SW4100602_HISTORICAL FILE_20150909

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW ��r9(2��92
DOC TYPE
❑ CURRENT PERMIT
❑ APPROVED PLANS
HISTORICAL FILE
DOC DATE
YYYYMMDD

5 W 4 l 0 0 Lo 0 Zr W's'-ro
REQUESTED BY:
Leigh Frazier
DATE: 9/1/2
f5 RECEIVED
N.C.Dept. of ENR
SEP 0 9 2015
SHIP TO:
North Carolina Division of Energy, M,En"el ,]L'&' Land'
Resources
Land Quality Division
1612 Mail Service Center
Raleigh, NC 27699-1612
ATTN :
TELE# 919-707-9220
Fed -Ex Signature Required
DESCRIPTION: Siemens. Energy - State Stormwater
Permit Name/Ownership Change Form
From: Leigh Frazier
Siemens Inc.
3050 Westinghouse Rd.
Rural Hall NC 27045
Phone [phone]
Email: lei h.trazier siemens.com.
VALUE:
Thank you,
Leigh Frazier RECEIVED
E9fS Support
Siemens SEP a 1 &15
3050 Westinghouse Rd DENR-LAND QUALITY
IRuraCxall XC 27045 STORMWATER PERMITTING
336-9694350
Ceigh. Fraz ier@siem ens. com

State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STATE STORMWATER PERMIT NAME/OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION
1. Stormwater Management Permit Number: SW4100602
2. Project Name: High Density Infiltration Basin Project
3. Current Permit Holder's Company Name/Organization: siemens Energy Inc
4. Signing Official's Name: Amogh Bhonde Title: Plant Manager
5. Mailing Address: 3050 Westinghouse Road���_��_
City: Rural Hall State: NC Zip: 27045
6. Phone: ( 336 ) 969-1491 Fax: ( 336 ) 969-1580
II. PROPOSED PERMITTEE 1 OWNER 1 PROJECT 1 ADDRESS INFORMATION
This request is for: (please check all that apply)
❑ Name change of the owner (Please complete Items 1, 2 and 3 below)
❑ Name change of project (Please complete Item 5 below)
®Change in ownership of the property/company (Please complete Items 1, 2, 3, and 4 below)
❑ Mailing address 1 phone number change. (Please complete Item 4 below)
❑ Other (please explain):
I. Proposed permittee's company name/organization: Siemens Corporation
2. Proposed permittee's signing official's name:
3. Proposed permittee's title:
4. Mailing Address: 3050 Westi
City: Rural Hall State: NC Zip
Phone: ( 336 ) 969-1265 Fax:( ___
5. New Project Name to be placed on permit: NIA
27045
Please check the appropriate box. The proposed permittee listed above is:
❑ HOA or POA (Attach documentation showing that the HOA or POA owns, controls, or has a
recorded easement for all areas that contain stormwater system features. Print name of HOA or
POA in #1 above and provide name of HOA/POA's authorized representative in #2 above)
✓❑ The property owner
❑ Lessee (Attach a copy of the lease agreement and complete Property Owner Information on
page 4)
❑ Purchaser (Attach a copy of the pending sales agreement. Final approval of this transfer will be
granted upon receipt of a copy of the recorded deed)
❑ Developer (Complete Property Owner Information on page 4) RECEIVE
SEP 0 12015
GENR-LAND QUALITYSSW NIO Change Rev24Sept2012 Page 1 of 4 STORMINATER PERMITTING

Ills. REQUIRED ITEMS
A request to transfer a permit will not be approved by the Division of Water Quality (DWQ) unless all
of the applicable required items listed below are included with the submittal. Failure to provide the
listed items may result in processing delays or denial of the transfer.
1. This completed and signed form. This certification must be completed and signed by both the current permit holder and the pew applicant if this is a change of ownership.
2. Legal documentation of the property transfer to a new owner.
3. A copy of any recorded deed restrictions, covenants, or easements, if required by the permit.
4. The designer's certification (DWQ Engineer and Designer Certification Forms are available from
each DWQ Regional office), if required by the permit and if not already submitted to DWQ.
5. If the proposed permittee is a firm, partnership, association, institution, corporation, limited liability
company, or other corporate entity, provide documentation showing the authority of the named
representative to act on behalf of the proposed permittee.
6. The $40.00 processing fee. If this is an initial transfer from the original permittee the processing
fee is not required. Subsequent ownership transfers will require the $40.00 processing fee.
IV. CURRENT PERMITTEE'S CERTIFICATION
Please check one of the following statements and fill out the certification below that statement:
❑ Check here if the current permittee is only changing his/her/its name, the project name, or mailing
address, but will retain the permit. I, , the current
permittee, hereby notify the DWQ that I am changing my name and/or I am changing my mailing
address and/or I am changing the name of the permitted project. I farther attest that this application
for a name/ownership change is accurate and complete to the best of my knowledge. I understand
that if all required parts of this application are not completed or if all required supporting information
and attachments listed above are not included, this application package will be returned as
incomplete.
0 Check here if current permittee is transferring the property to a new owner and will not retain
ownership of the permit.
I, , the current permittee, am submitting this application
for a transfer of ownership for permit 4 sw4100602. I hereby notify DWQ of the sale or
other legal transfer of the stormwater system associated with this permit. I have provided a copy of
the most recent permit, the designer's certification for each BMP, any recorded deed restrictions,
covenants, or easements, the DWQ approved plans and/or approved as -built plans, the approved
operation and maintenance agreement, past maintenance records, and the most recent DWQ
stormwater inspection report to the proposed permittee named in Sections II and V of this form.
further attest that this application for a name/ownership change is accurate and complete to the best
of my knowledge. I understand that if all required parts of this application are not completed or if all
required supporting information and attachments listed above are not included, this application
package will be returned as incomplete. I assign all rights and obligations as permittee to the
proposed permittee named in Sections II and V of this form. I understand that this transfer of
ownership cannot be approved by the DWQ unless and until the facility is in compliance with the
permit.
Signature: Date: 031111
"ohAo.u.�c��er�o L&v L.,._. a Notary Public for the State of
l,3orAAOrwol�no_ , County of _y___a+rs._mAIn_, _ _ , do hereby certify that
rv��j� 3hohc�� personally appeared before me this the
31_sA day of N" 20 IS , and acknowledge the due execution of the
oin instrument. Witness my hand and official seal /,..NNotary Signature X40TARY ,�,
I-,. WY
Q OOMMISSIOPI EXPIRES
KtAt
-3 Idaly
SSW N/O Change Rev24Sept2012 Page 2 of 4 Boo .�
OU may,

