to the previous letter dated October 27, 2005 with the
enclosed NO EXPOSURE CERTIFICATION for Exclusion from National Pollutant Elimination
System (NPDES) Storm Water Permitting,NPDES FORM 3510-11.
Specifically, the contact information contained has now been changed. Mr. George Kalfayan,
Senior Environmental and Health and Safety Manager, has now been replaced by Ms. Bessie
Williams, Senior Environmental and Health and Safety Manager. She is now listed as the contact
for the enclosed information. If you have any questions please contact Brian'Maas, ECS
Carolinas, LLP at 336.856.7150.
Sincerely,
Brian E. Maas, REM Clint Adamkavicius
Principal Scientist Staff Engineer
Branch Manager
4811 Koger Boulevard • Greensboro, NC 27407 * [phone] • Fax [phone]

i
ENGINEERING CONSULTING SERVICES, LTD.
0
Geotechnical • Construction Materials • Environmental
October 27, 2005
Storm Water No Exposure Certification (4203)
USEPA
401 M Street, SW
Washington, D.C. 20460
Subject: Dell, Inc.
3200 Temple School Road
Winston-Salem,NC
Dear Sir or Madam:
Please find enclosed the NO EXPOSURE CERTIFICATION for Exclusion from
National Pollutant Discharge Elimination System (NPDES) Storm Water Permitting,
NPDES FORM 3510-11.
Dell meets the conditions and provisions to obtain an Exclusion from NPDES Storm
Water Permitting. By signing and submitting this No Exposure Certification form, the
Dell, Inc, Winston-Salem,NC is certifying that a condition of no exposure exists at its
facility and site, and is obligated to comply with the terms and conditions of 40 CFR
122.26(g)•
If there are any comments or questions,please contact Mr. George Kalfayan, Senior
Environmental and Health and Safety Manager at the contact information contained on
the enclosed form or C. R. Newman, Engineering Consulting Services, at 336.956.7150.
Sincerely,
C. R. Newman
Principal
6909 International Drive, Suite 103 • Greensboro, NC 27409 • [phone] • Fax [phone]

' -orrn•Approved
United States Environmental Protection Agency {�OM I,ON� D40-0211,
NPDES A Washington, DC 20460 tJ L_ L1 U LS
FORM �' E
�� NO EXPOSURE CERTIFICATION for Exclusion from
3510-11 ®�
NPDES Storm Water Permitting jUk JUL 2 5 2006
Submission of this No Exposure Certification constitutes notice that the entity identified in Section A does not require permi L'guthorization for its storm water
discharges associated with industrial activity in the State identified in Section B under EPA's Storm Water Multi-Sector GeneraFPermtt"tlC t? thtri�Risti=n
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 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.add ition,.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.
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: �IEI�1 I1 ioTlr1,G • 1 } }, I I ImmIppI ll I, II I I�+IhI I I I IppI 1 1 2. Phone: 13,3,6i 21311i 0111111�
3. Mailing Address: a.Street: 13,21010, 1TjIel`�11�'1,eI ISlci�ggll t14piai(Ji I I I II I II I
b.City. J lilnlSltIQ11—ISIalllElM I I I I I I I i j c.State: NQ d.Zip Code: 2 /ry 1 7 —
B. Facility/Site Location Information
1. Facility Name: �)iE1LIL1 JAC, . , I I I I I Ih I f I I IRD l I I I I I I I I �
2.a. Street Address: 131210101 ITIeI" pIi,el ISlcll)0,0,1, 1p,iC)0 I I I I I I I I
b.City: j IiiniSIt,o, i—,Si411e,M I I I I I I I I I c.County: Flqrgw,, NTT
�7 a
d.State: � e.Zip Code: L21 !I l l OI /�7 I—I I I I 1 ��
3. Is the facility located on Indian Lands? Yes ❑ No ❑✓
4. Is this a Federal facility? Yes❑ No © p
j yv
5.a. Latitude: �6 0.l3� - b. Longitude: ❑Io1IO uJ L7 J� LQ 'ry �d
6.a.Was the facility or site previously covered under an NPDES storm water permit? Yes ❑ No ❑� a rn �f
b. If yes,enter NPDES permit number: Z a
7. SICIActiv4 Codes: Primary: X57 1 Secondary(if applicable):1 I t I
8.Total size of site associated with industrial activity: 8 9 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
�OE—, ' XC_
� ��-

C�
NffDES A Form Approved
FORM ,EPA NO EXPOSURE CERTIFICATION for Exclusion from OMB No.2oao-o211
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 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
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 owned or maintained by the discharger Wl
9. Waste material(except waste in covered,non-leaking containers[e.g.,dumpsters])
10. Application or disposal of process wastewater(unless otherwise permitted) 21
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
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: lqqq r
��rr,, M P
Print Title: {' 'I"1� 111"I�I 1�4 I` 1� ���'I�I I I I I I I I I i I I I 11 {
Signature:
Date;
EPA Form 3510-11 (10-99) Page 2 of 4

