NCGNE0584_COMPLETE FILE - HISTORICAL_20091009

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO. IV C& N C 0�29
DOC TYPE Q"HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE ❑ U I O U
YYYYMMDD

;'
NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
October 5, 2009
Hanesbrands, Inc
Tommy Thompson
1000 E Hanes Mill Rd
Winston Salem NC 27105
Subject: No-Exposure Certification NCGNE0584
Hanesbrands- Northridge Direct
531 Northridge Park Dr
Forsyth County
Dear Mr Thompson:
The Division has reviewed your submittal of the No-Exposure Certification for Exclusion from NPDES Stormwater
Permitting form. Based on your submittal and signed certification of no exposure at the above referenced facility, the
Division is granting your conditional exclusion from permitting 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 5, 2014). At that time you must re-certify with the Division, or
obtain NPDES permit coverage for any stormwater discharges from your facility.
Your conditional exclusion from permitting 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 Rose Pruitt at [phone].
4Steve
,
Tedder
Winston Salem Regional Supervisor
Surface Water Protection Section
cc: Winston Salem Regional Office
Central Files m O ��
Stormwater Permitting Unit, No-Exposure Files, Sarah Young
North Garaiina Division of Water Quality,Winston-Salem Regional Office Iti*
Location:585 Waughtown St Winston-Salem,North Carolina 27107 Phone:[phone] FAX:[phone] Customer Service:1-877-623-6748lntarnet:www.ncwaterguaii�.orq An Equal Opportunity 1 Affirmative Action Employer

NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
October 5, 2009
Hanesbrands, Inc
Tommy Thompson
1000 E Hanes Mill Rd
Winston Salem NC 27105
Subject: No-Exposure Certification NCGNE0584
Hanesbrands- Northridge Direct
531 Northridge Park Dr
Forsyth County
Dear Mr Thompson:
The Division has reviewed your submittal of the No-Exposure Certification for Exclusion from NPDES Stormwater
Permitting form. Based on your submittal and signed certification of no exposure at the above referenced facility, the
Division is granting your conditional exclusion from permitting 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 N PDES 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 5, 2014), At that time you must re-certify with the Division, or
obtain NPDES permit coverage for any stormwater discharges from your facility.
Your conditional exclusion from permitting 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 Rose Pruitt at [phone].
Sincere y,
Steve W. Tedder
Winston Salem Regional Supervisor
Surface Water Protection Section
cc: Winston Salem Regional Office
Central Files
Stormwater Permitting Unit, No-Exposure Files, Sarah Young
North Carolina Division of Water ouallty,Winston-Salem Regional office
Location:585 Waughtcwn St.Winston-Salem,North Carolina 27107 One
Phone:[phone] FAX:[phone] ti Customer Service:1-877-623-6148 NorthCarolina
Internet:www.ncwalerguality.org 'Jtj'atura//y
An Equal Opportunity 1 Affirmative Action Employer yLi `i "

® Division of Water Quality
n Division of Soil and Water Conservation
❑ Other Agency
Facility Number: Facility Status: Active Permit: NCGNE0584 ❑ Denied Access
Inspection Type: Comoliance Evaluation Inactive or Closed Date:
Reason for Visit: Routine County: Forsyth Region: Winston-Salem
Date of Visit: 02125/2009 Entry Time:1Q:30 AM Exit Time: 11-00 AM Incident#:
Farm Name: Northridge Direct Owner Email:
Owner: Hanesbrands Inc Phone: [phone]
Mailing Address: 5100 E manes Mill Rd __ _ _ Winston Salem NC 27105
Physical Address: 531 Northridge Park Dr Rural Hall NC.27045
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm: Latitude: Longitude:
Question Areas:
Certified Operator: Operator Certification Number:
Secondary OIC(s):
On-Site Representative(s): Name Title Phone
Primary Inspector: Rose Pruitt Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
evaluate for NE. Need to cover dumpsters and remove construction materials. will call to reinspect
Page: 1

