NCG030611_COMPLETE FILE - HISTORICAL_20170207

Progress Rail
A Caterpillar Company
Progress Rail, A Caterpillar Company
Winston Salem Facility
2950 Temple School Road
Winston-Salem NC 27107
NCDENR Winston-Salem Regional Office
Division of Energy, Minerals & Land Resources
450 Hanes Mill Rd — Suite 300
Winston-Salem, NC 27105
RE: Notice of change in facility ownership
Dear Glen White,
NC Department of
Environmental Quality
Received
FEB 0 7 2017
Winston-Salem
Regional Office
Thank you for your response in regards to our name change request. In this packet you will find
the Permit Name/Ownership Change form and a bill of sale.
Tf vni i haves anv ni iactinnc niaacP rnntart Matt npnnin at TAA 7AQ c;A)Q nr I(ata Mactrnhatfiicta
at 336.769.5986.
Sincerely,
Ken Walker, Facility Manager
Phone: [phone]
E-mail: [e-mail]
Enclosed Documents: Permit Name/Ownership Change Form and Bill of Sale

Division of Energy, Mineral & Land Resources
Land Quality SectionlStormwater Permitting
National Pollutant Discharge Elimination System
NCDENR
"-
� PERMIT NAME/OWNERSHIP CHANGE FORM
Ermwowwnrt.u+o Nan�aeawvcn
1. Please enter the permit number for which the change is requested.
FOR AGENCY USE ONLY
Date Received
Year
Month
Da
NC Department of
Environmental Quality
Received
FEB 0 7 2017
NPDES Permit
(or) Certificate of Covetaggston-Salem
N
G S. 0
N C 10 10 1 3 0 Gffice
11. Permit status prior to requested change.
a.
Permit issued to (company name):
Caterpillar Axle Manufacturing
b.
Person legally responsible for permit:
Kenneth A Walker
First MI Last
Facility Manager
Title
2950 Temple School Road
Permit Holder Mailing Address
Winston-Salem NC 27107
City State Zip
[phone] ( )
Phone Fax
c.
Facility name (discharge):
d.
Facility address:
2950 Temple School Road
Address
Winston-Salem NC 27107
Citv State Zin
e.
Facility contact person:
Matthew J Dennig [phone]
First / MI / Last Phone
Ill. Please provide the following for the requested change (revised permit).
a.
Request for change is a result of:
® Change in ownership of the facility
❑ Name change of the facility or owner
If other please explain:
b.
Permit issued to (company name):
Progress Rail
c.
Person legally responsible for permit:
Kenneth A Walker
First MI fast
Facility Manager
Title
2950 Temple School Road
Permit Holder Mailing Address
Winston-Salem NC 27107
r ct .a 7: ,
1.11� JL(Ll4 t.�l
[phone] kwalker(aprogressrail.com
Phone E-mail Address
d.
Facility name (discharge):
e.
Facility address:
2950 Temple School Road
Address
Winston-Salem NC 27107
City State Zip
f.
Facility contact person:
Matthew J Dennig
First T Ml Last
[phone] [e-mail]
Phone E-mail Address
IV. Permit contact information (if different from the person legally responsible for the permit)
Revised Jan. 27. 2014

NPDES PERMIT NAME/OWNERSHIP CHANGE FORM
Page 2 of 2
Permit contact: Kate A Mastrobattista
First Ml Last
Safety Specialist 1
Title
2950 Temple School Road
Mailing Address
Winston-Salem NC 27103
City State Zip
[phone] [e-mail]
Phone E-mail Address
V. Will the permitted facility continue to conduct the same industrial activities conducted prior
to this ownership or name change?
® Yes
❑ No (please explain)
VI Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS
ARE INCOMPLETE OR MISSING:
❑ This completed application is required for both name change and/or ownership change
requests.
❑ Legal documentation of the transfer of ownership (such as relevant pages of a contract deed,
or a bill of sale) is required for an ownership change request. Articles of incorporation are
not sufficient for an ownership change.
.....................................................................................................................
The certifications below must be completed and signed by both the permit holder prior to the change, and
the new applicant in the case of an ownership change request. For a name change request, the signed
Applicant's Certification is sufficient.
PERMITTEE CERTIFICATION (Permit holder prior to ownership change):
1, Kenneth A Walker, attest that this application for a name/ownership change has been reviewed and is
accurate and complete to the best of my knowledge. I understand that if all required parts of this
application are not completed and that if all required supporting information is not included, this application
package will be returned as incomplete.
Signature Date
APPLICANT CERTIFICATION
1, Kenneth A Walker, attest that this application for a name/ownership change has been reviewed and is
accurate and complete to the best of my knowledge. I understand that if all required parts of this
application are not completed and that if all required supporting information is not included, this application
package will be returned as incomplete.
qC3 J—L— a -/ - I -?
Signature Date
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Division of Energy, Mineral and Land Resources
Stormwater Permitting Program
1 AV) AAa:1 Qer- ice Center
1V.L - .. l Y.�.V Vl..l.\..
Raleigh, North Carolina 276994612
Revised Jan. 27, 2014

January 11, 2017
Subject: Memorandum of Understanding between Caterpillar, Inc. and
Progress Rail Services Corporation which is a wholly -owned subsidiary of
Caterpillar, Inc.
Caterpillar, Inc. is transferring certain property, plant and equipment located at 2950 Temple
School Road, Winston Salem, NC 27107 to Progress Rail Services Corporation as of January 1,
2017.
Caterpillar Inc. and Progress Rail Services Corporation agree the value of the property, plant
and equipment approximates net book value (Original Cost less Accumulated Depreciation) as
of January 1, 2017. This transfer value is $195,723,788.85. The complete asset listing and net
- attach
led Value Is attachled in Appendix A.
Caterpillar, Inc. will invoice Progress Rail Services Corporation for the assets being transferred
and such invoice will be paid via normal intercompany settlement procedures. The invoice will
be supported by a list of all assets being transferred showing the net book value of each asset.
Progress Rail Services Corporation will pay any and all property recording fees on the above
described property. Caterpillar Inc. will be responsible for any property taxes through
December 31, 2016.
The above transaction is accepted by:
Cater illar, Inc.
Signa ure
/T%,D 5-. &(5/ASS S rc� �j •.
Title
I-
Date
Progress Rail Services Corporation
Signature
V �-­b
Title
1 I zo I'1
Date

