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NCGNE0948_COMPLETE FILE - HISTORICAL_20180817
STORMWATER DIVISION CODING SHEET NC6 PERMITS PERMIT NO. /V C-0 Iy 0 DOC TYPE eHISTORICAL FILE ❑ MONITORING REPORTS DOC DATE o A01 E YYYYMMDD ROY COOPER Govemor MICHAEL S. REGAN Secretary w WILLIAM E. TOBY VINSON, JR. Energy,Mineral Interim Director and Land Resources ENVIRONMENTAL QUALITY August 17, 2018 Mr. Erich Burke Qorvo US, Inc. 7628 Thorndike Road Greensboro, N.C. 27409 Subject: Rescission of NPDES Stormwater Permit No Exposure Certification Number NCGNE0948 Guilford County Dear Mr. Thorndike: On January 23, 2018: the Division of Energy. Mineral and Land Resources received your request to rescind your coverage under No-Exposure Cerification Number NCGNE0948. This certification was for exclusion from NPDES Stormwater Permitting. In accordance with your request, Certification for No-Exposure Number NCGNE0948 is rescinded effective immediately. If something changes and your facility would again qualify for a No-Exposure exclusion from permitting, you should notify this office immediately. Also, operating a treatment facility, discharging wastewater or discharging specific types of stormwater to waters of the State without valid coverage under an NPDES permit is against federal and state laws and could result in fines. We will be happy to assist you in assuring the proper certification or permit coverage. If the facility is in the process of being sold, you will be performing a public service if you would inform the new or prospective owners of their potential need for NPDES permit coverage. State of North Carolina I Environmental Quality I Energy, Mineral,and Land Resources Central Office 1 1612 Mail Service Center I Raleigh, NC 27609 919 707 9200 l If you have questions about this matter, please contact us at 919-707-9200, or the Stormwater staff in our Winston-Salem Regional Office (336) 776-9800. Sincerely, for William E. Toby Vinson, Jr., PE, CPESC, CPM Interim Director Division of Energy, Mineral and Land Resources cc: Winston-Salem Regional Office Stormwater Permitting Program Central Files FOR AGENCY USE ONLY • . Division of Energy,Mineral& Land Resources Date Received Al. Land Quality Section/Stormwater Permitting Program Year Month Day � NCDENiRNational Pollutant Discharge Elimination System C'E�I V� Na CWO —,Oew .a ,of 1 D Ro��E r.oNmm. REsa.ccs RESCISSION REQUEST FORM BAN 93 �lvt Please fill out and return this form if you no longer need to maintain your NPDES stormwatesp�"e,QUAClN Ml7TjNG 1) Enter the permit number to which this request applies: Individual Permit (or) Certificate of Coverage N I C I S 1 1 J J I I N I C I G N6 1 O T r{ g 2) Owner/Facility Information: *Final correspondence will be mailed to the address noted below Owner/Facility Name O Rva L� 5 t S01 c- • _ Facility Contact E iF,l c-H C3 %1 (W E Street Address -7(oj, 15 T ti 0 a r10 1 E R City G R ECAJS75 Org o State 1-9 C— ZIP Code .X-7 yo4 County LFORP E-mail Address ERticN $ uRIfC @ Go lev0. 0-t- Telephone No. `'.3 L 4 31 - Ca a Y x Fax: 3) Reason for rescission request (This is required information. Attach separate sheet if necessary): LJ Facility closed or is closing on ff '3d'17 All industrial activities have ceased such that no discharges of stormwater are contaminated by exposure to industrial activities or materials. ❑ Facility sold to on r---] . If the facility will continue operations under the new owner it may be more appropriate to request an ownership change to reissue to permit to the new owner. ❑ Other: 4) Certification: I, as an authorized representative, hereby request rescission of coverage under the NPDES Stormwater Permit for the subject facility. I am familiar with the information contained in this request and to the best of my knowledge and belief such information is true, complete and accurate. Signature d/ w Date _P,[?GCT-A o FAClL1-r/E5 Print or type name of person signing above Title Please return this completed rescission request form to: NPDES Permit Coverage Rescission Stormwater Permitting Program 1612 Mail Service Center Raleigh, North Carolina 27699-1612 1612 Mail Service Center,Raleigh, Forth Carolina 