NCGNE1699_Application_20241105

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FOR AG1C�I EONLY l Revised 10/6/2023
NCGNE YY q
Assigned to: 13. CP)fl
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Division of Energy, Mineral, and Land Resources
National Pollutant Discharge Elimination System
No Exposure Certification for Exclusion
NCGNE0000
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. Industrial materials or activities include, but are not limited to:
•❑ material handling equipment or activities, •❑ by-products,
•❑ industrial machinery, •❑ final products,or
•❑ raw materials, •❑ waste products.
•❑ intermediate 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 industrial materials stored m the following contamer-types, provided
a
the containers are not dete[iotatoted and do nqt leak
„ t
•❑ drums, •0"tanks and l� 't'
•❑ barrels £-�'-'"� I 40"-similarcontamers -.eft a
For new fklities.applicants should apply,no.earlier than 60 daysabefore the•start of operation!A'
Iis will allow
DEMLR staff to verify conditions during+active operation. For facilities that already have'an'industrial stormwater
permit in North Carolina DEMLR must approve your,application for No Exposure.Certification before this exclusion
is effective:Until are issued a No Exposure Certification and your NPDES`perriit is rescinded,yourfacility must
continue to abide by the terms and conditions of the current permit.
A No Exposure Certification must be provided for each facility qualifying for the no exposure exclusion.Additionally,
the exclusion from NPDES permitting is available on a facility-wide basis only- not for individual outfalls. If any
industrial activities or materials are,orwill be,exposed to precipitation,the facility is not eligible forthe 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).
NC DEQ Stormwater Program requires a one-time$250 application fee via check made payable to NC DEQ. There
is no annual fee once covered under a No Exposure Certification. If approved, your conditional No Exposure
Certification has no expiration date but must be self-recertified at least annually.Please look for information about
recertification under the No Exposure section on this page: https:Hdeg.nc.goy/about/divisions/energy-mineral-
land-resources/npdes-no-exposure.
Directions: Print or type all entries on this application form. Send the original, signed application to: NCDEMLR
Stormwater Program, 1612 MSC, Raleigh, NC 27699-1612. The submission of this form does not guarantee
exclusion from NPDES stormwater permitting. Prior to exclusion from NPDES-stormwater-permitting-a-site-
-_----inspection will be conducted.
Page 1 of 5

1. Owner/Operator(to whom all permit correspondence will be mailed):
Name of legal organizational entity: Legally responsible person(as signed in Item 7 below):
ACTEGA North America,Inc. Chandler Johnston
Mailing address: City: State Zip Code
101 Reliance Road Kings Mountain PA 28086
Telephone number: Email address:
980 389 5045 [e-mail]
Type of Ownership: - -
_ Government
❑ County ❑ Federal ❑ Municipal ❑State
Non-government
® Business(If ownership is business,a copy of NCSOS report must be included with this application)
❑ Individual
2. Industrial Facility(facility requesting exclusion):
Facility name: Facility environmental contact:
ACTEGA North America,Inc. Chandler Johnston
Street address: Telephone number:
101 Reliance Road 980-389-5045
Email address:
[e-mail]. ,—,-.. ,.,. .�. s w
city Countya,'7' -.._:-- State -"--�; Zip Code .
Kings Mountain s>,+ Cleveland NC .'., ✓28086 fi•.
Latitude of entrance :, 350 15 01.28" N T t r� Fes" 3,r `
Longitude of entrance, 810 24'33.26"W, All
Parcel Identification Numbef(PIN)
-�.;.591,22if
a,i'
Date operation'beganS «Standard Industrial Classification(SIC)Code`
= 6/15/2024, 4' ,+".1• y_ .^- 2851
Brief description of the types;of industrial activaties;and'prdducts=produced at this facihtv,P, '`"
Facility manufactures specialty coatings end"inks for the grephicarts industry.
1q r r,
3. Consultant(if applicable):
Name of consultant: Samuel Joshi Consulting firm: Joshi Environmental,Inc.
Street address: 500 Office Center Drive,M400 City: State and zip code:
Fort Washington PA 19034
Telephone number: Email address:
215-389-2811 [e-mail]
4. Exposure Checklists
Are any of the following materials or activities exposed to precipitation, now or in the foreseeable future? If you
answer"Yes"to any of these items,you are not eligible for the no exposure exclusion.
Using,storing,or cleaning industrial machinery or equipment,and areas where residuals from
using,storing,or cleaning industrial machinery or equipment remain and are exposed to ❑Yes ® No ❑ N/A
stormwater
Materials or residuals on the ground or in stormwater inlets from spills/leaks ❑Yes ® No❑ N/A
Materials or products from past industrial activity ❑Yes ®•No❑ N/A
MateriaLhandling-equipment-(except-adequately mn>a�i - vehicles) ❑Yes ® No❑ N/A
Page 2 of 5

