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NCGNE0966_COMPLETE FILE - HISTORICAL_20170209
STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. /V UCoNL V 9 L l� DOC TYPE GJiHISTORICAI FILE ❑ MONITORING REPORTS DOC DATE ❑ YYYYMMDD -)Ztqs ZHAECO Sw[� 3 � 7 February 2017 North Carolina Department of Environment and Natural Resources Division of Energy, Mineral and Land Resources 1612 Mail Services Center 1 Raleigh, North Carolina 27699-1612 RE: NPDES No Exposure Exclusion Number NCGNE0966 To Whom It May Concern, Please rescind our NPDES No Exposure Exclusion coverage under the enclosed Exclusion number NCGNE0966 for our 502B Radar Rd. Warehouse facility in Greensboro, NC. We no longer occupy the building or have any rental or lease agreement for the facility. Should you have any questions or concerns regarding this circumstance please don't hesitate to contact our Environmental Manager Van Sullivan at 336-709-0655. Sincerely, RECEIVED Keith Statzer FES o q 2017 General 416.2 OENRUNI) QUALITY NORM AIER PERMITTING Z4?4 hCC�- ��- 6368 HAECO Airframe Services t +1-336-668-44 10 extension 54" 623 Radar Road,Greensboro,North Carolina 27410-6221 m+1-336-215-7643 www,haeco.aero Division of Water Quality/Surface Water Protection 1 National Pollutant Discharge Elimination System RCDENR ANNUAL NO EXPOSURE EXCLUSION SELF RE-CERTIFICATION E �C`° NCGNE0000 V C FEB o 9 2e17 Do not submit this form to DWQ unless requpkii'd LAND Qi1ALI-y Jf VIl'r'V�I^�C�TCj'7, rirr. For questions,please contact the DWQ Regional Office for your area or the Central Office, (Please print or type) Facility's No Exposure Exclusion No. Date Completed (MM/DD/YYYY) N I C I G I N I E 1 0 1 9 6 1 6 1 1 1 / 1 4 / 2 0 1 1 6 1) Has the facility name or owner changed? ❑Yes ® No (if yes,please submit a separate Name/Ownership Change Form to DWO located at http://portal.ncdenr.org/webAvq/wstsufn pdessw#Application_Forms_N P DES) 2) 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 to maintain your no exposure exclusion,and must immediately apply for a permit from DWQ. a. Using, storing, or cleaning industrial machinery or equipment, and areas where [:]Yes ® 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 spillstleaks ❑Yes ® No c. Materials or products from past industrial activity ❑Yes ® No d. Material handling equipment(except adequately maintained vehicles) ❑Yes ® No e. Materials or products during loading/unloading or transporting activities ❑Yes ® No f. Materials or products stored outdoors(except final products intended for outside ❑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 ® No and similar containers h. Materials or products handled/stored on roads or railways owned or maintained by ❑Yes ® No the discharger i. Waste material (except waste in covered, non-leaking containers[e.g., dumpsters]) ❑Yes ® No j.Application or disposal of process wastewater(unless otherwise permitted) ❑Yes ® No 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 ® No (i.e., not closed and stored upside down to prevent precipitation accumulation) Page 1 of 3 SW1J-NESR-29Ju12o10 ` NCG4E0000 No Exposure Self Re-Certification 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? 3) Above Ground Storage Tanks(ASTs): If you answer"No"to any of the following items,you are not eligible to maintain your no exposure exclusion,and must immediately apply for a permit from DWQ. a. Are exterior ASTs and piping free of rust damaged or weathered coating, pits, or [:]Yes[:] No ® NIA deterioration, or evidence of leaks? b. Is secondary containment provided for all exterior ASTs? If so, is it free of any ❑Yes❑ No® NIA cracks, holes,or evidence of leaks, and are drain valves maintained locked shut? 4) Secondary Containment: If you answer"No"to any of the following items,you are not eligible to maintain your no exposure exclusion,and must immediately apply for a permit from DWQ. a. Is secondary containment provided for all single above ground storage containers [—]Yes[:] No® NIA (including drums, barrels, etc.)with a capacity of more than 660-gallons? b. Is secondary containment provided for above ground storage containers stored in ❑Yes❑ No ® NIA 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 ® NIA Amendments and Reauthorization Act(SARA)water priority chemicals'? d. Is secondary containment provided for hazardous substances"designated in 40 []Yes[:] No® N/A CFR§116? e.Are release valves on all secondary containment structures locked? ❑Yes❑ No ® NIA Footnotes to Questions 4)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 M 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. 