NCGNE0976_COMPLETE FILE - HISTORICAL_20160516

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO. Iv CC, ^ , E-G�n /
DOC TYPE VHISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE 05-
YYYYMMDD

I
PAT MCCRORY
^r Governor
DONALD R. VAN DER VAART
Secretary
Energy,Mineral
and Land Resources TRACY DAVIS
ENVIRONMENTAL QUALITY Director
May 16, 2016
Mr. James Stockdale
General Dynamics Mission Systems, Inc.
7220 US Hwy 158
Stokesdale, NC 27357
Subject: Name/Ownership Change Request
No Exposure Certification NCGNE0976
General Dynamics Mission Systems,
Inc.
Formerly General Dynamics AIS
Guilford County
Dear Mr. Stockdale:
The Division has reviewed your submittal of the permit name/ownership change form for the
subject No-Exposure Certification. 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.
If you have any questions or need further information, please contact the Stormwater
Permitting Program at [phone],
Sincere
SIGNED BY
BETHANY GEORGOULIAS
for Tracy E. Davis, P.E., CPM, Director
Division of Energy, Mineral and Land
cc: Winston-Salem Regional Office
Stormwater Permitting File
State of North Carolina I Environmental Quality I Energy,Mineral and Land Resources
1612 Mail Service Center 1 512 North Salisbury Street I RaIeigh,North Carolina 27699-1612
919 707 9220 T

January 19, 2016
,BAN -1 ��15
'c:i'i'�li il1F i��frr�-a : A.i,.:.� F�
VIA FIRST CLASS MAIL i.�
North Carolina Division of Energy, Mineral &
Land Resources
Attn: Storm Water Permitting
1612 Mail Service Center
Raleigh, NC 27699-1612
Re: Notification of General Dynamics Advanced Information Systems, Inc. Name
Change to General Dynamics Mission Systems, Inc.
Permit Number: Storm water NCGNE0976
To Whom It May Concern:
Effective January 1, 2016, General Dynamics Advanced Information Systems, Inc. ("GDAIS")
changed its name to General Dynamics Mission Systems, Inc. Operations at General Dynamics
Mission Systems facilities will continue in substantially the same manner as they have under
GDAIS. This change in name will have no impact on emissions or the operation of any emission
units permitted under GDAIS's Storm Water Permit Number NCGNE0976.
By this letter, GDAIS is requesting an administrative revision to the Storm Water Permit
Number NCGNE0976 to change the permitee name to General Dynamics Mission Systems, Inc.
Please contact me if you have any questions regarding this request or if you need any additional
information.
1, James Stockdale, am the Senior Vice President of Business Operations for General Dynamics
Mission System, Inc., and I certify that this request meets the criteria for use of an administrative
permit revision and that, based on information and belief formed after reasonable inquiry, the
statements and information in this letter are true, accurate, and complete.
Ja s Stock ale
Se or Vice President of Business Operations for General Dynamics Mission System, Inc.
Dated: January 19, 2016
cc: Allison A. Torrence
2394198.1

GLJ
w5ft
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality ""
STATE STORMWATER PERMIT NAME/OWNERSHIP CHANGE FORM 41�i j
I. CURRENT PERMIT INFORMATION
1. Stormwater Management Permit Number: Iy L 6 IV E 0 ? 7 Cp
2. Project Name: rr,,
3. Current Permit Holder's Company Name/Organization: nerol u 1'JQI inr 1
4. Signing Official's Name: J O M ES Stc1CKd0le- Title: See)I Or V 1' &.sllxss 0P01V WS
5. Mailing Address: u () U5 014avy.
City: fyk6f7 Q'1e State: NC Zip: cad 735 7
6. Phone: 30 J 9 r7sQ Fax:
II. PROPOSED PERMITTEE / OWNER / PROJECT/ ADDRESS INFORMATION
This request is for: (please check all that apply)
Name change of the owner (Please complete Items 1, 2 and 3 below)
❑ Name change of project (Please complete Item 5 below)
❑ Change in ownership of the property/company (Please complete Items 1, 2, 3, and 4 below} /
❑ Mailing address / phone number change. (Please complete Item 4 below) V/
❑ Other (please explain):
I. Proposed permittee's company name/organization: ero) Qnomfo. Mf on i S
2. Proposed permittee's signing official's name: i orn ole
3. Proposed permittee's title: Pl'l!Q1' V I C+° re 1 f 903!/t,�s 0 r
4. Mailing Address: / f Q
City: Il! 0 State: YI Gj Zip: Y1
Phone: ( Fax:
5. New Project Name to be placed on permit: V11` C
Please check the appropriate box. The proposed permittee listed above is:
❑ HOA or POA (Attach documentation showing that the HOA or POA owns, controls, or has a
recorded easement for all areas that contain stormwater system features. Print name of HOA or
POA in #1 above and provide name of HOA/POA's authorized representative in#2 above)
❑ The property owner
[EXessee (Attach a copy of the lease agreement and complete Property Owner Information on
page 4)
❑ Purchaser (Attach a copy of the pending sales agreement. Final approval of this transfer will be
granted upon receipt of a copy of the recorded deed)
❑ Developer (Complete Property Owner Information on page 4)
SSW N/O Change Rev24Sept2012 Page 1 of 4

