NCG140014_COMPLETE FILE - HISTORICAL_20170612

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V IL'f
DOC TYPE
�. HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
O � � � v � `ca
YYYYMMDD

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Analytical
www.pacela6s.rarn
June 07, 2017
Mr. Derek Secrist
Foltz Concrete Pipe Company
11875 North NC Highway 150
Winston Salem, NC 27127
RE: Project: Stormwater
Pace Project No.: 92342774
RECEIVED
JUN i "017
CENTRAL FILES
DVVR SECTION
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville. NC 28078
[phone]
NC�-IybC, /y
Dear Mr. Secrist:
Enclosed are the analytical results for sample(s) received by the laboratory on June 02, 2017. The
results relate only to the samples included in this report. Results reported herein conform to the most
current, applicable TNI/NELAC standards and the laboratory's Quality Assurance Manual, where
applicable, unless otherwise noted in the body of the report.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
o- .1h1
Angela Baioni
[e-mail]
[phone]
Project Manager
Enclosures
cc: Ms. Ouida Campbell, Foltz Concrete Pipe Company
REPORT OF LABORATORY ANALYSIS
This report shall not lye reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 1 of 12

r
Pace Analytical Services, LLC
e
aceMalytiml 9800 Kincey Ave. Suite100
Huntersville, NC 28078078 s
www.pacefts.com (704)87S9092
CERTIFICATIONS
Project: Stormwater
Pace Project No.: 92342774
Asheville Certification IDs
2225 Riverside Drive, Asheville, NC 28804 North Carolina Wastewater Certification #: 40
FloridalNELAP Certification #: E87648 South Carolina Certification #: 99030001
Massachusetts Certification #: M-N6030 VirginiaNELAP Certification #: 460222
North Carolina Drinking Water Certification #: 37712
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC. Page 2 of 12

r lacieAnalyfical"
www.pacelab cam
SAMPLE ANALYTE COUNT
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville. NC 28078
[phone]
Project:
Pace Project No.:
Stormwater
92342774
Analytes
Lab ID
Sample ID
Method
Analysts
Reported
Laboratory
92342774001
Outfall #1
SM 2540D
CJH1
1
PASI-A
EPA 9040
KDF1
1
PASI-A
92342774002
Outfall #2
SM 2540D
CJH1
1
PASI-A
EPA9040
KDF1
1
PASI-A
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC. Page 3 of 12

aceAnalytical
wwwpacembs.aom
ANALYTICAL RESULTS
Pace Analytical Services, J LC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Project: Stormwater
Pace Project No.: 92342774
Sample: Outfall 91 Lab ID: 92342774001 Collected: 06/01/17 08:00 Received: 06/02/17 11:22 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No, Qual
2540D Total Suspended Solids Analytical Method: SM 2540D
Total Suspended Solids 71.4 mg/1- 2.8 1 06/07/17 01:41
9040 pH Analytical Method: EPA 9040
pH 9.6 Std. Units 0.10 1 06/06/17 17:00 H6
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 06/07/2017 09:16 PM without the written consent of Pace Analytical Services, LLC. Page 4 of 12

lacieAnalyfical"
www.Pacelaftcom
ANALYTICAL RESULTS
Project: Stormwater
Pace Project No.: 92342774
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
(704)875r9092
Sample: Outfall #2 Lab lD: 92342774002 Collected: 06101/17 07:45 Received: 06/02/17 11:22 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qua]
2540D Total Suspended Solids Analytical Method: SM 2540D
Total Suspended Solids 50.7 mg/L 5.6 1 06/07/17 01:42
9040 pH Analytical Method: EPA 9040
pH 8.1 Std. Units 0.10 1 06106/17 17:00 H6
Date: 06/07/2017 09:16 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 5 of 12

aceAnalytical.
www.pec"s.corn
QUALITY CONTROL DATA
Project: Stormwater
Pace Project No.: 92342774
Pace Analytical Services, I LC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078 '.
[phone]
QC Batch: 363659
Analysis Method:
SM 25401)
QC Batch Method: SM 2540D
Analysis Description:
2540D Total Suspended Solids
Associated Lab Samples: 92342774001, 92342774002
METHOD BLANK: 2016167
Matrix: Water
Associated Lab Samples: 92342774001, 92342774002
Blank Reporting
Parameter
Units
Result Limit
Analyzed Qualifiers
Total Suspended Solids
mg/L
ND
2.5 06/07/17 01:37
LABORATORY CONTROL SAMPLE:
2016168
Spike LCS
LCS % Rec
Parameter
Units
Conc. Result
% Rec Limits Qualifiers
Total Suspended Solids
mg1L
250 252
101 90-110
SAMPLE DUPLICATE: 2016169
92342687003 Dup
Parameter
Units
Result Result
RPD Qualifiers
Total Suspended Solids
mg1L
5.6
ND
SAMPLE DUPLICATE: 2016170
92342744001 Dup
Parameter
Units
Result Result
RPD Qualifiers
Total Suspended Solids
mg1L
515
500 3
Results presented on this page are In the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 06/07/2017 09:16 PM without the written consent of Pace Analytical Services, LLC. Page 6 of 12

aceMalXical
Cwwwyecelabs.00m
Project: Stormwater
Pace Project Nlo.: 92342774
QC Batch: 363493
QC Batch Method: EPA 9040
Associated Lab Samples: 92342774001, 92342774002
SAMPLE DUPLICATE: 2015174
Parameter Units
pH
Std. Units
QUALITY CONTROL DATA
Analysis Method: EPA 9040
Analysis Description: 9040 pH
92342774002 Dup
Result Result RPD Qualifiers
8.1 8.2 0 H6
Pace Analytical Services, LLC
9800 xincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Results presented on this page are in the units Indicated by the "Units' Column except where an alternate unit is presented to the right or the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 06/07/2017 09:16 PM without the written consent of Pace Analytical Services, LLC.
Page 7 of 12

Pace Analytical Services, GLC
KinceyAve,�aneAnalytica!
9800Huntersville, NC128077B
www.parafabs.com [phone]
QUALIFIERS
Project: Stormwater
Pace Project No.: 92342774
DEFINITIONS
DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot.
ND - Not Detected at or above adjusted reporting limit.
J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit.
MDL -Adjusted Method Detection Limit.
POL - Practical Ovantitation Limit.
RL - Reporting Limit.
S - Surrogate
1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270, The result for each analyze is
a combined concentration.
Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values.
LCS(D) - Laboratory Control Sample (Duplicate)
MS(D) - Matrix Spike (Duplicate)
DUP - Sample Duplicate
RPD - Relative Percent Difference
NC - Not Calculable.
SG - Silica Gel - Clean -Up
U - Indicates the compound was analyzed for, but not detected.
Acid preservation may not be appropriate for 2 Chloroethylvinyl ether,
A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA
Method 8260.
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenyiamine using Method 6270. The result reported for
each analyte is a combined concentration.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TNI - The NELAC Institute,
LABORATORIES
PAST -A Pace Analytical Services - Asheville
ANALYTE QUALIFIERS
H6 Analysis initiated outside of the 15 minute EPA required holding time.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 06/07/2017 09:16 PM without the written consent of Pace Analytical Services, LLC. Page 8 of 12

0
55'ce Ana lyfical
wwwpacefabs.00m
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Project: Stormwater
Pace Project No.: 92342774
Analytical
Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch
92342774001
Outfall #1
SM 2540D
363659
92342774002
Outfall #2
SM 2540D
363659
92342774001
Outfall #1
EPA 9040
363493
92342774002
Outfall #2
EPA 9040
363493
Date: 06/07/2017 09:16 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 9 of 12