5) Other information: If you answer"Yes"to any of the following items,and the answer if different from how it was answered when originally applying,you might not be eligible to maintain your no exposure exclusion. Please contact the Division if this is the case. a. Does your facility store used, recycled, or otherwise reclaimed pallets outside? ❑ Yes ® No •b. Does your facility have coal piles on site? ❑Yes ® No c. Does your facility store other fuel sources outside in piles, such as wood chips, ❑Yes ®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❑ No®NIA Please specify: Page 2 of 3 SWu-NESR-29Jul2010 NCGNE0000 No Exposure Self Re-Certification 6) 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/maintaining 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 this 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 provided. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information,the information provided is to the best of my knowledge and belief true,accurate and complete. I am aware that there are significant penalties for providing false information,including the possibility of fine and imprisonment for knowing violations. I certify that I am familiar with the information contained in this document and that to the best of my knowledge and belief such information is true,complete,and accurate. Printed Name of Person Signing: Keith Statzer Title:General Mana er-(502 B Warehouse Facility) (Signature) (Date Signed) Please note: The Regional Office may 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($10,0130)_ This completed form must be kept on rile at the facility for at least 5 years. Do not submit this form to DWQ unless requested. Page 3 of 3 SWU-NESR-29M2010 �dA A== NCDENR North Carolina Department of Environment and Natural Resources Pat McCrory Donald R. van der Vaart Governor Secretary July 15, 2015 RECEIVED N Mr. Keith Statzer N.C. Dept. of ENR Triad International Maintenance Corporation JUL 2 0 2015 (TIMCO)dba HAECO Airframe Services _ Winston Salem 502 A& B Radar Road Regional office Greensboro,NC 27410 Subject: Rescission of NPDES Stormwater Permit No Exposure Certification Number NCGNE0966 Guilford County Dear Mr. Statzer: On March 26, 2015 the Division of Energy, Mineral and Land Resources received your request to rescind your coverage under No-Exposure Cerification Number NCGNE0966. This certification was for exclusion from NPDES Stormwater Permitting. In accordance with your request, Certification for No-Exposure Number NCGNE0966 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. 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) 771-5000. Sincerely, ORIGINAL SIGNED BY BETHANY GEORGOULIAS for Tracy E. Davis, PE, CPM, Director cc: Zinston-Salem Regional Office Division of Energy, Mineral and Land Resources cc: Regional Office Stormwater Permitting Program Central Files -wlattachments Division of Energy, Mineral, and Land Resources Energy Section •Geological Survey Section•Land Quality Section 1612 Mail Service Center, Raleigh, North Carolina 27699-1612.919-707-92001 FAX:919-715-8801 512 North Salisbury Street,Raleigh,North Carolina 27604• Internet:http:l/portal.nGdenr.org/web/irl An Equal Opportunity 1 Affirmative Action Employer—50%Recycled l 10%Post Consumer Paper FOR AGENCY USE ONLY Division.of Water Quality I Surface Water Protection Date Received Year Month .1 Da RCDENR National.Pollutant Discharge Elimination System kS5 ��, RESCISSION REQUEST FORM MAR ��Q G Please fill out and return this form if you no longer need to maintain your NPDES stormwater D warF� &6LlFFR ER OU�C�S +�r7TrNG, 1) Enter the permit number to which this request applies: Individual Permit (or) Certificate of Coverage N� .Gf •5' >;Nr C sG N E 0 9 5 6 2? Owner/Facility information: •Final correspondence will be mailed to the address noted below Owner/Facility Name Triad International Maintenance Corporation TIMCO dba HAECO Airframe Services _ Facility Contact Jordan Geras Street Address 502 A&B Radar Road _ City Greensboro State NC ZIP Code 27410 County Guilford _ E-mail Address Jordan.Reras@haeco.aero_ Telephone No. 336- 668-4410 Ext: 5444 Fax: 336-665-9009 3) Reason for rescission request(This is required information, Attach separate sheet if necessary): Facilit closed is closing on 311115 - .