�. i

V. PROPOSED PERMITTEE CERTIFICATION: (This section must be completed by the
Proposed Permittee for all transfers of ownership)
Siemens Corporation , hereby notify the DWQ that I have acquired
through sale, lease or legal transfer, the responsibility for operating and maintaining the permitted
stormwater management system, and, if applicable, constructing the permitted system.
acknowledge and attest that I have received a copy of: (check all that apply to this permit)
the most recent permit
UZJ the designer's certification for each BMP
❑✓ any recorded deed restrictions, covenants, or easements
❑✓ the DWQ approved plans and/or approved as -built plans
[Z] the approved operation and maintenance agreement
®past maintenance records from the previous permittee (where required)
DWQ stormwater inspection report showing compliance within 90 days prior to this transfer
have reviewed the permit, approved plans and other documents listed above, and I will comply with
the terms and conditions of the permit and approved plans. I acknowledge and agree that I will
operate and maintain the system pursuant to the requirements listed in the permit and in the
operation and maintenance agreement. I further attest that this application for a name/ownership
change is accurate and complete to the best of my knowledge. I understand that if all required parts
of this application are not completed or if all required supporting information and attachments listed
above are not incl ded t is application package will be returned as incomplete.
Signature: Date: 0115111 S _
I,or,rlr�rlou �1� a Notary Public for the State of
t•�ovl�,. emynk"Vnc" , County of V=orsWAAO _ , do hereby certify that
rnoah 34►ond� personally appeared before me this the
3��- day of Q�A_LQ _ 2015 , and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal, o�OP FUIV,"N,�
(Notary Seams N�Aly
Notary Signature OOMMISSiOi4evines
O UBLtC
COUN
Additional copies of the original permit and the approved Operation and Maintenance a579v rient can
be obtained from the appropriate Regional Office of the Division of Water Quality.
This completed form, including all supporting documents and processing fee (if required), should be
sent to the appropriate Regional Office of the North Carolina Department of Environment and Natural
Resources, Division of Water Quality, as shown on the attached map.
Please note that if the Proposed Permittee listed above is not the property owner, the property owner
must complete and sign page 4 of this document. Both the lessee / developer and the property
owner will appear on the permit as permittees.
SSW N/O Change Rev24Sept2012 Page 3 of 4

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VI. PROPERTY OWNER CONTACT INFORMATION AND CERTIFICATION
If the Proposed Permittee listed in Sections I! and V of this form is not the Property Owner, the
Property Owner must provide his/her Contact Information below and sign this form:
Printed Name: NIA
Organization:
Title within the Organization:
Street Address:
City:
Mailing Address:
city
Phone:
Email:
State:
(if different from street address)
State:
Fax:
Zip:
Zip:
I certify that I own the property identified in this permit transfer document and have given permission
to the Proposed Permittee listed in Sections II and V to develop and/or, lease the property. A copy
of the lease agreement or other contract, which indicates the party responsible for the construction
and/or operation and maintenance of the stormwater system, has been provided with the submittal.
As the legal property owner I acknowledge, understand, and agree by my signature below, that I will
appear as a permittee along with the lessee/developer and I will therefore share responsibility for
compliance with the DWQ Stormwater permit. As the property owner, it is my responsibility to notify
DWQ by submitting a completed Name/Ownership Change Form within 30 days of procuring a
developer, lessee or purchaser for the property. I understand that failure to operate and maintain the
stormwater treatment facility in accordance with the permit is a violation of NC General Statute
(NCGS) 143-215.1, and may result in appropriate enforcement action including the assessment of
civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Signature of the property owner l i Date:
I, , a Notary Public for the State of
, County of , do hereby certify that
personally appeared before me this the
day of , 20 , and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal,
Notary Signature
(Notary Seal)
SSW NIO Change Rev24Sept2012 Page 4 of 4

SIEMENS
Tracy Davis, PE, CPM
Director -Division of Energy, Mineral, and Land Resources
N.C. Department of Envirorunent and Natural Resources
1601 Mail Service Center, Raleigh, NC 27699-1601
NPD11_S_Automatic Transfer of Ownership Written Agreement (per 40 CFR 122.61)
Permit Number: NCG030238
Ownership Transfer Date: October 1, 2015
Current Permittee: Siemens Energy Rural Hall
3050 Westinghouse Rd
Rural Hall, Forsyth County
Current Owner: Siemens Energy Inc.
4400 Alafaya Trail Q 1-400
Orlando, FL 32826
New Owner: Siemens Corporation
Physical Address: 170 Wood Avenue South
Iselin, NJ 08830
Mailing Address: 3050 Westinghouse Rd
Rural Hall, NC 27045
RECEIVED
SEP 012015
GEIIR_LAND QUALITY
STORE HATER PERMITTING

Transfer Agreement: The undersigned New Owner Responsible Official (RO) acting on behalf
of the New Owner accepts the responsibility to comply with the coverage and all of the
requirements in the above named NPDES permit. The New Owner is the parent company of the
Current Owner, therefore the New Owner will retain the ultimate liability under the permit. The
Current Owner Responsible Official acting on behalf of the Current Owner agrees to transfer
permit responsibility, coverage and liability to the New Owner on the transfer date defined
above.
New Owner Signature:_
O'CONNOR ON pnNO'CONNOp SUSA.OR
SUSAN °'Siemens,
email=eue.oc
D.I. 2D15,09V 9.011 '.1fi:d2-04'00'
New Owner Responsible Official (Signature)
Susan R. O'Connor
New Owner Responsible Official (Print Name)
Current Owner Signature:
Curl' nt Ow�ie� esponsible Official (Signature)
�Mom Ka NEE
Current Owner Responsible Official (Print Name)
August 31, 2015
Date
Vice President and SRE Americas
EHS Officer
Title
Date
% " t'
Title

S t.J 1+1 o o (0 0 Z.
REQUESTED BY:
DATE: 8-14-2015 ,: �_ RECEN
N,C. Dept.
Leigh Frazier
F..: AUG 18
SHIP TO:
North Carolina Department of Environment and
Natural Resources (NCDENR)
585 Waughtown St
Winston Salem, NC 27107 - 2241
ATTN:
TrLE4 [phone]
Fed -Ex Standard, Signature Required
DESCRIPTION: DESCRIPTION: Updated Emergency Action
Plan Rev4, Siemens Energy
From: Leigh Frazier
Siemens, Inc.
3050 Westinghouse Rd.
Rural Hall, NC 27045
Phone [phone]
Email: lei h.trazier siemens.com
VALUE:
Thankyou,
Leigfi Frazier
M Support
Siemens
3050'Westingfiouse Rd
RRurafOaCC, XC 27045
33 6-969-.1350
Cewfi, Frazier@siemens. com
fENR
2015
;AIL
)FFICF

q-�- s
S`a-Cze.-

SIEMENS
3050 Westinghouse Road
Rural Hall, NC 27045
Tel. [phone]
Fax [phone]
August 11, 2015 L7aq
FedE.x S f '9 J l� 6
Signature Rcquiicd
RECEIVED
. N.C. Dept. of EI!R
North Carolina Department of Environmental and Natural Resources AUG $ ?Q�5
585 Waughtowri St;
Winston-Salem, NC 27107 r�. WNSTON-sALEM
REGIONALOFFICE
Subject: Siemens Energy, Inc. 2014 Updated Emergency Action Plan Rev4
Rural Hall Facility, 3050 Westinghouse Road, Rural Hall, NC 27045
To Whom It May Concern:
Enclosed is an updated copy of our Integrated Emergency Action Plan (EAP) and Contingency Plan tor
your records.
Most recently revised:
• Page 10, Section -5.63: Added the location of all AEDs in the facility.
• Page 13, 3'd Shift Contact changed to Security
• Page 15, Security Radio phone number & Security Office phone number updated
• Page 10, Siemens F.HS Director changed to Janaina Gameiro
If you have any questions or require further information on this matter, please contact me at (336) 969-
1265, or the facility QE14S Manager, Mr. Srikanth Parvathaneni, at [phone].
Sincerely,
/' wig --
James Whiticar
EHS Officer
Siemens Energy, Inc.
Cc: Srikanth Parvathaneni, Siemens Energy, Inc.
Siemens Energy, Inc.
3050 Westinghouse Rd
Rural Nall, NC 27045