Document Name:
Document Revised: Sept. 21, 2016
�ceAnalj 1Cc3�a
Sample Condition Upon Recei t(SCUR)
Page I of 2
Document No.:
Issuing Authority:
F-CAR-CS-033-Rev.01
Pace Quality Office
Laboratory receiving samples:
Asheville ❑ Eden❑ Greenwood ❑ Huntersvilie �� Raleigh❑ Mechanicsville❑
INI• Client Name:
{�J
h
Project #:
Courier: Fe ❑UPS ❑LISPS _ ❑Client
❑ Commercial ace ❑Other:�L� (' '.1
Custody Seal present? ❑Yes ONO -----seals Intact? dpov -bNo
W0#:92342774
92342774
Date/Initials Person Examining Contents: 7 7 / -7
Packing Material: ❑Bubble Wrap ❑Bubble Bags _ None ❑Other: r /
Thermometer rn
un ID:j�p Type of Ice: 'et ❑131ue ❑None i pies on ice, cooling process has begun
Correction Factor: Cooler Temp Corrected (•C): , �j Biological Tissue Frozen? ❑Yes QN67'
Temp should be above freezing -to 6'C
USDA Regulated Soil ( M.WA, water sample)
Did samp�e�s onii to in a quarantine zone within the United States: CA, NY, or SC (check maps)? Did samples originate from a foreign source (internatio y,
mvec Ii inrru lino W-H and Vuo�tn Ricoh nYPs M
Comments/Discrepancy.
Chain of Custody Present?
0 Yes
[IN.
❑N/A
1.
Samples Arrived within Hold Time?
es
[]NO
❑N/A
2.
Short Hold Time Analysis (c72 hr.)?
[]Yes
© 6
❑N/A
3.
Rush Turn Around Time Requested?
❑Yeses
❑N/A
4.
Sufficient Volume?'
®Yes
❑No
El N/A
5.
Correct Containers Used?
-Pace Containers Used?
Mfe,
es
[]No
❑No
,' ❑N/A
[]N/A
6.
Containers Intact?
es
[IN.
❑N/A
7.
Samples Field Filtered?
Yes
[]No
b<A
8. Note if sediment is visible in the dissolved container .
Sample Labels Match COC?�
-Includes Date/Fime/ID/Analysis Matrix:
es
[:)No
❑N/A
9,
Heads ace In VOA Vials (>5-6mm)?
Oyes
ONO
A
10.
Trip Blank Present?
Trip Blank Custody Seals Present?
❑Yes
❑Yes
®o
[]NO
❑N/A
/A
11.
CLIENT NOTIFICATION/RESOLUTION
Person Contacted: Date/Time:
Comments/Sample
Discrepancy:
Field Data Required? ❑Yes ❑No
Project Manager SCURF Review:��
Project Manager SRF Review: Date:
Note: Whenever there is a discrepancy affecting North Carolina compliance samples, a copy of this form will be sent to the North Carolina DEHNR Certification Office (i.e.
Out of hold, incorrect preservative, out of temp, incorrect containers)
Page 10 of 12

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BP3U-250 mL Plastic Unpreserved (N/A)
BPZU-500 mL Plastic Unpreserved (N/A)
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13PIU-1 liter Plastic Unpreserved (N/A)
BP3S-250 mL Plastic H2SO4 (pH < 2) (Cl-)
8P3N-250 mL plastic HNO3 (pH < 2)
BP32-250 mL Plastic ZN Acetate & NaOH (>9)
MC-250 mL Plastic NaOH (pH > 12) (Ci )
WGM-Wide-mouthed Glass jar Unpreserved
AG1U-1 liter Amber Unpreserved (N/A) (Cl-)
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AG1H-1 liter Amber HCi (pH < 2)
AG3U-250 mLAmber Unpreserved (N/A) (Cl-)
AG1S-1 liter Amber H2SO4 (pH < 2)
AWS-250 mLAmber H2SO4 (pH < 2)
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AG3A(DG3A)-250 mL Amber NH4CI (N/A)(CI-)
OG9H40 mL VOA HCI (N/A)
VG9T-40 mLVOA Na2S203 (N/A)
VG9U-40 mL VOA Unp (N/A)
DG9P-40 mL VOA H3PO4 (N/A) '
VOA (6 vials per kit)-5035 kit (N/A)
V/GK (3 vials per kit)-VPH/Gas kit (N/A)
SPST-125 mL Sterile Plastic (N/A— lab)
SP2T-250 mL Sterile Plastic (N/A — lab)
MA-250 mL Plastic (NH2)2SO4 (9.3.9.7)
Cubitainer
VSGU-20 mL Scintillation vials (N/A)
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CHAIN -OF -CUSTODY 1 Analytical Request Document
The Chain -of -Custody is a LEGAL DOCUMENT. All relevant fields must be completed accurately.
Section A Section B Section C
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Required Client Information: Required Project Information: Invoice Information: Page : 1 Of 1
Company: Foltz Concrete Pie Camp" Report TO: Derek Socrist Attention:
Address11875 North NC Highway 150 Copy To: Company Name:
Winston Salem, NC 27127
Address'
Regulatory Agency
Email: derek.sacris ads i e-com
Purchase Order #:
Pace Quote:
Pnone: {336}764.a341 Fax
Project Name: Stormwater
Paco Project Manager. angels.tinioniapacalabs. cam.
-' State! location
Requested Due Date.
Project #:
Pace Profile #: 3979.1
NC
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A division of
Matthew E. Gantt, P.E.
Regional Engineer
Land Quality Section
Winston- Salem Regional Office
Subject: Notice of Deficiency
NOZ-2016-SP-0006
Permit No. NCG 140
Foltz Concrete Pipe Co.
Dear Mr. Gantt:
I am writing. in response to your letter dated Aug 24, 2016 informing us of our Notice of
Deficiency. The steps we will take to rectify our deficiencies are listed below.
1. We will place the SWPPP in a 3 ring binder and make current updates at least
annually. The annual training that we provide the employees and any spill
records will be kept in there as well. We are creating a new outfall which gives
us 2 points to monitor going forward.
2. Qualitative Monitoring will be done, likely at the same time as samples are
collected, and the records will be kept with the SWPPP.
3. Analytical monitoring will be done on both outfalls twice annually and results
sent to Raleigh.
S
Derek Secrist
Regional Manufacturing Manager
Foltz Concrete Pipe Co.
FOLTZ CONCRETE PIPE COMPANY 11875 N NC HIGHWAY 150, WINSTON-SALEM, NC 27127 TEL: [phone] 8001229-8525 FAX: [phone]

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■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attacn�2his card to the back of the mailpiece,
or on the front if space permits.
Derek`Secrist, manager
Foltz Concrete Pipe Co., LLB:
11875 N NC Hwy 150
Winston-Salem, NC 27127
l. it - '7 Sr -
C. Date cif Delivery
D. Is delivery address different from item 17 ❑
If YES, enter delivery address below;
II �III�I ���I IIIII I I I [I I II II�l I�I 1 II I I II I �If3. ❑Adult Signature
vice e Signature Delivery
C e.IGed Mail®
9590 9403 0921 5223 9938 71 ❑ Certified Mail Restricted Delivery
❑ coned on Delivery
p _ _ n firin N, n. F,u. lTrnneier, from eervi n 1ahPlt_ _ _ ❑ Collect on Delivery Restricted Delivery
17015,06140.0005. 8164 4436 � p insurred Mail
Restricted Delivery
II lover S500S
❑ Priority Mail Expresso
❑ Registered MalllM
❑ Wislered Mail Restrictec
Irvery
Retum Receipt for
❑ Signature CenfirmatianT
❑ Signature Confirmation
Restricted Delivery
mPS Form 3811, .July 2015 PSN 7530-02-000-9053 � lP `� r � �� Domestic Return Receipt

1111111111111111111111111111111111111111111111
9„0,�03o9r.,.23,,,,.
United States
Postal Service
First -Class Mail
Postage & Fees Paid
LISPS
Permit No. G-10
A
• Sender: Please print your name, address, and ZIP+4® in this box*.?
North Carolina Department of
Environmental Quality
450 West Hanes Mill Road, Suite 300
Winston-Salem, NC 27105
Land Quality w Gw