27699-1612 Phone:91 M07-63001 FAX:919-807-6492 An Equal Opportunity\Affirmative Action Employer ®r i V' �o HCDEHR North Carolina Department of Environment and Natural Resources Division of Water Quality Pat McCrory Charles Wakild, PE John E. Skvarla, III Governor Director Secretary _ June 3, 2013 Mr. Erich J. Burke, PEy� ''{ mod Senior Environmental Engineer SUN 12 2013 RF Micro Devices, Inc. 7628 Thorndike Road GENTKtal FILES Greensboro, NC 27409-9421 mrvaI30G Subject: No-Exposure Certification NCGNE0948 RF Micro Devices—Old Corp. 7625 Thorndike Road—Greensboro, NC Guilford County Dear Mr. Burke: The Division has reviewed your submittal of the No-Exposure Certification form requesting Exclusion from NPDES stormwater Permitting for the RF Micro Devices — Old Corp facility located at 7625 Thorndike Road in Greensboro, NC. Based on the submittal of the signed certification and the site visit conducted by Mike Mickey on May 31, 2013, the Division is granting the 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 the no-exposure certification, RF Micro Devices is obligated to maintain no- exposure conditions at this facility. If conditions change such that the facility can no longer qualify for the no- exposure exclusion, you are obligated to immediately obtain NPDES permit coverage for any stormwater discharge. Otherwise, the discharge becomes subject to enforcement as an un-permitted discharge. RF Micro Devices must re-certify the no-exposure status annually using the attached form. Any"Yes" answer would require that you obtain NPDES permit coverage for stormwater discharges from the facility. The annual self re- certification form does not need to be submitted to' DWQ unless requested. Please note that this 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 Mike Mickey at(336) 771-5000. Sincerely, for Charles Wakild, PE cc: Debbie Shoffner(City of Greensboro,Stormwater Management Division,via email: debbie.shoffner@greensboro-nc.gov) Stormwater Permitting Unit, No-Exposure Files Winston-Salem Regional Office Central Files Wetlands and Stormwater Branch 1617 Mail Service Center,Raleigh,North Carolina 27699-1617 Nor thCarolina Location:512 N.Salisbury St.Raleigh,North Carolina 27604 ;Vat mall Phone:919-807-63001 FAX:91 9-807-64941 Customer Service:1-877-623$748 ` Intemet:www.ncwaterquaiity.org An Equal opportunity S Affirmative Action Employer O Fualril FOR AGENCY USE ONLY Division rSurface Water Protection Date Received Year nToatn nay ������ National Pollutant Discharge Elimination System Certificate of Coverage NTH Ci4riClrlNA L7EPtRTMEYT OF NO EXPOSURE CERTIFICATION for Exclusion N G N E fj�vur mm'a T µn tWuw.Ar,o:Pcra 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 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-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 owner/operator(address to which all certification correspondence will be mailed): Name R V7 w f c o t7E V f Gr S Contact t1 R I c Street Address 7 t3 a R A o City G04ce" Stated ZIP Code �.7 Yo Telephone No. '33 43 2 g b Y; _ Fax: `33 4 6 7 S - o r e 8 Email E13J(kitG- R Rf=fia • coal . MAY Page 1 of 7 o �e SW U-NE-12Aug2010 � � i ca NCGNE0000 No Exposure Certification 2) Location of facility producing discharge: Facility Name Iz - �(C&O n L D Cza t7 Facility Contact C Ric N 13 u R V-,C Facility Street Address 7 L a 5 T A-0(z AJ 4114r Ft k)A D City 6 CtE c 1v S a-arAo State tj C_ ZIP Code 7 Yz,9 County C I Telephone No. I a 6 9 3 i - soy.), Fax: `3-3 a/ 3 g Email CaLj{zKe FeEM0 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). :. Y4 S- +4 2 t 4 kf o u 4.a TL.° r o d.