NCGNE0103_COMPLETE FILE - HISTORICAL_20090717

STORMWATER DIVISION CODING SHEET
RESCISSIONS
PERMIT NO.
DOC TYPE
❑COMPLETE FILE -HISTORICAL
DATE OF
RESCISSION
❑ c�2-6��J O'% �7
YYVYMMDD

t -
NC®ENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Ed Steagall
MW -Manufacturers - MW Manufacturers
1110 Box 1600
Fayetteville, NC 28302
Dear Ed Steagall:
Division of Water Quality
Coleen H. Sullins
Director
July 17, 2009
Subject: Rescission of No Exposure
No Exposure Number NCGNE0103
MW Manufacturers - MW Manufacturers
Dee Freeman
Secretary
On 3/2/2009, the Division of Water Quality received your request to rescind you coverage under No Exposure Number
NCGNE0103, In accordance with your request, No Exposure Number NCGNE0l03 is rescinded effective immediately.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 sribject 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 permit 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 natter, please contact Sarah Young at [phone], or the Water Quality staff in our
Fayetteville Regional Office at 910-433-3300.
Sincerely,
�-�s&
COlecrl 1-1. Sullins
cc: Iayetteville Regional Office
Slormwater Permitting Unit
DWQ Central Files - w/attachments
Fran McPherson, DWQ I3udget Office
Wetlands and Storrnwater Branch
1617 Mail Service Center, RAO. North Carolina 27699.1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone: 91H07-6300 4 FAX [phone] Customer Service; 1-877-623-6748
Internet. www.nccwaterqual4y.org
An Equal Opportunity 1 AffrmatiYe Action Employer
NorthCarotina
)Vatilrally

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VITA 10 161• . 1 • • "
2/23/2009
NC Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27699
To Whom It May Concern:
MW Manufacturers, Inc.
PO Box 1600, 408 Pine Street
Fayetteville, NC 28302
Phone [phone]
MAR 0 2 QALUI
DENF - ATEri
w@tlsinds & s6r,rmwater Branch
We would like to request that our No Exposure Certification
NCGNEO103 for the facility at 318 Blount St. Fayetteville, NC be
rescinded. The reason for this request is MW Manufacturers sold
this property to Blount St. Investments in March of 2006.
Since MW Manufacturers no longer owns the property at 318
Blount St. Fayetteville,.NC, please rescind our No Exposure
Certification NCGNEO103.
If you have any questions or concerns, please give me a call at
910-483-0321. Thanks for all your help with this issue.
Sincer ly,
Ed Steagall

• ': - ; . '
?� �,.t, is
. ry
fi r
fi r

NCG080714
Town of Hope Mills -
Fayetteville
10129/08
comments provided previously to proceed with rescission
NCG170107
Waverly Mills Inc -
Fayetteville
02/16/09
site visit on 516109, met with Ed Baldwin, facility has definitely shut down, re
NCG170373
UCO Fabrics Inc -
Fayetteville
01/01/09
site visit on 5112/09, met with Dan Daly, all industrial activity has stopped, re
NCG200449
Metal Recycling
Fayetteville
04102109-
site visit on 5112109, sign on door reads facility closed effective March 16, 2
NCG210141
Fleetwood Homes of
Fayetteville
01l23109
site visit on 516109, facility appears abandoned, no materials/equipmenttproc
NCGNE0103
MW MariEitacturers -
Fayetteville
03/02/09
staff familiar with sell of facility, rescission appropriate, new owners may n
NCG030463
13 & B Fabricators Inc Mooresville
12108108
NCG030539
Entertainment Mooresville
04/06/09
Distribution
NCG030550
Fontaine Truck Mooresville
04/17/09
NCG080640
Con -Way Freight - Mooresville
1 ill 8108
NGG080648
Estes Express Lines Mooresville
03/04/09
NCG100052
Don's Auto Parts Inc - Mooresville
03/23/09
NCG140335
Concrete Supply Co - Mooresville
02/23/09
NCG140355
APAC-Georgia Mooresville
02/23/09
NCG140356
APAC Georgia- Mooresville
M23109
NCG140371
Apac Southeast - Mooresville
02/23/09
NCG1600a7
Rea Contracting LLC Mooresville
02123109
NCG160153
J T Russell & Sons Mooresville
12108/08
NCG160169
Rea Contracting LLC Mooresville
02/23/09
- Rea Contracting
NCG170118
Carolina Mills- Mooresville
03102109
NCG170315
Adrian Madora Plant Mooresville
03/17/09
NCG170381
Belmont Dyers Mooresville
03111/09
NCG 180014
Null Industries Inc - Mooresville
02126109
NCG180018
RSI Home Products - Mooresville
03/06/09
NCG180030
Kincaid Furniture Co Mooresville
02/23/09
(Alexvale Upholstery
NCG180124
Bassett Furniture Mooresville
02/23/09
NCG180229
Broyhill Furniture Mooresville
03/03/09
NCG200422
William Simmons - Mooresville
12/08/08
NCGNE0015
General Electric Mooresville
02/02/09
NCS000083
Celanese Acetate Mooresville
02/25/09
NCG060273
Smithfield Packing Raleigh
01101/09
Company Inc -
NCG080578
Roadway Express - Raleigh
02/16/09
NCG080691
Town of Chapel Hill - Raleigh
01/12/09
NCG080721
Connex TCT LLC - Raleigh
04/15/09
NCG08079B
Town of Cary - Fleet Raleigh
01/05/09
NCG140225
Rea Contracting LLC Raleigh
02123/09