Pro :ress Rai!
A Caterpillar Company
Progress Rail, A Caterpillar Company
Winston Salem Facility
2950 Temple School Road
Winston-Salem NC 27107
North Carolina Department of Enviromental Quality, Land Quality
450 West Hanes Mill Road t 01
astmeo alkt�l
Suite 300 NC pep e�ta� Qu
Winston-Salem NC 27105 Env►ro Received
]AN
RE: Notice of change in facility ownership Seem
n-
W iosto O{ff�ce
' Regto►�a�
Dear Mr. Glenn White,
Please accept this letter as Caterpillar Axle Manufacturing Facilities notification of new
ownership. Caterpillar Axle Manufacturing was purchased by Progress Rail, a Caterpillar
company. The facility's new name is Progress Rail Winston-Salem. The official ownership
change is effective January 1, 2017.
The primary contact for the facility will be Matt Dennig, Production Manager. Matt's phone
number is 336.769.5629 and e-mail address is mdennig(&progressrail.com. The facility
secondary contact will remain Kate Mastrobattista, Safety Specialist I. Kate's phone number is
336.769.5986 and e-mail address is [e-mail].
If you have any questions, please feel free to contact me.
Sincerely,
Ken Walker, Facility Manager
Phone: [phone]
E-mail. [e-mail]

Energy, Mineral &
Land Resources
ENVIRONMENTAL QUALIYY
Kate Mastrobattista
Caterpillar Axle Manufacturing, Inc.
2950 Temple School Road
Winston-Salem, NC 27107
December 13, 2016
Subject: Compliance Inspection
Permit No. NCG 030611
Caterpillar, Inc.
�nr0Y th f 'U UILLY
• via�tu �.v uia�y
Dear Ms. Mastrobattista:
PAT McCPORY
DONALD R. VAN DER VAART
Secretary
TRACY DAVIS
oireriar
On December 13, 2016 Glen Write, inspectors with the North Carolina Department of
Environmental Quality -- Department of Energy, Minerals && Land Resources met with you (EHS
Supervisor), Matt Dennig (EHS Manager), Shaw Meek (Factory Manager), David Stevenson
(Facilities Support), and Amanda Williams (EHS Continuous Improvement Lead) at the subject
facility, located at 2950 Temple School Road in Winston-Salem, to conduct a compliance
inspection for the facilities Industrial Stormwater Permit.
Permit:
This facility holds General Stormwater Permit NCG030652 to discharge stormwater from
industrial activity classified as Heat Treating of Metal.(SIC 3398), Fabricating of Metal
Products (SIC 3398), Manufacturing of Measuring and Analyzing Instruments (SIC 38)
under the National Pollutant Discharge Elimination System (NPDES). The permit became
effective November 1, 2012 and expires on October 31, 2017. A copy of the current permit is
required to be maintained with the Stormwater Pollution Prevention Plan (SPPP) documents. A
copy of the current permit was available for review at the time of inspection.
Records/Reports:
This facility was required to develop and maintain a Stormwater Pollution Prevention Plan
(SPPP) in accordance with Part II, Section A of the permit.. Inspector reviewed the SPPP and
each of its components. The SPPP and the SPCC are both being updated annually as required.
All certifications are current and responsible parties are as indicated in the plan. Qualitative
monitoring is conducted on a monthly basis although the permit only requires it bi-annually for
facilities as well as this plant. Analytical Monitoring is performed bi-annually by a contracted
third party environmental firm. All records were complete and accurate. No deficiencies noted.
State of North Carolina. I Environmental Quality I Energy, Mineral and Land Resources
Winston-Salem Regional Office 1 450 Hanes Mlll Road, Suite 300 1 Winston-Salerit, NC 77103
336 776 9800

Facility Site Review:
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A11eC1 YVV,VVV '_]A -"VAAAkJ AAAJL VlA\%L AVA VAALA ""o AUvuia Uaa ua a+VAV.
They have been producing and assembling axles used in Caterpillar equipment but their scope
has recently changed since the facility was bought out in August of 2016. Employees were
notified in October of 2016. They currently have 77 employees working on one shift. The new
1JWL-te 1S Fiugfuss Nall, a suuslulwy 01 %-ULGi�1111M. A il�1PCd1S L11UL OFUId.L1U11S afe L:V11VC1L111g
more to warehouse rather than production operations and there is new construction going on at a
loading dock area in the rear of the plant. The only exposures outside now are racks used in
production. They are neatly stored on concrete waiting to be hauled to a facility up north. There
is a tank farm for production fuels but fuels are currently being removed and the tank farm is
being taken out of process. Dumpsters are stored under permanent roof and are again in a very
clean, well maintained area. There are some contractor dumpsters in an area, on concrete, that
are not under cover but they are not permanent fixtures. No deficiencies were observed.
Effluent Receiving Waters:
Effluent from this facility drains to Swaim Creek, class "C" waters of the Yadkin Pee -Dee River
Basin via two outfalls draining from two dry ponds, a part of this facility.
Self-Monitorin Program:
Part 11, Sections B & D of the permit require this facility to perform qualitative and analytical
monitoring on a semi-annual basis unless a Tiered Response is'triggered. Monitoring is
r OC7 _ V
performed as required and reports are well prepared by a third party designated by Caterpillar.
This facility was found to be compliant with the requirements of its General Stormwater Permit.
Tf haves fiirt},ar rn,aotinnv nr rann,ra aaoirtonnn _1P� nnntonf l:1an Wh;fP nFVPn>~n at Zqr,,-
ia Zvi+ awes'— a. ua�aa�a �uvJuvaaJ va Avll uaAv u.A JAJ4WA�v F-A "O - VVAAEµv� VAvaA •� aAa �v va t�v✓L� u� -�-!v
776-9660.
Enclosures:
Inspection Report
Sincerely,
Matthew E. Gantt, P.E.
Regional Engineer
Land Quality Section
Winston-Salem Regional Office
cc: Division of Mineral and Land Resources (WSRO)
Stare of North Carolina I Environmental Quality I .Energy. Mineral and Land Resources
Winston-Salem Reglonal otfflce 1 450 Hanes Mill Road,_ Sultc 300.1 Winston-Salem. NC 27103
336 776 9800

Compliance Inspection Renort
Permit: NCGO30611 Effective: 11/01/12 Expiration: 10/31/17 owner: Caterpillar Inc
SOC: Effective: Expiration: Facility: Caterpillar Inc
County: Forsyth 2950 Temple School Rd
Region: Winston-Salem
Winston Salem NC 27107
Contact Person: Terrial Campbell Title: Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Rep rosentative(s):
Related Permits:
Inspection bate: 12113/2016 Entry Time: 10:OOAM Exit Time: 11:00AM
Primary Inspector: Glen White Phone: [phone]
Secondary Inspector(s):
Reason for Inspection: Routine inspection Type: Compliance Evaluation
Permit Inspection Type: Metal Fabrication Stormwater Discharge CGC
Facility Status: Compliant [] Not Compliant
Question Areas:
Storm water
(See attachment summary)
Page: 1