Energy,. Mineral &
Land Resources
ENVIRONMENTAL QUALITY'
August 24, 2016
CERTIFIED MAIL 47015 0640 0005 8164 4436
RETURN RECEIPT REQUESTED
Derek Secrist, Manager
Foltz Concrete Pipe Co., LLC
11875 N NC Hwy 150
Winston-Salem, NC 27127
Subject: NOTICE OF DEFICIENCY
NOV-2016-SP-0006
Permit No. NCG 140014
Foltz Concrete Pipe Co., Inc.
Davidson County
Dear Mr. Secrist:
PAT McCRORY
Governor
DONALD R. VAN.DER VAART
Secretary
TRACY DAVIS
Director
On August 18, 2016 Blair Palmer, Multi -Media Inspector with the North Carolina Department of
Environmental Quality, visited the facility located at 11875 N NC Hwy 150, to conduct a
compliance inspection as required by your industrial sto riwater permit. On Aagast 24, 2016 a
follow-up was conducted by Glen White to verify deficiencies. Your assistance with inspection
was greatly appreciated.
This facility is covered under General Permit No. NCG 140014 which allows the discharge of
stormwater point source discharges associated with activities primarily engaged in production of
Ready -Mixed Concrete [SIC 32731 and like activities to the surface waters of North Carolina
The following observations and violations were noted during NCDEQ's Multi -Media inspection
and subsequent file review and were verified by DEMLR's review:
Stormwater Pollution Prevention Plan (SPPP):
The General Permit NCG 140000, Part 111, No. 1 thru 10 requires the permittee to
develop and implement a SPPP that includes all of the information required in No. 1 thru
10. Inspection revealed that this facility has developed a Stormwater Pollution
Prevention Plan but it has not been maintained as the permit requires. Deficiencies
include: annual review and update of the SPPP and the siteplan, annual training, spills
records. Create a new sampling outfall below the plunge pool discharging near the creek.
State of North Caro€ina, I En%lronmental Quality I Energy. Mineral and Land Resources
Winston-Salem Regional Office 1 450 Hanes Mill Road, Suite 300 1 WlnstOn-Salern. NC 27103.
336 T76 9800

2. Qualitative Monitoring):
General Permit NCG 140000, Part IV Section C requires the facility to conduct
qualitative monitoring twice per year following the established guidelines. The facility
has not been monitoring per requirements. Monitoring must be completed twice annually
and records must be kept with the SPPP for a minimum of five (5) years.
3. Analytical Monitoring):
General Permit NCG 140000, Part IV Section A & Table 7 requires the facility to
conduct analytical monitoring twice annually at each of the facilities stormwater outfalls
and quarterly where stormwater and process wastewater are comingled. In this case,
discharge is not considered comingled, therefore analytical monitoring is only required to
be conducted twice annually.
Results are required to be sent to:
NCDEQ's Stormwater Permitting Unit
1612 Mail Service Center
Raleigh, NC 27699-1612
Required Response
Accordingly, you are directed to respond to this letter in writing within 30 calendar days of
receipt of this Notice. Your response should outline how the violations will be addressed and
should be sent to this office at the letterhead address and include the following:
Stormwater Pollution Prevention. Plan (SPPP) should include annual stormwater training
for all employees that work outside and have exposure to stormwater including all drivers
and the personnel running the plant on a daily basis. Document training with pen/ink
signatures and keep a sign in sheet for in the SPPP. Responsible Party Certification must
be signed and updated annually. Go through the SPPP at least once a year and mark up
any changes to the facility, operating procedures; personnel, etc. Sign off with a revision
note for annual revision.
2. Begin Qualitative Monitoring and provide twice annually. Keep records in the SPPP
binder. This may be conducted at the same time that analytical samples are taken.
3. Begin Analytical Monitoring per permit requirements defined in Part IV, Table 7.
Monitoring will be required to be conducted quarterly since discharge is comingled
stormwater and process wastewater. Keep records in SPPP and maintain for five (5) year
minimum.
State of North Car6lina I Environmental Quality I Energy, Mineral and Land Resources
Winston-Salem Regional Office 1 450 Hanes Mill Road, Suite 300 I Winston-Salem, NC 27103
336 776 9800

Thank you for your attention to this matter. This Office is considering sending a
recommendation for enforcement to the Director of the DEMLR (Division of Energy, Minerals,
& Land Resources) regarding these issues and any future/continued violations that may be
encountered. This office requires that the violations, as detailed above, be abated
immediately and properly resolved. Environmental damage and/or failure to secure proper
authorizations have been documented on the subject tract as stated above. Your efforts to
undertake activities to bring the subject site back into compliance is not an admission, rather it is
an action that must be taken in order to begin to resolve ongoing environmental issues.
Pursuant to G.S. 143-215.6A, these violations and any future violations are subject to a civil
penalty assessment of up to a maximum of $25,000.00 per day- for each violation. Your
above -mentioned response to this correspondence, the degree and extent of harm to the
environment and the duration and gravity of the violation(s) will be considered in any civil
penalty assessment process that may occur. Should you have any questions regarding these
matters, please contact Glen White at [phone].
Sincerely,
Matthew E. Gantt, P.E.
Regional Engineer
Land Quality Section
Winston-Salem Regional Office
Enclosures: Inspection Report
cc: DEMLR - WSRO
Bradley Bennet — DEMLR — Stormwater Permitting Unit
State of North Catalina I Environmental Quality I Energy. Mineral and Land Resources
Winston-Salein Regional 0€fice 1 450 Hanes Mill Road. Suite 300 1 Winston-Salem. NC 27103
336 776 9800

Permit: NCG140014
SOC:
County: Davidson
Region: Winston-Salem
Contact Person: Eric Parrish
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s)-
Related Permits:
Compliance Inspection Report
Effective: 07/01/16 Expiration: 06/30/17 Owner : Foltz Concrete Pipe Co LLC
Effective: Expiration: Facility: Foltz Concrete Pipe Co LLC
11875 N NC Hwy 150
Winston Salem NC 27127
Title: Phone: [phone]
Inspection Date: 0812412016
Primary Inspector: Glen White
Secondary Inspector(s):
Certification: Phone:
EntryTime: 10:OOAM Exit Time: 11:OOAM
Phone: [phone]
Reason for Inspection: Routine Inspection Type: Technical Assistance
Permit Inspection Type: Ready Mix Concrete Stormwater/Wastewater Discharge COG
Facility Status: ❑ Compliant ® Not Compliant
Question Areas:
Storm Water
(See attachment summary)
Page: 1

permit- NCG140014 Owner- Facility: Foltz Concrete Pipe Co LLC
Inspection Date: 08124/2016 Inspection Type : Technicai Assistance Reason for Visit: Routine
Inspection Summary:
(See Compliance Letter- NOD).
Page: 2

Permit: NCG140014 Owner - Facility: Foltz Concrete Pipe Co LLC
Inspection Date: 08/24/2016 Inspection Type : Technical Assistance Reason for Visit: Routine
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? Cl ❑ ® ❑
Comment: Add outfall_ location below the plunge pool near the creek. Clean-up plunge pool periodically and
add fresh stone as needed. Provide analytical monitoring at this location and at the outfall at the
other end of facility. Provide a clearath with a safe way to collect samples. If a platform or
landing needs to be constructed for safety and ease of collection lease complete this task.
Permit and Outfalls Yes No NA NE
# 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: A current copy of the permit should be in the SPPP file. Provide the SPPP in a Three (3) ring
binder. Keep all related records in this file.
One outfall is beino added. Please update the Site Ian.
Qualitative Monitoring
Has the facility conducted its Qualitative Monitoring semi-annually?
Yes No NA NE
❑N❑❑
Comment: Perform Qualitative Monitoring at each outfall twice (2 times) annually. Keep records in SPPP. .
Provide a clear, acessible path to each outfall and a safe way to collect samples.
stormwater Pollution Prevention Plan
Yes No NA NE
Does the site have a Stormwater Pollution Prevention Plan?
E ❑ ❑ ❑
# 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?
❑ E ❑ ❑
# 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)?
0 ❑ ❑ ❑
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
0 ❑ ❑ ❑
# Does the facility provide and document Employee Training?
❑ N ❑ ❑
# Does the Plan include a list of Responsible Party(s)?
❑ ®❑ ❑
Page: 3