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---- __ Firm AQproved
United States Environmental Protection Agency - r � pMgiNo:2on0
NPDES Washington',DC 20460 °j! f In ire, ij 'u
FORM
3590-11 I,�' ,EPA NO EXPOSURE CERTIFICATION for Exclusion fr m i
f+ JUL 2 5
NPDES Storm Water Permitting t.i 2006 b`
Submission of this No Exposure Certification constitutes notice that the entity identified in Section A does not require pe eh,It
for its storm wat r
discharges associated with industrial activity in the State identified in Section B under EPA's Storm Water Multi-Sector ener '
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,and/or 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 outfal Is. 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-: Pei 11 1 lI C] • mp�p p �-+h n �3na 2.Phone: 1-313.6�2 31��I1�1,1i
3.Mailing Address: a.Street: 131210101 ITjgrgL 1,(Et I_5g1 Igg1I i�`f`'I`^I� I I I I�7I I(�I I
b.CY.. IWjijjS1tloLx�JS1a,l,em I i_ i 1 I I I I 1 c.State: � d.Zip Code: 121 II10 I!-1 1 _1 1 1
B. Facility/Site Location Information
1,Facility Name: Piell ill I Ilr a cl�•1 I 1 I l I I I I 1 1 I I ! I I I I I I I
2.a.SVeetAdrrdr77ess: 131210101 I[l�lel�'91p 1,t jSlclj ,aall , iRg44 I I l 1 L_1 I I I
b.City: Iy AASX101i�1—ISI�lI�"1�7I I I I I I I I I I c.County: FIoIrls�lt 11 I
d.State: � e.Zip Code: 121 / l0i /t-I I I I --------""
3.Is the facility located on Indian Lands? Yes❑ No ❑✓ m
Z owl
� m
4. Is this a Federal facility? Yes❑ No M0
5.a.Latitude: W W 0111" b.Longitude: 18 0�• 1031 3,81
M
6.a.Was the facility of site previously covered under an NPDES storm water permit? Yes ❑ No ❑✓ ' � I
b. If yes.enter NPDES permit number. f m
7.SICIActivity Codes: Primary: �l Secondary(if applicable): 1 1 l 1 1
8,Total size of site associated with industrial activity: I-B-9 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 fur 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) ,���/,r� /1'1� �c /'1[ �r Page 1 of 4

NPDES NO EXPOSURE CERTIFICATION for Exclusion from Form Approved
FORM ts,EPA OMB No.2044-021 i
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 stone water
2. Materials or residuals on the ground or in storm water inlets from spillsAeaks El Q✓
3. Materials or products from past industrial activity 2
4. Material handling equipment(except adequately maintained vehicles) El 0
5. Materials or products during loadingfunloading or transporting activities El ❑✓
6, Materials or products stored outdoors(except final products intended for outside use[e.g.,new cars]where El 0
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 El ✓❑
9. Waste material(except waste in covered,non-leaking containers[e.g.,dumpstersl) ❑ ❑✓
10. Application or disposal of process wastewater(unless otherwise permitted)
11. Particulate matter or visible deposits of residuals from root stacks andlor vents not otherwise regulated ✓�
(i.e.,under an air quality control permit)and evident in the storm water outflow
D. Certification Statement
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 M54,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 Use information,including the possibility
of fine and imprisonment for knowing violations.
Print Name: � gs:is iiiq lyY1i1-:Liii4M E; 11 I 1 1 1 I_ 1 1 l t I I I III
Print Title: S ' o r S r
Signature:
Date: loll a
EPA Form 3510-11(10-99) Page 2 of 4

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Division of Water Quality
n Division of Soil and Water Conservation
❑ Other Agency
Facility Number: Facility Status: Active Permit: NCGNE0304 ❑ Denied Access
Inspection Type: Stormwater Inactive or Closed Date:
Reason for Visit: Routine County: Forsyth Region: Winston-Salem
Date of Visit: 10/25/2006 Entry Time:12.50 PM Exit Time:01.00 PM Incident#:
Farm Name: Dell, Inc. Owner Email:
Owner: Dell Inc Phone: [phone]
Mailing Address: 3200 Temple S-choQ_Rd Winston Salem NC 27107
Physical Address: 3200 Temple School Rd Winston Salem NC 27107
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm: Latitude: 36°03'31" Longitude: 80'07'38"
Question Areas:
Other Issues
Certified Operator: Operator Certification Number:
Secondary OIC(s):
On-Site Representative(s): Name Title Phone
Primary Inspector: Rose Prujtt Phone:
Inspector Signature: Date: /
Secondary Inspector(s):
Inspection Summary:
Inspector visited site 10/25/2006 between 12:50 pm and 1 pm to evaluate the facility request for no exposure certification. At the time
of the inspection there was no indication of industrial materials or activity exposure to stormwater. The inspector has no objections to
the No Exposure certification being issued for this facility.
Noted the presence of a large number of deteriorating sandbags in the main parking area. They appeared to have been placed there
to prevent sediment from an undeveloped parcel of the facility from entering stormdrains and/or a small pond below. The
undeveloped parcel showed signs of erosion and sediment loss. vegetative cover was not well established.
Page: 1

Permit: NCGNE0304 Owner-Facility: Dell Inc Facility Number:
Inspection Date: 10/2512006 Inspection Type:Stormwater Reason for Visit: Routine
Other Issues Yes No NA NE
28. Were any additional problems noted which cause non-compliance of the Permit or CAWMP? n n n ❑
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report those n n ❑ n
mortality rates that exceed normal rates?
30.At the time of the inspection did the facility pose an air quality concern? If yes,contact a regional Air n n n n
Quality representative immediately.
31. Did the facility fail to notify regional DWQ of emergency situations as required by Permit? n n n n
32. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative? n n ❑ n
33. Does facility require a follow-up visit by same agency? 1=l ❑ ❑ n
Page. 2