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Y <br /> Bute of California 11020 Sun Center Drive,Suite 200 <br /> State Water Resources Control Board Rancho Cordova,CA 95670 <br /> NOTICE NON-APPLICABILITY <br /> i <br /> Submission of this Notice of Non-Applicability (NONA) constitutes notification that the facility operator <br /> identified is not required to comply with the Industrial Activities No. 97- 03 DWQ Storm Water General Permit <br />' (General Permit). Please note that the State Board is in the process of revising General Permit. Once adopted, <br /> the NONA form may no longer be valid as the revised permit may no longer provide any exemption to certain <br /> category(s) of industries from the requirements of general permit. <br /> I <br /> I. FACILITY OPERATOR (� <br /> NAME. Derr, Q. C04ck Ma =_ CONTACT PERSON ��'h_ 1f "A--_ <br /> ADDRESS ia(q 5prin2 erteK ()r. TrrLE r�festc�n.c,� .� ,"C' T� <br /> CITY 2-1 Pon _ STATE CO� ZiP `3S3L PHONE Q?a4 2 34—ZoQy <br /> II. FACILITY SITE INFORMATION <br /> I FACILI D R n R_ 01045-_, AC- CONTACT PERSONc'A <br /> LOCATION 11219 E . L��,�s.e 1^C7FQ _ TITLE _.os!�gNNQ_r <br /> CITY i~SGct �xs(Z ._ sTATg:4,, zIP ITS3Zp_, ,I QNE o709 z 3(4"Zd3�l <br /> rFfze.sh <br /> SIC CODE(s) dI O/q /9. I JYPU OF 11118IN aaVQ e. bye. rac ess�n <br /> nrN►eg a 1 lqq i <br /> I III, BASIS OF NON-APPLICABILITY <br /> 1. Closed Facility. The facility is closed and all closure, moving, and clean-up activities are complete. <br /> Date of closure I I Did you move to a new location in CA? Yes No <br /> I <br /> l If Yes, start date at new location? I I Will you file new NOV Yes No <br /> NEW FACILITY INFORMATION <br /> NAME CONTACT PERSON <br /> r MAILING ADDRESS TITLE <br /> CITY STATE ZIP- <br /> 2. No Storm Water Discharge/Exposure. Storm water associated with industrial activity does not <br /> discharge to waters of the United States because: <br /> a. the storm water is retained on site (such as in evaporation or percolation ponds). <br /> b. the storm water is discharged to a municipal sanitary sewer systems or municipal combined <br /> sewer system. <br /> C. the storm water is retained offsite(such as in evaporation or percolation ponds). <br /> v'd. all industrial activities are conducted inside (including material storage& handling) <br /> Please provide appropriate supporting documentation such as photographs, site layout, design <br />` parameters, etc to justify this. <br />