Permit: NCG140014 Owner - Facility: Foltz Concrete Pipe Co LLC
Inspection Date: 08/24/2016 Inspection Type : Technical Assistance Reason for Visit: Routine
Stormwater Pollution Prevention Plan Yes No NA NE
# 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: U ate SPPP annuai!y.. This can be accomplished in-house. Go through the SPPP with a pen
and mark=up any changes. Sign and date revisions or add a revision sheet, sign and date that
plan was revised.
Provide employee training annually w/pen/ink signatures. Keep in SPPP.
Provide Spills records. _Update Siteplan to include new outfall.
Page: 4

Permit: NCG140014
SOC:
County: Davidson
Region: Winston-Salem
Contact Person: Eric Parrish
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Compliance „Inspection Report
Effective: 07/01/16 Expiration: 06/30/17 Owner: Foltz Concrete Pipe Co LLC
Effective: Expiration: Facility: Foltz Concrete Pipe Co LLC
11875 N NC Hwy 150
Winston Salem NC 27127
Title: Phone: [phone]
Inspection Date: 08/18/2016
Primary Inspector: Blair Palmer
Secondary Inspector(s):
Certification: Phone:
Entry Time: 08:55AM Exit Time: 11:35AM
Phone: [phone]
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Ready Mix Concrete Stormwater[Wastewater Discharge COC
Facility Status: ❑ Compliant ® Not Compliant
Question Areas:
■ Storm Water
(See attachment summary)
Page: 1

Permit: NCG140014 Owner - Facility: Foltz Concrete Pipe Co LLC
Inspection date: 08/18/2016 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
The facility's is currentely monitoring(analytical only) at one outfall. Some trash was observed at the outfall adjacent and
south of the pond exit discharage point. There is needs to be clarification on what the faiclity should be monitoring and
follow-up will be conducted by DEMLR personnel. The facility does not have a rain gauge on -site, but Mr. Parrish uses a
rain gauage at his residence, which is -- 112 mile away from this facility. There needs to be clarification made on whether
the facility performs truck or vehicle cleaning, as this would trigger wasterwater requirements. Also, the facility uses on
ocassions a product (liquid) mixed with water to corttro! dust on the gravel roads (aka haul roads). The containment
appears to be ok and one diesel tank(10,000 gallon capacity) is not used and it is double walled. No visible spills were
observed during the insepctian. Mr. Palmer did reminded Mr. Secrist of the preventative maintenance and housekeeping
requirements for NCG140000 permits.
Page: 2

Permit NCG140014 Owner - Facility: Foltz Concrete Pipe Co LLC
Inspection Date: 0811812016 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Analytical Monitoring
Has the facility conducted its Analytical monitoring?
# Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas?
Yes No NA NE
❑ ❑ ❑
❑❑®❑
Comment: Facility does not use more than 55 gallons of motor oil per month. Facilitv conducted monitorin
.on 4/1/2016 and results indicate compliance results attached to the file report). The results for
the last half of 2015 were conducted on 7/15/2015 and indicate compliance. No sampling was
taken during the 1 st half of 2015. It should be noted that the facility has not been submitting their
reports to Raleigh. They were advised to start doing so. One outfall is used, which may not be
totally correct for monitoring at this particular facility. Further discussion on " Summa ." The
outfall currently being monitored is at the exit point of the pond and located at 35 59' 28" N and 80
16' _26." A second outfall, not monitored, is located at the far northern section of property and it
is located at 35 59 37 N and 80 16 20 W. A third outfall near the pond, but southwest of it is not _
being monitored it is located at 35 59 27 N and 80 16 25 W.
Permit and Outfalls Yes No NA NE
# 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: As mentioned above. the facility has been only been monitoring one outfall at the exit point of the
pond. There is an additional outfall located in the far nothern section of the property (see file
photo) and another outfall located adjacent and to the southwest of the bond. -There are actually_
two pipes feadiing into a small basin. then one pipe leading into creek or tributary (see file photo).
Some water was observed exiting this pipe and it appeared to clear and somewhat milky. There
was evidencce of erosion at all but one (pond) outfall, COC has been automatically extended to _
6/30/17.
Qualitative Monitoring
Has the facility conducted its Qualitative Monitoring semi-annually?
Yes No NA NE
❑®❑❑
Comment: The facility has not performed anv qualitative monitoring for at least the last 6 years. No records
could be found. Facility advised to start monitoring.
Stormwater Pollution Prevention Plan Yes No NA NE
Does the site have a Stonnwater 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? ❑ ®❑ ❑
Page: 3

Permit: NCG140014 Owner. Facility: Foltz Concrete Pipe Co LLC
Inspection Date: 08/18/2016 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Stormwater Pollution Prevention Plan
# 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
❑ ❑ ❑
❑ ❑ Cl
M ❑ ❑ ❑
❑ ❑ ❑
❑ ❑ ❑
❑ ®❑ ❑
❑ ® ❑ ❑
❑®❑❑
❑ N ❑ ❑
Has the Stormwater Pollution Prevention Plan been implemented? ❑ N ❑ ❑
Comment: SPPP hasn't been updated since 2010. The current mar) for locating outfalls needs to be
updated and clearly labeled, along with GPS coordinates. No employee training has been done
alt. least since ,2010._The current plan needs to have at least Eric Parrish, Plant Manager, added
onto, since he does analytical monitoring at this site; There is no inspection program beingdone
at the facility. The Stormwater Pollution Prevention Plan has and is not being implemented.
Page: 4

Environmental
Quality
August 24, 2016
Mr. DerekSecrist- Manufacturing Manager
Foltz Concrete Pipe Co.
11875 North NC Hwy 150
Winston-Salem, NC 27127
Subject: Multimedia Compliance Inspection
Foltz Concrete Pipe Co.
Davidson County
Dear Pennittee:
PAT MCCRORY
Governor
DONALD R. VAN DER VAART
secretary
Department of Environmental Quality staff from the Winston-Salem Regional Office (WSRO) conducted
a multimedia compliance inspection of Foltz Concrete Pipe Co. on August 18, 2016 for permits and
programs administered by the following Divisions:
Division of Air
Division of Energy,
Division of Water
Division of Waste
Quality
Mineral, and Land
Resources
Management
Resources
We appreciate your cooperation during the inspection and hope that you have enjoyed the benefit of our
initiative to provide a single inspector capable of handling multiple areas of environmental compliance at
your facility. The results of each applicable inspection and any associated response actions or necessary
corrective measures are detailed in the inspection letters/reports attached to this transmittal sheet. If a
Division report is not attached, you may assume compliance with that particular Division's rules and
regulations at the time of inspection
If you have any questions regarding this multimedia inspection, please contact Blair Palmer at (336) 776-
9645 or [e-mail]. Thank you for your cooperation.
encl: Air Quality Inspection Report
Stormwater Inspection Report
cc: DAQ WSRO Files
+DEMLR WSRO Files
DWR WSRO Files
DWM WSRO Files
State of [North Carolina I Environmental Quality
Winston-Salem Regional Office 1 450 West Hanes Mill Road Suite 300 1 Winston-Salem North Carolina 27105-7407
336 776 9800 T 1 336 776 9797 F

