NCGNE0929_COMPLETE FILE - HISTORICAL_20130220

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE (YHISTORICALFILE
❑ MONITORING REPORTS
DOC DATE ❑ �DI,3O(�i(7�i D
YYYYMMDD

NC®ER—R
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Pat McCrory Charles Wakild,P.E. John E. Skvada, III
Governor Director. Secretary
February 20, 2013
Tony Holt, President
Dynayarn USA, LLC
PO Box 811
Graham, NC 27253
Subject: No-Exposure Certification NCGNE0929
Dynayarn USA, LLC
327 East Elm Street, Graham
Alamance County
Dear Mr. Holt:
The Division has reviewed your submittal of the No-Exposure Certification for Exclusion from NPDES Stormwater
Permitting'application. Based on your submittal of a signed certification of no exposure at the above referenced
facility, and on an inspection by Jenny Graznak of the Winston-Salem Regional office on February 7, 2013, the
Division is granting your conditional exclusion from permitting as provided for under 40 CFR 122.26(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 no longer qualifies for no-exposure exclusion,
you are obligated to immediately obtain NPDES permit coverage for your stormwater discharges. Otherwise, the
discharges becomes subject to enforcement as un-permitted.discharges. You must self re-certify annually using the
included form, or obtain NPDES permit coverage for any stormwater discharges from your facility. The annual self
re-certification does not need to be submitted to DWQ, unless requested.
Your conditional exclusion from permitting does not affect your facilities' 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 Jenny Graznak at [phone], or at
jenny.graznak(a)ncdenr.g_ov.
Sincerely,
1 �
i
W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
cc: WSRO files- 1) 1
Stormwater Permitting Unit:'No-Exposure File ' 1! 1J
North Carolina Division of Water Quality,Winston-Salem Regional office FEB 2 2 2013
Location:585 Waughtown St.Winston-Salem,North Carolina 27107 One
Phone:[phone] FAX:[phone] Customer Service:1-877-623-6748 North C a rolina
Internet:www.ncwaterquality•org A WAL �aturaCl�
An Equal opportunity 1 Affirmative Action Employer &

Compliance Inspection Report
Permit: NCGNE0929 Effective: Expiration: Owner: Dynayarn
SOC: Effective: Expiration: Facility: Dynayarn
County: Alamance 327•E,Elm St
Region: Winston-Salem
Graham NC 27253
Contact Person: John Halt Title: Phone: [phone]
Directions to Facility:
Exit 148 on 185/140 north on hwy 54 3/4 of one mile plant is on the left.
System Ciassifications:
Primary ORC:. Certification, Phone:
'Secondary ORC(s):
On-Site Representative(s):
Related Permits:
Inspection Date: 02/07/2013 Entry Time: 10:00 AM Exit Time: 11:30 AM
Primary Inspector: Jennifer F Graznak Phone: [phone]
Secondary Inspector(s):
Reason for inspection: Routine . Inspection Type: Compliance Evaluation
Permit Inspection Type: Stormwater Discharge, No Exposure Certificate
Facility Status: ® Compliant 0 Not Compliant
Question Areas:
®Miscellaneous Questions ®Misc
(See attachment summary)
Page: 1

Permit: NCGNE0929 Owner-Facility: Dynayam
Inspection Date: 02107/2013 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
Facility spilled aproximately 100 gallons of Stantx 3068 yarn lubricant(mineral oil)into small stream behind building on
February 4, 2012. They properly reported and cleaned up the spill,which resulted in a site visit by Jenny Graznak on
February 7, 2012. During a file review after the site visit, Ms. Graznak realized that the facility needs a stormwater permit
for textile activities. During her site visit, she had observed that the facility qualifies for No Exposure Certification and
encouraged them to apply for that: The spill was a very unusal occurence-the oil is not stored outside, but inside the
plant. It seeped out of the building through the wall and into the stream when the spicket was accidentally left in on
position. Facility has changed location of oil tote to prevent from happening again.
MISC Yes 'No NA NE
Is the facility compliant? ® Q fl 0
Comment:
Page: 2