•All industrial activities have ceased such that no discharges of storrr water are contaminated by exposure.to industrial activities or materials. ❑ Facility sold to F on i7---1 . 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 Date Z 4 Print or type name of person signing above Title Please return this completed rescission request form to: SW NPDES Permit Coverage Rescission Stormwater Permitting Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617 1617 Mail Service Center,Raleigh,North Carorma 27699-1617 Location:512 N.5ariswry St.Ralegh,North Carolina 27604 One Phone:919-807-63001 FAX:919$07-64921Customer Service:1-877-623-6748 ND CarOna Internet WWMr.11GWaferqualiry.ar4 )Va tilurall An Squat Opponunity 1 Atirmat Ye Acbon Employer y W � NCDENR North Carolina Department of Environment and Natural Resources Pat McCrory Donald R. van der Vaart Governor Secretary RECEIVED March 23, 2015 N.C. Dept.of ENR MAR 3 1 2015 Mr. Keith A. Statzer Winston-Salem HAECO Airframe Services Regional Office 623 Radar Road Greensboro, NC 27410 Subject: Name/Ownership Change Request No Exposure Certification NCGNE0966 HAECO Airframe Services Formerly Triad International Maintenance Corporation Guilford County Dear Mr. Statzer: The Division has reviewed your submittal of the permit name/ownership change form for the subject No-Exposure Certification, which we received on February 2, 2015. Division personnel have reviewed and approved your request to transfer the exclusion from NPDES stormwater permitting requirements. Please note that by our original acceptance of the No-Exposure Certification and by our approval of your request to transfer it, you are obligated to maintain no-exposure conditions at your facility. If conditions change such that your facility can no longer qualify for the 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. Annual re-certification is required, and we have enclosed one blank Annual No Exposure Exclusion Self Re-Certification form for your use. Your certification of no exposure does not affect your facility's legal requirements to obtain environmental permits that may be required under other federal, state, or local regulations or ordinances. Division of Energy, Mineral, and Land Resources Energy Section • Geological Survey Section • Land Quality Section 1612 Mail Service Center, Raleigh, North Carolina 27699-1612.919-707-92001 FAX: 919-715-8801 512 North Salisbury Street, Raleigh, North Carolina 27604•Internet: http:llportal,ncdenr.org/web/ir/ An Equal Opportunity 1 Affirmative Action Employer—50%Recycled 110%Post Consumer Paper If you have any questions or need further information, please contact the Stormwater Permitting Program at(919) 807-6300. Sincerely, ORIGINAL SIGNED B) KEN PICKLE for Tracy E. Davis. P.E., CPM, Director Division of Energy, Mineral and Land Resources cc:"Winston-Salem Regional Office Stormwater Permitting Program Files RECEIVED i N.C. Dent.of ENA _ MAR 3 1 2015 NCDENR Winston-Salem na North Carolina Department of Environment and Natural Resources a 'o 'O"i" Pat McCrory Donald R. van der Vaaq Governor Secretary March 23, 2015 Mr. Keith A. Statzer HAECO Airframe Services 623 Radar Road Greensboro, NC 27410 Subject: Name/Ownership Change Request No Exposure Certification NCGNE0967 HAECO Airframe Services Formerly Triad International Maintenance Corporation Guilford County Dear Mr. Statzer: The Division has reviewed your submittal of the permit name/ownership change form for the subject No-Exposure Certification, which we received on February 2, 2015. Division personnel have reviewed and approved your request to transfer the exclusion from NPDES stormwater permitting requirements. Please note that by our original acceptance of the No-Exposure Certification and by our approval of your request to transfer it, you are obligated to maintain no-exposure conditions at your facility. If conditions change such that your facility can no longer qualify for the 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. Annual re-certification is required, and we have enclosed one blank Annual No Exposure Exclusion Self Re-Certification form for your use. Your certification of no exposure does not affect your facility's legal requirements to obtain environmental permits that may be required under other federal, state, or local regulations or ordinances. Division of Energy, Mineral, and Land Resources Energy Section -Geological Survey Section • Land Quality Section 1612 Mail Service Center, Raleigh, North Carolina 