' Winston Service Center
EHS Programs
ENVIRONMENTAL, HEALTH & SAFETY
Document type
No.:
SIEMENS
QEHS Procedures Manual
Revision/Date: 4 2015-08-10
Winston Service Center
Issued by: EHS Department
Title
Integrated EAP and Contingency Plan
Handling: For Internal Use Only
ISO-9001 ISO-14001 OHSAS-18001
Table of Contents
Revision Sheet
1.0 Purpose
2.0 Scope
3.0 Authority
4.0 Organization
5.0 Emergency Action Plan
6.0 Contingency Plan
Page: 1 of 26 Appendices: 4
Released by:
Srikanth Parvathaneni
QEHS Manager
a-QMS
7/25/2013
Reviewed by:
Reviewer/Stakeholder
a-QMS
a-QMS
a-QMS
Reviewed by:
Reviewer/Stakehoider
a-QMS
a-QMS
a-QMS
Reviewed by:
Reviewer/Stakeholder
a-QMS
a-QMS
a-QMS
Prepared by:
James Whiticar
EHS Department
a-QMS
7/25/2013
Name
Org. Unit
Signature
Date
Siemens Energy, Inc.
®Siemens Energy, Inc. 2011 At Rights Reserved
Integrated Emergency Action Plan and Contingency Plan
Date: 8/10115 1 1 of 25
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EHS Programs
ENVIRONMENTAL, HEALTH & SAFETY
Revision Sheet
SIEMENS
Revision
Reissue
Date
Section
Description Of Change
1
7-25-13
Appendix A
Change name of coordinators and 2" 13rShift Supervisors
2
8-21-13
5.3
Modified evacuation process
3
4-21-14
Appendix A
Change alternative E.0 Sam Myers to Michael Cox
4
8-10-15
5.6.3
Add AED locations
4
8-10-15
Appendix A
Third Shift contact information
4
8-10-15
Appendix A
Security Phone number
4
8-10-15
Appendix A
Siemens Corporate EHS Director
Integrated Emergency Action Plan and Contingency Plan I I Date: 8110115 I 2 of 25
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EHS Programs SIEMENS
ENVIRONMENTAL, HEALTH & SAFETY
INTEGREGRATED EAP AND CONTINGENCY PLAN
1.0 PURPOSE:
The Integrated Emergency Action Plan (EAP) and Contingency Plan (CP) describes a course of action to
follow in order to assure the safety of personnel (employees, contractor personnel, visitors, and the
general public) who are present on the site, the environment, and equipment when an emergency
occurs. This plan also details communication requirements with the sublet EAP emergency and
management personnel. External reporting requirements are also detailed in this plan. The plan
provides the guidelines and procedures to meet these needs at the Siemens facility in Rural Hall, N.C.
2.0 SCOPE:
The Integrated Emergency Action Plan (EAP) and Contingency Plan (CP) provides information such as
examples of the types of emergencies that could occur at the Rural Hall site, procedures to follow in the
event of an emergency, and responsibilities of personnel during an emergency. Our plans describe
actions facility personnel will take, what emergency response equipment is available, what procedures
will be followed, and arrangements made with local emergency response authorities in order to minimize
hazards to human health or to the environment in the event of an accident involving hazardous materials.
3.0 AUTHORITY:
The Integrated Emergency Action Plan (EAP) and Contingency Plan (CP) was developed and
implemented to comply with OSHA 29CFR 1910.38 and 40 CFR 264.50 thru 56 and to assure for the
safety of personnel, protection of the environment and the protection of physical assets at the Siemens
Winston Service Center has documented and issued this Integrated Emergency Action Plan and
Contingency Plan.
The emergency coordinator has the full.authority to commit resources needed to respond to emergencies
at this facility. The emergency coordinators can deputize other employees to assist them in the event of
an emergency.
The authority to review, revise and approve this procedure is defined within our document control
procedures. Only the owners and approvers of this document are authorized to approve revisions made
to this document.
The Emergency Action Plan and Contingency Plan must be reviewed, and immediately amended
as necessary, whenever the following situations apply;
• Applicable regulations are revised;
• The plan fails in an emergency;
• The facility changes in its design, construction, operation, maintenance, or other
circumstances in a way that materially increases the potential for fires, explosions, or
releases;
• The list of emergency coordinators changes;
• Or the list of emergency equipment changes.
When changes are made that impact the Fire, Explosion or Spill Sections of this plan, revised copies of
this plan are to be sent to the following personnel or agencies:
1) Rural Hall Fire Department
n:
Integrated Emergency Action Plan and Contingency Plan I I Date: 8110/15 I 3 of 25
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EHS Programs
ENVIRONMENTAL, HEALTH & SAFETY
2) Forsyth County Fire Department
3) Forsyth County Sheriff's Office
4) Wake Forest Baptist Medical Center
5) Spill Response Contractor
6) Security
7) Tenant(s) Human Resource Manager
8) Emergency Coordinators
9) Plant Manager
4.0 Organization
4.1 Emergency Coordinator
Facilities and Maintenance Manager
The Facilities and Maintenance Manager shall be the primary Emergency Coordinator and have
primary responsibility for emergency responses to include the local fire department, training,
equipment, and evacuation. He/she shall consult with the Plant/General Manager, Operations
Management, and the Human Resources Manager. He/she will also communicate with the
tenant(s) FIR Manager in order to ensure plant -wide coordination when required. The Emergency
Coordinator will be responsible for recording events, coordinating internal and external resources,
consulting with Siemens EHS personnel as appropriate and reporting status and creating incident
reports.. Security, although contracted by the Siemens Real Estate Facility Manager
(SREFM)„ will be given directions by the Emergency Coordinator, since our primary
objective in an emergency is the safety of all personnel.
Alternate Emergency Coordinator
The alternate emergency coordinator has been designated to identify in Appendix A. In the event
that the Primary Emergency Coordinator is unavailable, the Alternate Emergency Coordinator
shall assume emergency response responsibilities. At all times there must be at least one
Emergency Coordinator on site or on call, with the ability to reach the facility in a short amount of
time, with the responsibility for coordinating all emergency response measures.
Continuity of Emergency Coordination
The emergency coordinator first arriving at the scene shall have the responsibility as the
emergency coordinator for the duration of the emergency, unless properly relieved by the
Facilities and Maintenance/QEHS manager. The emergency coordinator will be responsible for
recording events, coordinating internal and external resources, consulting with Siemens and
Siemens Corporate EHS personnel as appropriate and reporting status and creating incident
reports. The oncoming emergency coordinator assumes all responsibilities including record
keeping and notifications from the point of assuming emergency coordinator responsibilities.
4.2 Personnel Responsibilities Outside of Emergency Team
Management Personnel
The management personnel shall be responsible for maintaining organization within their area as
well as other measures that are called for to protect personnel and company property in their
assigned areas of responsibility. Management is responsible for maintaining posted sketches in
the area outlining emergency routes for employees in their area. They shall advise all new,
incoming employees of these routes during their orientation.
Integrated Emergency Action Plan and Contingency Plan
Date: 8110/15 1 4 of 25
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ENVIRONMENTAL, HEALTH & SAFETY
Security
Security shall be responsible for evaluating the type of emergency to determine whether the
emergency coordinator should be contacted in accordance with Section 8. Security shall
communicate and coordinate a plant wide evacuation with the tenant(s) in the event that an
evacuation is ordered. Security shall call 911 in the event of a fire alarm or upon observation or
notification of emergencies as defined in this plan.
Second Shift, Third Shift and Weekend Shift
The primary role of the second, third and weekend shift supervisors is to coordinate the initial
response (contain, assist and notify) according to the specific emergency procedure contained in
Section 5.1, and contact Security as quickly as possible.
Personnel Outside of Emergency Team
All Siemens WSC staff is part of the Emergency Response Organization and is the organization
established to help in an emergency. The Siemens WSC staff will be responsible for the
communications systems, record keeping, and facilities status during the emergency.
Liaison with External Organizations and the Press
The Emergency Coordinator will maintain liaison with Siemens and the tenant(s) management,
emergency organizations, Siemens and government officials.
The Siemens WSC HR Manager is the only person authorized to talk with reporters or the press.
All inquiries by the press are to be answered with "no comment" and forwarded to the Siemens
WSC HR Manager.
Emergency Support
Immediately following either decision, evacuate and search or search without evacuating, the
Emergency Coordinator shall notify the appropriate emergency organizations (Fire, Police,
Sheriff, Regulatory Agencies) giving them information that is available, outlining the plan for
action within the plant, and requesting advice and assistance as necessary.
Recorder
The Emergency Coordinator shall be responsible for recording the chronology of events, to
document changes that take place and to provide a record for the future. it is recommended that
the emergency coordinator assign record keeping responsibilities to a designated employee.
4.3 Arrangements with Local Authorities
Arrangements have been made with local authorities such as police, fire and local hospitals to
familiarize the local authorities with our facility layout, waste handling and generating activities,
and the types of injuries or illness that could result from fires, explosions, or releases. The local
emergency response agencies, identified in Appendix A, and various state agencies have been
requested to respond to this Hazardous Waste Contingency Plan. Also, their Chief
Administrators are invited to visit the facility in order to better coordinate potential hazardous
waste related emergency response procedures.
If more than one law enforcement agency or fire department responds to an emergency at our
facility, The Emergency Coordinator will hand over control of the incident to the agency that best
addresses the mitigation needs.
Integrated Emergency Action Plan and Contingency Plan
Date: 8/10/15 1 5 of 25
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' Winston Service Center SIEMENS
EHS Programs
ENVIRONMENTAL, HEALTH & SAFETY
5.0 Emergency Action Plan
5.1 General Guidelines for Specific Emergencies
Whenever there is a release, fire, explosion, the Emergency Coordinator must be notified in order
to immediately identify the character, exact source, amount, and areal extent of any release
material. The Emergency Coordinator may do this by observation or review of facility records or
manifests and, if necessary, by chemical analysis.
Concurrently, the emergency coordinator must assess possible hazards to human health or the
environment that may result from the release, fire, or explosion. This assessment must consider
both direct and indirect effects of the release, fire, or explosion (e.g. the effects of any toxic,
irritating, or asphyxiating gases that are generated, or the effects of any hazardous surface water
run-offs from water or chemical agents used to control fire and heat -induced explosions.)
If the emergency coordinator determines that the facility has had a spill, release, fire, or explosion
which could threaten human health, or the environment, outside the facility, he must report his
findings in accordance under Section 5.0 of this plan.
During an emergency, the emergency coordinator must take all reasonable measures necessary
to ensure that fires, explosions, and releases do not occur, recur, or spread to other hazardous
materials at the facility. These measures must include, where applicable, stopping processes
and operations, collecting and containing released waste, and removing or isolating containers.
If the facility stops operations in response to a fire, explosion, or release, the emergency
coordinator must monitor for leaks, pressure buildup, gas generation, or ruptures in valves, pipes,
or other equipment, wherever this is appropriate. Immediately after an emergency, the
emergency coordinator must provide for treating, storing, or disposing of recovered waste,
contaminated soil or surface water, or any other material that results form a release, fire, or
explosion at the facility.
The emergency coordinator must ensure that, in the affected areas of the facility:
• No materials that may be incompatible with the released material is treated, stored, or
disposed of until cleanup procedures are completed; and
• All emergency equipment listed in the Emergency Action Plan and Contingency Plan is
cleaned in the designated decontamination area and fit for its intended use before operations
are resumed.
5.2 FIRE AND EXPOLOSION
5.2.1 Small (incipient) Fire:
• An incipient fire is a small isolated fire that has not spread to the structure of the building or to
other equipment.
• If a member of the Incipient Fire Brigade is present then that member must initially evaluate
the situation and determine what type of fire extinguisher to use.
• If the incipient fire is located in chemical stripping, FIC, or where aluminum powder is present
then the fire department is to handle the situation.
• Security shall contact the Emergency Coordinator from the list in Appendix A.
Integrated Emergency Action Plan and Contingency Plan I Date: B110115 I 6 of 25
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• If the Emergency Coordinator is on site he/she shall conduct an initial evaluation of the
situation. If the Emergency Coordinator is off site, Security shall conduct the initial evaluation
and advise the Emergency Coordinator immediately.
The initial evaluation consists of the following:
• The fire could cause the release of toxic fumes;
• If the fire spreads, it could ignite material at other locations at the site or cause heat -induced
explosions;
• The fire could spread to off -site areas;
• Use of water or water and chemical fire suppressant could result in contaminated run-off
and/or a violent chemical reaction.
• If any of these conditions exist or could exist, appropriate actions should be taken.
5.2.2 Structural Fire or Explosion:
• A structural fire is a fire that has spread to other equipment or the structure of the building.
• Personnel, who discover major fire or explosion should leave the immediate area, pull the
nearest fire alarm pull box and call Emergency Coordinator and/or security at extension 1359.
• Security shall contact the Emergency Coordinator from the list in Appendix A.
• If the Emergency Coordinator is on site he/she shall conduct an initial evaluation of the
situation. If the Emergency Coordinator is off site, Security shall conduct the initial evaluation
and advise the Emergency Coordinator immediately (if feasible).
The initial evaluation consists of the following:
• The Emergency Coordinator will ensure that evacuation procedures have been initiated.
He/she will also communicate with the Tenant(s) HR Manager in order to ensure plant wide
coordination.
• Contact the appropriate local, state, or federal agencies as warranted.
5.3 Evacuation Alert System
The facility is equipped with audible work area alarms and visual strobes. The annunciation is
monitored by Security and the alarm monitoring service. The annunciation panel is located in the
lobby next to Security.
• The fire alarm can be initiated by any of the following:
1. Automatic initiation of water flow system and heat sensors.
2. Notifying Security by phone or other means.
3. Activating a fire alarm pull box.
If the evacuation alarm fails to operate when activated, security shall be notified and will
take the following steps:
1. Phones and radios can be used to announce the evacuation or; Security and/or
supervisors will physically go through the facility, announcing the evacuation.
5.3.1 Evacuation Process
Step 1
Once the fire alarm is activated, all employees are required to evacuate the building.
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Evacuation Routes and Assembling Area
• When the evacuation signal sounds, all employees, contractors, salesmen and visitors
shall proceed via the nearest exit identified on the attached plans and proceed to their
assembly area as designated on attached plans located in Appendix B.
• The escort (Siemens WSC employee) is responsible for ensuring that the visitor and/or
contractor are accounted for and they know where the assembly area is located.
• After evacuating and walking to the assembly area, employees will remain in the
assembly area until notified that it is safe to re-enter the building.
• Employees are not authorized to leave the evacuation area or facility grounds unless
directed to do so by the Emergency Coordinator, Plant Management or emergency
personnel (e.g. Fire Department),
Step 2: Make Sure Everyone Gets Out
The following steps will be initiated to ensure that everyone gets out:
• Once the evacuation signal has sounded, all employees are required to evacuate the
building.
• Employees are to follow the evacuation routes identified in the evacuation maps posted
throughout the facility. If a route is blocked by the release of hazardous materials or fire,
and alternate route should be found using the evacuation maps located in Appendix B.
• Department managers or designee should report -to their assigned assembly areas and
see that personnel remain at proper distances from the building until the all clear signal is
received. Employees are not authorized to leave the evacuation area or facility grounds
unless directed to do so by the Emergency Coordinator, Plant Management or emergency
personnel (i.e. Fire Department)
Step 3: Roll Call
In the event of an evacuation, each department manager or designee will perform a roll call to
ensure that every employee in their department is accounted. At the assembly area, each
department manager will verbally inform the EHS Officer if every employee has been accounted
for. Once inside, each department manager or designee will send the EHS Officer an e-mail to
verify that all employees have been accounted for (present or not present at the facility).
Step 4: Decision After Evacuation:
After evacuation of an actual emergency, the Emergency Coordinator in consultation with
Siemens Real Estate, the County Emergency Personnel, and the Plant Manager shall make a
decision regarding:
• Waiting period before employees may re-enter the building;
• Shutting off or turning back on utilities (electricity, gas, steam, etc.);
• Evacuation times in relation to end of shift, deciding whether to send
• employees home or hold in assembly area;
• Whether next shift should be notified not to report to work;
• Returning to the building for additional searching.
Once decision has been made to allow employees to re-enter the building, the Emergency
Coordinator will be instructed to communicate to all Siemens Management, HR Manager or the
tenant(s) Plant Manager, Siemens Real Estate, and any contractors on site that all is clear.
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After evacuation a non emergency situation, the Emergency Coordinator or -designee will
communicate the message to re-enter the building to the employees in the assembly area once
the cause of the evacuation has been discussed and determined.
5.3.2 Second Shift, Third Shift or Weekend
After evacuation of a non emergency during second shift, third shift or the weekend, the shift
supervisor(s) will take the role of the Emergency Coordinator and communicate the message to
re-enter the building to the employees in the assembly area once the cause of the evacuation has
been discussed and determined with maintenance and security. The supervisor will provide the
EHS Officer a report that ensures that all employees have been accounted for and a detailed
description of the situation.
After evacuation of an emergency situation, the shift supervisor will contact the Emergency
Coordinator or designee of the situation. During the emergency situation, the Emergency
Coordinator or designee will come to the facility to initiate the Contingency Plan. Also, the
supervisor will provide a report that ensures that all employees have been accounted for and a
detailed description of the situation.
5.4 Chemical Spill — Liquid or Solid
Facilities and Maintenance employees will respond to any reported chemical spill. These
employees have been properly trained in basic spill response. These employees can be notified
in person or by calling extension 1359. If maintenance cannot be reached then security is to be
notified (extension 1359).
5.4.1 Spill Evaluation
Answer the following questions when responding to a spill:
• What is the chemical?
• What is the PPE requirement?
• Do I have the necessary spill clean up and containment material present?
• What are the potential physical and toxic risks?
• If the spill occurs outside, am I aware of the requirements listed in the Stormwater Pollution
Prevention Plan (SWPPP) and the Spill Prevention, Control, and Countermeasures Plan
(SPCC)?
• If the spill reaches a certain level, do I know the Emergency Coordinator?
1. The Emergency Coordinator must determine when to contact the list of contacts in
Appendix A, which is dependent upon the nature of the spill.
5.4.2 Gas Release
If chlorine or fluorine gas was released into the facility then the evacuation order would be given.
However, to confirm a chlorine gas release has occurred, a chlorine gas meter would be used to
determine the amount of gas released. If fluorine gas released in the fluorine ion cleaning (FIC)
area then ammonia would be released to suppress the fluorine gas.
5.5 Emergency Procedures for Severe Weather
5.5.1 Tornadoes
The facility utilizes a NOAA weather radio to be alerted to any tornado warnings. If a tornado
warning is issued by the National Weather Service for the Rural Hall area then all employees are
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to report to the designated tornado shelter. While in the tornado shelter, the HR Specialist will
take a roll call to ensure that all employees are accounted for. Once the tornado warning is lifted
then employee will resume normal operations.
5.5.2 Winter storm
If a winter storm occurs that has been determined to make roads impassable or has a utility
outage for the facility then the employees will call 866-367-7972 or on-line at
www.siemens,com/energy/darkwebsite for information about the plant closing. If the storm
occurs during the shift then the supervisors will notify the employees that the plant is closing.
5.5.3 Flood
If the facility is being flooded then the facility will follow the evacuation procedure listed in
Section 5.3.
5.6 Medical Emergency:
5.6.1 General Guidelines
A medical emergency includes injuries and/or illnesses that will require more than the routine first
aid treatment.
5.6.2 Person Discovering the Emergency
The person discovering an employee in need of emergency medical assistance should follow
these steps:
1. Do not activate the fire alarm.
2. Call the radio access channel (extension 1359) from the nearest phone.
3. Stay with the employee needing medical assistance until trained emergency personnel
arrives, but do not attempt to move them unless they are in imminent danger.
4. Always be sure to follow blood borne pathogen protocols.
5.6.3 On -Site Emergency Medical Technician (Siemens EMT or Security)
1. Provide initial or stabilizing assistance and determine if additional medical treatment is
required.
2. If the EMT goes to the scene of an incident then they must take the AED and first aid
bag. There are five AEDs in the building — Security office, Outside of the front office,
Outside of the Manufacturing offices, Across from David Cox's office, and on the wall at
the restroom near Forged Blade Machining and New Parts.
3. Call 911 if a life threatening condition exists.
4. Call an ambulance, if necessary. Notify doctor and hospital of the emergency.
5. Notify the EHS Officer or QEHS Manager immediately of the emergency situation.
6. The On -site Emergency Medical Technician or EHS Officer may also contact WorkCare
for assistance (24-hr Triage Assistance).
5.6.4 HR Manager
Notify the employee's designated emergency contact of the injury or illness and of the action that
has been taken. Notify the employee's supervisor of the emergency. Ensure that all necessary
accident reports are completed.
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5.7 Threats Against the Facility
5.7.1 General Guidelines for Bomb Threat
If an employee receives a call concerning a bomb threat then the employee should try to get as
much information as possible from the caller. Afterwards, the employee should notify the
Emergency Coordinator and/or the HR Manager immediately, so they can contact the proper
authorities in order to determine the best course of action. If the authorities authorize the
evacuation of the facility then the evacuation protocol will be followed as in Section 5.3.1. Also,
the HR Manager will notify the Plant/General Manager and the tenant(s) Manager in order to
ensure plant -wide coordination when required.
If the call occurs during night shift working hours then the employee or Security would take the
call. If an employee answers the phone then he/she will contact Security and then Security would