Permit: NCG030611 Owner - Facility: Caterpillar Inc
Inspection Date: 1211312016 Inspection Type : Compliance Evaluation Reason for Visit: Routinc
Inspection Summary:
Inspection conducted on 12/13/16 by Glen White of NCDEQ - DEMLR and Caterpillar staff: Kate Mastrobattista (EHS
Supervisor), Matt Dennig (EHS Manager), Shaw Mech (Factory Manager), David Stevenson (Facilities Support & WW
Treatment Coordinator)and Amanda Williams (EHS Continued Improvement Lead). SPPP plan and SPCC documents were
reviewed- All responsible parties, certitications and inspection records were complete and currnet. Records well
maintained.
Review of the grounds, dry pond locations, secondarily contained tank farm were conducted as well. No issues were found.
The entire facility is very clean and well maintained. No issues were observed.
Glen White
NCDEQ -DEMLR
Page: 2

Ob
Permit: NCG030611 Owner - Facility: Caterpillar Inc
Inspection Date: 12113/2016 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Analytical Monitorinq Yes No NA NE
Has the facility conducted its Analytical monitoring? ® ❑ ❑ ❑
# Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas? ❑ ❑ e ❑
Comment: Analytical Monitoring conducted bi-annually by contracted third party environmentall firm. All
zinc copper, lead and pH have all tested consistently within required parameters_ Very clean
facility, no deficiencies noted.
Permit and Outfalls
# Is a copy of the Permit and the Certificate of Coverage available at the site?
# Were all outfalls observed during the inspection?
# If the facility has representative outfall status, is it properly documented by the Division?
# Has the facility evaluated all illicit (non stormwater) discharges?
Comment:
Qualitative Monitorina
Has the facility conducted its Qualitative Monitoring semi-annually?
Yes No NA NE
❑ ❑ ❑ ❑
❑ ❑ ❑ ❑
❑ ❑ ❑ ❑
Yes No NA NE
■ ❑ ❑ ❑
Comment: Qualitative monitoring required bi-annual) David Stevenson conducts monitoring/inspections
monthly. No deficiencies noted.
Stormwater Pollution Prevention Plan
Does the site have a Stormwater Pollution Prevention Plan?
# Does the Plan include a General Location (USGS) map?
# Does the Plan include a. "Narrative Description of Practices"?
# Does the Plan include a detailed site map including outfall locations and drainage areas?
# Does the Plan include a list of significant spills occurring during the past 3 years?
# Has the facility evaluated feasible alternatives to current practices?
# Does the facility provide all necessary secondary containment?
# Does the Plan include a BMP summary?
# Does the Plan include a Spill Prevention and Response Plan (SPRP)?
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
# Does the facility provide and document Employee Training?
# Does the Plan include a list of Responsible Party(s)?
# Is the Plan reviewed and updated annually?
# Does the Plan include a Stormwater Facility Inspection Program?
Yes No NA NE
® ❑ ❑ ❑
■❑❑❑
M❑❑❑
■❑❑❑
® ❑ ❑ ❑
® ❑ ❑ ❑
❑ ❑ ❑
❑ ❑ ❑
® ❑ ❑ ❑
e❑❑❑
■❑❑❑
Page: 3

Permit: NCG030611 Owner - Facility: Caterpillar Inc
Inspection Date: 1211312016 Inspection Type : Compliance Evaluation
Stormwater Pollution Prevention Plan
Reason for Visit: Routine
Has the Stormwater Pollution Prevention Plan been implemented?
Comment: SPPP and SPCCupdated annually. All records current. No deficiencies noted.
Yes No NA NE
❑ ❑ ❑
Page:

Public Works
Department
Stormwater/Erosion and
Sedimentation Control Program
Ciry of W-uuron-salerrm
P.O. Box 2511
Winston-Salem. NC 27102
CizyUnk 311 (336127.8000)
Fax [phone]
ruvuxmormrvazmmarr. mm
October 6, 2014
Mr. Terrial Campbell
EHS Supervisor
Caterpillar Inc.
2950 Temple School Road
Winston Salem, NC 27107
Dear Mr. Terrial Campbell:
The Stormwater Division of the City of Winston-Salem would like to thank you for
your time and professional courtesy regarding the September 10, 2014 inspection of
Corning Inc.
As per your request, a copy of the completed surface water inspection form has
been enclosed to you. Part 4 of this report (Required Actions to be completed by
Facility) contains Annotations #149 that Caterpillar Inc. must complete. Please
provide documentation that verifies Caterpillar Inc. successful completion of the
corrective measures to me by January 6, 2014.
The Stormwater Division reserves the right to enter and inspect Caterpillar Inc. as
often as necessary to determine compliance with permit requirements of
NCG030611
Thank you for your continued support and implementation of the City of Winston-
Salem's Stormwater Program. If you have any questions, please feel free to contact
me at [phone].
Sincerely,
Ladonta "Jamal" Clark
Stonnwater Inspector
Phone: [phone]
Cell: 336.416.2403
Fax: [phone]
Gry C,euceii: i` -w Allrn Joints; V'� i H. Buns. Mayor Pro Mrn?o.. Xorche Ward: Dmix D. Ai rnx Nonh Warta: Pan Bic, Sourh-s Wird: Ruben C. auk. Wm Waid:
Molly L ighr. 5aueh Wald: W-6 Mershd. No« ht , Ward: Derwin L hlentbomery. E= Ward lam« Taylor. Jr.. Soudr r Ward: City N4mgm.. La D. Qniry
Call 311 or 336-727-8000
[e-mail]

U
14ins1[mSalem
Stormwater/Erosion Control Division
Surface Water Inspection for Industrial Sites
,General l Information'
A) Official Company Name: Caterpillar, Inc. Axel manufacturing
B) Physical Address: 2950 Temple School Rd
C) Telephone Number: 336-769-5600 (Operator)
D) Mailing Address, if di fferent from above address: NIA
E) Authorized contacts to represent company in environmental regulatory issues:
Primary contact: Terrial Campbell
Title: EHS Supervisor
Contact number(s): 336-769-5638 24-hour phone# [phone]
Email address:
Secondary contact: Kate Mastrobattista
Title: EHS Associate
Contact number(s): Direct Line: 336.769.5986 24-hour phone # (570)- 236-1718
Email address: [e-mail]
Tertiary contact: Kerry Idlebird
Title: Facilities Engineering Super.
Contact number(s): 336-769-5947 24- hour phone# [phone]
Email address: [e-mail]
F) SIC Code Number of business: 3532
G) NC Stormwater NPDES Permit Number: NCG030611
Permit Category: Manufacturing of Industrial and Commercial Machinery
H) Any other control authority permit(s) (air quality control, wastewater, hazardous waste) & number(s):
Air Permit: 01065114 Waste Water Permit: Industrial User Permit (IUP) #1038
I) Brief description of industrial activities that occur on -site: The industrial activities that occur on -site are
receiving, machining, and assembling components to build rear axles, front wheels, and suspension parts
for Caterpillar machines.
1) uiumaie Receiving Waters: Swaim Creels
TMDL stream ❑Yes ©No
Part I - Stormwater Contro_ is
1. Best Management Practices
a. List the nonstructural controls employed by the facility:
1. The metal shavings area is covered with a shed in order to prevent Stormwater pollution.