Permit: NCGNE0584 Owner-Facility: Flanesbrands Inc Facility Number:
Inspection Date: 02/25/2009 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Page: 2

i000 E. Hanes Mill Road
Winston-Salem,NC 27105
336 918 7056 tel
HANEsbrandsINC
February 23, 2009
Stormwater Permitting Unit
Division of Water Quality
1617 Mail Service
Raleigh, NC 27699-1617
Re: No Exposure Certification for Exclusion
Dear Sirs and Madams:
Please find enclosed a completed No Exposure Certification for the 531 Northridge Distribution
Facility of Hanesbrands Inc.
Sincerely,
Don Brown i t� t
Environmental Manager ,{ ►P
Cc North Carolina Division of L:nvironmental and Natural Resources
Winston-Salem Regional Office
585 Waughtown Street
Winston-Salem, NC 27107
Attw Rose Pruitt
H I

FOR AGENCY USE ONLY
Al*'AF
Date Received
Division of Water Quality/Surface Water Protection Year Mnth Day
b Z
of ge
NCDEN' R National Pollutant Discharge Elimination Systern CertifieatIE101 1'
'ke
rn C.Ru-rw�C�ea.nrMert cx NO EXPOSURE CERTIFICATION for Exclusion N N E S
F.rvx�arrrrvr arm Naun.r.Rrsw�:�a
NCGNE0000
NO EXPOSURE CERTIFICATION Please check here if this is a renewal: D RENEWAL
National Pollutant Discharge Elimination System application for exclusion from a stormwater Permit
based on NO EXPOSURE:
Submission of this No Exposure Certification constitutes notice that your facility does not require permit
authorization for its 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,
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 with locked or non-operational taps or valves;
adequately maintained vehicles used in material handling;and final products, other than products that
would be mobilized in stormwater 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, 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).
You must re-apply for the No Exposure Exclusion once every five (5) years.
For questions,please contact the D WO Regional Office for your area. (See page 5)
(Please print or type)
1) Mailing address of owner/operator(address to which all certification correspondence will be mailed:
Name -F- 6-NE5 6 RA,NjS �J C-
Contact boo R R 0t,Ul�
Street Address le-2r20 E_ �-A N)F5 nA I L A-D
City W( N 5TotJ - -5,a, LP t"\ State KfG ZIP Code 27/0 S
Telephone I - -5-ig (O Fax: ,> (9 _�o S`
2) Location of facility producing discharge:
Facility Name No{Z-C`H K[ G-J7-- D I KE C.7—
Facility Contact M � L-1-,SS A- 5P kV LL
Street Address S-3 ! Isic iZTt R_11 D G--1r__
City �I�L ELA_LL_ State_AG,_ZIP Code 2,70�:4= S_
County FO (?-s y t+ _
Telephone No. 3 L _ 5- 9.7 6 . Fax: 3_ 3 6 — 4`3 O�-
Page 1 of 5
SWU-NE-060508 Last revised 06/05/2008

NCGNE0000 No Exposure Certification
3) Physical location information:
Please provide a narrative description of how to get to the facility (use street names, state road numbers, and
distance and direction from a roadway intersection). U S 32 NORT .T ice4 74-AJf
12v( L H--ALL RcA--T1 a-oC--a"p kjnrZ _i4 _rn .ZipvSTltc,gL QtR t,c o►✓ R6_7T
(A copy of a map with the facility clearly located on it should be included with the certification application.)
r 4) Is the facility located on Native American Lands? ❑ Yes INo
5) Is this a Federal facility? ❑ Yes `t<N0
6) Latitude Z^]�2-5—Longitude ,3 o 3 2-(deg., min., seconds)
7) This NPDES No Exposure Exclusion application applies to which of the following:
❑ New or Proposed Facility Date operation is to begin
Existing Date operation began 19 9 3
❑ Renewal of existing No Exposure Certification Certification No.: NCGNE
S) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes )(No
If yes, what is the NPDES Permit Number?
9) Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: Z 3 2 2
10) Provide a brief description of the types of industrial activities and products produced at this facility:
i 4 c c 4- t`ry f S A D( `F2 k 13v c f oN cc— R r=o ,2
fNLS N �� D � LZ`S
11) Does this facility have any Non-Discharge permits (ex: recycle permits)?
X&0
❑ Yes
If yes, list the permit numbers for all current Non-Discharge permits for this facility:
Exposure Checklists(12. - 14.)
12) 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 for the no exposure exclusion.
a. Using, storing, or cleaning industrial machinery or equipment, and areas where ❑ Yes kNo
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 )N0
G. Materials or products from past industrial activity ❑ Yes ;'00
d. Material handling equipment (except adequately maintained vehicles) ❑ Yes kN0
e. Materials or products during loading/unloading or transporting activities ❑ Yes (�(N0
f. Materials or products stored outdoors (except final products intended for outside Cl Yes XN0
use [e.g., new cars] where exposure to stormwater does not result in the discharge
of pollutants)
Page 2 of 5
SWU-NE-060508 Last revised 06/05/2008