111. REQUIRED ITEMS
A request to transfer a permit will not be approved by the Division of Water Quality (DWQ) unless all
of the applicable required items listed below are included with the submittal. Failure to provide the
listed items may result in processing delays or denial of the transfer.
1. This completed and signed form. This certification must be completed and signed by both the
current permit holder and the new applicant if this is a change of ownership.
2. Legal documentation of the property transfer to a new owner.
3. A copy of any recorded deed restrictions, covenants, or easements, if required by the permit.
4. The designer's certification (DWQ Engineer and Designer Certification Forms are available from
each DWQ Regional office), if required by the permit and if not already submitted to DWQ.
5. If the proposed permittee is a firm, partnership, association, institution, corporation, limited liability
company, or other corporate entity, provide documentation showing the authority of the named
representative to act on behalf of the proposed permittee.
0. The $40.00 processing fee. If this is an initial transfer from the original permittee the processing
fee is not required. Subsequent ownership transfers will require the $40.00 processing fee.
IV. CURRENT PERMITTEE'S CERTIFICATION
Please check one of the following statements and fill out the certification below that statement:
Check here if the current permittee is,only cha gi g his/her/its name, the project name, or mailing
a ress, but will retain the permit. I, �rI -/_1 ICS 1 S , the current
permittee, hereby notify the DWQ that I am changing y name and/or I am changing my mailing
address and/or I am changing the name of the permitted project. I further attest that this application
for a name/ownership change is accurate and complete to the best of my knowledge. I understand
that if all required parts of this application are not completed or if all required supporting information
and attachments listed above are not included, this application package will be returned as
incomplete.
❑ Check here if current permittee is transferring the property to a new owner and will not retain
ownership of the permit.
I, , the current permittee, am submitting this application
for a transfer of ownership for permit# . I hereby notify DWQ of the sale or
other legal transfer of the stormwater system associated with this permit. I have provided a copy of
the most recent permit, the designer's certification for each BMP, any recorded deed restrictions,
covenants, or easements, the DWQ approved plans and/or approved as-built plans, the approved
operation and maintenance agreement, past maintenance records, and the most recent DWQ
stormwater inspection report to the proposed permittee named in Sections 11 and V of this form. I
further attest that this application for a name/ownership change is accurate and complete to the best
of my knowledge. I understand that if all required parts of this application are not completed or if all
required supporting information and attachments listed above are not included, this application
package will be returned as incomplete. I assign all rights and obligations as permittee to the
proposed permittee named in Sections II and V of this form. I understand that this transfer of
ownership cannot be approved by the DWQ unless and until the facility is in compliance with the
permit.
Signature: L Date:
a Notary Public for the State of
County of , do hereby certify that
�ra personally appeared before me this the
l day of , 20 16 , and acknowledge the due execution of the
for ing instrument. Witness my hand and official seal, (Notary Seal)
Notary S nature
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SSW N/0 Change Rev24Sept2012 Page 2 of 4
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V. PROPOSED PERMITTEE CERTIFICATION: (This section must be completed by the
Proposed Permittee for all transfers of ownership)
I , hereby notify the DWQ that I have acquired
through sale, lease or legal transfer, the responsibility for operating and maintaining the permitted
stormwater management system, and, if applicable, constructing the permitted system. I
acknowledge and attest that I have received a copy of: (check all that apply/ito this permit)
H
the most recent permit
the designer's certification for each BMP
❑ any recorded deed restrictions, covenants, or easements
❑ the DWQ approved plans and/or approved as-built plans
❑ the approved operation and maintenance agreement
❑ past maintenance records from the previous permittee here required)
DWQ stormwater inspection report showing complian e within 90 days prior to this transfer
I have reviewed the permit, approved plans and other do uments listed above, and I will comply with
the terms and conditions of the permit and approved pl ns. 1 acknowledge and agree that I will
operate and maintain the system pursuant to the req ' ements listed in the permit and in the
operation and maintenance agreement. I further att t that this application for a name/ownership
change is accurate and complete to the best of my nowledge. I understand that if all required parts
of this application are not completed or if all requ' ed supporting information and attachments listed
above are not included, this applicati p ag will be returned as incomplete.
Signature: Date:
I, a Notary Public for the State of
Co my of , do hereby certify that
personally appeared before me this the
day of , 20 , and acknowledge the due execution of the
forgoing instrument. Witness my and and official seal,
(Notary Sealy
Notary Signat1, including
Additional co original permit and the approved Operation and Maintenance agreement can
be obtained fppropriate Regional Office of the Division of Water Quality,
This completeincluding all supporting documents and processing fee (if required), should be
sent to the ap Regional Office of the North Carolina Department of Environment and Natural
Resources, Df Water Quality, as shown on the attached map.
Please note t Proposed Permittee listed above is not the property owner, the property owner
mustcompletn page 4 of this document. Both the lessee/developer and the property
owner will appear on the permit as permittees.
SSW N/O Change Rev24Sept2012 Page 3 of 4