b. Are the BMPs reasonable & appropriate for the facility? ®Yes ❑No
In order to prevent stormwater pollution, commercial fuel tanks from contractors need to
have proper devices installed to catch all leaning gasoline. Also, no gas rags need to be
placed on gas tanks.
c_ Are BMPs installed correctly, maintained, and effective operating condition? ©Yes ❑No
All trash bin from contractors need to be covered at all times in order to minimize
pollution.
2. Provide a brief description of other controls that manage/prevent/minimize stormwater runoff
(e.g., erosion and sediment controls, inlet protection/control at storm drains, diversion structures):
Booms have been placed in front of storm drains to prevent Stormwater runoff.
Part 2 — Miscellaneous
1. Any evidence of discharge to receiving waters/MS4? (e.g.: stormwater runoff dry weather discharge, co -
mingling of process wastewater): ❑X Yes ❑No
The Stormwater Discharge Outfalls for Caterpillar discharge into Swaim Creek.
2) Do the stormwater outfalls on -site correspond with those listed on the site map and in SPPP?
®Yes ❑No
Comments
Yes, the stormwater outfalls on -site correspond with those listed on the site map and in
SPPP, but the site map is missing the potential pollutants that could be discharged and the
physical location for both outfalls.
3) Summary of Stormwater Discharge Outfalls

SDO Identification
Potential Pollutants that
could be discharged
Physical Location
Latitude and Longitude
SDO-1
?
?
Latitude 36Q 03' 43.8
Longitude -80- 06'
54.8"
SDO-2
?
?
Latitude 36Q 03' 41.5
16.0"
Site Overview
Part 3 — SPPP Review (can be completed in office)
Yes No Notes
Is there a SPPP?
✓
I
Please update SPPP
Does SPPP include a certification statement by the responsible
✓
corporate officer?
Does the general map depict the facility's location on a USGS
✓
quad map (or equivalent map) with receiving waters (or MS4)
listed?
Identification of impaired waters or watershed (if applicable)?
✓
Narrative Description of these Industrial Activities:
Storage Practices
Unloading/Loading Activities
Outdoor Processes
Particulate Generating/Control Processes
'r
Waste Disposal
Does site map denote drainage items: flow direction,
✓
Missing industrial
boundaries, % impervious, and structures? Also includes SDOs,
activity areas.
industrial activity.areas, and site topography?
A list of major spills that have occurred within the past three
✓
No spills
years (with corrective actions to prevent futures ills)?
A signed, annual certification that the facility has been tested for non-
✓
stormwater discharges from the site?
Comments:
NnTP• Ph—AcP nnria+P +hP f itv of W;ncMn .SZAPrn .gfnrmwa+rr Divieinn?e rnnfarF
.... sue,. .....»�..._�....».-. _u.. .. .> ... ............ �.»...L., .... W.. _.�. Y_. _.._.,� .,
information to Caterpillar, Inc. Axel manufacturing Spill Notification List. The contact for
spill notification is: Mr. Keith Huff, Stormwater Director [phone] = landline (336)
406-3332 = cell phone number. Mr. Huffs email address is keithh1 a�citvofws_org for
providing written notification.

Stormwater Management Strategy
Yes No Notes
Does SPPP incorporate the nine baseline controls:
Feasibility Study (technical & economic review to minimize pollutant exposure)
Sc%oirdniy %-ULI MILIcnt (table summary of tanks, stored materials, reieaserecords)
BMP Summary (listing of site structural/nonstructural practices)
SPRP & Procedures (identified, responsible personnel w/ signatures & dated)
PM & GH (inspection of material handling areas & regular cleaning schedules)
Facility Inspections (biannual inspections of facility and all stormwater systems)
Employee Training (annual basis for staff who perform S" and I'M functions)
Responsible Party (specific position (s)-developing, implementing, & revising SPPP)
Amendment & Annual Update (of major spills, nonsw flo%vs, BMPs, sampling data
✓
✓
✓
✓
No signature and no dates.
✓
,/
✓
No signature or no dates.
V
Does SPPP contain completed routine inspection reports/records
regarding reportable implementation of the nine baseline controls
(Le. SPPP Implementation)?
✓
Analytical Monitoring
Yes No Notes
Are samples collected within 30 minutes of measurable rain events
✓
and at least 72 hours since the last storm event?
Are sampling events 60 days apart? (F,XCEPTION: Tier 2 & 3 responses)
NIA
Is analytical monitoring complete (including schedule) for each
✓
SDO? (EXCEPTION: ROS)
Any exceedences of pollutant parameters when compared against the
permit benchmark values?
NIA
Has Facility implemented appropriate, selected actions to reduce
pollutant concentrations, in response to benchmark exceedences (if
applicable)?
Qualitative Monitoring
Yes No Notes
Is qualitative monitoring being performed during measurable storm
✓
events?
Is qualitative monitoring complete (including schedule) for each
✓
SDO?
Are monitoring events 60 days apart? (EXCEPTION: Tier 2 & 3 responses)
NIA
✓
Any observable, excessive amounts of pollutant indicators in
stormwater discharge at SDOs?

Part 4 = Required Actions to be completed by Facility:
1. In order to prevent vandalism, please install a lock out tag out device for valve near
dock 31.
2. Immediately dispose of the rags immersed in gas and devise and implement a BMP for
gas nozzles to have a proper place to rest in. Also, include the new BMP in SPPPP.
3. Please ensure all contractors have BMP measures in place for trash dumpsters and
shop vacuums that risk exposure to the creeks. Also, include the new BMP measure in
the SPPPP.
4. Immediately clean up the hydraulic oil leak near metal shavings building and increase
cleaning frequency to weekly, as per your Good Housekeeping Program requirements.
5. Please update the City of Winston Salem, Stormwater Division's contact information
to Caterpillar, Inc. Axel manufacturing Spill Notification List.
6. Please add the industrial activity areas and physical locations to the site map.
7. Please update SPPP to current year and date.
S. Update the spill prevention and response procedures with the identified, responsible
personnel with signatures and dates.
9. Update and sign the responsible party with signature and dates
Company Representative(s) that participated in inspection: Mr. Campbell and Mrs. Mastrobattista
Title(s): EHS Supervisor and EHS Associate
Start of Inspection: 9:00am
Completion of Inspection: 2:00pnn
Date: 9/10/2014
Signature of Stormwater Inspector:
Title: Stormwater Inspector

Picture # 1 Valve for secondary containment tank near dock 31
In order to prevent vandalism, please install a lock out tag out device for valve near dock 31.
Picture#2 Contactors gas tank with no BMP measures.
Immediately dispose of the rags immersed in gas and devise and implement a BMP for gas nozzles to
have a proper place to rest in.