v
N6GNE0000 No Exposure Certification
g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, ❑ Yes Xtlo
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes KNo
the discharger
i. Waste material (except waste in covered, non-leaking containers [e.g., dumpsters]) ❑ Yes KN0
j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes XNo
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes YNo
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 VrNo
(i.e., not closed and stored upside down to prevent precipitation accumulation)
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?
13) Above Ground Storage Tanks (ASTs): If you answer "No" to any of the following items, you are not
eligible for the no exposure exclusion.
a. Are exterior ASTs or piping free of rust, damaged or weathered coating, pits, or KYes ❑ No
deterioration, or evidence of leaks?
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 shut?
14) Secondary Containment: if you answer "No" to any of the following items, you are not eligible for the
no exposure exclusion.
a. Is secondary containment provided for single above ground storage containers KYes ❑ No
(including drums, barrels, etc.) with a capacity of more than 660-gallons?
b. Is secondary containment provided for above ground storage containers stored P!�,Yes ❑ No
in close proximity to each other with a combined capacity of more than 1,320-
gallons?
c. Is secondary containment provided for any amount of Title III Section 313 >(Yes ❑ No
Superfund Amendments and Reauthorization Act (SARA) water priority
chemicals?
d. Is secondary containment provided for any amount of hazardous substances? XYes ❑ No
e. Are release valves on all secondary containment structures locked? >�Yes ❑ No
15) Hazardous Waste:
Page 3 of 5
5WU-NE-060508 Last revised 06/05/2008

NCGNE0000 No Exposure Certification
a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? ❑ Yes KN0
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste ❑ Yes 500
generated per month) of hazardous waste?
c. is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste ❑ Yes Mo
generated per month) of hazardous waste?
If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste:
How is material stored:
Where is material stored:
How many disposal shipments per year:
Name of transport/disposal vendor:
Vendor address:
16) 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 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 submit a no exposure certification form once every five.(5)years to the North Carolina
Division of Water Quality 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 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 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.
I certify that I am familiar with the information contained in this application and that to the best of my knowledge and
belief such information is true, complete, and accurate.
Printed Name of Person Signing: tf A L GA y
Title: TD ( R y9— G7`0 2 T)t S T V Tf
(Signature of Applicant) 0 (date Signed
Please note: This application for the No Exposure Exclusion is subject to approval by the
NCDENR Regional Office prior to issuance. The Regional Office may inspect your facility for
compliance with no exposure conditions prior to that approval. The Regional Office may also
inspect your facility at any time in the future for compliance with the No Exposure Exclusion.
Page 4 of 5
SWu-NE-060508 fast revised 06/05/2008