NORTH CAROLINA DIVISION OF
AIR .QUALITY
Inspection Report
Date: 08/ 19/2016
Facility Data
Foltz Concrete Pipe Co.
11875 North NC Hwy 150
Winston Salem, NC 27127
Lat: 35d 59.5080m Long. 80d 16.3080m
SIC: 3272 / Concrete Products, Nee
NAICS: 327332 / Concrete Pipe Manufacturing
Facility Contact
Eric Parrish
Plant Manager
[phone]
Contact Data
Authorized Contact
Derek Secrist
Manufacturing Manager
[phone]
Technical Contact
Derek Secrist
Manufacturing Manager
[phone]
Winston-Salem Regional Office
Foltz Concrete Pipe Co.
NC Facility ID 2900057
County/FIPS: Davidson/057
Permit Data
Permit 05881 / R10
Issued 2/11/2016
Expires 1/31/2024
Classification Small
Permit Status Active
Current Permit Application(s) None
Program Applicability
SIP
Compliance Data
Comments: The facility plans on applying for permit exemption based on the
revised/amended 15 NCAC 02Q .0102. Inspection part of WSRO multimedia Inspection Date 08/1812016
program. Inspector's Name Blair Palmer
Operating Status Operating
Compliance Code Compliance - inspection
Inspector's Signature: Action Code FCE
On -Site Inspection Result Compliance
Date of Signature: 08,12312016 AS
Total Actual emissions in TONSIYEAR;
TSP
S02
NOX
VOC
CO
PM10
HAP
2014
0.1710
0.0100
1.19
0.0700
1.0000
0.0240
42.80
2009
0.4300
---
---
---
---
0.1900
0.0258
Five Year Violation History:
Date Letter TYIN Rule Violated
06/10/2014 NOV Permit Permit Condition
Performed Stack Tests since last FCE; None
Da a Test Results Test Method(s)
h Hiehest HAP Emitted
Violation Resolution Date
06/20/2014
Source(s) Tested

Permitted Sources:
Emission Source__.F�_nt_rolContra] System
Emission I C1
Source ED P Description System ED Description
Central mix precast concrete products manufacturing (22.5 cubic yards/hr maximum rated
capacity) consisting of the following:
Flyash Silo
CD-4 Baghouse (264 square feet of filter area)
ES-2
cement Silo
CD-2
Baghouse (132 square feet of filter area)
ES-5
Cement Mixer
F—CD-5
Baghouse (100 square feet of filter area)
Centralmixprecast concrete products manufacturing (15 cubic yards/hr maximum rated capacity)
of the following:
ES-4
Cement silo.
CD-3a —'FB—aghouse
(264 square feet of Ater area)J
Insignificant / Exempt Activities:
Source
I- I - Naturaniquefied Petroleum
Gas -fired Vaporator
(0.7 million Btu per hour
maximum beat input capacity)
1-3 - Steam -heated Kiln
1-4 -Natural/Liquefied Petroleum
Gas -fired Vaporator (0.5 million Btu per hour maximum heat input capacity)
1-5 - Aboveground Storage Tank
containing Diesel (10,000 gallons Capacity)
P
1-6 - Aboveground Storage Tank
containing Diesel (1,000 gallons capacity)
1-7 - Aboveground Storage Tank
containing Liquefied Petroleum Gas
(1,000 gallons capacity)
1-8 -Three (3) Storage Tanks
containing Concrete Admixtures
(1,000 gallons capacity, each)
1-9 - Storage Tank
containing a lignin-based dust suppressarit (1,500 gallons capacity)

Introduction:
On August 18, 2016, Mr. Blair Palmer, DAQ Environmental Specialist and WSRO Multimedia inspector, contacted Mr.
Derek Secrist, Manufacturing Manager, and Mr. Eric Parrish, Plant Manager, both employees of Foltz Concrete Pipe Co.,
for the purpose of an unannounced targeted compliance inspection. This facility was previously inspected by WSRO-
DAQ personnel on June 2, 2015 and the facility appeared to be operating in compliance at that time. The August 18, 2016
inspection also served as a multimedia inspection. A separate storm water report will be written by Mr. Palmer for
DEMLR. Foltz Concrete Pipe Co. is a central mix concrete. batch plant that manufactures precast concrete products and
reinforced concrete pipe. The plant generally operates: 9-10 hours a day, 5 days a week, and 52 weeks a year. [BEAM
contact information was verified with plant personnel and no changes are needed in IBEAM at this time.
Safety:
Safety equipment on the site includes safety shoes, a hard hat, safety glasses, and hearing protection. Inspectors should be
aware of trip hazards, forklifts, and truck traffic throughout the entire premises.
Applicable Regulations:
According to permit Condition A. I of Air Permit No. 05881 R10, this facility is subject to the following regulations: Title
l5A North Carolina Administrative Code (NCAC), Subchapter 2D .0202, 2D .0515, 2D .0521, 2D .0535, 213.0540, 2D
.0611, 2D .1$06, 2Q .0309 and 2Q .0711. This facility is not subject to RMP requirements of the 112(r) program since it
does not use or store any of the regulated chemicals in quantities above the threshold levels in the rule, Foltz Concrete
Pipe Co. is only subject to the General Duty requirements contained in the General Duty Clause,
Discussion:
This facility is divided into two central mix concrete batch plants. One manufactures precast concrete pipes, while the
other produces other pieces such as box culverts, pond detention systems, and grease traps. The central mix precast
concrete pipe plant cunsists of tw;, silos and a mixer. The plant also utilizes a 4 compartment aggregate storage bin.
Aggregate is loaded into the -storage bin via conveyer, and discharged from the bin onto a conveyer that also weighs the
aggregate. The material is conveyed to mixer ES-5. Cement silo ES-2 is filled with cement approximately once a day and
is controlled by bagfilter CD-2. Flyash silo ES -I is filled with flyash about every week and is controlled by bagfilter CD-
4. Each silo's respective bagfilter is located on top of the silo. Neither silo was being loaded during the inspection.
Cement is gravity fed from the silo into a weigh hopper and fly ash is auger fed from the silo to the same weigh hopper.
The materials are then discharged directly into the mixer. The weigh hopper does not exhaust externally. Mixer ES-5
receives the cement, fly ash, and aggregate and is controlled by bagfilter CD-5, located on the platform above the mixer.
Water and admixtures are added to the mixer and the material is discharged onto a conveyer and carried to pipe forms
inside the production building, Rebar reinforced pipes are cured in this large warehouse. In the winter months, a curtain is
put up over the pipes (forming an exempt kiln, I-3) and steam from exempt vaporator 1-1 is pumped in to assist in curing
of the pipes. This was not operating during the inspection since the weather is currently warm and the vaporator is
generally used during colder months.
At the precast plant, cement is delivered to silo ES-4 approximately every day. Emissions from this silo are controlled by
bagfilter CD-3a, located on top of the silo. Cement from this silo is auger fed into a production building and into a weigh
hopper and then a mixer. Aggregate is stored in a two compartment storage bin and conveyed into the building and to the
mixer. Admixtures and water are added to the mixer. This operation discharges wet concrete from the mixer to buckets, '
which are then taken to pre -assembled forms on the plant property. The concrete is poured into the forms and allowed to
cure. LPG -fired vaporator 1-4 is also located on site, but it isn't used at the current time.
All other equipment on the insignificant/exempt activities list, including the 3 fuel tanks (1-5, 16, and 1-7) and 4 chemical
storage tanks (I-8 and I-9), were verified as present. 1-5 is not used at all according to Mr. Secrist.