Materials or products during loading/unloading or transporting activities ❑ Yes x❑ No ❑ N/A
Materials or products stored outdoors(except final products intended for outside use[e.g., new ❑yes ® No ❑ N/A
cars]where exposure to stormwater does not result in the discharge of pollutants)
Materials contained in open,deteriorated,non-sealed',or leaking storage drums barrels,tanks, ❑Yes ® No El N/A
and similar containers
Materials or products handled/stored on roads or railways owned or maintained by the discharger ❑Yes ® No❑ N/A
Final products that would be mobilized in stormwater discharges(e.g.,rock salt) ❑Yes ® No❑ N/A
Waste material(except waste in covered,non-leaking containers[e.g.,dumpsters]) ❑Yes® No❑ N/A
Application or disposal of process wastewater(unless otherwise permitted) ❑Yes® No ❑ N/A
Particulate matter orvisible deposits of residuals from roof stacks and/or vents not otherwise ❑Yes® No ❑ N/A
regulated(i.e.under an air quality control permit)and evident in the stormwater outflow
Empty containers that previously contained materials that are not properly stored(i.e.,not closed ❑ Yes ® No ❑ N/A
and stored upside down to prevent precipitation accumulation)
Fh
r any exterior ASTs,as well as drums,barrels,tanks and similar containers stored outside,has ❑Yes 0 No ❑ N/A
e facility had any releases in the past three(3)years?
'Sealed means banded or otherwise secured and with locked or non-operational taps or valves.
Above Ground Storage Tanks(ASTs)and Secondary Containment
If you answer"No"to any of the following-items-,,you are not eligible for the no eiposure exclusion:'
Are exterior ASTs or piping freg.of rust,damaged or weathered coating pits,or detenoranon or
evidence of leaks? �^*'`�' w ' -a - .� ❑Yes❑No 1K
Is secondary containment provided for all exterior,ASTs?If so is iL free of any cracks,boles,or ° rf .''A
evidence of Ig3ks,and are drain,valves-maintained locked shut? ' , r ❑Ye"s❑No® N/A
Is secondarycoptainment provided for single,,"akoye;ground.storage containers(including drums
^� ®Yes❑No El N/A
barrels,etc.)wtth-a capacity'ofmore than 660-gallons? """" �,� 3'4_- .-
Is secondary containment provided for.a6ove ground storage containersstored in dose,pros`imity ®Yes❑ No ❑ N/A
to each other with a combined capacity'of more.than 1,320gallons? '�4 1, �"F
Is secondary containment provided for Title III Section 313 Superfund Amendfr Mgaincl ®Yes❑ No El N/A
Reauthorization Act(SARA)water priority chemicals?
Is secondary containment provided for hazardous substances designated in 40 CFR§116? ©Yes❑ No Cl N/A
Are release valves on all secondary containment structures locked? ❑Yes❑No© N/A
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.
Are vehicles used in material handling in disrepair and/or leaking fluid? ❑Yes ® No ❑ N/A
Does this facility store used, recycled,or otherwise reclaimed pallets outside? ❑Yes ® No ❑ N/A
Does this facility have coal piles on site? ❑Yes ® No ❑ N/A
Does this facility store other fuel sources outside in piles,such as wood chips,sawdust,etc.? ❑Yes ® No❑ N/A
Page 3 of 5