HALErIGH, NORTH CAROLINA
4956 !V S£ 17
\ MT.ArRY 26 Mr. r30' 5
64
201 1560 f F561 (KING) 1562 C�KING s,! MI. 563
�-=ate ��, ` C��./,�.�_. ��J � � '�'+�i. _ °�_��•� � �^�����o\vle 'r -�/�r_
il/7
� ''a ✓ I u J 1�r., ���1- _1 1 7 bsca�f� I`�r _ .C�� 1 �,• �. J � \r .
6 u •l/ C' v,,, 1 0 a 4 t 5 C
92�� fl `--� ( ./' SDrSo�..1J _�r r r �� � � �� .��is� 4 - `•s p \\ �� `'�
o� \l� r r� �� '�.Jl�{ r��\ ( �p° 3 a.L.✓Tr• .tf �o_. °r���...a_
�� F4�i� r '� ,•/ ��'.'�/S,� s�8Z8�iF/ I ���—i Lam• 1 .�:.I '��� \.�� � ✓Q ��`'}��
050
t � i,.J I� � -, •�-���� k' F��jril�ns� •:;'�• �•t',::� •� Jam,,
.J �C? r 6Qr f y �U2'211 H 1;•` .} l r ` o /�k'
`r:� `� ��� .' _ •may lV .1
1 ( 6 I r'\\ \ •\ �°. �� mQ�y ° �/ •�G •Qit
• �� I• •io�.�-/Lr\\c' ,\ Q, �r„� ���✓✓J�
a .� � n, tom— � /1 . ���� �•• \ \,� �J
UP
If
1� 0 J 1 1 Ji \ �Jr r` / J'-`\� 1 �[?q ` ..�' i� .r,-_,�.-.••r��''t� //�• 1 4
�f`-�, ��� leaz I'u ° '` �o,/r��� � , t°S ::.� � ��,�I �.1��-�� '��. °;�, •Ci �• �•ei \�`%
r
�� � r:1`^� � '� '634 a � t,�• i� } Yd., �t ��.•�•• ••J �
� • �L/i .�•�` i' 1, � ry � \�A'r U� �� `.v ; .�����. 939�0.
809 � ��`• � O�\ -'�a� ,,,,`ffffff `4� 1/,�r J,• - p •'r �.` � \ � � •'
1 � •C"' ram—; �) � •��: _•_�� `QO�:i� �•1 c� -�,' ••�t �.9
� ( �`�� !ter/ •1• J � �.��' � l�`��.�� � �� S ,_— `�ii � G' '' -
��_r !J'•�A. +I �J i --s=_ .ape :1 YC�v— cv-1J �� •�/• .. `)�•
�_ .. __. -f\ 9d� tli\` /111 \ l SO ,r�' .\ �� �__. r-f .(.,•�

® Division of Water Quality
n Division of Soil and Water Conservation
❑ Other Agency
Facility Number: Facility Status: Aglivp,_ Permit: NCGNE0584 ❑ Denied Access
Inspection Type: Compliance Evaluation Inactive or Closed Date:
Reason for Visit: Follow-up __ County: Forsyth Region: Winston-Salem
Date of Visit: 09123/2009 Entry Time:09 00 AM Exit Time:0920 AM Incident#:
Farm Name: Northridge Direct Owner Email:
Owner: Hanesbrands Inc Phone: [phone]
Mailing Address: 1000 E Hanes Mill Rd Winston Salem NC 27105
Physical Address: U1 Northridge Park Dr Rural Hall NC 27045
Facility Status: n Compliant n Not Compliant Integrator:
Location of Farm: Latitude: Longitude:
Question Areas:
Certified Operator: Operator Certification Number:
Secondary OIC(s):
On-Site Representative(s): Name Title Phone
Primary Inspector: Rose Pruitt Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
Met Tom Hoots at site. dumpster now covered ok to issue no exposure
Page: 1

Permit: NCGNE0584 Owner-Facility: Nanesbrands Inc Facility Number
Inspection Date: 09/23/2009 Inspection Type: Compliance Evaluation Reason for Visit: Follow-up
Page: 2