FOR AGENCY USE ONLY
An4& Date Received
Division of Water Quality/Surface Water Protection Year Month Day
.....
National Pollutant Discharge Elimination System Certificate ofCo
NC®ENRveragc
Vr H c,.x,,,„„[%p .e� O NO EXPOSURE CERTIFICATION for Exclusion
TNWIOYMF,yT 41P NhTWW.{7.SQ.Zr1'A
NCGNE0000
NO EXPOSURE CERTIFICATION
National Pollutant Discharge Elimination System application for exclusion from a Stormwater Permit based
on NO EXPOSURE:
Submission of this No Exposure Certification constitutes notification that your facility does not require a
permit for 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.
For permitted facilities in North Carolina, DWO must approve your application for No
Exposure Certification before this exclusion is effective. Until you are issued a No
Exposure Certification and your NPDES permit is rescinded, your facility must continue
to abide by the terms and conditions of the current permit.
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 j
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).
i
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 i
1
terms and conditions of 40 CFR 122.26(g).
You are required to self re-certify your No Exposure Exclusion annually.
For questions,please contact the DWO Regional Office for your area. (See page 6)
(Please print or type)
1) Mailing address of ownedoperator(address to which all certification correspondence will be mailed):
Name 4 t-k AIA AAA LLc-
Contact _o,�A.JA. HOLT
Street Address2
City (rLkAVtA►^� State NC-. ZIP Code 27 �
Telephone No. � LF'�? �( �y Z Fax: �3(0�-3`f - 2 I!� _
Email C.-!'1 0'rn c0t� FFER
RECEIVED "N.C. Dept.ofENRc Page 1 of 7 FE 4 ?�1 . . .3
Winstcn-Saiem _ ?zanch
SWU-NE-12Aug2414 ,=i LW"—w ..
s

NCGNE0000 No Exposure Certification
2) Location of facility producing discharge:
Facility Name —t>yP At-f J411.'4 S A L.c-
Facility Contact ac� tq g!rL _
Facility Street Address �a�'] ��E Lvvl S i R�_rn t
City C1r�t _ State MC_ ZIP Code �27�53
County ALAf At-ACl-
Telephone No. ga,(- rf Ef'22 Fax: 33' 3"i_S- 21
Email f0n► 3 C—a ef!I VIOL y��V
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). V a or't _-f S j o k
o rt 5 . 3 rn i i l ckv4 (- o ivy �g
(A copy of a map with th facility clearly located on it should be included with the certification application.)
4) Is the facility located on Native American Lands? © Yes UAO
5) Is this a Federal facility? ❑ Yes ❑mo
6) Latitude_&,Y6J75q Longitude T r]CY.31,7 q q (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
V Existing - Date operation began A?9xL ` 9
❑ Renewal of existing No Exposure Certification Certification No.: NCGNE
8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes ❑ No
If yes, what is the NPDES Permit Number? t� bEtq O_jD''.qX_/>
9) Standard Industrial Classification: P* %'LM f-t— f;CbiL TIE xF-1
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code:
10) Provide a brief description of the types f industrial activities and products produced at this facility:
11) Does this facility have any Non-Discharge permits(ex: recycle permits)?
&.f 4o
❑ Yes
If yes, list the permit numbers for all current Non-Discharge permits for this facility:
}
}4
}}4F
1.
gI
1
Page 2 of 7
SWU-NE-12Aug2010 I

NCGNE0000 No Exposure Certification
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 C(No
residuals from using, storing or cleaning industrial machinery or equipment remain
and are exposed to stormwater
b. Materials or residuals on the ground or in stormwater inlets from spills/leaks ❑ Yes VNo
c. Materials or products from past industrial activity ❑ Yes lR/lo
d. Material handling equipment (except adequately maintained vehicles) ❑ Yes Cif No
e. Materials or products during loading/unloading or transporting activities ❑ Yes QXo
f. Materials or products stored outdoors (except final products intended for outside ❑ Yes R-�o
use[e.g., new cars]where exposure to stormwater does not result in the discharge
of pollutants)
g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, E] Yes ao }
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes &40
the discharger
i. Waste material (except waste in covered, non-leaking containers [e.g., dumpsters]) ❑ Yes I5/No ..
j. Application or disposal of process wastewater(unless otherwise permitted) ❑ Yes E91"No
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes E(No
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 A �
(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 SAO
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 and piping free of rust, damaged or weathered coating, pits, or ❑ Yes ❑ No [IN/A
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any ❑ Yes ❑ No' R(N/A
cracks, holes, or evidence of leaks, and are drain valves maintained locked shut?
Page 3 of 7
S W U-N E-12Aug2010
I
i
I