Does this facility have air emissions associated with industrial activity(e.g.,degreasing operations, ®Yes ❑ No ❑ N/A
plating, painting,or metal finishing)?
!f yes:
Describe the industrial activity: ACTEGA manufactures water-based,solvent-based,and
energy curable coatings and inks in batch operations.All operations are indoors.
Are those emissions permitted by an Air Quality Permit? k7 Yes ❑ No
Please specify: Air Permit#10791R00
5. Other Facility Conditions (check all that apply and explain accordingly):
®This facility has other NPDES permits. - - - ` - - �- ---If checked,list the permit numbers for all current NPDES permits:
Wastewater discharge permit NC0020737)issued by the City of Kings Mountain,NC.
❑This facility has Non-Discharge permits(e.g.recycle permit).
If checked,list the permit numbers for all current Non-Discharge permits: n/a
❑This facility stores hazardous waste in the 100-year floodplain.
If checked,describe how the area is protected from flooding: n/a
❑This facility is a(mark all that apply)
® Hazardous Waste Generation Facility (RCRA SQG; EPA ID#NCD980847149
❑ Hazardous Waste Treatment Facility
❑ Hazardous Waste Storage Facility ,m �
❑ Hazardous Waste Disposal Facilty
If checked indicate -+ur A, ,, 4 �?
• Kilograms of was e�8eheraated each month ' <1004 Kg
• Type(s)ofwas � Waste Products(D001,D002 D003 000 ,p018;t1020 U039,U154) ,"`. { k-
• How rr?atenal is stored: x p $ " �'_ `
5_4Hazardous Waste is stored andOors trydesignated location m closed contai rs
Whgretatena)agstored m '-
Y fka im:`a^s .'.1m '#4
• Numberof waste shipments per
year• Name of transp�oft/disposal vepdpr# Pmnac(e Enpirgnmenta!S� ces or vmdar n
• Transport/dispossal vendor EPA ID: To be confirmed before transport/disposal
• Vendor address: To be determined;
Note:Site is new and has not generated any waste,yet.
❑This facility is located on a Brownfield or SUPERFUND site.
If checked,briefly describe the site conditions:
n/a
❑This facility is located on Native American Lands. n/a
6. Required Items (Application will be returned unless all of the following items have been included):
E Check for$250 made payable to NCDEQ
0 Copy of most recent Annual Report to the NC Secretary of State(if applicable)
®This completed application and any supporting documentation
Rl Copy of county map or USGS quad sheet with the location of the facility clearly marked
Page 4 of 5

7. Applicant Certification
North Carolina General Statute 143-215.6B(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...shall be guilty of a Class 2 misdemeanor which may include a fine not
to exceed ten thousand dollars($10,000).1 hereby request exclusion from NPDES stormwater permitting.
Under penalty of law, I certify that:
8] I am the person responsible for the industrial activity,for satisfying the requirements of this exclusion,and for any civil _
or criminal penalties incurred due to violations of this exclusion.
EJ 1 have read and understand the eligibility requirements for claiming a condition of"no exposure'and obtaining an
exclusion from NPDES stormwater permitting.
® 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)).
RI I understand that I am obligated to maintain no exposure conditions and complete a Self-Recertification form at least
once each year and,if requested,provide this certification to the operator of the local municipal separate storm sewer
system(MS4)into which the facility discharges(where applicable).I understand that I must allow the North Carolina
Division of Energy,Mineral,and Land Resources,or MS4 operator where applicable,to perform inspections to confirm
the condition of no exposure and to make such inspection reports publicly available upon request.I understand I must
keep a copy of annual recertifications on file at the facility.
9 I understand that in the event that the site no longer qualifies for a No Exposure,Exclusion-that l must obtain coverage
under an NPDES permit prior to anyl.pomtsource'discharge cf stormwaterfrom the facility u �
i y e� -1' �
&7 The information submitted m thiIs,NOI is,,to thebest of my knowledge and belief true accurate,and complete based on
my inquiry of the person"orpersons who`manage the system,Yorthose persons diFectly res,Ponsible fo�gatheiing the
x
mformatiorr.
Printed Name of Person Signing 'Chandler Johnston;—, Z
p"i
d
Title: NC EHS Manager
10/2,8/2024r r{p
Signature of Applicant Date Signed-
Mail the entire package to: DEMLR—Stormwater Program
Department of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
Page 5 of 5