Pruitt, Rose
From: Thompson, Tommy [[e-mail]]
Sent: Thursday, September 17, 2009 12:56 PM
To: Saini, Sanjiv
Cc: Pruitt, Rose
Subject: Storm Water Inspections
Attachments: hbi_emaii logo.jpg; Blank Bkgrd.gif
Follow Up Flag: Follow up
Flag Status: Flagged
V�
Sanjiv,
Rose Pruitt is responsible for inspections at our sites. If you would, please call her at 771-5000 to schedule a 'sit.
Rose,
Sanjiv Saini will contact you to schedule the 2 Northridge inspections. For reference his number is 519-4886.
Tomrn, 76mpsor
.-V
H�I �-
HANtESD?'anas INC
VV
Legal, Compliance, and Risk Management
Sr. Mgr., International Environmental Affairs
1000 Hanes Mill Road
Winston-Salem, NC 27105
v
Phone: [phone] v
FAX: [phone] v
[e-mail]

This transmission is intended only for use by the intended recipients).If you are not an intended recipient you should not read,disclose,copy, ~-
circulate or in any other way use the information contained in this transmission.The information contained in this transmission may be
confidential and/or privileged.If you have received this transmission in error,please notify the sender immediately and delete this transmission
Including any attachments.
2

=ReglOnal
i000 E. }lanes Mill Road 9
Winston-Salem,NC 27105
336 918 7056 tel
e
HANESbYL ndsINC
February 23, 2009
Stormwater Permitting Unit
Division of Water Quality
1617 Mail Service
Raleigh, NC 27699-1617
Re: No Exposure Certification for Exclusion
Dear Sirs and Madams:
Please find enclosed a completed No Exposure Certification for the 531 Northridge Distribution
Facility of Hanesbrands Inc.
Sincerely,
Don Brown
Environmental Manager
Cc North Carolina Division of Environmental and Natural Resources
Winston-Salem Regional Office
585 Waughtown Street
Winston-Salem, NC 27107
Attn: Rose Pruitt
H I

FOR AGENCY USE ONLY
* Date Received
Division of Water Quality /Surface Water Protection Year Month Day
NCDENR National Pollutant Discharge Elimination System Certificate of Coverage
NICIGI
Win,c�c�Yr� NO EXPOSURE CERTIFICATION for Exclusion N
FNVp -FMT•W NQI .ray fttia3
NCGNE0000
NO EXPOSURE CERTIFICATION Please check here if this is a renewal: ❑ RENEWAL
National Pollutant Discharge Elimination System application for exclusion from a Stormwater Permit
based on NO EXPOSURE:
Submission of this No Exposure Certification constitutes notice that your facility does not require permit
authorization for its 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,
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 with locked or non-operational taps or valves;
adequately maintained vehicles used in material handling;and final products, other than products that
would be mobilized in stormwater 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, 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).
You must re-apply for the No Exposure Exclusion once every five (5) years.
For questions,please contact the DWO Regional Office for your area. (See page 5)
(Please print or type)
1) Mailing address of owner/operator(address to which all certification_correspondence will be mallets:
Name 4ANE-5 6 RA-NdS --X--Q C-
Contact IR O t t)N/
Street Address f cr7 c> E /J=A lu t~5 M 1 LL_ D A-A)
Q City kl I N 5- -0 N) - -5 A L(t_(-A State�&C-ZIP Code
Telephone No. -5-f C) - -5-,c 1 O Fax: A ,5 (9 -2-7p -e--
2) Location of facility producing discharge:
N
t Facility Name NQ2`L-H Kl;C] G i--- D 1 K IF—C T
N Facility Contact N\ S L-i-.SS/a, S?tZv LL
Street Address 3 O IZTE t C--"-'-
City VtZA L ELIO,- L.L _ State JL GG_ZIP Code _:FQ
County Fo t±
Telephone No. 33 j2 ( 8 7 - Fax: 3_ 3 --4�0)
Page 1 of 5
5WU-NE-060508 Last revised 06/05/2008