NCGNED000 No Exposure Certification
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 all single above ground storage ❑ Yes ❑ No VN/A
containers (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 &, /A
in close proximity to each other with a combined capacity of more than 1,320-
gallons?
c. Is secondary containment provided for Title III Section 313 Superfund C] Yes ❑ No M-N/A
Amendments and Reauthorization Act(SARA) water priority chemicals'?
d. Is secondary containment provided for hazardous substances"designated in 40 ❑ Yes © No. R N/A
CFR §116?
e. Are release valves on all secondary containment structures locked? ❑ Yes © No R�N/A
15) Hazardous Waste:
a. Is this facility a Hazardous Waste Treatment,Storage,or Disposal Facility? ❑ Yes IZA0
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste ❑ Yes &Ao
generated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator(1000 kg. or more of hazardous waste ❑ Yes &Ao
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 1 disposal vendor:
Vendor address:
Footnotes to Questions 14) c. &d.
*Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require
secondary containment. However, some exceptions may be made for de minimis amounts of certain substances,
and/or other qualifiers, as described in the exemptions from reporting requirements of Title III SARA 313 in 40 CFR
§372.38.
"Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require
secondary containment. However,some exceptions may be made for amounts less than the Reportable Quantities
of the hazardous substances listed in 40 CFR§117.3.
Page 4of7 I
swu-NE-12Aug201 a €

NCGNE0000 No Exposure Certification
16) Other information: If you answer"Yes"to any of the following items,you might not be eligible for the
no exposure exclusion. A more in-depth evaluation of the site circumstances may be required.
a. Does your facility store used, recycled, or otherwise reclaimed pallets outside? ❑ Yes ER/No
b. !Does your facility have coal piles on site? ❑ Yes 6;4o
c. Does your facility store other fuel sources outside in piles, such as wood chips, ❑ Yes Q Ao
sawdust, etc.?
d. Does your facility have air emissions associated with its industrial activity(e.g., ❑ Yes 5l0
degreasing operations, plating, painting and metal finishing)? If so, describe the
industrial activity:
e. If you answered yes to d., are those emissions permitted by an Air Quality Permit? ❑ Yes ❑ No "/A
Please specify:
f. Please list any other environmental program permits (federal, state, etc.) not
specified earlier in this application (such as Hazardous Waste Permits, etc.).-
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
Page 5 of 7
SW U-NE-12Aug2010

NCGNE0000 No Exposure Certification
17) 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 annually self re-certify No Exposure and,if requested,submit the re-certification to
DWQ or the operator of the local municipal separate storm sewer system (MS4)into which the facility discharges(where
applicable). I understand that I must allow the forth 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 faciliiv_.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 gatheredand 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. f� l
Printed Name of Person Si ing: A l�
Title:~
(Signatu f Applicant) (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.
North Carolina General Statute 143-215.6 B(i) provides that:
f
Any person who knowingly makes any false statement,representation,or certification in any application, record,report,plan,or other
document filed or required to be maintained under this Article or a rule implementing this Article;or who knowingly makes a false
statement of a material fact in a rulemaking proceeding or contested case under this Article;or who falsifies,tampers with,or knowingly
renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
[Environmental Management)Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine
not to exceed ten thousand dollars($10,000).
There is currently no fee for a No Exposure Exclusion.
Page 6of7
SW U-NE-12Aug2010