Attachment 2
2023 NCSOS Report

BUSINESS CORPORATION ANNUAL REPORT
11 r 1)22
NAME OF BUSINESS CORPORATION: ACTEGA NORTH AMERICA,INC.
0826105 Filing Office sa On1y
SECRETARY OF STATE ID NUMBER: STATE OF FORMATION: DE E-Filed Annual Report
0826105
REPORT FOR THE FISCAL YEAR END: 12/31/2023 CA202407902436
3/19/2024 11:46
SECTION A: REGISTERED AGENT'S INFORMATION Q Changes
1. NAME OF REGISTERED AGENT: COGENCY GLOBAL INC.
2.SIGNATURE OF THE NEW REGISTERED AGENT:
SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT
3. REGISTERED AGENT OFFICE STREET ADDRESS&COUNTY 4.REGISTERED AGENT OFFICE MAILING ADDRESS
212 South Tryon Street Suite 1000 212 South Tryon Street Suite 1000
Charlotte, NC 28281-0001 Mecklenburg County Charlotte, NC 28281-0001
SECTION B: PRINCIPAL OFFICE INFORMATION
1. DESCRIPTION OF NATURE OF BUSINESS: Coating,Inks, & Adhesives
2. PRINCIPAL OFFICE PHONE NUMBER: [phone] 3.PRINCIPAL OFFICE EMAIL: Privacy Redaction
4. PRINCIPAL OFFICE STREET ADDRESS 5.PRINCIPAL OFFICE MAILING ADDRESS
1450 Taylors Lane 1450 Taylors Lane
Cinnaminson,NJ 08077 Cinnaminson, NJ 08077
6.Select one of the following if applicable.(Optional see instructions)
❑ The company is a veteran-owned small business
❑ The company is a service-disabled veteran-owned small business
SECTION C: OFFICERS (Enter additional officers in Section E.)
NAME: Sarah Schaefer NAME: Mark Wallace NAME: Mark Wallace
TITLE: Secretary TITLE: Chief Financial Officer TITLE: Vice President
ADDRESS: ADDRESS: ADDRESS:
650 W.67th Avenue,Suite 200 1450 Taylors Lane 1450 Taylors Lane
Schererville, IN 46375 Cinnaminson,NJ 08077 Cinnaminson,NJ 08077
SECTION D:CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business
ent(tv.rah Schaefer 3/19/2024
S SIGNATURE DATE
Forth must be signed by an officer listed under Section C ofthis form.
____-_Sarah_Schaefer - Secretary
Print or Type Name of Officer Print or Type Title of Officer
MAIL TO:Secretary or State, Business Registration Division,Post Once Box 29525,Raleigh,NC 27626-0525

SECTION E: ADDITIONAL OFFICERS
NAME: Martin Babilas NAME: Thorsten KLoller NAME: Andrei Sotkeylclene
TITLE: Executive Director TITLE: Executive Director TITLE: Chief Executive Officer
ADDRESS: ADDRESS: ADDRESS:
Abelstr.43 Abelstr.43 1450 Taylors Lane
Wesel,XX46483 Wesel,-XX46483--- - -- Ciririaminson,NJ 08077
NAME: Andrei Sotkeviciene NAME: NAME:
TITLE: president TITLE: TITLE:
ADDRESS: ADDRESS: ADDRESS:
1450 Taylors Lane
Cinnaminson, NJ 08077
NAME: NAME: NAME:
TITLE: TITLE: TITLE:
ADDRESS: ADDRESS: ADDRESS:
NAME: NAME: NAME:
TITLE: TITLE: TITLE:
ADDRESS: ADDRESS: ADDRESS:
NAME: NAME: Name:
TITLE: TITLE: TITLE:
ADDRESS: ADDRESS: ADDRESS:
NAME: NAME: NAME:
TITLE: TITLE: TITLE:
ADDRESS: ADDRESS' ADDRESS

Attachment 3
Site Plan (County Map)

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ACTE A North America, Inc. Site Plan
101 R liance Road
Kings ountain, NC 28086

Joshi Environmental, Inc.
500 Office Center Drive
Suite #400
Li Ft. Washington, PA 19034
(215) 389-281 1
October 31 , 2024
Fed Ex Tracking #0201 7796 4737 6732
Brittany Cook /4C
DEMLR - Stormwater Program `CF
Department of Environmental Quality
1612 Mail Service Center yiG cO
Raleigh, NC 2 7699-1 61 2
M�RsTo V��
Also. via Email: [e-mail] RMggR
Subject: ACTEGA North America, Inc. pR��RgtiJ
101 Reliance Road
Kings Mountain, NC 28086
Stormwater "No Exposure' Certification Application
Dear Ms. Cook:
On behalf of ACTEGA North America, Inc. (ACTEGA), Joshi Environmental, Inc. QEI) is
pleased to submit the enclosed "No Exposure' Certification application for exclusion
from NPDES Stormwater Permitting. ACTEGA manufactures specialty coatings and inks
for the graphic arts industry. ACTEGA is in Cleveland County, Kings Mountain, North
Carolina.
A check made payable to the "NCDEQ" for $250.00 is included for the "No Exposure"
Certification approval.
The "No Exposure' provision under the stormwater Phase II rule provides for permit
exemption for all industrial categories identified in 40 CFR 122.26(b)(14) except
construction if the discharger can certify that a condition of"No Exposure' exists at the
industrial site or facility. ACTEGA believes that the site satisfies the "No Exposure'
provisions under the rule.
Should you have any questions concerning this application, please feel free to contact
me or Chandler Johnston, NC EHS Manager at [phone].
Sincerely,
Samue o ii, CSP,- E
Principa ngineer
Enclosure
cc: Chandler Johnston, ACTEGA