VI. PROPERTY OWNER CONTACT INFORMATION AND CERTIFICATION
If the Proposed Permittee listed in Sections lI and V of this form is not the Property Owner, the
Property Owner must provide his/her Contact Information below and sign this form:
Printed Name: _:]Omc'S S�uCKC G
Organization: 6`eoerrl ! I'ssf o4
Title within the Organization: 5�r}j f/�V CC iE'S1FY2 f- (,1,5I r� �p(�
Street Address: 'V ao V f r"ahc�a lS -7
City: , 911 1 ' State: NC Zip:
Mailing Address: 'Ll/9
(if different from street address) I
City: YI nj ` State: Y a zip: Y `
Phone: r� a Fax:
Email: r
I certify that I own the property identified in this permit transfer document and have given permission
to the Proposed Permittee listed in Sections II and V to develop and/or, lease the property. A copy
of the lease agreement or other contract, which indicates the party responsible for the construction
and/or operation and maintenance of the stormwater system, has been provided with the submittal.
As the legal property owner I acknowledge, understand, and agree by my signature below, that I will
appear as a permittee along with the lessee/developer and I will therefore share responsibility for
compliance with the DWQ Stormwater permit. As the property owner, it is my responsibility to notify
DWQ by submitting a completed Name/Ownership Change Form within 30 days of procuring a
developer, lessee or purchaser for the property. I understand that failure to operate and maintain the
stormwater treatment facility in accordance with the permit is a violation of NC General Statute
(NCGS) 143-215.1, and may result in appropriate enforcement action including the assessment of
civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Signature of the property owner Date: G1
a'y / Ill 14166.s U
, a Notary Public for the State of
County of / , do hereby certify that
personally appeared before me this the
day of 20 16 , and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal,
lw� f 64" (Notary Seal)
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SSW N/O Change Rev24Sept2012 Page 4 of 4

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NCDEt'IR
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 Sohn E. Skvarla, 111, Secretary
December 5, 2013
Byron Bellman
General Dynamics
3801 Boren Drive
Greensboro, NC 27407
Subject: No Exposure Certification NCGNE0976
General Dynamics—Stokesdale Facility
Guilford County
Dear Mr. Bellman:
The Division has reviewed your submittal of the application for No Exposure Certification requesting exclusion from
NPDES stormwater permitting for the General Dynamics facility located at 7220 US Highway 158 in Stokesdale, NC.
Based on your submittal of a signed certification of no exposure and on the site visit conducted by Aana Taylor-Smith on
December 4, 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, General Dynamics 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.
General Dynamics 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 DEM!_R, 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.
i
If you have any questions or need further information, please contact Aana Taylor-Smith or me at(336) 771-5000.
Sincerely,
or4_.
Matthew E. Gantt, PE
Regional Engineer
Land.Quality Section
Enclosures:
1. Annual Self-Recertification Form
CC: Stormwater Permitting Unit—No Exposure Files
Central Files - DWR
WSRO Files—Land Quality
Winston-Salem Regional Office
585 Waughtown Street,Winston-Salem, NC 27107 . Phone: [phone] FAX: [phone]
i