Picture# 3 A contractors trash dumpster and shop vac without proper BMP measures
Please ensure all contractors have BMP measures in place for trash dumpsters and shop vacuums that
risk exposure to the creeks.
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1 - r ; 3, " • •�yam, •$ _ � �: L .h , �'L.�. 4' _ _ „-
{Y 14
' i - • T t . . • ; • hf ` .h't '�•,„ ft S',h :-h - +R {` •1 •\ t t�- •h
.• - .f r' i •It !erp� .fib 1 y + 4� '� •� tr ]]FY,'„'�- _ I
Picture au<c m -4 yu�auv■ ac$r icLauarxeuuRuu A R.
Immediately clean up hydraulic oil leak near metal shavings building and increase cleaning frequency to
weekly, as per your Good Housekeeping Program requirements.

Compliance inspection Report
Permit: NCG030611 Effective: 11/01/12 Expiration: 10t31117 Owner: Caterpillar Inc
SOC: Effective: Expiration: Facility: Caterpillar Inc
County: Forsyth 2950 Temple School Rd
Region: Winston-Salem
Winston Salem NC 27107
Contact Person: Terrial Campbell Title: Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 09/10/2014 Entry Time: 09:OOAM
Primary Inspector: Aana Taylor -Smith
Secondary Inspector(s):
Certification:
Phone:
Exit Time: 02:00PIv1
Phone: [phone]D
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Metal Fabrication Stormwater Discharge COC
Facility Status: Compliant ❑ Not Compliant
Question Areas:
Storm Water
(See attachment summary)
Page: 1

Ij
NCGOMIa! 1 Owner _ Facility: Caterninar Inc
Inspection Date; 09/1012014 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
See local program inspection letter dated 10/06/14 from LaDonta Clark, City of Winston-Salem.
Page: 2

Permit: NCG030611 Owner - Facility: Caterpillar Inc
Inspection Date: 0511012014 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Storrnwater Pollution Prevention Plan
Yes No NA NE
Does the site have a Stormwater Pollution Prevention Plan?
N
❑ ❑ ❑
# Does the Pion include a General Location (tJSGS} map?
0
❑ ❑ ❑
# Does the Plan include a "Narrative Description of Practices"?
N
❑ ❑ ❑
# Does the Plan include a detailed site map including outfalt locations and drainage areas?
0
❑ ❑ ❑
# Does the Plan include a list of significant spills occurring during the past 3 years?
N
❑ ❑ ❑
# Has the facility evaluated feasible alternatives to current practices?
0
❑ ❑ ❑
# Does the facility provide all necessary secondary containment?
0
❑ ❑ ❑
# Does the Plan include a SMP summary?
S
❑ ❑ ❑
# Does the Plan include a Spill Prevention and Response Pian (Si
0
❑ ❑ ❑
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
E
❑ ❑ ❑
# Does the facility provide and document Employee Training?
❑ ❑ ❑
# Does the Plan include a list of Responsible Partyi
❑ ❑ ❑
# Is the Plan reviewed and updated annually?
❑
® ❑ ❑
# Does the Plan include a Stormwater Facility Inspection Program?
❑
❑ ❑ ❑
Has the Stormwater Pollution Prevention Plan been implemented?
❑
❑ ❑ ❑
Comment: Plan needs updated contact information and industrial areas added to site map.
Qualitative Monitoring Yes No NA NE
Has the facility conducted its Qualitative Monitoring semi-annually? E ❑ ❑ ❑
Comment:
Analytical Monitoring Yes No NA NE
Has the facility conducted its Analytical monitoring? 0 ❑ ❑ ❑
# Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas? ❑ ❑ 0 ❑
Comment:
Periidt and Outialls Yes No NA NE
# Is a copy of the Permit and the Certificate of Coverage available at the site? 0 ❑ ❑ ❑
# Were all outfalls observed during the inspection? ❑ ❑ ❑
# If the facility has representative outfall status, is it properly documented by the Division? ❑ ❑ ® ❑
# Has the facility evaluated all illicit (non stormwater) discharges? E ❑ ❑ ❑
Comment:
Page: 3

n
IhfinstonSalem
Public Worb
Mpartmwr
Storm�vatee/Emsioo aad
5edimenthri6n Con& l Frog.
City Of ussmn'silem
P.O. Sax 2511
Woman-Salem.'NC 27102
C ty! ink'311 (336.727.8000)
F. 336.748.3173
Call 311 or 336-727-8000
dtylink c4otws.org
October 10, 2014
Mr. Terrial Campbell
I HS Supervisor
Caterpillar Inc.
2950 Temple School Road
Winston'Salem, NC 27107
Dear'Mr. Terri al. Campbell:
The•Stormwater Division of the City of Winston-Salem would like to thank you.for
yViju Mitt/ G11U VJVJt.a�ioilal UVULtV.5y 1crMaIUII1r' ule OTwptw JUIUa.t. 1 Vj eV I-r ml Fp,a.alvia ail
Corning Inc.
As per your request, a.copy of the -completed surface water. inspection form has
been,enclosed to�you. Part 4 of this report (Required Actions to,be completed by
Facility) contains Annotations #1-49 that Caterpillar Inc. must complete: Please
provide documentation that verifies Caterpillar Inc. successful completion of the
corrective measuresto me'by Jairuary .12, 2015.
The Siormwater Division; reserves. the right to enter and* inspect_CaterpilIar Inc. as.
often as'necessary to`deterinine'compliance with permit requirements of
NC603061 l
Thank you. for your continued! support and implementation of the City of Winston-
Salem's Storrnwater Program. 'If you have Any P questions, please feel free to contact
meat (336) 74 7-6964.
Sincerely, _a�6z
Ladoh4i "Jamal" Clark
Stormwater.'I nspector
Phone: :336.747 M64
Cell': 336-4`16.2403
Fax:.336.748:3173
(7ry Gammt6.J%Gyer Atka joi=; Yrrim H. Bwim' h(rj" Pro Tempam. bicrthesa Vhjd; Denite O. Adams; North WauL Dan Bom Smrdmvtt Ward; Robert C' C]erk, West Watd.,
Mdl)' �'btG Soer6 Ward; Warta Miradtrl; N-: ` - -Wad: Ikrwin L hinarpimerK. luau Weld: jaran Taykwjs; Sou ` - -Ward: Csty hlieaper. lse D. Guriry-