NCGNE0000 No Exposure Certification
3) Physical location information:
Please provide a narrative description of how to get to the facility(use street names, state road numbers, and
distance and direction from a roadway intersection). US .52 Noa-Tf, N f-Ni
`1,/R.c,,L WALL RO D _ a QCIC—E-:�_D K)OR-7 4 _i`n RG-7
(A copy of a map with the facility clearly located on it should be included with the certification application.)
4) Is the facility located on Native American Lands? ❑ Yes VNo
5) Is this a Federal facility? ❑ Yes )�<No
6) Latitude Z792-5—Longitude —,,;30.303862_kdeg., min., seconds)
7) This NPDES No Exposure Exclusion application applies to which of the following:
❑ New or Proposed Facility Date operation is to begin
Existing Date operation began 9 3
❑ Renewal of existing No Exposure Certification Certification No.: NCGNE
8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes XN0
If yes, what is the NPDES Permit Number?
9) Standard industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: Z- 3 :2- 2
10) Provide a brief description of the types of industrial activities and products produced at this facility:
I,S A S 2 k 9 y t O _CA R, I-- � -
��v � Y`T`( L"` A R o D�_/ L T S
11) Does this facility have any Non-Discharge permits(ex: recycle permits)?
�lo
❑ Yes
If yes, list the permit numbers for all current Non-Discharge permits for this facility:
Exposure Checklists(12. - 14.)
12) 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 for the no exposure exclusion.
a. Using, storing, or cleaning industrial machinery or equipment, and areas where ❑ Yes XNo
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 )<N0
c. Materials or products from past industrial activity ❑ Yes XIN0
d. Material handling equipment (except adequately maintained vehicles) ❑ Yes kN0
e. Materials or products during loading/unloading or transporting activities ❑ Yes 1!1�No
f. Materials or products stored outdoors (except final products intended for outside ❑ Yes Xio
use [e.g., new cars]where exposure to stormwater does not result in the discharge
of pollutants)
Page 2 of 5
SWU-NE-060508 Last revised 06/05/2008

NCGNE0000 No Exposure Certification
g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, ❑ Yes V\N0
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes IN(No
the discharger
i. Waste material (except waste in covered, non-leaking containers [e.g., dumpsters]) ❑ Yes kNo
j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes XN0
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes `(No
otherwise regulated (i.e., under an air quality control permit) and evident in the
stormwater outflow
1. Empty containers that previously contained materials that are not properly stored ❑ Yes $�,11\10
(i.e., not closed and stored upside down to prevent precipitation accumulation)
m. For any exterior ASTs, as well as drums, barrels, tanks, and similar containers ❑ Yes "o
stored outside, has the facility had any releases in the past three (3) years?
13) Above Ground Storage Tanks (ASTs): If you answer "No" to any of the following items, you are not
eligible for the no exposure exclusion.
a. Are exterior ASTs or piping free of rust, damaged or weathered coating, pits, or KYes ❑ No
deterioration, or evidence of leaks?
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 shut?
14) Secondary Containment: If you answer "No" to any of the following Items, you are not eligible for the
no exposure exclusion.
a. Is secondary containment provided for single above ground storage containers O((Yes ❑ No
(including drums, barrels, etc.) with a capacity of more than 660-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-
gallons?
c. Is secondary containment provided for any amount of Title III Section 313 Kyes ❑ No
Superfund Amendments and Reauthorization Act (SARA) water priority
chemicals?
d. Is secondary containment provided for any amount of hazardous substances? XYes ❑ No
e. Are release valves on all secondary containment structures locked? NYes ❑ No
15) Hazardous Waste:
Page 3 of 5
SWU-NE-060508 Last revised 06/05/2008

NCGNE0000 No Exposure Certification
4
a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? ❑ Yes KNo
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste ID Yes 500
generated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste ❑ Yes Mo
generated per month) of hazardous waste?
If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste:
How is material stored:
Where is material stored:
How many disposal shipments per year:
Name of transport/disposal vendor:
Vendor address:
16) 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 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 submit a no exposure_certification form once every five (5)tears to the North Carolina
Division of Water Quality 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 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 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.
I certify that I am familiar with the information contained in this application and that to the best of my knowledge and
belief such information is true,complete,and accurate.
Printed Name of Person Signing: 4 A L C-,q
Title: D ( R 1E CT ( T t2 V T tQ
4,M0
(Signature of Applicant) U (date Signed)
Please note: This application for the No Exposure Exclusion is subject to approval by the
NCDENR Regional Office prior to issuance. The Regional Office may inspect your facility for
compliance with no exposure conditions prior to that approval. The Regional Office may also
inspect your facility at any time in the future for compliance with the No Exposure Exclusion.
Page 4 of 5
SW U-NE-060508 Last revised 06/05/2008