contact the Emergency Coordinator to alert he/she of the situation.
5.7.2 Procedures to follow if taking the call of a bomb threat
1. Record the time and exact words of the message;
2. Have the caller repeat the message and keep the caller on the line as long as possible;
3. Have someone nearby notify the Emergency Coordinator
4. Ask the caller the reason for making the threat;
5. Note the caller's sex, speech, mannerisms, signs of intoxication, phrases, etc.; and
6. Determine if the caller is using an internal or external line (look at caller ID).
5.7.3 Written Threats:
Threats received in writing should be preserved for investigation for possible fingerprints and if
possible should not be handled once the letter has been opened. When the threat is received, the
person receiving the letter shall personally contact the Emergency Coordinator,
5.8 Emergency Procedures for Civil Disturbance
5.8.1 General Guidelines
The purpose of this procedure is to detail action to be taken in order to protect personnel and
property from any negative effects as a result of civil disturbance. These actions include
notification of the proper authorities for resolving the disturbance, providing a protective
separation between the disturbance and our personnel, and taking necessary steps to protect our
property from destruction as a result of the disturbance.
5.8.2 Responsibilities
Security
Secure Guard Station --Call 911 (if necessary), the Human Resources Manager and the
Emergency Coordinator
Human Resources Manager
Notify local authorities. Notify the tenant(s) HR Manager to determine need for coordination. Have
plant management personnel give direction to their employees. Provide liaison with the police.
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Management Personnel
Keep employees and other individuals away from the disturbance.
6.0 Contingency Plan
6.1 Reporting of Significant Event Requirements to initiate the Contingency Plan
A Significant event is defined as:
• Serious accident, life threatening illness, risk of epidemic
• Definition of a "serious accident" — fatal accident, life endangering injuries, poisoning
• Large-scale damage to plant or equipment, Fires (extinguished by external fire fighters, and/
or having influence on the production), explosion
• Crises (e.g. terror attacks, criminal threats, kidnapping, bomb scare, putsch), civil unrest,
natural catastrophes (e.g. flood, earthquake, hurricane, tornado),
• Loss of radio -active sources or contamination by radio -active material,
• Technical emergency (Impacts from outside: Fire, implosions, plane crash, gas release,
power supply interruptions)
• Imminent or actual (unplanned sudden or non -sudden) release of hazardous materials to
the air, soil or water of the environment, and release of hazardous substances of which the
reportable quantity require reporting to regulatory agency.
• Failure to follow permit requirements which result in self reporting or notice of violation or
citation by a regulatory agency.
• Accident during the transport of dangerous goods in conjunction with release of dangerous
goods
• Indications 1 suspected cases
1. that are capable of becoming events with negative results to the Image of Siemens
Energy Sector
2. respectively unplanned contact to authorities as a result of these events
3, for the occurrence of one of the events described above.
• ? 3 persons injured respectively affected by a single event
Loss of limb(s)
• Any Electric shock accident
• Motor vehicle accident resulting in hospitalization of two or more persons
• The Emergency Coordinator is responsible to ensure events are reported to Siemens.
• All significant events must be reported within 2 hours by phone to the Siemens Corporate
Contacts listed in Appendix A of this document. The purpose of this contact is to notify and
gain guidance on what we are to communicate to external entities.
• After notification to Siemens Corporate, the facility Siemens representative identified in
Siemens Procedure POO-057-AO1 shall notify the appropriate external entities based on
event being reported.
6.2 Incident Reporting Requirements
The Emergency Coordinator must document the incident by recording the time, date, and details
of any incident which requires implementing the contingency plan. Within 15 days after the
incident, the EHS Manager must submit a written report on the Environmental incident to the
Regional Administrator identified in Appendix A: The report must include:
(1) Name, address, and telephone number of the owner or operator;
(2) Name, address, and telephone number of the facility;
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(3) Date, time, and type of incident (e.g., fire, explosion);
(4) Name and quantity of material(s) involved;
(5) The extent of injuries, if any;
(6) An assessment of actual or potential hazards to human health or the environment, where this
is applicable; and
(7) Estimated quantity and disposition of recovered material that resulted from the incident.
6.3 Evacuation of Local Areas (Evaluation, Action and Notification)
If the Emergency Coordinator in conjunction as applicable with the Emergency Responding
Agency (e.g. Fire Department) assessment indicates that evacuation of local areas may be
advisable, the emergency coordinator must immediately notify the appropriate local authorities
identified and either the government official designated as the on -scene coordinator for that
geographical area, or the National Response Center using their 24-hour toll free number listed in
Appendix A. The emergency coordinator must be available to help appropriate officials decide
whether local areas should be evacuated.
6.4 Contingency Plan Resources
Siemens Real Estate Facilities Management
The Siemens Real Estate Response Center should be notified during any emergency situation
concerning the building and/or property. They will assign personnel from Siemens Real Estate
Facilities Management and/or their contractors accordingly to remove/restore utility services and
assess/repair damages.
Maintenance Support
The Siemens Facility Maintenance group will be directed, as needed, by the emergency
personnel to assist in removal of services (power, water, etc.) during such emergencies.
Security
Plant Security will assist in controlling access to emergency locations and to direct outside
emergency response services to proper locations on the plant property.
6.5 Command Post (if needed)
Purpose
The Command Post provides a location for responsible personnel to collect data, make decisions,
and resolve immediate problems at the scene of the emergency.
Location and Function,
The command post will be established at the Security Control Office ('B' Building). The Plant
Security will man it with other personnel designated by the Emergency Coordinator.
Alternate Command Post
An alternate command post will be designated by Security and/or the Emergency Coordinator, as
needed.
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Staff
All Siemens WSC staff is part of the Emergency Response Organization and is the organization
established to help in an emergency. The Siemens WSC staff will be responsible for the
communications systems, record keeping, and facilities status during the emergency.
Liaison with External Organizations and the Press
The Emergency Coordinator will maintain liaison with Siemens and the tenant(s) management,
emergency organizations, Siemens and government officials. The Siemens HR Manager is the
only person authorized to talk with reporters or the press. All inquiries by the press are to be
answered with "no comment" and forwarded to the Siemens HR Manager.
Emergency Support
Immediately following either decision, evacuate and search or search without evacuating, the
Emergency Coordinator shall notify the appropriate emergency organizations (Fire, Police,
Sheriff, Regulatory Agencies) giving them information that is available, outlining the plan for
action within the plant, and requesting advice and assistance as necessary.
Arrangements made with Local Authorities
Arrangements have been made with local authorities such as police, fire and local hospitals to
familiarize the local authorities with our facility layout, waste handling and generating activities,
and the types of injuries or illness that could result from fires, explosions, spills, or releases. The
local emergency response agencies, identified in Appendix A, and various state agencies have
been requested to respond to this Hazardous Waste Contingency Plan. Also, their Chief
Administrators are invited to visit the facility in order to better coordinate potential hazardous
materials and/or waste related emergency response procedures.
If more than one law enforcement agency or fire department responds to an emergency at our
facility, The Emergency Coordinator will hand over control of the incident to the agency that best
addresses the mitigation needs.
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Appendix A
Emergency Contact Information
EMERGENCY COORDINATORS
■ Primary Emergency Coordinator - Gary Gingras — Facilities Manager
1500 Oscar Frye Road
Pinnacle, NC 27043
[phone] (Work)
[phone] (Cell)
SIEMENS
• Alternate Emergency Coordinator — Michael Cox - Support Services Supervisor
125 Prestwick,
Rural Hall, NC 27045
[phone] (Work)
[phone] (Cell)
• Alternate Emergency Coordinator — James Whiticar -- EHS Officer
6504 Dornoch Drive
Greensboro, NC 27410
[phone]
[phone]
■ Alternate Emergency Coordinator — Srikanth Parvathaneni — QEHS Manager
4702 Jefferson Wood Court,
Greensboro, NC 27410
[phone] (Work)
[phone] (Cell)
Siemens Winston Service Center Management/Supervision
Plant/General Manager
Operations
Controller
Human Resources Mgr
Second Shift (3:30pm — 11:30pm)
Third Shift (11:30pm-7:30am)
Security
Amogh Bhonde
Cory Phillips
James Rochester
Samara Satterfield
Ed Majersky
Security
Security
[phone] (Cell)
[phone] (Cell)
[phone] (Cell)
[phone] (Cell)
[phone]
[phone] (Radio)
[phone] (Radio)
[phone] (Security Office)
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Tennant(s) Management/Supervision
Security maintains a current list of contacts and their phone numbers.
SIEMENS CORPORATE CONTACTS
Siemens Energy EHS Director
Janaina Gameiro- [phone] (Work)
Siemens Real Estate Response Center [phone]
WorkCare (24-hr Triage Assistance) [phone]
SIEMENS
WINSTON-SALE M/FORSYTH COUNTY EMERGENCY ORGANIZATIONS
Rural Hall Fire Department 969-9368 or 911
Winston Salem City Muddy Creek Water Treatment Plant
6am-6pm 765-0130
6pm-6am 784-4710
Forsyth County Fire Department 727-2222 or 911
Forsyth County Sheriff's Office 727-2112 or 911
Forsyth County Ambulance Service 727-2222 or 911
N.C. State Highway Patrol 761-2441 or 911
Wake Forest Baptist Medical Center 716-2255 or 911
Regional coordinator:
Winston-Salem/Forsyth County Office of Emergency Management
Smith Reynolds Airport, Room 104 [phone]
Winston-Salem, NC 27105
Forsyth County Environmental Affairs [phone]
Forsyth County Government Center
201 N. Chestnut St,
Winston Salem, NC 27101-4120
N.C. Department of Environmental and Natural Resources
(NCDENR) [phone]
Winston-Salem Regional Office
585 Waughtown Street
Winston-Salem, NC 27107-2241
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EMERGENCY ORGANIZATIONS - CONTRACTORS
Shamrock Environmental Corporation
503 Patton Avenue
Greensboro, NC 27406-
24 Hour Emergency Response 800-881-1098
Non -Emergency [phone]
In the event of an emergency, Shamrock Environmental is contracted by Siemens to provide
comprehensive environmental services to include emergency response, wastewater treatment,
industrial services, waste management, remedial and stream and wetland restoration.
NORTH CAROLINA EMERGENCY ORGANIZATION
N.C. Emeraencv Response Commission
Hotline [phone] or (9191 733-1361
NC EPCRA
4714 Mail Service Center
Raleigh, NC 27699-4714
FEDERAL ORGANIZATIONS
_
NATIONAL RESPONSE
CENTER
(NRC) [phone]
P_ _ E_
United States Environmental Protection Agency
Region 4
Sam Nunn Atlanta Federal Center
61 Forsyth Street, SW
Atlanta, GA 30303-8960
FEDERAL BUREAU OF INVESTIGATION
Charlotte [phone]
Raleigh [phone]
Greensboro [phone]
US EPA HOTLINE [phone]
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Appendix B
Site. Maps
SIEMENS
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Appendix C.
The DOT identification of hazardous materials located at the Rural
Hall Facility
The following are examples of hazardous materials located at the
facility:
➢ 2.1 — Flammable Gases — Acetylene, Hydrogen, Propane
➢ 2.2 — Non Flammable Gases — Argon, Nitrogen
➢ 3 — Flammable Liquid — Acetone
➢ 4.3 — Water Reactive — Aluminum Powder
➢ 5.1 — Oxidizer — Oxygen gas
➢ 6.1 — Toxic — Chromium metal powder
➢ 8 - Corrosive — Hydrochloric Acid, Hydrofluoric Acid, Sulfuric Acid, Potassium
Hydroxide
Siemens Energy, Inc. CSiemens Energy, Inc 2011 All Rights Reserved TO INTEGRATED EAP AND
CONTINGENCY PLAN - 8-10.15.00C
Hard Copies of this procedure are uncontrolled.

