NCGNE0180_COMPLETE FILE - HISTORICAL_20110314

STORMWATER DIVISION CODING SHEET
RESCISSIONS
PERMIT NO.
�C 61Ur--- b I g U
DOC TYPE
❑COMPLETE FILE -HISTORICAL
DATE OF
RESCISSION
❑ � (I v3 � -!
YYYYMMDD

+l
NCDE R
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Kenneth J. I-[allatt
Pill (formerly known as IvVyeth)
407 Davis Drive
Durham, NC 27713
Dear Perini
Division of Water Quality
Coleen H. Sullins
Director
March 14, 2011
Dee Freeman
Secretary
Subject: Rescission ofNPDL;S Stormwater Permit
Certificate of Coverage Number NCGNE0180
Wyeth-Ayerst - Wyeth
Durham County
Oil 1/27/201 1, the Division of Water Quality received your request to rescind your coverage under
Certificate of Coverage Number NCGNE0180. In accordance with your request, Certificate of Coverage
Number NCGNE0190 is rescinded effective immediately.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 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 NPDI-'-S 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 Raleigh Regional Office at NPDES SW.
Sincerely,
for Coleen H. Sullins, Director
cc: Raleigh Regional Office
Stormwater Permitting Unit
Fran McPherson, DWQ Budget Office - please waive applicable fees
Wetlands and Stormwater Branch
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748
Internet: mvw.ncwatMuality.org
An Equal Opportunity 4 Affirmalive Action Employer
One
NorthCarolina
Aawa!!y ,

dGWA
PIAI'r
NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
March 14, 2011
Kenneth .1. 1-Iallatt
I'f irer (formerly known as Wyeth)
407 Davis Drive
Durham, NC 27713
Subject: Rescission of NPDES Stormwater Permit
Certificate of Coverage Number NCGNEO 180
Wyeth-Ayerst - Wyeth
Durham County
Dear Permittee:
Dee Freeman
Secretary
On 1/27/201 I, the Division of Water Quality received your request to rescind your coverage under
Certificate of Coverage Number NCGNE0180. In accordance with your request, Certificate of Coverage
Number NCGNEOI 80 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 NPDIES 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 Raleigh Regional Office at NPDI71S SW.
Sincerely,
44") 145e-�)�
for Coleen H. Sullins, Director
cc: Raleigh Regional Office
Stormwater Permitting Unit
Fran McPherson, DWQ Budget Office - please waive applicable fees
Wetlands and Stormwater Branch One
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Noi-thCal Olilla
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604 )Vatit�����
Phone: [phone] FAX. 91M07-64941 Customer Service: 1-877-623-6748
Internet: www,ncwaterquality.org
An Equal Opportunity t Affirmative Action Employer

Pfizer 01/25/201 1
Kenneth J. I-iallatt
4300 Oak Park
Sanford, NC 27330
SW NPDES Pen -nit Coverage Rescission
Stonnwater Permitting Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Re: Rescission Request Form for Pfizer facility at 407 Davis Drive, Durham, NC
Dear Sirs:
Please find the enclosed Rescission Request Form for the Pfizer facility that was
conducting operations at 407 Davis Drive, Durham, NC, 27713 until December 21, 2010.
Please note that should you have any questions regarding this Rescission Request, please
address all correspondence to me at the mail address at the top of this letter.
Sincerely yours,
cqklv�
Kenneth J. Hallatt
Associate Director, Global Operations
919-566-4309
7JAN 2 7 20111 !

