NCGNE1701_Application_20241120

FOR AGENCY USE ONLY Revised 10/6/2023
NCGNE 17 0 1
Assigned to: (�
ARO FRO MR RRO WARO WIRO WSRO
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 in the following container types, provided
the containers are not deteriorated and do not leak:
• drums, • tanks,and
• barrels, • similar containers.
For new facilities, applicants should apply no earlier than 60 days before the start of operation. This 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 Until you are issued a No Exposure Certification and your NPDES permit is rescinded,your facility must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.
A No Exposure Certification must be provided for each facility qualifying forthe 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,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).
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.gov/about/divisions/energy-mineral-
land-resources/nodes-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):
Lubrizol Advanced Materials,Inc. David Jackson,Plant Manager
Mailing address: City: State Zip Code
207 Telegraph Drive Gastonia NC 28056
Telephone number: Email address:
[phone] [e-mail]
Type of Ownership:
Government
❑County ❑ Federal ❑ Municipal ❑ State
Non-government
Cd 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:
Lubrizol Advanced Materials Inc. Robert Schrein
Street address: Telephone number:
4333 York Highway [phone]
Email address:
City County State Zip Code
Gastonia -aiGaston NC 28056
Latitude of entrance: 35.201599
Longitude of entrance: $1 207725
Parcel Identification Number(PIN): 3543052945
Date operation began: Standard Industrial Classification(SIC)Code:
11/22/2024 (Date purchased by Lubrizol) 14225- General Warehousing and Storage
Brief description of the types of industrial activities and products produced at this facility:
Storage of finished latex goods/assorted raw materials
3. Consultant (if applicable):
Name of consultant: Consulting firm:
Mariah Gnegy, PhD Trinity Consultants Inc.
Street address: City: State and zip code:
325 Arlington Ave. Suite 500 Charlotte
Telephone number: Email address:
[phone] x3459 [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 2 No❑ N/A
stormwater
Materials or residuals on the ground or in stormwater inlets from spills/leaks ❑Yes♦a No ❑ N/A
Materials or products from past industrial activity ❑Yes 8 No ❑ N/A
Material handling equipment(except adequately maintained vehicles) ❑Yes 0 No ❑ N/A
Page 2 of 5

Materials or products during loading/unloading or transporting activities ❑Yes 0 No❑ N/A
Materials or products stored outdoors(except final products intended for outside use[e.g.,new El Yes 2 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 l�No El N/A
and similar containers
Materials or products handled/stored on roads or railways owned or maintained by the discharger ❑Yes la No❑ N/A
Final products that would be mobilized in stormwater discharges(e.g.,rock salt) ❑Yes B No ❑ N/A
Waste material(except waste in covered,non-leaking containers[e.g.,dumpsters]) ❑Yes B No ❑ N/A
Application or disposal of process wastewater(unless otherwise permitted) ❑Yes B No ❑ N/A
Particulate matter or visible deposits of residuals from roof stacks and/or vents not otherwise ❑ Yes la 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 la No ❑ N/A
and stored upside down to prevent precipitation accumulation)
FtFor any exterior ASTs,as well as drums,barrels,tanks and similar containers stored outside,has ❑Yes ❑ No 2 N/A
he 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 exposure exclusion.
Are exterior ASTs or piping free of rust,damaged or weathered coating,pits,or deterioration,or ❑Yes❑No 2 N/A
evidence of leaks?
Is secondary containment provided for all exterior ASTs?If so,is it free of any cracks,holes,or ❑Yes❑No N/A
evidence of leaks,and are drain valves maintained locked shut?
Is secondary containment provided for single above ground storage containers(including drums, ❑Yes❑No a N/A
barrels,etc.)with a capacity of more than 660-gallons?
Is secondary containment provided for above ground storage containers stored in close proximity ❑Yes❑No N/A
to each other with a combined capacity of more than 1,320 gallons?
Is secondary containment provided for Title III Section 313 Superfund Amendments and ❑Yes El No Cd N/A
Reauthorization Act(SARA)water priority chemicals?
Is secondary containment provided for hazardous substances designated in 40 CFR §116? ❑Yes❑No 2 N/A
Are release valves on all secondary containment structures locked? ❑Yes❑No♦a 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 E 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 B No ❑ N/A
Does this facility store other fuel sources outside in piles,such as wood chips,sawdust,etc.? ❑Yes{a No ❑ N/A
Page 3 of 5

Does this facility have air emissions associated with industrial activity(e.g.,degreasing operations, ❑ Yes la No ❑ N/A
plating,painting,or metal finishing)?
If yes:
Describe the industrial activity:
Are those emissions permitted by an Air Quality Permit? ❑ Yes ❑No
Please specify:
S. 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:
❑This facility has Non-Discharge permits(e.g. recycle permit).
If checked,list the permit numbers for all current Non-Discharge permits:
❑This facility stores hazardous waste in the 100-year floodplain.
If checked,describe how the area is protected from flooding:
❑This facility is a(mark all that apply)
❑ Hazardous Waste Generation Facility
❑ Hazardous Waste Treatment Facility
❑ Hazardous Waste Storage Facility
❑ Hazardous Waste Disposal Facility
If checked,indicate:
• Kilograms of waste generated each mo;)Jon
• Type(s)of waste:
t
How material is stored:
• Where material is stored:
• Number of waste shipments per year:
• Name of transport/disposal vendor: ,y
• Transport/disposal vendor EPA ID:
• Vendor address:
❑This facility is located on a Brownfield or SUPERFUND site.
If checked,briefly describe the site conditions:
❑This facility is located on Native American Lands.
6. Required Items (Application will be returned unless all of the following items have been included):
2 Check for$250 made payable to NCDEQ
B Copy of most recent Annual Report to the NC Secretary of State(if applicable)
B This completed application and any supporting documentation
®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 143-215.6E(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:
VJ 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.
YJ I have read and understand the eligibility requirements for claiming a condition of"no exposure"and obtaining an
exclusion from NPDES stormwater permitting.
i/ 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)).
Ad 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.
AG I understand that in the event that the site no longer qualifies for a No Exposure Exclusion that I must obtain coverage
/ under an NPDES permit prior to any point source discharge of stormwater from the facility.
�d The information submitted in this NOI is,to the best of my knowledge and belief,true,accurate, and complete based on
my inquiry of the person or persons who manage the system,or those persons directly responsible for gathering the
information.
Printed Name of Person Signing: AV.1-O P QK5 eh(
Title: Pc,AN-r- M A a 06 E tt
2)�,7� �] ,,X __� 1 1 / 1 2 12L1
Sign ure 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
Annual Report to North Carolina Secretary of State