(u &J 7 6'1,S i S 4 ev 4-,. �e 'f (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 E9//No 5) Is this a Federal facility? ❑ Yes &]/No 6) Latitude 3 6°o Y '3143 Longitude `1R 57 'gj (deg., min., seconds) 7) This NPDES No Exposure Exclusion application applies to which of the following: o New or Proposed Facility Date operation is to begin V Existing Date operation began liq9 r-ecc 4 ad d i 4,'oti >7 F ❑ Renewal of existing No Exposure Certification Certification No.: NCGNE 8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes "o 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: 3 6 -2 10) Provide aRbrief description of the types of industrial activities and products produced at this facility: t^I r-+4- �e 5+ n; Se'M; ".06, r tp u i LC 5 11) Does this facility have any Non-Discharge permits(ex: recycle permits)? VNo Q Yes If yes, list the permit numbers for all current Non-Discharge permits for this facility: Page 2 of 7 SWU-NE-12Aug2010 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 E( 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 &r/No c. Materials or products from past industrial activity ❑ Yes Id No d. Material handling equipment(except adequately maintained vehicles) ❑ Yes Ed No e. Materials or products during loading/unloading or transporting activities ❑ Yes M No f. Materials or products stored outdoors(except final products intended for outside ❑ Yes VNo 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 Ef No and similar containers h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes i(No the discharger i.Waste material (except waste in covered, non-leaking containers [e.g., dumpsters]) ❑ Yes E(No j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes a'No k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes 1 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 EKNo (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 0 Yes 2 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 C/Yes © No ❑ NIA deterioration, or evidence of leaks? b. Is secondary containment provided for all exterior ASTs? If so, is it free of any IdYes ❑ No ❑ N/A cracks, holes, or evidence of leaks, and are drain valves maintained locked shut? Page 3of7 S W U-N E-12Aug 2014 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 B�Yes ❑ No ❑ NIA containers (including drums, barrels, etc.)with a capacity of more than 660- gallons? b. Is secondary containment provided for above ground storage containers stored E�Yes ❑ No ❑ NIA 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 ELAN/A Amendments and Reauthorization Act (SARA) water priority chemicals'? d. Is secondary containment provided for hazardous substances"designated in 40 © Yes ❑ No t�N/A CFR §116? / e. Are release valves on all secondary containment structures locked? d Yes © No ❑ NIA 15) Hazardous Waste: a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? ❑ Yes WNo b. Is this facility a Small Quantity Generator(less than 1000 kg. of hazardous waste ❑ Yes 19 No generated per month) of hazardous waste? c. Is this facility a Large Quantity Generator(1000 kg. or more of hazardous waste ❑ Yes 0'No 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 4 of 7 SW U-N E-12Aug2010 NCGNE0000 No Exposure Certification 1 G) 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 [Ao b. Does your facility have coal piles on site? © Yes d/No c. Does your facility store other fuel sources outside in piles, such as woad chips, ❑ Yes M No sawdust, etc.? / d. Does your facility have air emissions associated with its industrial activity (e.g., ❑ Yes ® No 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 ElNo d NIA 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: C) `f 0q `T t a- Program: A 0- CQ�aJQ �-<1 Permit:, S Q li Program: Permit: Program: Permit: Program: Permit: Program: Permit: Program: Permit: Program: Page 5 of 7 SWU-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 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: E Q IC 6 U R LIE Title: Sf- Cum • 4� �-1 (3. (Signature of A icant) (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 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 fora No Exposure Exclusion. Page 6 of 7 SWU-NE-12Aug2010 NCGNE0000 No Exposure Certification Final Checklist This application should include the following items: 2"" This completed application and all supporting documentation. Cl"' 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 B. 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 Re final Office Contact Information: Asheville Office ...... (828) 296-4500 f� Fayetteville Office ... (910) 433-3300 1 al',an- Mooresville Office _ (704) 663-1699 Raleigh Office ..... 919 791-4200 ] g .. ( ) ".��1:- ! Ile I° Washington Office ...