NCGNE0049_COMPLETE FILE - HISTORICAL_20101025

STORMWATER DIVISION CODING SHEET
RESCISSIONS
PERMIT NO.
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DOC TYPE
❑COMPLETE FILE -HISTORICAL
DATE OF
RESCISSION
❑ 1-6 % D /0 a-3
YYYYMMDD

PIA
NCDENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Division of Water Quality
Coleen H. Sullins
Director
October 25, 2010
Bobby Bush
Hickory Springs Manufacturing Company - Hickory Springs Mfg. Co. -High Point
PO Box 128
Hickory, NC 28603
Dear Permittee:
Dee Freeman
Secretary
Subject: Rescission of NPDES Stormwater Permit
Certificate of Coverage Number NCGNE0049
Hickory Springs Manufacturing Company - Hickory
Springs Mfg. Co.-I-ligh Point
Guilford County
On 3/24/2010, the Division of Water Quality received your request to rescind your coverage under
Certificate of Coverage Number NCGNE0049. In accordance with your request, Certificate of Coverage
Number NCGNE0049 is rescinded effective immediately.
Operating a treatment facility, discharging wastewater or discharging specific types of stormwater to
waters of the State without valid coverage under an NPDES permit will subject the responsible party to a
civil penalty of up to $25,000 per day. It is the intention of DWQ that enforcement proceedings will
occur for persons that have voluntarily relinquished permit coverage when, in fact, continuing pert -nit
coverage was necessary. If, in retrospect, you feel the site still requires permit coverage, you should
notify this office immediately. Furthermore, if in the future you wish to again discharge to the State's
surface waters, you must first apply for and receive a new NPDES permit.
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 Brian Lowther at [phone], or the Water
Quality staff in our Winston-Salem Regional Office at NPDES SW.
Sincerely,
A'�J4G1&
fa• Colleen 1-1. Sullins, Director
cc: Winston-Salem Regional Office
Stormwater Permitting Unit
Fran McPherson, DWQ Budget Office
Wetlands and Stormwater Branch One
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 North Caro ll1 nil
Location: 512M N. Salisbury St. Raleigh, North Carolina r Service;
���i�Nn r y�
Phone: 919$07-631]0 l FAX: [phone] Customer Service: 1-877-623-6748 l L lt"
Internet: www.rimaterquality,org
An Equal Opporlunity 1 Affirmative Action Employer

HICKORY
SPRINGS,
VIA CERTIFIED MAIL
70092820000124232622
Randy G. Waibel, CH%IM
Corporate Environment-0 Manager
Hickory Springs Manufacturing Company
235 2nd Avenue NW
P.O. Box 128
Hickory, North Carolina 28603
823.328.2201 Office
828,328.4228 Fax
rswaibel@hic',orysprings.com
March 24, 2010
mm }
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0 1 �
Stormwater Permitting Unit
Division of Water Quality
� }
D " I �;�.1;.:
16-17 Mail Service Center
M
Raleigh, North Carolina 27699-1617
;J
Subject: ,'notice of Termination
NFDES No Exposure Certifications
Hickory Springs Manufacturing Company
(Multiple Locations,,
To VVhcm I, 101ay Coy acern:
Thy; purpose -of this latter to provide: notification to the Department that the
`allowing Hickory Springs locations have recently ceased ali industrial
manufacturing operations:
Location —
Address
No Exposure Certification No
i /Tian E3E:LI; 5ewino �fant
105 Hall Industrial Park,
iVCGNE0052
Hudson, NC 28638
pixie Regency Plar;t
2116 Highland Avenue NE,
NCGNE0038
Hickory, NC 28601.
---_ -
High Point"r=qam �'lar't
1-141 Corporate Drive,
NCGNE4}049
High Point, NC 272�4
�
.--wton Plant
1516 Mt. Olive Road,
NCGNE0044
Newton, NC 20658
Consequently, and .. given there's no exposure conditions, we are hereby
requesting ter.-nination of the above -referenced No Exposure Certifications.

F NIA TF Michael F. Easley, Governor
`O�� 9pG William G. Russ Jr., Secrclary
North Carolina Department of Environment and Natural Resources
� � Alan W. Klimek, 1'. F. Director
Division of Water Quality
Q Colcen IL Sullins, Deputy Director
Division of Water Quality
April 20, 2005
Wilbur E Mann, III
Hickory Springs Manufacturing Co
PO Box 128
Hickory, NC 28603
Subject: No Exposure Certification NCGNE0049
Hickory Springs Mfg. Co. -High Point - 1141 Corporate Dr
Randolph County
Dear Permittee:
The Division has reviewed your submittal of the No -Exposure Certification for Exclusion from NPDES
Stormwater Permitting form, which we received on August 16, 2004. We apologize for the extended period it
has taken us to get back to you on this request and we appreciate your patience as we have worked through
this process. Based on your submittal and signed certification of no exposure at the above referenced facility
the Division is granting your certification as provided for under 40 CFR 126.22(g) which is incorporated by
reference in North Carolina regulations.
Please note that by our acceptance of your no exposure certification, you are obligated to maintain no
exposure conditions at your facility. If conditions change such that your facility can no longer qualify for a 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. Your
conditional no -exposure exclusion expires in five years (April 30, 2010). At that time you must re -certify with
the Division, or obtain NPDES permit coverage for any stormwater discharges from your facility.
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 Jonathan Diggs at [phone] ext.
537, or at [e-mail].
Sincerely,
for Alan W. Klimek, P.E.
cc: Winston-Salem Regional Office ..Central Files — wlattachments
Stormwater Permitting Unit Files
N. C. Division of Water Quality 1617 Mail Sc;Mcc Ccnter Raleigh, North Carolina 27099-1617 [phone]
-A
NCDE�tR
Customer Service
1-977-623-6748