27699-1612.919-707-92001 FAX:919-715-8801 512 North Salisbury Street, Raleigh, North Carolina 27604•Internet:http:/Iportal.ncdenr.org/webllr! An Equal Opportunity 1 Affirmative Action Employer—50% Recycled 110%Post Consumer Paper Y • L If you have any questions or need further information, please contact the Stormwater Permitting Program at (919) 807-6300. Sincerely, ORIGINAL SIGNED B) KEN PICKLE for Tracy E. Davis, P.E., CPM, Director Division of Energy, Mineral and Land Resources cc4inston-Salem Regional Office Stormwater Permitting Program Files Central Files :a Taylor-Smith, Aana A I ■ � From: Jordan Geras <Jordan.Geras@TIMCO.aero> Sent: Thursday, May 01, 2014 3:00 PM To: Taylor-Smith, Aana Subject: TIMCO Aviation Attachments: No Exposure Certification Additions.pdf Aana, Thank you for taking the time and speaking with me this morning. I have attached a letter explaining the no exposure certifications TIMCO currently holds for our file. If you have any additional questions or concerns please don't hesitate to contact me. Thank You Jordan Geras Environmental Manager TIMCO Aviation Services Office: 336-668-4410 ext. 5444 Cell: 336-215-7643 Fax: 336-393-0313 Email: Lrdan.gerasCcDtimco.aero TIMCO Jordan Geras Environmental Manager May I,2014 Aana Taylor-Smith Environmental Specialist 585 Waughtown Street Winston Salem,.NC 27107 Dear Ms.Taylor-Smith, T[MCO Aviation currently has(2)No Exposure Certifications filed with the North Carolina Department of Environment and Natural Resources;NCGNE0966&NCGNE0967. Suice our initial approval dates of October and November 2013, facility expansion has occurred through the rental of additional connected facilities. Certification NCGNE0967 which originally addressed 500A Radar Road now encompasses 500A, E, F,G& H connecting facilities. Certification NCGNE0966 which was originally addressed 502-B Radar Road has now expanded to 502A& B Radar Road, with TIMCO now renting its connecting warehouse. Operations have not changed within in this cluster of rental warehousing,just TCMCO's footprint on the complex. All additional facilities were previously constructed units and at the time of the original certifications TQviCO had not rented the connecting warehouses. But due to production increases and storage necessities the need to rent these units became essential. The following letter will serve as notification to the address changes incorporating the above unit additions. Please don't hesitate to contact me if you have any additional questions or concerns. Sincerely, Jordan Geras Cc: Bruce Bonney(email) Todd Walker(email) Neal Harper(email) 623 Radar Road Greensboro,NC 27410 Office:(336)668-4410 Ext 5444 Cell:(336)215-7643 [gypp NCDENR North Carolina Department of Environment and Natural Resources Division of Energy, Mineral, and Land Resources Land Quality Section Tracy E. Davis, PE, CPM Pat McCrory, Governor Director John E. Skvarla, III, Secretary November 25, 2013 Jordan Geras Triad International Maintenance Corporation (TIMCO) 623 Radar Road Greensboro, NC 27410 Subject: No Exposure Certification NCGNE0966 TIMCO—502-B Radar Road Guilford County Dear Mr. Geras: The Division has reviewed your submittal of the application for No Exposure Certification requesting exclusion from NPDES stormwater permitting for the TIMCO facility located at 502-B Radar Road in Greensboro, NC. Based on your submittal of a signed certification of no exposure and on the site visit conducted by Aana Taylor-Smith on September 27, 2013, the Division is granting 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, TIMCO is obligated to maintain no exposure conditions at this facility. If conditions change such that the facility no longer qualifies for no exposure exclusion, you are obligated to immediately obtain NPDES permit coverage for any stormwater discharge. Otherwise, the discharge becomes subject to enforcement as unpermitted discharge. TIMCO must recertify the no exposure status annually using the included form. Any "yes" answer would require that you obtain NPDES permit coverage for stormwater discharge from the facility. The.annual self-recertification form does not need to be submitted to DEMLR, 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 Aana Taylor-Smith or me at(336) 771-5000. Sincerely, Matthew E. Gantt, PE Regional Engineer Land Quality Section Enclosures: 1. Annual Self-Recertification Form CC: Debbie Shoffner(City of Greensboro Stormwater Management Division,via