JUSTIFICATION FOR REMISSION REQUEST
DWQ Case Number: WQ-2008-0001 County: Pamlico
Assessed Party: Coastal Marketing & Development Company
Permit No. (if applicable): Amount Assessed: 14� ,367.94
Please use this form when requesting remission of this civil penalty. You must also complete the
"Request For Remission Waiver o Right to an Administrative Hearing,and Stipulation o
Facts" form to request remission of this civil penalty. You should attach any documents that
you believe support your request and are necessary for the Director to consider in evaluating
your request for remission. Please be aware that a request for remission is limited to
consideration of the five factors listed below as they may relate to the reasonableness of the
amount of the civil penalty assessed. Requesting remission is not the proper procedure for
contesting whether the violation(s) occurred or the accuracy of any of the factual statements
contained in the civil penalty assessment document. Pursuant to N.C.G.S. § 143B-282.1(c),
remission of a civil penalty may be granted only when one or more of the following five factors
applies. Please check each factor that you believe applies to your case and provide a detailed
explanation, including copies of supporting documents, as to why the factor applies (attach
additional pages as needed).
(a) one or more of the civil penalty assessment factors in N.C;G.S. 14313-282.1(2)
were wrongfully applied to the detriment of the petitioner (the assessment factors are listed in
the civil penalty assessment document);
(b) the violator promptly abated continuing environmental damage rig from the
violation (i.e„ explain the steps that,you took to correct the violation and prevent future
occurrences);
_ (c) the violation was inadvertent or a result of an accident (i.e., explain why the
violation was unavoidable or something you could not prevent or prepare for);
(d) the violator had not been assessed civil penalties for any previous violations;
(e) payment of the civil penalty will prevent payment for the remaining necessary
remedial actions (i.e., explain how payment of the civil penalty will prevent you from performing
the activities necessary to achieve compliance).
EXPLANATION (attach additional pages as necessary):
r

MCDENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Ed Steagall -
MW Manufacturers - MW ManUfactllrers
PO Box) 600
Fayetteville, NC 28302
Dear Ed Steagali:
Division of Water Quality
Coleen H. Sullins
Director
July 17, 2009
Subject: Rescission of No Exposure
No Exposure Number NCGNE0103
MW Manufacturers - MW Manufacturers
Dee Freeman
Secretary
On 3/2/2009, the Division of Water Quality received your request to rescind you coverage under No Exposure Number
NCGNI✓0103. In accordance with your request, No Exposure Number NCGNE0103 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
hermit coverage when, in fact, continuing permit coverage was necessary. If, in retrospect, you feel the site still requires
permit coverage, you should uoti fy this off ice immediately. Furthermore, if in the future you wisli 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 Sarah Young at [phone], or the Water Quality staff in our
Fayetteville Regional Office at 910-433-3300.
Sincerely,
Coleen H. Sullins
cc. Fayetteville Regional Office
Stornnvater Permitting Unit
DWQ Central Files - w/attachments
Fran McPherson, DWQ Budget Office
Wetlands and Stormwater Branch
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Locatiom 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone] Customer Service; 1-877-623-6748
Internet: www.ncwalerquality.org
NorthCarotina
An Equal Opportunity 1 Affirmative Action Ernployor