Form Approved
United States Environmental Protection Agency OMB No.2040.0211
NPDES tt:i Washington, DC 20460
FORM ��, Epq NO EXPOSURE CERTIFICATION for Exclusion from
3510-11
NPDES Storm Water Permitting
Submission of this No Exposure Certification constitutes notico that the entity identified in Section A does not require permit authorization for its storm water
discharges associated with industrial activity in the State identified in Section B under EPA's Storm Water Mufti -Sector General Permit due to the existence
of a condition of no exposure.
A condition of no exposure exists at an industrial facility when all industrial materials and activities are protected by a storm resistant shelter 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,
Industrial machinery, raw materials, intermediate products, by-products, final products, orwaste 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 without operational taps or valves;
adequately maintained vehicles used In material handling; and
— final products, other than products that would be mobilized In storm water 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, the entity In Section A is certffying that a condition of no exposure exists at Its facility or site,
and is obligated to comply with the terms and conditions of 40 CFR 122.26(g).
ALL INFORMATION MUST BE PROVIDED ON THIS FORM,
Detailed instructions for completing this form and obtaining the no exposure exclusion are provided on pages 3 and 4.
A. Facility Operator Information p o -I
1. Name: i- C o r S r l r s QQ f 2. Phone: [phone]i 2121011�
3. Mailing Address: a. Street: IPI� I�Q"f 11121`'I
b. City: �Jjijcr ILV
C. State: ICI d. Zip Code: i2181610131 — i 01112t 81
B. Facility/Site Location Information
� M �^t
1. Facility Name: µitjjcXQrl(Y`� ISIp�rIZ Ag1si 1Mflgl • I IQg • I I I I I I �
2. a. Street Address: 11-�1114111 �J`golrt _ praItlel P-']rli,y,e, I, I I , I I , I I I I Il I �
b.City: t`•111�(1J� I-Pigi'�it1 I I I t I_ I I 1 I--I_II I c.County: PApI�l1ph I
d. State: G'i g e. Zip Code: 121726141 - 1 1 1 1 1
3. Is the facility located on Indian Lands? Yes No
4. Is this a Federal facility? Yes No
5. a. Latitude: 1315 (S 4J � " b. Longltude: O,t� �OJ �3J • G
8. a. Was the faGltty or stte previously covered under an NPDES storm water permit? Yes No © V
b. If yes, enter NPDES permit number:
7. SIC1Activlty Codes: Primary: �101B6J Secondary (if applicable): I I I I
8. Total size of site associated with Industrial activity: 4 . 7 acres
9. a. Have you paved or roofed over a formerly exposed, pervious area in order to qualify for the no exposure exclusion? Yes ❑ No W1
b. If yes, please indicate approximately how much area was paved or roofed over. Completing this question does not disqualify you for the no exposure
exclusion. However, your permitting authority may use this Information in considering whether storm water discharges from your Site are likely to have
an adverse impact on water quality, in which case you could be required to obtain permit coverage.
Less than one acre One to five acres More than five acres
EPA Form 3510-11 (10-99) Page 1 of 4

It
NPDES NO EXPOSURE CERTIFICATION for Exclusion from Form Approved
FORM ,EPA OMB No. 204p-02t1
3510-11 NPDES Storm Water Permitting
C. Exposure Checklist
Are any of the following materials or activities exposed to precipitation, now or In the foreseeable future?
(Please check either 'Yes" or'No" In the appropriate box.) If you answer "Yes" to any of these questions
(1) through (11). you are not eligible for the no exposure exclusion.
Yes
No
1. Using, storing or cleaning industrial machinery or equipment, and areas where residuals from using, storing
ID
W1
or cleaning Industrial machinery or equipment remain and are exposed to storm water
2. Materials or residuals on the ground or in storm water inlets from spilislloaks
3. Materials or products from past Industrial activity
4. Material handling equipment (except adequately maintained vehicles)
5. Materials or products during load inglunloadIng or transporting activities
El
0
S. Materials or products stored outdoors (except final products Intended for outside use [e.g., now cars] where
❑
171
exposure to storm water does not result In the discharge of pollutants)
7. Materials contained in open, deteriorated or leaking storage drums, barrels, tanks, and similar containers
S. Materials or products handled/stared on roads or railways owned or maintained by the discharger
❑
9. Waste material (except waste in covered, non -leaking containers [e.g.. dumpsters])
❑
10
10. Application or disposal of process wastewater (unless otherwise permitted)
❑
21
11. Particulate matter or visible deposits of residuals from roof stacks and/or vents not otherwise regulated
(i.e., under an air quality control permit) and evident in the storm water outflow
D. Certification Statement
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 storm water permitting.
I certify under penalty of law that there are no discharges of storm water 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(9)(2)).
I understand that I am obligated to submit a no exposure certification form once every five years to the NPDES permitting authority and, If requested, 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 NPDES permitting authority, 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. I understand that I must obtain coverage under an NPDES permit prior
to any point source discharge of storm water 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 penattles for submitting false Information, including the possibility
of fine and Imprisonment for knowing violations.
Print Name: L,l lIrO4 ls il" 4 gn151 l 1C-v1 S; f l ii!g 14 I I I I I I I I I
Print Title: VIP, JtInI sl"Ir�l-I IPrgC11; ;1 q iqI I I I I I I �
Signature:
Date:
EPA Form 3510-11 (10-99) Page 2 of