email:deborah.shoffner@greensboro-nc.gov) Stormwater Permitting Unit— No Exposure Fifes Central Files - DWR WSRO Files—Land Quality Winston-Salem Regional Office 585 Waughtown Street,Winston-Salem, NC 27107.. Phone: 336-771-50001 FAX:336-771-4631 Taylor-Smith, Aana From: Taylor-Smith, Aana Sent: Friday, September 27, 2013 2:17 PM To: Bennett, Bradley Cc: Georgoul!as, Bethany Subject: New NEC facilities Hi there, I inspected three facilities today that applied for No Exposure.Those three NEC apps were being reviewed by Sheri Montalvo, but I know she's on her"break"from being a temp employee, so I thought I'd send this your way. Findings are as follows: NCGNE0966 (TIMCO at 502E Radar Rd): They are not 100% moved in yet. I will re-inspect when they are finished moving and update with results. NCGNE0967 (TIMCO at 500A Radar Rd): Can be issued now. No problems with NEC. NCGNE0968 (Nypro Mebane): Can be issued now. No problems with NEC. Thanks! If there are any questions, please let me know. Have a great weekend, Aana Taylor-Smith Land Quality Section Division of Energy, Mineral,and Land Resources NC DENR Winston-Salem Regional Office Phone: (336) 771-5034 Fax(336) 771-4631 E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties. - U pda ed� ebb S Vu6� @ C�G C' j 2_1 j i3 RECEIVED N.C.pelt.of ENR SEP 9,.2 M3 cnt5 Wlnaton4olom FOR AGENCY USE ONLY 8t+F s,on o"Mater Qualitv/Surface Water Protection Date Received �+ Year 410n1h Dav NCDE R National Pollutant Discharge Elimination System CenificateofCoverage v v NO EXPOSURE CERTIFICATION for Exclusion F J,Mx r.r,VT u-0 NW A..Rr.e_-,,.r9 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 NPOES 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 7r<�� rs, �.�ioti�,l /ncun.l=i.,r.�c�. C�ele,-CA.vr.r Contactr�G Street Address _ �1�,,r 20'A City lrryy l5 bard State Ale_�_ ZIP Code a7411 U Telephone No. �34, 669--414//0 ��. SU�lyFax: 53G 6C05—g009 Email 105 pArl ._ r r r 4C° -6tv n. c-e no Page 1 of 7 spa � s SwU-NE-12Aug2010 W n R-tyA uaLtTM Branch NCGNE0000 No Exposure Certification 2) Location of facility producing discharge: Facility Name '�ic,_ Two a+f NG� r.n�� nlcwn�Y.Nc�viG� ( car Earil�:�kS.1m�� Facility Contact �Z-4c.,L^_ Facility Street Address City 6 State Ave- ZIP Code 7 County '6-V1X&y-� Telephone No, 3,34, 6G8- {c Iz;, e�'wf- SYyT Fax: 3X &(, - gcro4 Email . 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�l-e"S-r s eY___c;�kc�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 Xo 5) Is this a Federal facility? ❑ Yes �No 6) Latitude 3!. •c>88.C4 Longitude -7�i •`J 33G 37 (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 ❑ 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: 1 5 S I 10) Provide a brief description of the types of industrial activities and products produced at this facility: iavr AIrC✓O. In rr/rl�' �7r���,rfty+ a �rw�ww5 _e_5 1.71✓. 11) Does this facility have any Non-Discharge permits (ex: recycle permits)? ❑ Yes If yes, list the permit numbers for all current Non-Discharge permits for this facility: Page 2of7 5WU-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 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 XNo c. Materials or products from past industrial activity ❑ Yes 9KO d. Material handling equipment (except adequately maintained vehicles) ❑ Yes 7<o e. Materials or products during loading/unloading or transporting activities ❑ Yes /KN a f. Materials or products stored outdoors (except final products intended for outside ❑ 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 /No and similar containers h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes 21No the discharger i. Waste material (except waste in covered, non-leaking containers [e.g., dumpsters]) ❑ Yes /NO j. Application or disposal of process wastewater (unless otherwise permitted) ❑ Yes /No k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes )ZNo 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 X 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 /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 ZNIA deterioration, or evidence of leaks? b. Is secondary containment provided for all exterior ASTs? If so, is it free of any ❑ Yes ❑ No ZNIA cracks, holes, or evidence of leaks, and are drain valves maintained locked shut? Page 3 of 7 SWU-NE-12Aug2010 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 ❑ 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 /N/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 /N/A Amendments and Reauthorization Act (SARA) water priority chemicals*? d. Is secondary containment provided for hazardous substances— designated in 40 /Yes ❑ No ❑ N/A CFR §116? e. Are release valves on all secondary containment structures locked? © Yes ❑ No /N/A 15) Hazardous Waste: a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? /Yes ❑ No b. Is this facility a Small Quantity Generator(less than 1000 kg. of hazardous waste ❑ Yes /No generated per month) of hazardous waste? c. Is this facility a Large Quantity Generator(1000 kg. or more of hazardous waste ❑ Yes /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. 