Stormwater/E.ro.sion Control. Division
-Stirace Wittef Inspection for Indtisttiad 840s
General Company Namanufacturing.nformation[
A), Official C6m''- Caterpillaejft.- �,Axel manufacturing.
. . .
B).Physical Address-- 2954'Temple Sc.hool*d
33 . I
C) ieiepnone;iN,umoer:,jio-769'-:-5(3truAtyperator)
0)'Mailing Address, i£different 6om4bove address:"N/A
E)-Autnorized contacts Wrepresent company in environmental regulatoryis5uezi:
Primary qqntaci:'Terrial Camp_ bell
Title.-EHS Supervisor
Contact number('s)- 336-:769r5639. 14-ohour phone# [phone]
Eftiail addie§s..
Secondary contact:'Kate Mastrobattisita
Title"TH S Asgocfiite>
Contact-number(s): Direct,Line: 336.769.598.6. 24-hour. phone # (570)- 2362-1718
Einail-address:�Miistr6bgittigta Katie A eit.coin
Teitiqy contact-.Ker6e1dkbifd
irtle: F aci 1i dies, Eiigineerin_g: Super
Contact�numbe,r(i):,336-769'59,47 24--h6ti.r..Phd-n-i#z407-758'2181
7
Einail,-Iaddress: [e-mail]:
,F): SIC 'C.6d6,,NidAberof bdsines's:" 3532
,0) NQStormwa.ter'NPDES P&ftnit.,N,iiinb.&r:.NCG03061l
Permit Category: -Manufactuking,of tndustriai an-d't-6mmerdAMichinery
H Any other controljaiithbrityperffiit(§) (air qqotycontfol Wastewater, hazardods waste) & number(s):
Air Permit:,01065R4 Waste'Water.Permit::Indust'n"ai Userjermit1(lUV)'#l0.38'
J)Brief description of industiiA-aciivities.thai,occur-on-site: The.'industriaUacIiVities thaf.,occur on-site.are,
;receivihg,.maciiiningi;and�assenibliii"'-' om'dfieiiii to"biii1d.rear axles, ffiDnt Wheeb, ah&sfi_S­
g7F, p pposion:Patts
f6r,C- atefr p#14r niachbies.
vvtjtv.jb. ow illin t'X VrA
TMDL stream . ffYes ENO
-Part.1 .- Stormwater Controls
-L. Bes'l.M,aziAgefn.eiit.P.ra.cticts
I - M. ., '. -
a.Lisiihe:non/siructur"a'l-.contr6ls-employed'.by.the•faciiiiy:-
J. The fietkl sh , avihks4i6i.is covered With iished i6,'6r&r to'p'feVeiWStoiinWAtefr pollution.

:b. Are the BMPs:reasonable & appropriate for the facility? ®Yes, ❑No
>mments. Jn order to prevent stormwater pollution, commercial.fuel'tanks,from contractors need to
have proper devices, installed to catch all lea king gasoline. Also, no gas rags need to be
placed on gas'tariks.
c. Are BMPs installed, correctly, maintained, and.effective operating condition? ®Yes ❑No
All"trash bin from contractors need to be covered -at ail times in.order to minimize
,pollutiOlh
2. Provide.a-hrief description of other controls that: rnanage/prevent/minimize stormwater- runoff
(e.g., erosion;and sediment controls, inlet.protection/control at,storhi drains, di"version structures):
Booms; have, been placed in front of storm drains'=to; prevent Storniwatet runoff..
Part 2 — Miscellaneous
1. Any evidence of'discharge :,to,receiving waters/MS4?.(e.g;: stormwater runoff, .dry .weather discharge,.co-
mingling -of process • wastewater): ®Yes ❑No
Cornments
The Stormwater Discharge qutfalls for Caterpillar discharge"]'nto""Swuirn 'CFeek:
2) Do fhe:stormwaier ouifalls;on-site,correspond tivith:those listed-ori the site,map andin SPPP?
®Yes' ❑No
Comi"ien'
Yes, the stormwater outfalls on -site. correspond with those fisted on "the;site map'and n
SPPP;'but,the,site,mapT'is missing the. potential'p(Mutantsthat,could be discharged and.the
ph) sisal-loeation _for both outfalIs.
3) Su'rrimary_of 5torinwater Discharge Ntfalis

SDO Identification
Potential Pollutants.that
could b,6.'di§dIidrged,
Physical Locatio'n
Latitude aria Longitude
SDO-1
. Z?
Latitude 366 03' 43.8
L6ngftude -80- 06' 1
54
SDO-2
Ldtitude,36-. 031 41.5
LGagitude -80o 06'
Site .Ove,-�,Wew-
Part 3 — SPPP'Review (can be completed in office
Yes No Notes
'Is there a SPPP?'
✓
Please.,qpda;�eISPPF
Does SPPP,ificlu& e:resporisitile
SP9
corpotate-officei?
Does the-generdl'-map.:depicLthefacility's ,location oma USSQS
(- quadmap0 r equivalehtrftap)--With receiving Waters (or-MS4)
listed?
Identificafion,of impaired - waters- or watershed (if applicable)?-
NarrativeDOscrip*n-.6f these.-Indusifial, Activities:
torage Practices
. Storage
Unload ih.g"ading Activities
0.6*6i;Piocesses
✓
'Particu'late Geiierating/Control.Ptocesses
Wasid'Disposal
✓
Do&s site Mai) denote drairiadd items: flow direction.
Missing industrial
- boundaries, %'*pervious- a;�a. structures? AlsolincludesSROsj.
activity areas:
indti§tiial`detivity,-'ar6as,,and, site tolp§graphy-?
A.list,of.major.spil.isttiat-,haV&,6ccutred withiwthe;past<th-ree
✓
No spills
years (with,corrective.acfions=.to prevent future spills)?
A. s i gn e d,, annual certification th�fi*it�'is been iestedTor no'i-
ft
✓
siormwater dikharges Tfom .the -site?
Coffimerii-i:
NOTEPlease update the -City of Winston S;ilem,,St6rmwat-eir.DiVisiofi's contact
inf6rinitibn.to-Caterpjjlar.,Iiic"Aiiel-ma.ii,i.i-fgictu.ringSp'il.IN.otifi'catio'ti,,List. The.0fit4iffor
�spill. notification, is: Mr.'.K.O.th-Huff, $tormwiter Director (316)147-696.2 = landim''e(336)
40&,3332 = cell phone,number. Mr. Hufrs.email address .i . S,keithhJnacityoNs'.oEg1Qr-
p 'difig:wntten notification.
rovi