ttHLGIU rI. I4 IJ f. 1 .1 —1 I,Vr._.,r,rr
+fir 4956 fV SE MT.A1HV 76 Mr
c/ 156� . k 5{l} (KING) 162 KfNG i / Mf. .563 1 T30' $61
17 ir.. C/' \\� „C •may° - ,~ � � j., .. 1 q { `r� `1jr�j 1 •' -1 r �4 '
x- °so,11• 1` f -__".' �9V' /�:! �fl/ ',,�. O965
akrore
�°
�B@5r ��'•'.-1�a - _,• .1 Q, •989 � -moo' �•c e! \, ,�_ .,` -.p ld°��.- J- '��p: 'J 1
rl' � ._.J y ru� • - f _^!�„ .$ubs[a�;"__
923 1.1�. / . /996r r"� __ CCrt- �i. /�\, 4 \ � .\� .� f _
\P'` :�= •—,F��� -. 4 ✓' - -_�',�1 •e�ylJ� 6}I '� �95p
�1' r rh + I•• M' - _
t16J6 d Chqo
`,` '} �or°�5C /.,-� �-�`�-' - +7r - '"roacr\\C;__ri .tom./�'.�1i [�,'y^%\ •' �,�'
(( \ t •�. •
1i.1 d 90.
't• 973/• � ` $ / - ��•.t,'rcrLe� ••�.': �, � 99C'--moo .
J' "�;�,� e.„, 1 �' �•' r -s$9 ' •71 sib•'\.•/•. ,n .1, �y
• {'• .�f/+)i\/, �%�i� .� f '� ���� �. �,'I�azareth�� �•�: •° J•'•'i�•- 1 •t( \•: ."'J�/-.� 95p
0�/i'• ���. �•'�//^�.�` c o�.�='`f'V�yy, A e �,nr' � 3f� "s�l i:4�,_'`T�, ,i}� f" '! � -6�.
��_'¢ ^` r / r r �, 1�f� •�D�rTa,� RJ.t
'`�• 4r. Q z ;.&� �;`' '_, H`ti J.i: 1,` '�:� lll'�li.H dli
JN ,L Tdik ///'JJJUUU ` sh,.•��,.t •., /�yJ�m �•.•;Il•: \ �•s }'r't�°~: .`\s�`�:.-{� �� �� "'
- `/4—_��/_ `.•� ,t\ \ v'�-'• �� [�'r t, \�'�. / °fit°.11�' ` �•�4• r
l V J� �'r -\•: °/�e� '� _7�� ') r ? .�7 °�� � .�i..\ l �y •ka` '. �BT k• �'''t l ��_
r;. �Cy - - �•`ti~s J' { '� 4- n c P c,l.� -`.�k�, 9 r� •�✓'••� , \ �,
I(jJ�/�.yn^,1.'JlS'p0� / - . /J� ^.CJ � \�\ :\` 'r• i`✓'r _/ .° �,hC��' .�ti�.�lr—\J/fir �• � r r,.,' 1
/ �` 0 _ '8 1 •�-, 'r - °r __ I•j A.,.Ji /`� '.4�1\ 11. .P./, 'l ��••`\�,,tom`✓. �, `
'` 7 I �fl -� �1�`r\ I ..ems� l� '. ,� � l•, ,^�� � ,�' '/'� .'�
r, K �. o•�o,`�� -,1 - .�� ( III!!! s�r��C''�-� �'� `r � ��.� �, � '� .�l - i-.o..f`I+
\ ° a~-� = ( _ y✓�"' -\�\!JJ 1t -ti v t'fS`�'" -✓✓ .����ti -1 -� � '•r ram-961
77• -..-. •ra ,� })i/
. Sri - ti •t r ` '
�� I��1632 t, x\� ! / {+'�`•"•� � �" ` - ��-• •.F. / ram.. .\-