0� \NA7'F Michael F.1--2sley,Governor
9QG William G. Koss Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, 1'. E. Director
Division of Water Quality
Q Y Coleen 1-1. Sullins, Dcputy Director
Division of Water Quality
April 20, 2005
Ed Steagall
MW Manufacturers
PO Box 1600
Fayetteville, NC 28302
Subject: No Exposure Certification NCGNE0103
MW Manufacturers - 318 Blount St
Cumberland 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 September 10, 2003. 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].
cc: Fayetteville Regional Office
Stormwater Permitting Unit Files
Sincerely,
for Alan W. Klimek, P.E.
Central Files - w/attachments
N. C. Division of Water Quality 1617 Mail Service Center Raleigh, North Carolina 27699-1617 [phone]
OA
VC -DER
Customer Service
1-877-023-6748

rOMIr
pp ed
United States Environmental Protection Agency40-0211
NPDES®��� Washington, DC 20460
FORM '�' NO EXPOSURE CERTIFICATION for Exclusion
351 l]-11
NPDES Storm Water Permitting
Submission of this No Exposure Certification constitutes notice 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 Multi -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, 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 sheiter 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 (ability 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 :o procipitation, the facility is
not eligibie for the n3 exposure exclusion.
By signing and submitting this No Exposure Certification form, the entity in Section A is certifying 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
1. Name: I n l*J l IM IA IN I u 1 F I A 1 CIT I lAI P,t F III S I I- I- I I I l i- I I I I I 12. Phone: fil 111, 0 14 i'bi_ll013i-Zi 1
3. Mailing Address: a. Street: I p 10 1 1610 1Y. to 0 0
6,City; IrIAI1EI'YI"TIel 41-1L-ILIS I i I I I I I I I j c.,State: LLVI d.Zip Code: I'AISI�,t01Zt- I 1 II I
B. FacilitylSite Location information
1. Facility Name: Awl MA-1 NM I E_li (__ d
I u lR 151.915 I I I I __I-_1 - I I l I
1 I I I I
2. a. Street Address: � 3 1 t 1b1 II % 10 1u I NIT
I IS IT• 1 1 I
b. City: lFIN ly IlellITIEFIVIT-ILIL-IE71 _I
I I I 'I 11 1 I -1-1 c.County:
IC.1L1_}MI5IElKIt-IAI4ID
d. State: 10 1 CJ e. Zip Code: 1,Ai !tj 3 101
lI I _
3. Is the facility located on Indian Lands? Yes ❑
No
r OTE
il`1'j�
4. Is this a Federal facility? Yes ❑
No ®
I`l
5. a. Latitude: 2 51 ' u z� �t J "
b. Longitude: 117 181 ` 15 ]J �3 �I "
I 0 #
6>. a. Was the facility"or site previously covered under an NPDES storm water permit? Yes ❑
u u
No ®�
T
�" ��""[3
b. if yes, enter NPDES permit number: ------ -------
___
7. SIC/Activity Codes: Primary:
8. Total size of site associated with industrial activity:
Secondary (if applicable): j I I I
acres
9. a. Have you paved or roofed over a formerly exposed, pervious area in order to qualify for the no exposure exclusion?
DENR - WATER QUALITY
P01fii SOURCE BRANCH
Yes❑ No
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 he required to obtain permit coverage.
Less than one acre ❑ One to five acres ❑ More than five acres ❑]
EPA Form 3510-11 (10-99)
Page t of 4
D

NPDES Ir NO EXPOSURE CERTIFICATION for Exclusion from Form approved
3510-11 80EPA NPDES Storm Water Permitting OMB No.2040-0211
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
❑
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 spills/leaks
3. Materials or products from past industrial activity
4. Material handling equipment (except adequately maintained vehicles)
�(
5. Matenats or products during loading/unloading or transporting activities
6. Materials or products stored outdoors (except final products intended for outside use [e.g., new cars] where
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
B. Materials or products handled/stored on roads or railways owned or maintained by the discharger
9. Waste material (except waste in covered, non leaking containers [e.g., dumpsters])
10. Application or disposal of process wastewater (unless otherwise permitted)
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(g)(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 inspection$ 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 penalties for submitting false information, including the possibility
of fine and imprisonment for knowing violations.
Print Name: 1EPi
Print Title: 1 9 I L I AI w IT I I NI XI N I At G I V I RI I I I I I I I I I I I I I I I I I I I I
Signature: - N
— -----------------------------------
Date: 10 15 10111b
EPA Form 3510-11 (10-99) 1 Page 2 of 4