Stormwater ManagementStrategy
Yes .No Notes
Does SPPP -incorporate, the nine baseline, controls:
Feasibility Study (tmhnicai & economic review to minimize pollutant I .XposurC)
Secondary Containment (table .summarvWtanks. :stored'cnatcrials, rcleaserecords)
BMP Summary (listing of site structurallnonstructural practices)
SPRP &•Procedures (identified; respotisible personnel w/ signatures & dated)
P1VI,& 'GH (inspection of rnaterial handling areas &.regular cleaning schedules)
Facility Inspectloris'(biann6dl inspections of facility and ail stonnwater syslerns)
Employee Training (annual basis for.staff who perform SRP and Mfbnctions)
Responsible Party (specific position(s)-developing.; implementing., & revising SPPP)
Amendment & .Annual Update (of ffinjor spills; iions%i flows; l3MPs. sampling data
✓
✓
✓
✓
✓
No signature and no dates.
✓
./
✓
No signature or no dates.
Does SPPP contain.completed'routine inspection reports/records
regarding"reportable,impleme.nt, tion of the nine-baseline'cantrols.
(i.e. SPPP I i lementatioli)?
✓
"' ia" a
ntonAnatMorigry
Yes No Notes
Are samples.collected within 30 minutes of measurable rain events
✓
'and at.least 72 hours siiice,thel'last.storm,event?
Are sum ling •events 60,dMs art?'(EXCEPTION: Tier2'&'Iri sponses)
NIA
I"s analytical monitoringgcompleie (including schedule} for each
SDO? (EXCEPTION: ROS)
✓
Any,.exceedences of,pollutant:.parar ieters -when compared against the
permit benchmark -value's'?
N/A
Has Facility implemented•appropriate; selected actions to reduce
pollutant concentrations, In response=to benchmark exceedences (if
applicable)?.
Qualitative Monitoring
Vas XT�, TiT.,teo
1 VJ 1\V
Is qualitative inoriitoring being per ormed4cluring measurable storrri
f
events?
Is qualitative=monitoring complete(including schedule),foreach
/
SDO?
Are irionitorrri' events 60 `days'a art? (EXCEPT" I(N`Xier�2 & 3 responses)
NIA
Anyobser'VAble;,eaccessive amounts=of pollutarit;indicators in
stonnwater discharge -at Slams:

Par dRegtiired Actions to be comple#ed by Fa
1. -In order to prevent vandalism; please install a l©& out'tag put device,f©r valve near
uucEc � i.
2. Immediately Aispose ofibe rags'immersed in gas" and ;devise-.and'implement a BMP4or
gas nozzles to have,a proper place to rest.in.:Also,4nclude:the new- BMP in.SPPPP.
3. Please ensure,all contractors have BMP measures in place for trash. dumpstemand
shop vacuums,thatrisk exposure to the creeks. Also,:inciude the new BMP'measurelin
the-SPPPP.
4. Immediately clean.up.the hydraulic oil.leak'near.metal.shaviags huilding and increase
cleaning frequency. to weekly, as per -your -Good Housekeeping Program requirements.
S. -Please,update the=City of W.inston,Salem, ,Stormwater Division's contact information
to Caterpillar, Inc. Axel mannfacturing.Spill Notification List.
6. ;Please add4fie industriaLactivity areas and. physical locationstto the site map.:
7. Please update•SPPP to'currentyear and date.
$. Update the spill preventidirand response-procedures'rwith the -identified,. responsible
personnel with, signatures` and .-dates.,
9: Update;andsign the;respont ible party with signature,and dates
Company Representatives) that participated in inspection:,Mr. Campbell and Mrs. Mastrobattista
Title(s):-EHS Supervisor-aiiid 'EHS Associate
Start.of Irspection ..9:06ain
Completion of- Inspection: 2; pOpm:
Date: 9/10/2.014
Sigiiature'oi'Stvrinwater Inspector:' - --
Title: Stormwater Inspector

Pi&iire*T VkW6 f6k secondary containment tank near dock-3.1
in order to brevent,viindaliSM. Dlease.instail a"Ilock out tag out.device for valve near ,.dock 31.
Picture#2 Coniactor.s gas iank with,no_BMP°'measures.
Immediately dispose,ewerags. 'immersed in gas.and-devise and im.
plement-a. B_MP: for gas -nozzles to
have w a, proper- piace,46 rcsf, in.

Picture#:3 A. contractors -trash Aumpster:an&shop vac without proper BMP measures.
Please ensure:all contractors have BMP'.measures in.place for trash dumpsters and,shop vacuums that
'risk.exposure!to the.creeks.
•JI
f;
•
�
L
i,�t• �
j
f
` '
j•
Y
' � � �
•yyid�,,
F+
,
• �� � �
Y��
p.
Picture #4 Hydraulic. oil near inetal "shavings: building:
Inimediately'clean`ul hydraulie-6d'.leak near metal shavings. building and uicrease cleaning frequency to
•weepy,;as° per .your ,Good'Housekeeping,Program requirements.

C®ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Chuck Wakild, P.E. Dee Freeman
Governor Director Secretary
November 27, 2012
Caterpillar, Inc.
Attn: Terrial S. Campbell, EHS Supervisor
2950 Temple School Road
Winston Salem, NC 27107
Subject: Compliance Evaluation Inspection
NPDES General Stormwater Permit NCG030000
Certificate of Coverage NCG030611
Caterpillar, Inc., Winston Salem Plant
Forsyth County
Dear Mr. Campbell:
Ron Boone of the Winston-Salem Regional Office of the NC Division of Water Quality (DWQ)
conducted a compliance evaluation inspection (CEI) at the subject facility on November 21, 2012.
Your assistance and cooperation during the inspection was greatly appreciated. An inspection
checklist is attached for your records and the inspection findings are summarized below.
The facility is located at 2950 Temple School Road, in Winston Salem, Forsyth. County, North
Carolina, at approximate coordinates 36.059998°,-80.117438°. Stormwater related to 'industrial
activity is discharged from the site to Swaim Creek, which is currently classified as a Class'C water
located in the Yadkin Pee -Dee River Basin.
Documentation & Monitoring Review
The site has an excellent Stormwater Pollution Prevention Plan (SP3). It is complete, current,
fully implemented. Mr. Boone found no deficiencies in the SP3 document.
To date, one Analytical/Qualitative Monitoring (AM/QM) event has occurred. No exceedences
of permit benchmarks occurred.
Site Review
The site was very clean and well maintained. Mr. Boone identified no violations or deficiencies
during his inspection of the site.
During the inspection, Mr. Boone spoke with you about the possibility of acquiring a No
Exposure Certification (NEC) for the site. The site has very little industrial activity occurring outside
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107 One
Phone: [phone] FAX: [phone] Customer Service: 1.877-623-6748 NorthCarohna
Internet: www.ncwaterquality.org Vatuyallff
An Equal Opportunity 1 Affirmative Action Employer r/ s

Caterpillar, Inc.
Attn: Terrial S. Campbell, EHS Supervisor
Compliance Evaluation Inspection, NCG030611
11127/2012, page 2 of 2
and should seriously consider taking the necessary. actions to qualify for a NEC. Please access our
website at the following URL to access certification forms and guidance for the NEC:
hftp://Portal.ncdenr.om/web/Wq/ws/su/npdessw#tab-3
You are reminded that violations of the NCG030000 general stormwater permit are subject to
civil penalties not to exceed $25,000 per day/per violation. Should you have any questions regarding
the permit, this letter, or the inspection, please do not hesitate to contact Mr. Boone or me at (336)
771-5000.
Sincerely,
W. Corey Basinger
Water Quality Regional Supervisor
Winston-Salem Region
Division of Water Quality
Attachments:
1. BIMS Inspection Checklist
cc SWP_- WSRO ..
Central Files
Stormwater Permitting Unit