Permit Conditions/Applicable Regulations:
Condition A.2 contains the 15A NCAC 2Q .0304 and 15A NCAC 2D .0202 permit renewal and emissions inventory
requirements, The permit expires January 31, 2024 and the facility will be required to submit a renewal request and air
pollution emission inventory report for the 2022 calendar year 90 days prior to the expiration of the permit. This process
was discussed briefly with Mr. Secrist, however, the facility plans on requesting rescission due the newla:mcnded DAQ
exemption rules under 15A NCAC 02Q "Activities Exempted From Permit Requirements. " Compliance is indicated at
this time.
Condition A.3 contains the 15A NCAC 2D .0515 particulate control requirement. This condition sets the maximum
allowable particulate emissions rate for concrete batehing using the following two equations:
E = 4.10 * (P)'-" for P <= 30 tonsA
E = 55 * (P) 0-1- 40 for P > 30 tonslh
AP42 Emissions factors were used to calculate potential emissions during permit review R10, and this emissions rate is
met for the mixer even when a bagfilter is not used. The emissions rate is met on the concrete and flyash silos if the
bagfilters are functioning properly, None of the silos were being loaded with material with during the inspection;
however, the bagfilters appeared to be in good working order. Compliance is expected.
Condition AA contains the 15A NCAC 2D .0521 visible emissions control requirement. This plant is limited to 20%
opacity emissions from the vent of the bagfilters and any other stack or vent, As previously discussed, the silos were not
loading during the inspection; therefore, compliance could not be verified.
Condition A,5 contains the 15A NCAC 2D .0535 rule which requires the permittee to notify the DAQ director of any
excess emissions lasting longer than four hours resulting from a malfunction, a breakdown of process or control
equipment or any other abnormal conditions. Mr. Secrist stated that the plant had not had any incidents of excess
emissions. Compliance is anticipated.
Condition A.6 contains the 15A NCAC 2D .0540 fugitive dust control requirement. This facility has a history of
numerous fugitive dust complaints, the most recent being on June 3, 2014; however, the facility has not yet been required
to implement a fugitive dust plan. The facility currently uses a water truck with an additive called Chryso Dust
Suppressant mixed into the water to control fugitive dust. This tank containing the Chryso Dust tank on located on site.
Mr, Secret stated that the facility was not using the dust suppressant as much, and was simply using water. The water
truck was not running during the inspection, due to wet conditions as a result of recent rains. Mr. Palmer did not observe
any fugitive dust emissions leaving the property boundary during the inspection. Mr, Palmer also reminded Mr. Secrist of
this rule. Compliance with 2D .0540 is anticipated.
Condition A.7 contains the 15A NCAC 2D .0611 fabric filter inspection, maintenance, and recordkeeping requirements
for particulate matter emissions control. The facility is required to perform, at a minimum, an annual (for each 12-month
period following the initial inspection) internal inspection of each bagfilter system and perform periodic inspection and
maintenance as recommended by the equipment manufacturer. The facility is required to record the results of all
inspection and maintenance activities in a logbook. According to the log maintained by Mr. Parrish and discussion with
him during the inspection, the following maintenance was performed recently on all 3 bagfilter systems. The facility
performed internal inspections on CD4, CD-2, and CD-5 on July 21, 2016 and no problems noted. CD-3A was last
inspected on July 20, 2016 and this bagfilter had the filters changed during this time. Discussion with plant personnel
indicates that the facility keeps extra bags on -site. Compliance with this condition is demonstrated.
Condition A.g contains the 15A NCAC 2D .1806 control and prohibition of odorous emissions requirements. The process
at this facility is inherently low in odor emissions, so compliance is expected. Mr. Palmer observed no odors while on the
premises,
4

Condition A.10 contains the 15A NCAC 2Q .0711 toxic air pollutant emissions limitation requirement. The condition
states, in part, that the facility shall be operated and maintained in such a manner that emissions of any listed TAPS from
the facility, including fugitive emissions, will not exceed TPERs listed in 15A NCAC 2Q .0711. Calculations in the R07
permit review based on the CY2014 emissions inventory demonstrated that this facility's emissions are multiple orders of
magnitude below the respective TPERS at normal production rates. Below is the table taken from the most recent review
dated February 11, 2016:
i d• i"•I:F• s ! �i 1!e: --. _ •
.''l� !�• _ ��'�"�� � �=�
! i,�
�.•..n. 1�,._ ram• ��.• . _
3
�g
Arsenic (7783941) �� 0.053 Ib/yr 0.0 103 lb/yr — }
Beryllium Metal (7440-41-7)
0.29 lb/yr
0.00019 lb/yr
[_Cadmiun Metal (744043-9) 0,37 lb/yr
~ Chromium VI (So1CR6) 0.013 lb/day
0.0000472 Ib/yr
0.0 000 15 8 lb/day(l) �
F Manganese (MNC) �0.63 lb/day
0,000145 lb1day(2)
Nickel Metal (7440-02-0)
0.13 lb/day
0.0000296 lb/days')
00.00395 lblyr (reported value) _ 250 dayslyr = 0. 0000 15 8 lb/day
�')0.0364 lb/yr. (reported value) - 250 days/yr = 0,000145 lb/day.
t3t0.00739 lb/yr (reported value) � 250 days/yr = 0.0000296 tblday
_
Compliance with 2Q .0711 is demonstrated.
NSPS/NESHAP:
NSPS APPLICABILITY — The facility does not own/operate any sources subject to NSPS rules
promulgated under 40 CFR Part 60,
The exempt Natural/LPG-fired Vaporators (I-1 and I-4) are not subject to 40 CFR Part 60, Subpart Dc
— Standards of Performance for Small Industrial — Commercial — Institutional Steam Generating
Units, because the heat inputs of each do not exceed the applicability threshold of this rule.
The exempt Storage Tanks containing Diesel (I-5 and 1-6) and LPG (I-7) are not subject to 40 CFR
Part 60, Subpart Kb — Standards of Performance for Volatile Organic Liquid Storage Vessels
(Including Petroleum Liquid Storage Vessels) for Which Construction, Reconstruction, or
Modification Commenced After July 23, 1984, because the capacity of each is less than 75 cubic
meters (approximately 19,813 gallons).
NESHAP APPLICABILITY -- This facility does not own/operate any sources subject to NESHAP
rules promulgated under 40 CFR Parts 61 or 63,
The exempt NaturaVLPG-fired Vaporators (I-1 and I-4) are not subject to 40 CFR Part 63, Subpart
JJJJJJ - NESHAP for Area Sources: Industrial, Commercial, and Institutional Boilers, because,
although it is uncertain if the Vaporators are considered as boilers under this rule, it does not apply to
gas -fired units. As mentioned in the R09 review, an Initial Notification Form was received by DAQ
from the Permittee on September 7, 2011 acknowledging that this facility is not subject to this rule.
Foltz Concrete Pipe Co, operating under Air Permit No. 0588R10 does not own or operate an
emergency generator, fire pump, or any other RICE which would be subject to 40 CFR 63 Subpart

ZZZZ - National Emission Standard for Hazardous Air Pollutants for Stationary Reciprocating
Internal Combustion Engines.
PSD APPLICABILITY - This facility is minor for PSD since it does not have the potential to emit more than 250 tons
of any criteria pollutant per year (after controls) and does not own/operate 1 of the 28 named PSD source categories
limited to 100 tons of any criteria pollutant per year (after controls). PMio emissions have been triggered for PSD
increment tracking in Davidson County with a baseline date of November 30, 1978. Increment tracking is not necessary
because there are no modifications associated with this renewal.
Facility Wide Emissions:
The facility wide actual emissions from the CY2014 Emissions Inventory (EI) are listed below and they are taken from
the most permit review by Mr. Leo Governale, WSRO-DAQ Permit Engineer:
"Actual and potential emissions were calculated by this reviewer based on revised information as discussed under 2D .0202
in Section 1I. of this review. Actual emissions were based on the following: (1) Actual production of concrete pipe for CY
2014 of 25,000 cubic yards at 22.5 cubic yards/hr, (2) Actual production of precast concrete structures of 10,000 cubic yards
at 15 cubic yards per hour and (3) Natural Gas consumption of 23.79 mmSCF used by Vaporator 1-1 (Vaporator 1-4 was not
utilized during CY 2014). Potential emissions were based on scaled up totals for the actual values by a factor of 3.510 (8,760
potential _ 2,496 actual CY 2014 reported hours of operation). See Attachment for the full complement of spreadsheets and
supporting information."
n
�'il
MW
��
^:'.
:::
ry .1 .,L��—::�:7:�:2" F9'. �°
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: a�
..r� 'E!F�
{lf �: .,.�ni .
PM
� __.�... 0.171 _ ��
61.30._._.__._--........f
------'-0.278
-...-�..___—....
PM10 -- - ~�
0.024
{ "
27A6
I --
0.083 --
SO2 T
0.01
1
0.03
NO.
1.19
4.18
CO
--� 1.00
3.51
VOC
i 0.07
0.23
�HAPT.Ut f lbs/yr]
1 44.88
183.00
159.91
HAPHighes, (Hexane) f lbs/yr]
42.80
�-
150.00
150-00
Permit Discussion:
The facility plans on applying for permit exemption based on the revised/amended 15 NCAC 02Q .0102.
Compliance History:
Foltz Concrete Pipe Co. has been subject to numerous compliance actions and the previous five-year history is listed
below:
A On June 10, 2014 a Notice of Violation was sent to this facility after it was found that they were operating the
bagfilter CD-3a with town filters, in violation of Condition 13.6 of Air Quality Permit 05881 R09. This facility
responded to this violation in writing, stating that they had replaced the filters, and the violation was resolved.
6

➢ On May 24, 2012 this facility was issued a Notice of Deficiency for operating a mixer and bagfilter without an
Air Quality perrnit. The facility applied for and received a new permit on August 15, 2012 that included the mixer
and bagfilter.
Source Tests:
No stack testing or VE testing has ever been conducted at this facility.
Conclusion
Based on review of records and visual observations, this facility appeared to be operating in compliance with Air Quality
standards and regulations at the time of this inspection.