0
nut+ N-
FOR AGENCY USF ONLY
Dale Received
JL Division of Water Quality/Surface Water Protection Year �lonrn
��DENR National Pollutant Discharge Elimination System Cenifica[eofCoverage
NO EXPOSURE CERTIFICATION for Exclusion N N a
NCGN EO t700
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 re uired to self re-certify our No Exposure Exclusion annuall .
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 _General Dynamics
Contact Byron Bellman
Street Address 3801 Boren Drive
City Greensboro State_NC ZIP Code 27407
Telephone No. [phone] Fax: T(336) 323-9
Email [e-mail]
IN
Page 1 of 7 E,@v 6.2013
SWU-NE-12Aug2010 WATER 01JALffY
rmwaf"&wu:h

NCGNE0000 No Exposure Certification
2) Location of facility producing discharge:
Facility Name General Dynamics-Advanced Information Systems
Facility Contact Byron Belllman
Facility Street Address _7220 US Highway 158 _
City _Stokesdale State—NC ZIP Code _27357_
County _Guilford
Telephone No. _(336) 323-9752 Fax: _(336) 323-9634
Email �[e-mail]
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). _From 1-40,take NC-68 (N)toward High Point, PTI Airport._
Turn right onto US-158 and go 1.5 miles. Destination is 0.2 miles past Athens Road.
(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 IMINo
5) Is this a Federal facility? Q Yes QNo
6) Latitude 36 deg, 14 min, 14.97 sec Longitude 79 deg, 57 min, 20.74 sec (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_1 0/1120 1 3
❑ 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 ■No
If yes, what is the NPDES Permit Number?
9). Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code)that describes the primary industrial
activity at this facility
SIC Code: 3 6 6 1
10) Provide a brief description of the types of industrial activities and products produced at this facility:
Electronics/Cable manufacturing
11) Does this facility have any Non-Discharge permits(ex: recycle permits)?
ONo
❑ 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 0No
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 ONo
c. Materials or products from past industrial activity ❑ Yes ONo
d. Material handling equipment (except adequately maintained vehicles) ❑ Yes ■No
e. Materials or products during loading/unloading or transporting activities ❑ Yes ONo
f. Materials or products stored outdoors (except final products intended for outside ❑ Yes ONo
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 ONo
and similar containers
h. Materials or products handled/stored on roads or railways owned or maintained by ❑ Yes ONo
the discharger
i. Waste material (except waste in covered, non-leaking containers[e.g., dumpsters]) ❑ Yes ONo
j. Application or disposal of process wastewater(unless otherwise permitted) ❑ Yes ONo
k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑ Yes ONo'
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 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 ONo
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 ON/A
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
5WU-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 iN/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 ■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 ON/A
CFR §116?
e. Are release valves on all secondary containment structures locked? ❑ Yes ❑ No iN/A
15) Hazardous Waste:
a. Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? ❑ Yes ONo
b. Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste 0 Yes 0 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.
."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-12Aug2010

NCGNE0000 No Exposure Certification
1 6) 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 ■No
b. Does your facility have coal piles on site? ❑ Yes Flo
c. Does your facility store other fuel sources outside in piles, such as wood 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 [:] No ®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: Program:
Permit: •Program:
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
Permit: Program:
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SW U-N E-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 l must obtain coverage under
an NPDES permit prior to-any-point-source dischaMe of stormwater from the fay.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: 7rw L I-L0 idrl,,,
Title:
/ la
(Si nature of Applicant) at 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 our 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 appllcaOon,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 Articte shall be guilty of a Class 2 misdemeanor which may include a fine
not to exceed ten thousand dollars($10,000).
I
There Is currently no fee for a No Exposure Exclusion.
Page 6 of 7
5 W U-NE-12A ug2010

NCGNE0000 No Exposure Certification
Final Checklist
This application should include the following items:
6 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 27699-1617
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:
Asheville Office ...... [phone] Win ton sale
Fayetteville Office ... [phone] � r at gh t_ a I o-
Mooresville Office ... [phone] 1
Raleigh Office ........ [phone] l S ev'Ile oar sv to
Washington Office ...[phone] ~��
Wilmington Office ... [phone]
Winston-Salem ...... [phone]
F eft ills r�
Central Office .........[phone] "�
Wit n9ton
r
Page 7 of 7
SWU-NE-12Aug2010

Map of the General Dynamics Facility in Stokesdale, NC
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General Dynamics' space is on the back left corner of the building. Other companies occupy
the remainder of the building.