Procedure No.:
Page: 25 of 25
Appendix D
List of Emergency Spill Response Equipment
Aisle/Area
Column C12
Column C12
Column F11
Column F11
Column F11
Shipping/Receiving
Shipping/Receiving
Column B11
Column B11
Waste Storage & Shipping Area
Waste Storage & Shipping Area
Throughout the plant
Emergency Spill Response Equipment
Oil Spill Kit (95 gal over pack with oil socks)
Spill Control Kit with Shovel & Broom
Wash Station
(1) Vacuum Tank (250 gallon)
(1) Vacuum Tank (175 gallon)
Multi Chemical Spill Kit (65 gal over pack)
Spill Control Kit with Shovel & Broom
Oil Spill Kit (95 gal over pack with oil socks)
Spill Control Kit with Shovel & Broom
Multi Chemical Spill Kit (65 gal over pack)
Spill Control Kit with Shovel & Broom
Emergency Eye Wash/Shower Stations
Siemens Energy, Inc. CSiemens Energy, Inc. 2011 All Rights Reserved. TQJNTEGRATED EA? AND
CONTINGENCY PLAN • &10-15.DCC
Hard Copies of this procedure are uncontrolled.

.,: SIEMENS
g^ RECEIVED 3050 Westinghouse Road
N.C. Dept. of ENR
'r`! Rural Mall, NC 27045
FEB 19 2013 1 "rel. [phone]
FwL [phone]
February 18, 2013 Winston-Salem
Regional Office :- :+ Fcdl x Ovemight, signature Itequired
Mr. Cory Basinger, Director, DWQ
Winston-Salem Region, Division of Water Quality
North Carolina Department of Environment and Natural Resources
585 Waughtown Street
Winston-Salem, NC 27107
Subject: Siemens Energy, Inc. 2012 Stormwater Annual Summary Report
Stormwater Permit SW4100602
Rural Flail Facility, 3050 Westinghouse Road, Rural Hall, NC 27045
Dear Mr. Basinger:
As required under the above referenced permit, Siemens Energy performed a semi-annual inspection on
September 28'h, 2012 on the high density infiltration basin that included Mr. Kevin Davie P.E., Allied
Design, Inc. who was the project engineer for the design, permitting, and implementation of the
stormwater project. During the inspection, all slopes contained permanent vegetation; and the slopes
remained no steeper than 3:1, with no evidence of erosion. The grounds were professionally maintained
by landscape services throughout the year.
The fixed structures, such as the bypass structure and the infiltration basin manhole, were free of debris
and sediment build up. This information was documented on the inspection form and maintained in the
maintenance log. The facility's infiltration design does not incorporate a flow spreader, nor a vegetated
filter.
If you have any questions or require further information on this matter, please contact me at (336) 969-
1491 or the facility QHSE Manager, Mr. Sri Parvathaneni, at [phone].
incerely,
Amogh Bhonde
Plant Manager
Siemens Energy, Inc.
Cc: Srikanth Parvathaneni, Siemens Energy, Inc.
Siemens Energy, Inc.
3050 Westinghouse Rd
Rural Hall, NC 2 704 5