Compliance Inspection Report
Permit: NCG140014
SOC:
County: Davidson
Region: Winston-Salem
Contact Person: Eric Parrish
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Effective: 07/01/16 Expiration: 06/30/17 owner: Foltz Concrete Pipe Co. LLC.
Effective: Expiration: Facility: Foltz Concrete Pipe Co LLC
11875 N NC Hwy 150
Title:
Certification:
Winston Salem NC 27127
Phone: 336-76"341
Phone:
Inspection Date: 08/1812016 , Entry Time: 08:55AM Exit Time: 11:35AM
Primary Inspector: Blair Palmer �/p Phone: [phone]
Secondary Inspector(s):
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Ready Mix Concrete StormwaterNVastewa ter Discharge COC
Facility Status: ❑ Compliant Not Compliant
Question Areas:
Storm Water
(See attachment summary)
Page: 1

Permit: NCG140014 Owner- Facility: Foltz Concrete Pipe Co LLC
Inspection Date: 08/1812016 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
The facility's is currentely monitoring(analytical only) at one outfall. Some trash was observed at the outfall adjacent and
south of the pond exit discharage point. There is needs to be clarification on what the faiclity should be monitoring and
follow-up will be conducted by DEMLR personnel. The facility does not have a rain gauge on -site, but Mr. Parrish uses a
rain gauage at his residence, which is -- 112 mile away from this facility. There needs to be clarification made on whether
the facility performs truck or vehicle cleaning, as this would trigger waslerwater requirements. Also, the facility uses on
ocassions a product (liquid) mixed with water to control dust on the gravel roads (aka haul roads). The containment
appears to be ok and one diesel tank(10,000 gallon capacity) is not used and it is double walled. No visible spills were
observed during the insepction. Mr. Palmer did reminded Mr. Secrist of the preventative maintenance and housekeeping
requirements for NCG140000 permits.
Page: 2

Permit: NCG140014 Owner • Facility: Foltz Concrete Pipe Co LLC
Inspection Date: 0811812016 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Analytical Monitoring
Has the facility conducted its Analytical monitoring?
# Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas?
Yes No NA NE
❑■❑❑
❑ ❑ E ❑
Comment: Facilitv does not use more than 55 oallons of motor oil per month. Facility conducted monitorin
on 4/1/2016 and results indicate compliance results attached to the file report). The results for
the last half of 2015 were conducted on 7/15/2015 and indicate compliance. No sampling was
taken during the 1st half of 2015. It should be noted that the facility has not been submitting their
reports to Raleigh. They were advised to start doing so. One outfall is used, which may not be
totally correct for monitoring at this particular facility. Further discussion on "Summal}(." The
outfall currents being monitored is at the exit point of the pond and located at 35 59' 28" N and 80
16' 26." A second outfall, not monitored, is located at the far northern section of property and it
is located at 35 59 37 N and 80 16 20 W. A third outfall near the pond, but southwest of it is not
being monitored it is located at 35 59 27 N and 80 16 25 W.
Permit and Outfalls Yes No NA NE
# Is a copy of the Permit and the Certificate of Coverage available at the site? ❑ E ❑ ❑
# Were all outfalls observed during the inspection? 0 ❑ ❑ ❑
# If the facility has representative outfall status, is it properly documented by the Division? ❑ ❑ 0 ❑
# Has the facility evaluated all illicit (non stormwater) discharges? ❑ ■ ❑ ❑
Comment: As mentioned above, the facilitv has been onlv been monitorina one outfall at the exit point of the
pond. There is an additional outfall located in the far nothern section of the property (see file
photo)- and another outfall located adjacent and to the southwest of the pond. There are actually
two pipes feadiing into a small basin then one pipe leading into creek or tributary see file photo).
Some water was observed exiting this pipe and it appeared to clear and somewhat milky. There
was evidenc a of erosion at all but one(pond) outfall. COC has been automatically extended to
6/30117.
Qualitative Monitoring
Has the facility conducted its Qualitative Monitoring semi-annually?
Yes No NA NE
❑ S ❑ ❑
Comment: The facility has not performed any qualitative monitoring for at least the last 6 years. No records
could be found. Facility advised to start monitoring.
5tormwater Pollution Prevention Plan
Yes No NA NE
Does the site have a Stormwater Pollution Prevention Plan? S ❑ ❑ ❑
# 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? ❑ ❑ ❑
Page: 3

Permit: NCG140014 Owner • Facility: Foltz Concrete Pipe Co LLC
Inspection Date: 0811812016 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Stormwater Pollution Prevention Plan
# 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?
Has the Stormwater Pollution Prevention Plan been implemented?
Comment: SPPP hasn't been updated since 2010. The current mao for locatina outfalls needs to be
Yes No NA NE
❑ ❑ ❑
M ❑ ❑ ❑
0❑❑❑
■❑❑❑
❑■❑❑
❑■❑❑
❑ M ❑ ❑
❑■❑❑
❑ M ❑ ❑
updated and clearly labeled, along with GPS coordinates. No employee training has been done
alt least since 2010. The current plan needs to have at least Eric Parrish, Plant Manager, added
onto_ since he does analytical monitoring at this site. There is no inspection program being done
at the facility. The Stormwater Pollution Prevention Plan has and is not being implemented.
Page: 4

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aceAnalytical
www.paaalabS-="
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
July 23, 2015
Mr. Derek Secrist
Foltz Concrete Pipe Company
11875 North NC Highway 150
Winston Salem, NC 27127
RE: Project: 280159
Pace Project No.: 92258836
Dear Mr. Secrist:
Enclosed are the analytical results for sample(s) received by the laboratory on July 15, 2015. The
results relate only to the samples included in this report. Results reported herein conform to the
most current TNI standards and the laboratory's Quality Assurance Manual, where applicable, unless
otherwise noted in the body of the report.
Analyses were performed at the Pace Analytical Services location indicated on the sample analyte
page for analysis unless otherwise footnoted.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Liamm Carrubba
[e-mail]
Project Manager
Enclosures
cc: Ms. Ouida Campbell, Foltz Concrete Pipe Company
.;p�Ac
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Page 1 of 9

,�acmnalyficalo
www.pacarabs.cam
Project: 280159
Pace Project No.: 92258836
Pace Analytical Se5rlces, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Asheville Certification IDs
2225 Riverside Drive, Asheville, NC 28804
Florida/NELAP Certification #:.E87648
Massachusetts Certification #: M-NC030
North Carolina Drinking Water Certification #: 37712
CERTIFICATIONS
North Carolina Wastewater Certification #: 40
South Carolina Certification #: 99030001
West Virginia Certification #: 356
UrginiaNELAP Certification #: 460222
REPORT OF LABORATORY ANALYSIS
This report shall not he reproduced, except in full,
without the written consent of Pace Analytical Services, Inc- Page 2 of 9

1��a�eAnalyficalo
www,pacelabs.com
f
1
SAMPLE ANALYTE COUNT
Pace Analytical Services, Inc.
9800 KinceyAve. Suite 100
Huntersville, NO 28078
(704)87$-9082
Project: 280159
Pace Project No.: 92258836
Analytes
Lab ID Sample 1D Method Analysts Reported Laboratory
92258836001 FOLTZ 1 SM 2540D MDW 1 PASI-A
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in toil,
without the written consent of Pace Analytical Services, Inc.. Page 3 of 9