NCGNE0000 No Exposure Certification
Final Checklist
This application should include the following items:
❑ This completed application and all supporting documentation.
❑ A map with the location of the facility clearly marked.
❑ If the site currently has an NPDES Stormwater Permit, be sure to indicate the permit number in Question 8.
Mail the entire package to:
Stormwater Permitting Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1 6 1 7
Note
The submission of this document does not guarantee the issuance of a No Exposure Exclusion.
For questions,please contact the DWQ Regional Office for your area.
DWQ Regional Office Contact Information:
Asheville Office ...... [phone]inn�salem r 1 �� ;�*;<<,•1?,
Fayetteville Office ... [phone]
Mooresville Office ... [phone]
Raleigh Office ........ [phone]
. Iislville Mporesvillel
Washington Office ...[phone]
Wilmington Office ... [phone]
Winston-Salem ...... [phone]
Fpyatteaville
Central Office .........[phone]
1�l�ttngton
Page 7 of 7
5 W U-NE-12Aug2414
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North Carolina Department of Environment and Natural Resources
Division of Water'Quality
Pat McCrory Charles Wakild, P.E. John E. Skvarla, III
Governor Director Secretary
February 20, 2013
Tony Holt, President
Dynayarn USA, LLC
PO Box_811
Graham, NC 27253
Subject: No-Exposure Certification NCGNE0929
Dynayarn USA, LLC
327 East Elm Street, Graham
Alamance County
Dear Mr. Holt:
The Division has reviewed your submittal of the No-Exposure Certification for Exclusion from NPDES Stormwater
Permitting application. Based on your submittal of a signed certification of no exposure at the above referenced
facility, and on an inspection by Jenny Graznak of the Winston-Salem Regional office on February 7, 2013, the
Division is granting your conditional exclusion from permitting as provided for under 40 CFR 122.26(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 no longer qualifies for no-exposure exclusion,
you are obligated to immediately obtain. NPDES permit coverage for your stormwater discharges. Otherwise, the
discharges becomes subject to enforcement as un-permitted discharges. You must self re-certify annually using the
included form, or obtain NPDES permit coverage for any stormwater discharges from your facility. The annual self
re-certification does not need to be submitted to DWQ unless requested.
Your conditional exclusion from permitting does not affect your facilities' 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 Jenny Graznak at [phone], or at
ienny.graznak�ncdenrgov.
Sincerely,
t
i
W. Corey Basinger
Surface Water Regional Supervisor
Winston-Salem Regional Office
Division of Water Quality
cc: WSRO files
Stormwater Permitting Unit: No-Exposure File F
L
North Carolina Division of Water Quality,Winston-Salem Regional Office
Location:585 Waughtown St.Winston-Salem,North Carolina 27107 One r
Phone:[phone] FAK 336-771-46301 Customer Servioe:1-877-623-6748 NorthCarollna.
Internet:www.ncwaterqual'ity.org I
Naturall,# ,
An Equal Opportunity 4 Affirmative Action Employer

Compliance Inspection Report
Permit: NCGNE0929 Effective: Expiration: Owner: Dynayarn
SOC: Effective: Expiration: Facility: Dynayarn
County: Alamance 327 E Elm St
Region: Winston-Salem
Graham NC 27253
Contact Person: John Holt Title: Phone: [phone]
Directions to Facility:
Exit 148 on 185/140 north on hwy 54 314 of one mile plant is on the left.
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On-Site Representative(s):
Related Permits:
Inspection Date: 02/07/2013 Entry Time: 10:00 AM Exit Time: 11:30 AM
Primary Inspector: Jennifer F Graznak Phone: [phone]
Secondary Inspector(s):
Reason for Inspection: Routine . Inspection Type: Compliance Evaluation
Permit Inspection Type: Stormwater Discharge, No Exposure Certificate
Facility Status: ■ Compliant ❑ Not Compliant
Question Areas:
■Miscellaneous Questions ■Misc
(See attachment summary)
Page: 1

Permit: NCGNE0929 Owner-Facility: Dynayam
Inspection Date: 02/07/2013 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
Facility spilled aproximately 100 gallons of Stantx 3068 yarn lubricant (mineral oil)into small stream behind building on
February 4, 2012. They properly reported and cleaned up the spill, which resulted in a site visit by Jenny Graznak on
February 7, 2012. During a file review after the site visit, Ms. Graznak realized that the facility needs a stormwater permit
for textile activities. During her site visit, she had observed that the facility qualifies for No Exposure Certification and
encouraged them to apply for that. The spill was a very unusal occurence-the oil is not stored outside, but inside the
plant. It seeped out of the building through the wall and into the stream when the spicket was accidentally left in on
position. Facility has changed location of oil tote to prevent from happening again.
Misc Yes No NA NE
Is the facility compliant? Q D
Comment:
Page: 2

FOR AUENCY USE ONLY
Date _Received
Year
Division of Water Quality/Surface Water Protection Y , n�.nthoR� Day
td�DENR National Pollutant Discharge Elimination System CuliticateofCoverage
'4L I-ClvG —LYN4.IM Of NO EXPOSURE CERTIFICATION for Exclusion
utN�..�„„„Ha .nrso..vrm NCGNE0000
NO EXPOSURE CERTIFICATION
National Pollutant Discharge Elimination System application for exclusion from a Stormwater Permit based
on NO EXPOSURE:
Submission of this No Exposure Certification constitutes notification that your facility does not require a
permit for 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.
For permitted facilities in North Carolina, DWQ must approve your application for No
Exposure Certification before this exclusion is effective. Until you are issued a No
Exposure Certification and your NPDES permit is rescinded, your facility must continue
to abide by the terms and conditions of the current permit.
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 are required to self re-certifv your No Exposure Exclusion annually.
For questions,please contact the DWQ Regional Office for your area. (See page 6)
(Please print or type)
1) Mailing address of owner/operator(address to which all certification correspondence will be mailed):
Name 7ti u II�k AI 1 2SA tic_
Contact _�TO VKN A , HO lam;
Street Address 32�_ (,= . I—CrWI�..S3IZ_q_El� .
City C- A JkAy"` State NC. ZIP Code '2 1;'
Telephone No. f '-7 - - 7 Fax: 32)6—''SI - 21(r,(
Email -f-0n!1 Ca cc4A9 LiaLrY1 [.a._� !'� :v.
RECEIVED "F
N.C. Dept.of ENR
Page 1 of 7 FEB 20 2013
4
Winston-Salem . 3ranCf►
SWU-NE-12Au92010 C"ice 1fn