REQUESTED BY:
Srikanth Parvathaneni
DATE: 2.18.2013 RECEIVE
N.C. Dept. of E
FEB 19 i
7inc4nn_S`a e
SHIP TO:
Regional 0 'E
Mr. Corey Basinger
Division of Water Quality
North Carolina Department of Environment and
Natural Resources (NCDENR)
585 Waughtown St
Winston Salem, NC 27107
ATTN: Corey Basinger
TELE# [phone]
Fed -Ex Standard, Signature Required
DESCRIPTION: Response Letter
From: Leigh, Frazier
TurboCare, Inc.
3050 Westinghouse Rd.
Rural Hall, NC 27045.
Phone [phone]
Email: lei h.frazier siemens.com
VALUE:
Ttankkyou,
"Leigh FrazierforSri (Parvathaneni
UTIS Support
Siemens
3050 Westinghouse Rd.
1Rymf,' faCC, YC 27045
33 6-969-.1350
Ceinh. {razier@siemens. coma
NR
013

BK 2160 PG 0375
FtII1M CO,11C 61 FEE:(; 3o.00
PRESENTED E RE , 03/12/2MI , 10:2lIAli
DICKIE C. 1i011D REGISTER of DEEDS 9Y:80<ESP
S�t,T�,,+A+��T{{E��O�yF NCpREAL ESTATE EMA X31A w
Tax Lot No. Block Lots 4972-101, 4972,102 and 4972-327 Parcel Identifier No. 6900-96-2877
Verified by County an the day of 200_
by
Mail after n=rding to Smith Helms Mulliss & Moore, L.L.P. (KLP), P.O. Box 31247, Charlotte, NC 28231
This instrument was prepared by Smith Helms Mulliss & Moore, L.L.P. --
Brief description for the Index 3050 Westinghouse Road, Rural Hall, NC
NORTH CAROLINA NON -WARRANTY DEED
THIS DEED made as of the 0 day of October 2000 , by and between
GRANTOR
SIEMENS REAL ESTATE, INC., a Delaware
corporation
186 Wood Avenue South
Iselin, New Jersey 08830
SEEMF-NS WESTINGHOUSE POWER
CORPORATION, a Delaware corporation
4400 Alafaya Trai l
Orlando, Florida 32826-2399
Faster in appropriate block for each party: naoic, address, and, if appropriate, character of entity, e.g. corporation or partnership.
The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns, and
shall include singular, plural, masculine, feminine or neuter as required by context.
WYTNESSETH, that the Grantor, for a valuable consideration paid by the Grantee. the receipt of which is hereby
acknowledged, has and by these presents does grant, bargain, sell and convey tmto the Grantee in fee. simple, all that
certain lot or parcel of land situated in the City of - Rural Hall Bethania Township,
Forsyth County, North Carolina and more particularly described as follows:
SEE EXHIBIT A ATTACHED HERETO AND INCORPORATED HEREIN BY THIS REFERENCE.
Doc. No. 396120