(252) 946-6481 Wilmington Office ... (910) 796-7215 Winston-Salem ...... 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Burke, PE Senior Environmental Engineer RF Micro Devices, Inc. 7628 Thorndike Road Greensboro, NC 27409-9421 Subject: No-Exposure Certification NCGNE0948 RF Micro Devices—Old Corp. 7625 Thorndike Road—Greensboro, NC Guilford County Dear Mr. Burke: The Division has reviewed your submittal of the No-Exposure Certification form requesting Exclusion from NPDES stormwater Permitting for the RF Micro Devices — Old Corp facility located at 7625 Thorndike Road in Greensboro, NC. Based on the submittal of the signed certification and the site visit conducted by Mike Mickey on May 31, 2013, the Division is granting the conditional exclusion from permitting as provided for under 40 CFR 12226(g), which is incorporated by reference in North Carolina regulations. Please note that by our acceptance of the no-exposure certification, RF Micro Devices is obligated to maintain no- exposure conditions at this facility. If conditions change such that the facility can no longer qualify for the no- exposure exclusion, you are obligated to immediately obtain NPDES permit coverage for any stormwater discharge. Otherwise, the discharge becomes subject to enforcement as an un-permitted discharge. RF Micro Devices must re-certify the no-exposure status annually using the attached form. Any "Yes" answer would require that you obtain NPDES permit coverage for storm+,vater discharges from the facility. The annual self re- certification form does not need to be submitted to DWQ unless requested. Please note that this 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 Mike Mickey at(336) 771-5000. Sincerely, for Charles Wakild, PE cc: Debbie Shoffner(City of Greensboro,Stormwater Management Division,via email: debbie.shoffner@greensboro-nc.gov) Stormwater Permitting Unit, No-Exposure Files Winston-Salem Regional Office i Central Files Wetlands and Stormwater Branch One 1617 Mail Service Center,Raleigh,North Carolina 27699-1617 NOrthCarohna Location: Salisbury St.Raleigh,North Carolina 04 AduAdIlY Phone:91M9-$07.63041 FAX:919$O7-i4941 Customerr Service:1-877�23.6746 Internet:www.ncwaterquality.org An Equal Opportunity 1 Affirmative Action Employer ' RFMD ®® RF Micro Devices, Inc. 7628 Thornlike Road rfmd.com Greens4oro,NC 27409-9421 ISO 9001 and 14001 Certified eburke@rfmd.com p 336.931.8042 f 336,678.0188 m 336.215.3361 Erich J. Burke,PE Senior Environmental Engineer �IJJ FOR AGENCY USE ONLY � I}asc Received Division of Water Quality/Surface Water Protection Year r,ontn Da NC®ENR National Pollutant Discharge Elimination System cenificaleorc� e �e NO EXPOSURE CERTIFICATION for Exclusion E NICIGIN `" T W1 :: "`�of RECEIVED fNV:FpHNF.YT•Nl NR1A4V.�SOJiGFS NCGNE0000 N.C.Ceot.of ENR MAY 2 9 2013 NO EXPOSURE CERTIFICATION Winston-Salem National Pollutant Discharge Elimination System application for exclusion from a[Storm] wale r•Pefirit 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 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-certify 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 R Fr rh l C 6o 06 V 1 c-S Contact E_R I C>,..} 3 V (2 %C6, Street Address `7 $�t o a ni h 1tA.e I-k o A C T City G04EENS BO A0 State HC _ZIP Code oL7 V o9� Telephone No. 33 13 f - g d Y.;- Fax: _�3 L G 7 g - of e s Email SEA0 - Car+% Page 1 of 7 MAY 2 3 2013 SWU-NE-12Aug2010 NCGNE0000 No Exposure Certification 2) Location of facility producing discharge: Facility Name RF rklCiLo pE,4 ICcS - OLD ca R P Facility Contact C A t c 44 Q R tcE Facility Street Address 7 (.3L 5 T tko dz AJ D j Imo' R 0A D City RE C IV S i3 a n o State Nc- ZIP Code a-? 