NCGNE0000 No Exposure Certification
2) Location of facility producing discharge:
Facility Name M>4 M" / ivy O S A LL,.- -
Facility Contact 7 N • go Ls-
Facility Street Address 3Z�7 �^ l~Lvvi STIR 7
City 6r'kA%kA,'"^ State NC— ZIP Code 272
County /4LAMM-A Q_�L_ f
Telephone No. %4._ i rl kZ Fax: 32!:Ci _ 3`f s- 2 r `o 4
Email o a art r . taw
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). (S' oh T-13
pn 5 . 3 ' >ne_ m I t l v" i ow k �
(A copy of a map with th facility clearly located on it should be included with the certification application.)
4) Is the facility located on Native American Lands? ❑ Yes uVNo
5) Is this a Federal facility? ❑ Yes GVNo
6) Latitude ,%9759 Longitude,.'7l.39Z qqJ (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
V Existing Date operation began Ay'g L-
❑ Renewal of existing No Exposure Certification Certification No.: NCGNE
8) Was this facility or site ever covered under an NPDES Stormwater Permit? EI Yes ❑ No
If yes, what is the NPDES Permit Number? MA%j tAA�x b*s-H CQV*R
9) Standard Industrial Classification: GI Ar F-t— Fezt 11XFJE
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: Z Z 0 Z
10) Provide a brief description of the types f industrial activities and products produced at this facility-
2��\LA
11) Does this facility have any Non-Discharge permits(ex: recycle permits)?
o'(Vo
❑ Yes
if yes, list the permit numbers for all current Non-Discharge permits for this facility:
Page 2 of 7
SW U-NE-12Aug2010

' �r"f ,- .. �� �� :fir i ::1'�•
1'
i

NCGNE0000 No Exposure Certification
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 VNo
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 El Yes lNo
c. Materials or products from past industrial activity ❑ Yes "o
d. Material handling equipment (except adequately maintained vehicles) ❑ Yes M No
e. Materials or products during loading/unloading or transporting activities ❑ Yes t4lo
f. Materials or products stored outdoors (except final products intended for outside ❑ Yes "o
use [e.g., new cars]where exposure to stormwater does not result in the discharge
of pollutants)
g. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, ❑ Yes C�No
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes E1,40
the discharger
i.Waste material (except waste in covered, non-leaking containers [e.g., dumpsters]) ❑ Yes WNo
j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes [Ao
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes t"No
otherwise regulated (i.e., under an air quality control permit) and evident in the
stormwater outflow
I. Empty containers that previously contained materials that are not properly stored ❑ Yes [�(No
(i.e., not closed and stored upside down to prevent precipitation accumulation)
m. For any exterior ASTs, as well as drums, barrels, tanks, and similar containers ❑ Yes E/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 and piping free of rust, damaged or weathered coating, pits, or © Yes ❑ No IKNIA
deterioration, or evidence of leaks?
b. Is secondary containment provided for all exterior ASTs? If so, is it free of any ❑ Yes ❑ No &�(N/A
cracks, holes, or evidence of leaks, and are drain valves maintained locked shut?
Page 3 of 7
SWU-NE-12Aug2010