BUSINESS CORPORATION ANNUAL-REPORT �
uvxsu
NAME OF BUSINESS CORPORATION: Lubrizol Advanced Materials,Inc.
0581656 ding once Use Only
SECRETARY OF STATE ID NUMBER: STATE OF FORMATION: DE E-Filed Annual Report
0581656
REPORT FOR THE FISCAL YEAR END: 12/31/2023 CA202409802572
47P1024 07:45
SECTION A: REGISTERED AGENT'S INFORMATION : Q Changes
1.'NAME OF REGISTERED.AGENT: CT Corporation System" --
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
160 Mine Lake Ct Ste 200 160 Mine Lake Ct Ste 200
Raleigh, NC 27615-6417 Wake County Raleigh, NC 27615-6417
SECTION B: PRINCIPAL OFFICE INFORMATION
1.DESCRIPTION OF NATURE OF BUSINESS: Manufacturing 3r Sales
2.PRINCIPAL OFFICE PHONE NUMBER: [phone] 3.PRINCIPAL OFFICE EMAIL: Privacy Redaction
4.PRINCIPAL OFFICE STREET ADDRESS 5.PRINCIPAL OFFICE MAILING ADDRESS
9511 Brecksville Road 9911 Brecksville Road
Brecksville,OH 44141-3201 Brecksville,OH 44141-3201
6.Select one of the following If applicable.(Optional see Instructions)
❑ The company is a veteran-owned small business
ElThe company is a service-disabled veteran-owned small business
SECTION C:OFFICERS(Enter additional officers in Section E.)
NAME: Arnaldo Pano Serra NAME: Gordon Davies Walker NAME: ,Jose Ramon Gonzalez-Magaz
TITLE: President TITLE: Chief Financial Officer TITLE: Secretary
ADDRESS: ADDRESS: ADDRESS:
9911 Brecksville Road 29400 Lakeland Blvd. 29400 Lakeland Blvd
Brecksville,OH 44141 Wickliffe,OH 44092-2298 Wickliffe,OH 44092
SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business
entity.
Jose Ramon Gonzalez-Magaz 4/7/2024
SIGNATURE DATE
Form must be signed by an officer listed under Section C of this form.
Jose Ramon Gonzalez-Magaz Secretary
_ —Print or Type Name of Oficer Print or Type rifle of Officer
This Annual Report has been filed electronically.
MAIL TO:Secretary of State, Business Registration Division,Post Office Box 29525,Raleigh,NC 27626-0525

ATTACHMENT 3
USGS Quad Sheet (Gastonia South Quadrangle)

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NOV202:�)
Lubrizol
T J
November 18, 2024
DEMLR— Stormwater Program
Department of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
RE* Stormwater No Exposure Certification Application
Lubrizol Advanced Materials, Inc. —Gastonia, North Carolina
Gastonia Facility Warehouse
Dear Sir/Madam:
Lubrizol Advanced Materials, Inc. (Lubrizol) operates a chemical manufacturing facility at 207 Telegraph
Drive in Gastonia, North Carolina (Gastonia facility). Lubrizol plans to purchase the warehouse across the
public street from the Gastonia facility, located at 4333 York Highway, Gastonia, North Carolina (Gastonia
warehouse). The Gastonia warehouse will operate under Standard Industrial Classification (SIC) Code 4225,
General Warehousing and Storage.
In this submittal, Lubrizol is submitting a No Exposure Certification application for the Gastonia warehouse
to the North Carolina Division of Energy, Mineral, and Land Resources (DEMLR). This submittal constitutes
notification that the warehouse 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. Lubrizol is
submitting this cover letter in conjunction with Lubrizol's purchase of this warehouse property. Lubrizol
currently operates warehouse activities at this location under a lease agreement with the current property
owner; there are no changes in operations with the transfer of ownership of the property.
With this submission, Lubrizol is including the annual report submitted to the North Carolina Secretary of
State for the adjacent manufacturing facility. Please note that this report does not cover the Gastonia
warehouse as a separate entity.
A signed copy of the No Exposure Certification for the Gastonia warehouse is included in Attachment 1 to
this letter. Attachment 2 includes a copy of the most recent Annual Report to the North Carolina Secretary
of State for the adjacent manufacturing facility. A USGS map (Gastonia South quadrangle) indicating the
Gastonia warehouse location is included in Attachment 3.
If you have any questions about the information included in this submittal, please contact me at (704) 915-
4165.

Page 2
November 18, 2024
Sincerely,
Lubrizol Advanced Materials, Inc.
Robert Schrein
HSES Manager
Attachments
Cc: Brittany Cook (via e-mail: [e-mail])