l
r -
�'� Division of Water Quality / Surface Water Protection
A•la
NCDENRNational Pollutant Discharge Elimination System
"° m, AND"°"N-
"~ ~ertO•
ENviRESCISSION REQUEST FORM
AOMMENT AND ,uUwti RCSIXJNCE$
FOR AGENCY USE ONLY
Date Received
Year
Month
Day
Please fill out and return this form if you no longer need to maintain your NPDES stormwater permit.
1) Enter the permit number to which this request applies:
Individual Permit (or) Certificate of Coverage
N I C I S I I I I I I I I N I C I G I N I E 1 0 1 1 8 0
2) Owner/Facility Information: * Final correspondence will be moiled to the address noted below
Owner/Facility Name - Pfizer (formerly known as Wyeth)
Facility Contact
Street Address
City
County
Telephone No.
Kenneth J. Hallatt
407 Davis Drive
Durham
Durham
919
566-4309
State NC ZIP Code 27713
E-mail Address [e-mail]
Fax:[phone]
3) Reason for rescission request (This is required information. Attach separate sheet if necessary):
❑ Facility closed or is closing on F____1 . All industrial activities have ceased such that no discharges of
stormwater are contaminated by exposure to industrial activities or materials.
❑ Facility sold to �� on . If the facility will continue operations under the new owner it
may be more appropriate to request an ownership change to reissue to permit to the new owner.
® Other: Pfizer (formerly Wyeth) ceased all operations at this site on 12/21/2010 and turned the
facility back over to the Landlord, GRE Keystone Technology Park One LLC (Capital Associates
Management LLC acting as Investment Manager for GRE Keystone Technology Park Holdings LLC)
4) Certification:
I, as an authorized representative, hereby request rescission of coverage under the NPDES Stormwater Permit for the
subject facility. I am familiar with the information contained in this request and to the best of my knowledge and belief
such information is true, complete and accurate.
Signature
Date Z 5 -- 3-p'.] -20 t l
Kenneth 7_ Hallatt Asrnriatp Dirertar, Glnhal Qppratwnns
Print or type name of person signing above Title
Please return this completed rescission request form to:
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone: [phone] FAX: 91 M07.64921 Customer Service: 1.877-623.6748
Internet: www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer
SW NPDES Permit Coverage Rescission
Stormwater Permitting Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
1\ V l L l I%� 11 V 1 I l all
naturally

tN A TF Michael F. Easley, Governor
`OHO 9pG William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
co r Alan W. Klimek, P. E. Director
Division of Water Quality
Q Coleen 11. Sullins, Deputy Director
Division of Water Quality
April 20, 2005
Kenneth J Hallatt
Wyeth
407 Davis Dr
Durham, NC 27713
Subject: No Exposure Certification NCGNE0180
Wyeth - 407 Davis Dr
Durham 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 October 15, 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].
Sincerely,
for Alan W. Klimek, P.E.
cc: Raleigh Regional Office Central Files — wlattachments
Stormwater Permitting Unit Files
N. C. Division of Water Qualify 1617 Mail Service Center Ralcigb, North Carolina 27699-1617 [phone]
� jeA
�1CDEiNR
Customer Service
1-877-623-6748

Wyeth
y I �
OCT 1 5 2003
lii - ii-o 1 6_',-',�ify
P4;NT SQi';it:E E;:k. CH
10/06/2003
Wyeth Research
Kenneth J. Hallatt
407 Davis Drive
Durham, NC 27713
919-775-7100 ext, 2403
Mr. Bradley Bennett
Supervisor Storm Water and General Permits Unit
NCDENR / Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27699-1617
Re: No Exposure Certification for Wyeth Research facility in Durham, NC
Dear Mr. Bennett,
Attached for your use is a "No Exposure Certification for Exclusion from NPDES Storm
Water Permitting" form.
Wyeth is submitting this "Certification" for the Wyeth Research facility located at 407
Davis Drive, Durham, NC because its SIC code is 2836. However, please note that this is
not an industrial facility and hence no industrial activities will be conducted at this site.
The activities at the Durham facility will be limited to laboratory research operations. The
SIC code was assigned to the site to be consistent with parent corporation activities at
other locations.
As noted on the "Certification", there are no materials or activities exposed to
precipitation at this facility. Please call me at the number above if you have any
questions.
Sincerely yours,
Kenneth J. Hallatt
Manager, Environmental, Health and Safety