NPDES .r1, Instructions for the NO EXPOSURE CERTIFICATION for Form Approved
FORM ��r EPA OMB No. 2040-0211
3510-11 Exclusion from NPDES Storm Water Permitting
Who May File a No Exposure Certification Section B. Facility/Site Location Information
Federal law at 40 CFR Part 122.26 prohibits point source discharges of 1. Enter the official or legal name of the facility or site.
storm water associated with industrial activity to waters of the U.S. without
a National Pollutant Discharge Elimination System (NPDES) permit. However, 2. Enter the complete street address (if no street address exists, provide
NPDES permit coverage is not required for discharges of storm water a geographic description (e.g., Intersection of Routes 9 and 551), city,
associated with industrial activities identified at 40 CFR 122.26(b)(14)(i)- county, state, and zip code. Do not use a P.O. Box number.
(ix) and (xi) if the discharger can certify that a condition of "no exposure"
exists at the industrial facility or site. 3. indicate whether the facility is located on Indian Lands.
Storm water discharges from construction activities identified in 40 CFR
122.26(b)(14)(x) and (b)(15) are not eligible for the no exposure exclusion.
Obtaining and Maintaining the No Exposure Exclusion
This form is used to certify that a condition of no exposure exists at the
industrial facility or site described herein. This certification is only applicable
in jurisdictions where EPA is the NPDES permitting authority and must be
re -submitted at least once every five years.
The industrial facility operator must maintain a cendition,of no exposure at
its facility or site in order for the no exposure exclusion to remain applicable.
If conditions change resulting in the exposure of materials and activities to
storm water, the facility operator must obtain coverage under an NPDES
storm water permit immediately.
Where to File the No Exposure Certification Form
Mail the completed no exposure certification form to:
Storm Water No Exposure Certification (4203)
USEPA
401 M Street, SW
Washington, D.C. 20460
Completing the Form
You must type or print, using uppercase letters, in appropriate areas only.
Enter only one character per space (i.e., between the marks). Abbreviate
if necessary to stay within the number of characters allowed for each item.
Use one space for breaks between words. One form must be completed
for each facility or site for which you are seeking to certify a condition of no
exposure. Additional guidance on completing this form can be accessed
through EPA's web site at www.epa.gov/owm/sw. Please make sure you
have addressed all applicable questions and have made a photocopy for
your records before sending the completed form to the above address.
Section A. Facility Operator Information
1. Provide the legal name of the person, firm, public organization, or any
other entity that operates the facility or site described in this certification.
The name of the operator may or may not be the same as the name of
the facility. The operator is the legal entity that controls the facility's
operation, rather than the plant or site manager.
2. Provide the telephone number of the facility operator.
3. Provide the mailing address of the operator (P.O. Box numbers may be
used). Include the city, state, and zip code. All correspondence will
be sent to this address.
4. Indicate whether the industrial facility is operated by a department or
agency of the Federal Government (see also Section 313 of the Clean
Water Act),
5. Enter the latitude and longitude of the approximate center of the facility
or site in degrees/minutes/seconds. Latitude and longitude can
be obtained from United States Geological Survey (USGS) quadrangle
or topographic maps, by calling 1-(888) ASK-USGS, or by accessing
EPA's web site at http:llwww.epa.govlowmiswtindustry/index.htm and
selecting Latitude and Longitude Finders under the ResourceslPermit
section.
Latitude and longitude for a facility in decimal form must be converted
to degrees (°), minutes ('), and seconds (") for proper entry on
the certification form. To convert decimal latitude or longitude to
degreestminuteslseconds, follow the steps in the following example.
Example: Convert decimal latitude,45.1234567 to degrees (°), minutes
('), and seconds (").
a) The numbers to the left of the decimal point are the degrees: 451.
b) To obtain minutes, multiply the first four numbers to the right of the
decimal point by 0.006: 1234 x 0.006 = 7.404.
c) The numbers to the left of the decimal point in the result obtained
in (b) are the minutes: 7'.
d) To obtain seconds, multiply the remaining three numbers to the
right of the decimal from the result obtained in (b) by 0.06:
404 x 0.06 = 24.24. Since the numbers to the right of the decimal
point are not used, the result is 24".
e) The conversion for 45.1234567 = 45° 7' 24".
6. Indicate whether the facility was previously covered under an NPDES
storm water permit. If so, include the permit number.
7. Enter the 4-digit SIC code which identifies the facility's primary activity,
and second 4-digit SIC code identifying the facility's secondary activity,
if applicable. SIC codes can be obtained from the Standard Industrial
Classification Manual, 1987.
8. Enter the total size of the site associated with industrial activity in acres.
Acreage may be determined by dividing square footage by 43,560, as
demonstrated in the following example.
Example: Convert 54,450 ft2 to acres
Divide 54,450 ft2 by 43.560 square feet per acre:
54,450 ft2 - 43,560 ft2/acre = 1.25 acres.
9. Check "Yes" or "No" as appropriate to indicate whether you have paved
or roofed over a formerly exposed, pervious area (i.e., lawn, meadow,
dirt or gravel road/parking lot) in order to qualify for no exposure. If yes,
also indicate approximately how much area was paved or roofed over
and is now impervious area.
EPA Form 3510-11 (10-99) Page 3 of 4