5',z 9 County 6ki l G.so&_D Telephone No. 33 16 q 3 I - $oY3- Fax: -33 c 8 - of St3 Email EQy2LKE f�t7FyhD • QoAj 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). :1 q O ic 4,c, I; e $a +4 ' (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 Cii No 5) Is this a Federal facility? ❑ Yes B/No 6) Latitude_3( o 0 3(.13 Longitude 79�57 `49 (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 I1 Existing Date operation began I Ili I) r¢c eN-+ ed d +' fi'd ti b F ❑ Renewal of existing No Exposure Certification Certification No.: NCGNE 8) Was this facility or site ever covered under an NPDES Stormwater Permit? ❑ Yes "o 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: 3 (, 10) Provide abrief description of the types of industrial activities and products produced at this facility:p 11) Does this facility have any Non-Discharge permits(ex: recycle permits)? ISNo ❑ Yes If yes, list the permit numbers for all current Non-Discharge permits for this facility: Page 2 of 7 SWU-NE-12Aug2010 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 �2(1\10 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 r/No c. Materials or products from past industrial activity ❑ Yes d No d. Material handling equipment (except adequately maintained vehicles) ❑ Yes FNo e. Materials or products during loading/unloading or transporting activities ❑ Yes M/No f. Materials or products stored outdoors (except final products intended for outside o Yes ['No 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 R(No and similar containers h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes �Ao the discharger i. Waste material (except waste in covered, non-leaking containers [e.g., dumpsters]) ❑ Yes C/No j. Application or disposal of process wastewater(unless otherwise permitted) ❑ Yes Er k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes FIN 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 l"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 1�t 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 C/Yes ❑ No ❑ N/A deterioration, or evidence of leaks? b. Is secondary containment provided for all exterior ASTs? If so, is it free of any G2(Yes ❑ No ❑ N/A cracks, holes, or evidence of leaks, and are drain valves maintained locked shut? Page 3of7 SWU-NE-1 2Aug201 0 NCGNEOOOO 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 ❑ NIA 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 ❑ NIA 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 Cl No I"N/A Amendments and Reauthorization Act (SARA) water priority chemicals*? / d. Is secondary containment provided for hazardous substances—designated in 40 ❑ Yes ❑ No t/NIA CFR §116? / e. Are release valves on all secondary containment structures locked? 27 Yes ❑ No ❑ NIA 15) Hazardous Waste: a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? ❑ Yes Ig No b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste ❑ Yes Ei'No generated per month) of hazardous waste? c. Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste ❑ Yes E�3'No 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 SWU-NE-12Aug2a10 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 dNo b. Does your facility have coal piles on site? ❑ Yes M/No c. Does your facility store other fuel sources outside in piles, such as wood chips, ❑ Yes l//No sawdust, etc.? d. Does your facility have air emissions associated with its industrial activity(e.g., ❑ Yes VNo 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 Ef NIA 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: OS Yd`► `r la- Program: h i T Q jJ-'4 Permit: C 6 S a Program: 14M-2 • G-jA 5+C Sc c 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. 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)). 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 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: E R 1 C N _ ICE Title: 4.,0, -J J • 1-=r,ag . S •�-I . 13 (Signature of icant) (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 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 6 of 7 5WU-NE-12Aug2010 NCGNE0000 No Exposure Certification Final Checklist This application should include the following items: R"' This completed application and all supporting documentation. CT" 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 DWO Regional Office for your area. DWQ Regional Office Contact Information: Win iu Sale, ; Asheville Office ...... (828) 296-4500 { �� Fayetteville Office ... (910) 433-3300 Mooresville Office ... (704) 663-1699 Raleigh Office ........ (919) 791-4200 Washington Office ...(252) 946-6481 Wilmington Office ... (910) 796-7215 J = "cts Winston-Salem ...... 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