NCGNE0000 No Exposure Certification
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 all single above ground storage ❑ Yes ❑ No &KN/A
containers (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 Ej 4/A
in close proximity to each other with a combined capacity of more than 1,320-
gallons?
c. Is secondary containment provided for Title III Section 313 Superfund ❑ Yes ❑ No 9"N/A
Amendments and Reauthorization Act(SARA)water priority chemicals*?
d. Is secondary containment provided for hazardous substances**designated in 40 ❑ Yes ❑ No B'N/A
CFR §116?
e. Are release valves on all secondary containment structures locked? ❑ Yes ❑ No P(N/A
15) Hazardous Waste:
a. is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? ❑ Yes EAo
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste ❑ Yes &40
generated per month) of hazardous waste?
c. Is this facility a Large Quantity Generator(1000 kg. or more of hazardous waste ❑ Yes BAO
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:
Footnotes to Questions 14) c. & d.
*Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require
secondary containment. However, some exceptions may be made for de minimis amounts of certain substances,
and/or other qualifiers, as described in the exemptions from reporting requirements of Title III SARA 313 in 40 CFR
§372.38.
**Note that amounts below the 660-gallon (single) and 1,320-gallon (combined) bulk storage minimums require
secondary containment. However, some exceptions may be made for amounts less than the Reportable Quantities
of the hazardous substances listed in 40 CFR §117.3.
Page 4 of 7
S W U-NE-12Aug2010

NCGNE0000 No Exposure Certification
16) Other information: If you answer "Yes"to any of the following items,you might not be eligible for the
no exposure exclusion. A more in-depth evaluation of the site circumstances may be required.
a. Does your facility store used, recycled, or otherwise reclaimed pallets outside? ❑ Yes IR/No
b. Does your facility have coal piles on site? ❑ Yes "0
c. Does your facility store other fuel sources outside in piles, such as wood chips, ❑ Yes uAo
sawdust, etc.? 1
d. Does your facility have air emissions associated with its industrial activity(e.g., ❑ Yes E;I o
degreasing operations, plating, painting and metal finishing)? If so, describe the
industrial activity:
e. If you answered yes to d., are those emissions permitted by an Air Quality Permit? ❑ Yes ❑ No 5VNIA
Please specify:
f. Please list any other environmental program permits (federal, state, etc.) not
specified earlier in this application (such as Hazardous Waste Permits, etc.):
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
Page 5 of 7
SW U-NE-12Aug2010

NCGNE0000 No Exposure Certification
17) 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 annually self re-certify No Exposure and, it requested, submit the re-certification to
DWQ or the operator of the local municipal separate storm sewer system (MS4) into which the facility discharges (where
applicable). I understand that I must allow the North Carolina Division of Water Quality,or MS4 operator where the
discharge is into the local MS4,to perform inspections to confirm the condition of no exposure and to make such
inspection reports publicly available upon request.
In the event that the site no longer qualifies for a No Exposure Exclusion, I understand that I must obtain coverage under
an NPDES permit prior to any point source discharge of stormwater from the facility. Additionally, I certify under penalty of
law that this document and all attachments were prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information 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 Si A • 14a-t�
Title:
1 ,/
(Signatu f Applicant) (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.
North Carolina General Statute 143-215.6 B(i) provides that:
Any person who knowingly makes any false statement,representation,or certification in any application,record,report,plan,or other
document filed or required to be maintained under this Article or a rule implementing this Article;or who knowingly makes a false
statement of a material fact in a rule making proceeding or contested case under this Article;or who falsifies,tampers with,or knowingly
renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
[Environmental Management]Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine
not to exceed ten thousand dollars($10,000).
There is currently no fee for a No Exposure Exclusion.
Page 6 of 7
SWU-NE-12Aug2010

NCGNEOOOO No Exposure Certification
Final Checklist
This application should include the following items:
❑ This completed application and all supporting documentation.
1-1 A map with the location of the facility clearly marked.
❑ If the site currently has an NPDES Stormwater Permit, be sure to indicate the permit number in Question 8.
Mail the entire package to:
Stormwater Permitting Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Note
The submission of this document does not guarantee the issuance of a No Exposure Exclusion.
For questions,please contact the DWQ Regional Office for your area.
DWQ Regional Office Contact Information:
Asheville Office ...... [phone]
Fayetteville Office ... [phone] -.,'n3•�
Mooresville Office ... [phone] in on
f,
Raleigh Office ........ [phone] _ j r i4-Y ';� --
�r_,. ✓ lteville Moores !e t ��'
Washington Office ...[phone]
Wilmington Office ._. 910 796-7215
Winston-Salem ...... [phone] \Foye4�Vi!!e
Central Office .........[phone]
f�Wil` ngton
Page 7 of 7
SWU-NE-12Aug2010

2112113 Map of Latitude:36.0698,Longitude:-79.39241 MapQuest
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