i.
BK 2160 PG" 0376
The property hereinabove described was acquired by Grantor by instrument recorded in Book 2020, Pa a 2760,
Forsyth Public Registry.
A map showing the above described property is recorded in
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to
the Grautee in fee simple.
The Grantor stakes no warranty, express or implied, as to title to the property hereinabove described.
IN WITNESS WHEREOF, the Grantor has hereunto set his hand and seal, or if corporate, has caused this instrument to be signed
in its corporate name by its duly authorized officers by authority of its Board of Directors, the day and year first above written.
SIEMENS REAL ESTAM INC., a Delaware c222rati2n 6 (SEAL)
(Capm= Name) to
By: _
Title:
By:
(SEAL)
(SEAL)
Exec. YP & CFO
New Jersey , Middlesex County.
4 �►itlrtig_��a Notary Public of the County and State aforesaid certify that
Robert_ j�• Mawhirt personally appeared before me this day and aclmowle4ed that
helshe is president &CEO_ of SBUdENS REAL FSTATMF IIVC. a Delaware Corporadon,
and that Wshe as such President & CEO being authorized to do so, executed the
foregoing on behalf of the corporation.
Witness my hand and official stamp or seal, this 26 day of February 2001
My commission expires: Mev �_�Qj�S.rwsee4 !/3-_- Notary Public
.New Jersey Middlesex County.
1. Wirnie Pinkevicz a Notary Public of the County and State aforesaid testify that
Peter E. p2gaer personally appeared before me this day and acknowledged that
he/she is Z=A,_yZ k CFO _ of SMMENS REAL ESTATE, INC. a Delaware Corporation.
and that helshe as such E xea . I de CFO being authorized to do so• executed the
foregoing on behalf of the corporation.
witness my hand and official stamp or seal, this _ 26 day of February2001
,sttb/oft'e ee fied to be correct: 'Kris instrument and this certificate are duly registered at the date and time sad in the Boot and Page shown on the first
"pegs hereof. p�
f11CKIE C. Nt0GQ i;EGJSMOFpEEpS r REGISTER OF DEEDS FOR � ""!�►Iff _- — COUNTY
By t..�� epufyl scant - Ragister ofDeeda
1 Doc. No. 398120