IJCGNEbiBo-7, ck&
united States Environmental Protection Agency Form Approved
g y OMB No.2040-0211
NPDES Washington, Washington, DC 20460
FORM '�' NO EXPOSURE CERTIFICATION for Exclusion from
3510-11
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, andlor 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 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'
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 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: WiY I F I TA _I_ I I i I i I I _L__i__jI I I I I I I_ I _I I I 11 2. Phone: 1 g 1 j 1 f 11, 715, 71 11010,
3. Mailing Address: a. Street: ILIA-Vi I5
b. City c. State: � d. Zip Code: 13-17 171 I_ I —!Si - ICI_ I 1
B. Facillty/Slte Location Information
1. Facility Name: K T Xi T i l{ i i i I 1 1 I i i i i I i i i I i I i I I I i I f I
2. a. Street Address: I41a i_Z_I— Ib 1 AI V 1 I I s l I D IRA I V I FI I I I I I_ _ 1 1 I I I t� I I I I I I
b. City: 1Di UIR 1�l Ai ML I_ I I I I I I I_ I I I I I I I I I c. County: 1b I U 1i:1��-I&IM1 I I I
d. State: I IQ e. Zip Code: 140 1111 13 —1 I 1 1 1
3. Is the facility located on Indian Lands? Yes No
4. Is this a Federal facility? Yes No
5. a. Latitude: ( " UI L(" - b. Longitude: I III 3 o VJ "
6. a. Was the facility or site previously covered under an NPDES storm water permit? Yes ❑ No
b. If yes, enter NPDES permit number:
7. SIC/Activity Codes: Primary: 1 12-18 13Secondary(if applicable):
11((
8. Total size of site associated with industrial activity: 4- i 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
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 R One to five acres ❑ More than five acres
EPA Form 3510-11 (10-99) Page 1 of 4

NPDES �R� NO EXPOSURE CERTIFICATION for Exclusion from Form Approved
FORM �r P OMB No. 2040-0211
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
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)
El
5. Materials or products during loadinglunloading or transporting activities
6. Materials or products stored outdoors (except final products intended for outside use (e.g.. new cars] where
El
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
8. Materials or products handled/stored on roads or railways owned or maintained by the discharger
9. Waste material (except waste in covered, non4caking containers (e.g., dumpsters])
❑
10. Application or disposal of process wastewater (unless otherwise permitted)
0
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))_
f 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 penalties for submitting Use information, including the possibility
of fine and imprisonment for knowing violations.
Print Name: IKiEi0i0ii~I1—d4i iT 4AWL MITI I I I I l I i I I .i i f 1 i I I
Print Title: AtctAhAiQ.1 liE7 AYf•1fI AIEAtITIkI IAIMP1 ISINFIE111yI I
Signature:
Date: 11 101 0I F31 0I Sl
EPA Form 3510-11 (10.99) Page 2 of 4

NPDESFORM Instructions for the NO EXPOSURE CERTIFICATION for Form Approved
35100 M �-EPA OMB No.2440-0211
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
storm water associated with industrial activity to waters of the U.S, without
a National Pollutant Discharge Elimination System (NPDES) permit. However,
NPDES permit coverage is not required for discharges of storm water
associated with industrial activities identified at 40 CFR 122.26(b)(14)(i)-
(ix) and (xi) if the discharger can certify that a condition of "no exposure"
exists at the industrial facility or site.
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 condition 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/ownVsw. 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.
1. Enter the official or legal name of the facility or site.
2. Enter the complete street address (it no street address exists, provide
a geographic description [e.g., Intersection of Routes 9 and 55]), city,
county, state, and zip code. Do not use a P.O. Box number.
3. Indicate whether the facility is located on Indian Lands.
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://www.epa.gov/owra/swfindust/index,htm and
selecting Latitude and Longitude Finders under the Resources/Permit
section.
Latitude and longitude for a facility in decimal form must be converted
to degrees (1), minutes ('), and seconds (') for proper entry on
the certification form. To convert decimal latitude or longitude to
degrees/minutes/seconds, 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: 450.
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 f12/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 . A Instructions for the NO EXPOSURE CERTIFICATION for Form Approved
FORM ��-,EPA OMB No. 2040-0211
3510-1i Exclusion from NPDES Storm Water Permitting
Section C. Exposure Checklist
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 (11)
in this section, a potential for exposure exists at your site and you cannot
certify to a condition of no exposure. You must obtain (or already have)
coverage under an NPDES storm water permit. After obtaining permit
coverage, you can institute modifications to eliminate the potential for a
discharge of storm water exposed to industrial activity, and then certify to
a condition of no exposure.
Section D. Certification Statement
Federal 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 Trice -president of the corporation
in charge of a principal business function, or any other 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
authority to sign documents has been assigned or delegated to
the manager in accordance with corporate procedures;
For a partnership or sole proprietorship: by a general partner or the
proprietor; or
For a municipal, State, Federal, or other public facility: by either a
principal executive or ranking elected official.
Paperwork Reduction Act Notice
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