` -t_
gp rv` f - ,•i 'J 'sss} 11 t+ _ '. �j .,yl _ ._+��z ',1_ 1
^ L✓ fr �� 1F CA �' m• \ \� ,\� ` ' i� .�1 1 r� GAO'• ,••Q \`
cz
! \ ,a�~'r, yi;� .icV ,`� f i,, ,\`_/ �\ ,�\��� \J- � � I •,•^{ �1,'��'.' `:�a;� - -lr'/ r .7� ' y�'� .
-r��\ riy / ' m �} '� �•� r �� C+ Flirt
l,/'- _ _„ lf' �p . r,l r'ci o ;%rG v- � / ` fr' .:� r,•:+I• }. :\`` Crt'n �' \' �•\• \• ��.
" `_ -`' 1 � / , ♦ r/ � ,�-.,,•�_r� -�` � � 3 t���� L.:^� - 1 ram• ' �,
�5s
- �.\ i•. \�S �� ,�i f i`a It S! • ° gd='
RN
N 9"'.!'
l.'\ .92P\ .. (`,�� r �� ,!r �w- _ `/ :%: FJ l:. •o � t •.� 1c •%i.`.r::•., __n •/,
' 2US -�\�' jJ %J,J,4 r � 1.�+�pl\\�\J' ��' L�;� ^,� � - - �•�. ' �"'��1� `l:. r"'' - '• }� `,CS: ��. `�,+L,i.. -' /
P �\`:{`�/,�� �•r V ` n Jr \lam 1 �. ,� \ 4 � . � �, '�:. i � K l �i���. :��%--�.J.J r.
'1..(f�C ��\ � �r r a �L°�p�,_-,�� �./i -� /`� � r�o {� \� ! �1`` ••L. `I �� .� i, ,�\ � � 5• S1 •��`
r9.78^ nlv-. � r.;\!^S3P� .° �- j ,,° + -^ t .:'k. '\+-\��� �i'4 \\jRrk' •.� #1 :`,
Bag ` r. /i�5 -�� moo`` „^fll n f.��� �` /. �•� �� � - �`.C) _�• 933 .'r.
,\ � - V�' GG Lam• 1; r� o:. 1 .•' r� mil.
/r:, �%'��i! r l�`. `.- \��-••',n`C�� 11-�-���\ ° �ri,��� \`!}} r r'�. .\' ,++ram., `�,6 �� �-J��_ i•,00 �
r Jn fyJJ':r \�' \� 1r�r9°'�/� o��l .`�-';' •• `\\��d\ �\\l' `� � •; J' \O \ �,1rT=o%•• -
/����`•-, v ~� \ � .•\ °•�^�T / �: it � rl, y^ / ,r�' - r_ _ _•� S
r J i `-
�a� r.¢ �._r f��' it `����� —�'. ��'.•_ `f:]����RR��Q'��\[)))�\� `�^ �/'��_' �' `\:�•Ll !r l�, ��\: 1 -•'•• i •R
BM \ `' ✓~. \ 'a66 ''� -� ` --� rll� � - •�
/�:••�•i!Q -w� -'r��.7� ti?!�` e�� �. i/`C; � ` ,\ .�—�♦ ", ��: �' -957�S�e'- �.o" `-,q;` ,� r1
l..`_ � �l f: '�••/ •C: J r �•-C �.f�•. :/t\o \�\._.�r '-' .�\� ' 1,��`90�•rti��5a 1 ~`` `��1�'��.i• "'• �p�.9
��.�,`or•-^� %/ ����� '.,\ �<'�'r ,� �, ��r \\• / - .il. -r-- ter, r.I; ,% _,
� ��� ' �• /�~' 9D0. /'r\J � •• 1'rs�`� ��1��: ;ifj � `i r •a