NPDES i �, Instructions for the NO EXPOSURE CERTIFICATION for Form Approved
FORM �-,EPA OMB No, 2040-0211
3510-�f Exclusion from NPDES Storm Water Permitting
Section C. Exposure Checklist authority to sign documents has been assigned or delegated to
the manager in accordance with corporate procedures;
Check "Yes" or "No" as appropriate to describe the exposure conditions at
your facility. If you answer "Yes" to ANY of the questions (1) through ()1) For a partnership or sole proprietorship: by a general partner or the
in this section, a potential for exposure exists at your site and you cannot proprietor; or
certify to a condition of no exposure. You must obtain (or already have)
coverage under an NPDES storm water permit. After obtaining permit For a municipal, State, Federal, or other public facility: by either a
coverage, you can institute modifications to eliminate the potential for a principal executive or ranking elected official,
discharge of storm water exposed to industrial activity, and then certify to
a condition of no exposure. Paperwork Reduction Act Notice
Section D. Certification Statement
Federat statutes provide for severe penalties for submitting false information
on this application form. Federal regulations require this application to be
signed as follows:
For a corporation; by a responsible corporate officer, which means:
(i) president, secretary, treasurer, or vice-president of the corporation
in charge of a principal business function, or, any otherr person
who performs similar policy or decision making functions for the
corporation, or
(ii) the manager of one or more manufacturing, production, or
operating facilities, provided the manager is authorized to make
management decisions which govern the operation of the
regulated facility including having the explicit or implicit duty of
making major capital investment recommendations, and initiating
and directing other comprehensive measures to assure long
term environmental compliance with environmental laws and
regulations; the manager can ensure that the necessary systems
are established or actions taken to gather complete and accurate
information for permit application requirements; and where
Public reporting burden for this certification is estimated to average 1.0 hour
per certification, including time for reviewing instructions, searching existing
data sources, gathering and maintaining the data needed, and completing
and reviewing the collection of information. Burden means the total time,
effort, or financial resources expended by persons to generate, maintain,
retain, or disclose to provide information to or for a Federal agency. This
includes the time needed to review instructions; develop, acquire, install,
and utilize technology and systems for the purposes of collecting, validating,
and verifying information, processing and maintaining information, and
disclosing and providing information; adjust the existing ways to comply with
any previously applicable instructions and requirements; train personnel to
be able to respond to a collection of information; search data sources;
complete and review the collection of information; and transmit or otherwise
disclose the information. An agency may not conduct or sponsor, and a
person is not required to respond to, a collection of information unless it
displays a currently valid OMB control number. Send comments regarding
the burden estimate, any other aspect of the collection of information, or
suggestions for improving this form, including any suggestions which may
increase or reduce this burden to: Director, OPPE Regulatory Information
Division (2137), USEPA, 401 M Street, SW, Washington, D.C. 20460.
Include the OMB control number of this form on any correspondence. Do
not send the completed No Exposure Certification form to this address.
EPA Form 3510-11 (10-99) Page 4 of 4