Compliance Inspection Report
Permit: NCG030611 Effective: 10/21/11 Expiration: 10/31/12 Owner: Caterpillar Inc
SOC: Effective: Expiration: Facility: Caterpillar Inc
County: Forsyth 2950 Temple School Rd
Region: Winston-Salem
Winston Salem NC 27107
Contact Person: Terrial Campbell Title: Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 11/21/2012
Primary Inspector: Ron Boone
Secondary Inspector(s):
Certification:
Phone:
Entry TtmJe: 09:00 AM Exit Time: 11:00 AM
f Phone: [phone]
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Metal Fabrication Stormwater Discharge COC
Facility Status: ■ Compliant Cl Not Compliant
Question Areas:
E Storm Water
(See attachment summary)
Page: 1

Permit: NCG030611 Owner -Facility: Caterpillar Inc
Inspection Date: 11/21/2012 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
Please refer to the attached inspection summary letter.
Page: 2

I
Permit: NCG030611 Owner -Facility: Caterpillar Inc
Inspection Date: 11121/2012 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Stormwater Pollution Prevention Plan Yes No NA NE
Does the site have a Stormwater Pollution Prevention Plan?
# Does the Plan include a General Location (USGS) map?
# Does the Plan include a "Narrative Description of Practices"?
# Does the Plan include a detailed site map including outfall locations and drainage areas?
# Does the Plan include a list of significant spills occurring during the past 3 years?
# Has the facility evaluated feasible alternatives to current practices?
# Does the facility provide all necessary secondary containment?
# Does the Plan include a BMP summary?
# Does the Plan include a Spill Prevention and Response Plan (SPRP)?
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
# Does the facility provide and document Employee Training?
# Dees the Plan include a list of Responsible Party(s)?
# Is the Plan reviewed and updated annually?
# Does the Plan include a Stormwater Facility Inspection Program?
Has the Stormwater Pollution Prevention Plan been implemented?
Comment: Please refer to the attached inspection summary letter.
Qualitative Monitoring
Yes No NA NE
Has the facility conducted its Qualitative Monitoring semi-annually?
■ ❑
❑
❑
Comment: Please refer to the attached inspection summary letter.
Analytical Monitoring
Yes No
NA
NE
Has the facility conducted its Analytical monitoring?
■ ❑
❑
❑
# Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas?
■ ❑
❑
❑
Comment: Please refer to the attached inspection summary letter.
U1er l'I ...,r n..at_n_
r GIII IIL QIILJ VLl LI OIIJ
Yes wIo
wen
14E
# Is a copy of the Permit and the Certificate of Coverage available at the site? ■ ❑ ❑ ❑
# Were all outfalls observed during the inspection? ■ ❑ ❑ ❑
# If the facility has representative outfall status, is it properly documented by the Division? ❑ ❑ ■ ❑
# Has the facility evaluated all illicit (non stormwater) discharges? ®❑ ❑ ❑
Comment: Please refer to the attached inspection summary letter.
Page: 3

A� 1
RECEIVED
' e + fj N'C' DeIE °i ENR
k
m'�� � NOV 15 20��
.....,..vat�
Nut Carolina Department of Envirmmont and Nat iral Resources Rol°natar��
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
October 21, 2011
Mr. Terrial S. Campbell, EHS Supervisor
Caterpillar Inc
2950 Temple School Road
Winston-Salem, North Carolina 27107
Subject: General Permit No. NCG030000
Caterpillar Inc.
COC No. NCG030611
Forsyth County
Dear Mr. Campbell:
In accordance with your application for a discharge permit received on September 23, 2011, we are
forwarding herewith the siihjecl certificate of coverage (C,'OC) to discharge under the subject state — NPDES
general permit. This permit is issued pursuant to the requirements of North Carolina General Statute 143-215.1
and the Memorandum of Agreement between North Carolina and the US Environmental Protection Agency
dated October 15, 2007 (or as subsequently amended).
If any parts, measurement frequencies, or sampling requirements contained in this permit are
unacceptable to you, you have the right to request an individual permit by submitting an individual permit
application. Unless such demand is made, this certificate of coverage shall be final'and binding.
Please take notice that this certificate of coverage is not transferable except after notice to the Division
of Water Quality. The Division of Water Quality may require modification or revocation and reissuance of the
certificate of coverage. This permit does not affect the legal- requirements to obtain other permits which may be
required by the Division of Water Quality or permits required by the Division of Land Resources, Coastal Area
Management Act or any other federal or local governmental permit that may be required.
If you have any questions concerning this permit, please contact Bill Diuguid at telephone number
[phone].
Sincerely,
ORIGINAL. SIGNED B4
KEN PICKLE
Coleen H. Sullins
cc: Winston-Salem Regional Office
Central Files
Stormwater Permitting unit Files
Attachments
1617 Mail Service Center, Ralegh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone: 91 U07-63001 FAX: [phone] Customer Service: 1-877-623-6746
Intemet: www.ncwaterquality.org
An Equal Opportunity t Atfirmalive Action Employer
NorthCarolina
Nahmally
Cj:w�

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG030000
CERTIFICATE OF COVERAGE No. NCG030611
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the north Carolina Envirorniientai Managemient Comimission, and the
Federal Water Pollution Control Act, as amended,
Caterpillar, Inc.
is hereby authorized to discharge stormwater from a facility located at
Caterpillar, Inc.
2950 Temple School Road
Winston-Salem
Forsyth County
to receiving waters designated as Swaim Creek, a Class C water body to Yadkin Basin, in accordance with the
effluent limitations, monitoring requirements, and other conditions set forth in Parts 1, I1, II1, IV, V and VI of
General Permit No. NCG030000, as attached.
This Certificate of Coverage shall become effective October21, 2011.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day October 21, 2011.
ORIGIN PICKLE SIGNED B)
Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

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Latitude: 36'03'36" N C G 03 s 11 F
Longitude: 80'07'04" FaCIiI�I'
County: Forsyth Caterpillar Inc. Location' a�
Stream Class: C�
Receiving Stream: Swann Creek & South Fork Muddy
Creek NOT s« LT-10
Sui)-basin: 03-07-04 (Yadkin River Basin)

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Current Deed Date 9/23/2010
Disclaimer., Forsyth County cannot guarantee the accuracy of this information, and the Mao Scale
my hereby disclaims all .nrrantioc inclining warranties as to the accuracy of this � w __ 444a s.,o♦
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information. ' "'�'' ` ' ' "' "" I
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