5 **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 fisted in 40 CFR §117.3. Page 4 of 7 SWU-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 ; Vo b. Does your facility have coal piles on site? ❑ Yes / Io c. Does your facility store other fuel sources outside in piles, such as wood chips, ❑ Yes g"No sawdust, etc.? d. Does your facility have air emissions associated with its industrial activity(e.g., ; ces ❑ No degreasing operations, plating, painting and metal finishing)? If so, describe the industrial activity: Mince- pr,%y%k%nc4 up tis e'a&JvAl, L►�ncj or- rolllrxj1 e. If you answered yes to d., are those emissions permitted by lan Air Quality Permit? ❑ Yes /No ❑ NIA Please specify: 1�inor 2 4Z,& -_uQ /7 f�r�[sr�r � fi.� + �i_�t e✓ 70��� f. Please list any other environmental program permits (federal, state, etc.) not I specified earlier in this application (such as Hazardous Waste Permits, etc.): Permit: rogram: Permit: Program: Permit: Program: Permit: Program: Permit: Program: IV Permit: Program: Permit: Program: Page 5of7 5WU-NE-12Aug2010 NCGNE0000 No Exposure Certification 17) Certification: 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)). I understand that I am obligated to annually self re-certify No Exposure and, if requested, submit the re-certification to DWO 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 anv paint 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: Title: cl 13 (Signature of Applicant) (Date Signed) Please note: This application for the No Exposure Exclusion is subject to approval by the NCOENR 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 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. rJ14 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. DWo Regional Office Contact Information: Asheville Office ...... (828) 296-4500 'Winston:Shce 1�\ Fayetteville Office ... (910) 433-3300 in Mooresville Office ... (704) 663-1699 Raleigh Office ........ (919) 791-4200 ie _ Washington Office ...(252) 946-6481 Dorms Wilmington Office ... (910) 796-7215 Winston-Salem ...... 336 771-5000 Central Office .........(919) 807-6300 ►•{ Wil ngton Page 7 of 7 SWU-NE-12Aug2010 36.088725,-79.933734 - Google Maps Page I of I 502B Gooste Gree Radar Road Greensboro, NC 27410 1 € -4 I I RrLC br -0 Yarde ei P ('.25ut13 CltalEOr1 1 Service Censer tea" 0 A 4� ;,a send4Y fzd s� US Hea![h4tlorks�,, Medical Group�1 i rl Guil,'owJuvenile CPC �' iulnhielzees�, `+ 62013(�Sggla,� data®2013 Google I https://maps.-,00gle.com/maps?q=36.088725,-79.933734&num=l&t=h&vpsrc=0&ie=UTF... 8/23/201 3 Driving Directions From Greensboro, North Carolina to 500 Radar Rd, Greensboro, North... Page 1 of 1 Notes m aq u est. i Trip to: 500 Radar Rd Greensboro, NC 27410-6294 k 11.31 miles 1 16 minutes Greensboro, NC 0 1. Start out going west on W McGee St toward Blandwood Ave. Map 0.1 Mi 2. Turn left onto Freeman Mill Rd. Map 2.5 Mi i� 3. Merge onto 1-40 W/Fordham Blvd via EXIT 81B toward Winston-Salem. Map 5.8 Mi cm Highway Exits Exit li 217 EMU -+ „. 4, Merge onto 1-73 N 1 Future 1-840 via EXIT 212B toward Bryan Blvd. Mao 1.4 Mi ® 5. Take the W Friendly Ave exit, EXIT 2. Mar) 0.3 Mi rM RA1dF 6. Keep left to take the W Friendly Ave West ramp.Map 0.06 Mi (� 7.Turn slight left onto W Friendly Ave. Map 0.8 Mi f# 8.Turn right onto Old Friendly Rd. Map 0.3 Mi 1+ 9. Take the 2nd right onto Radar Rd, Map 0.04 Mi ® 10. 500 RADAR RD is on the right. Mag 500 Radar Rd, Greensboro, NC 27410-6294 Total Travel Estimate: 11.31 miles - about 16 minutes BOOKTRAVEL with mapquest (877) 577-5766 02013 MapQuest,Inc.Use of directions and maps is subject to the MapQuest Terms of Use.We make no guarantee of the accuracy of their content,road conditions or route usability.You assume all risk of use.View Terms of Use http:llw%vw.mapquest.com/print?a=app.core.ccbdc0348b8bf'?3 bee80de2a 8/23/201;