,�aeAnalytical
www.pacelabs.com
ANALYTICAL RESULTS
Project: 280159
Pace Project No.: 92258836
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Sample: FOLTZ 1 Lab iD: 92258836001 Collected: 07/14/15 11:00 Received: 07/15/15 15:35 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qua]
2540D Total Suspended Solids Analytical Method: SM 2540D
Total Suspended Solids 37.7 mg1L 14.3 1 07/19/15 13:32
Date: 07/23/2015 10:23 AM
-REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Page 4of9

UY
((( aceAnapical"
www.pacelabs.00m
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Project: 280159
Pace Project No.: 92258836
QC Batch; WET138925 Analysis Method: SM 2540D
QC Batch Method: SM 2540D Analysis Description: 2540D Total Suspended Solids
Associated Lab Samples: 92258836001
METHOD BLANK: 1513066 Matrix: Water
Associated Lab Samples: 92258836001
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Total Suspended Solids mg/L ND 2.5 07/19/15 13:26
LABORATORY CONTROL SAMPLE:
1513067
Spike LCS LCS
% Rec
Parameter
Units
Conc. Result % Rec
Limits Qualifiers
Total Suspended Solids
mg/L
250 272 109
90-110
SAMPLE DUPLICATE: 1513068
92259327001 Dup
Parameter
Units
Result Result RPD
Qualifiers
Total Suspended Solids
mg/L
260 252
3
SAMPLE DUPLICATE: 1513069
92258836001 Dup
Parameter Units Result Result RPD Qualifiers
Total Suspended Solids mg/L 37.7 38.9 3
Results presented on this page are in the units indicated by the 'Units" column except where an allemate unit is presented to the right of the result
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 07/23/2015 10:23 AM without the written consent of Pace Analytical Services, Inc..
Page 5 of 9

aceAnalytical
"W.pacslabs.WM
I
Pace Analytical SeVices, Inc.
9800 Kincey Ave. Suite 100
Huntersville. NC 28078
[phone]
QUALIFIERS
Project: 280159
Pace Project No.: 92258836
DEFINITIONS
DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot.
ND - Not Detected at or above adjusted reporting limit.
J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit.
MDL -Adjusted Method Detection Limit.
PQL - Practical Quantitation Limit.
RL - Reporting Limit.
S - Surrogate
1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each anatyte is
a combined concentration.
Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values.
LCS(D) - Laboratory Control Sample (Duplicate)
MS(D) - Matrix Spike (Duplicate)
DUP - Sample Duplicate
RPD - Relative Percent Difference
NC - Not Calculable.
SG - Silica Gel - Clean -Up
U - indicates the compound was analyzed for, but not detected.
Acid preservation may not be appropriate for 2 Chloroethylvinyl ether, Styrene, and Vinyl chloride.
A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis ofAcrolein and Acrylonitrile by EPA
Method 8260.
N-Nitrosodiph enyla mine decomposes and cannot be separated from Diphenyiamine using Method 8270, The result reported for
each analyte is a combined concentration.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TNI - The NELAC Institute.
LABORATORIES
PASI-A Pace Analytical Services -Asheville
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full.
Date: 07/23/2015 10:23 AM without the written consent of Pace Analytical Services, Inc.. Page 6 of 9

Pace Analytical Services, Inc.
0 9800 Kincey Ave. Suite 100
aceAnalytical Huntersville, NC 28078
wwwpecefabs•earo [phone]
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: 280159
Pace Project No.: 92258836
Analytical
Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch
92258836001 FOLTZ 1 SM 2540D WET/38925
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except In full,
Date: 07/23/2015 10:23 AM without the written consent of Pace Analytical Services, Inc.. Page 7 of 9

/,.f��ceArtalytical waljt `c vviluriruji U Url muce1 L (OUUKI rage '1 Uf L"
r DocumentNumber: Issuing Authority:
F-CHR-CS-003-t•ev.16 Pace Huntersville Quality Office
Client Name: VOIV, (.16cfet eL
Courier: ❑ Fed Ex ❑, UPS❑ USPS❑ Client❑ Commercial❑ Pac Other
Custody Seal on Cooler/Box Present: ❑ yes ❑ EnoSeals intact: ❑ yes
r
Packing Material: ❑ Bubble V❑1p one Other
Thermometer Used: Gun T14 ome IR G 01 Type of ice:. Wet Blue None
Temp Correction Factor T1401 No Correction
' Page 2 of 2 Is for Wernaf Use Only
❑ no
L Samples on Ice, cooling process has begun
A
Corrected Cooler Terri •C
p"
Temp should be above freezing to 6°C.
Biologlcaf Tissue ls`Frozen: Yes' N NI
Comments:
Date a.nd,l 10 1 ofp r on examining
contents:
Chain of Custod Present:
is es ONO
NIA
1,
Chain of Custod Filled Out:
©Yes o
❑NIA
2.n0
Chain of Custody Relinquished:
Oyes No
❑NIA
3.
Sampler Name & Signature on COG:
P49 , ❑Na
❑NIA
4,
Samples Arrived within Hold Time:
Yes ONO
❑NIA
5.
Short Hold Time Analysis !tMr :
©Yes o
❑NIA
6.
Rush Turn Around Time Requested:
Dyes 1240
❑NIA
7,
Sufficient Volume:,
❑Yes No
❑NIA'
8. ,
Correct Containers Used:
-Pace Containers Used:
�01 No
[la1'es " No
❑NIA
❑NIA
9,
Containers Intact:
113 es ONO
❑NIA
A 0.
Filtered volume received for Dissolved tests
❑Yes ONO
IA
11,
Sample Labels match COG:
-Includes date/timelID/Anal sis Matrix:
Dyes o
❑N/A
12.-tL IAe' 6oc5 1)04-
001 a,-) 60Y- V')
�q)aE(j-) CvC
; 00 Oq- C0c
All containers needing preservation have been checked.
All containers needing preservation are`found to be in
compliance with EPA recommendation.
exceptions: VOA, eoliform, TOC, 0&G, WI-t)RO (water)
❑Yes ONO i} t(
Dyes ❑No ®®®tGIA
j
Oyes ! o
111
Samples checked for dechlorination:
Dyes ❑No
92r
14.
Heads ace in VOA Vials >6mm :
Dyes ONO
(h dlA
16.
Trip Blank Present:
Trip Blank Custody Seals Present
Pace'Tri -Blank Lot # if urchased : __ -....-
Dyes ONO
Dyes ONO
.......... . .....-..__...._...
W IA
01/A
16,
_ ... _... _e.._........_.... _"_..
_..._..... - - ----
Client Notification/ Resolution: Field Data Required? Y 1 N
Person Contacted: DatelTime:
Comments/ Resolution:
SCURF Review: - ' Date: 1 c
SRF Reviewl bate:: -i
Note: Whenever there.is a:discrepancy affecting North Carolina compilance
samples,.a copy of this form will be sent to the North Carolina DEHNR
Certification:Offlce ( I.e out of hold,. Incorrect preservative, Tout of temp,
Incorrect containers)
1111111111hil �1�1 t ff ttt T
Page 8 of 9

Q
16Pacek7al ical'
rrtvrr.oaeeWtes.cam
CHAIN -OF -CUSTODY I Analytical Request Document
The Chain -of -Custody is a LEGAL DOCUMENT. All relevant fields must be completed accurately.
0
III
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Section A Section B Section C
Page: of
Raquired Client Informaton: Required Project Information: Invoice Information:
C(-pany'.,G#, ReportTo: Attention:
1837713
f�� seer ��
1lddress:
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Copy To:
J „ `�L_.
Company Nanw:
.
REGULATORY AGENCY
Fr�St_� A. C
Address:—
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r UST RCRA s OTHER
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Email To
Purchase order No.: ��J�:,
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Phone:
Fax: i Cow►
Project Name: -
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Site Location
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STATE:
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" aOeAnalytical.
www.pacelabs.com
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Nuntersville, NC 28078
[phone]
April 07, 2016
Mr. Derek Secrist
Foltz Concrete Pipe Company
11875 North NC Highway 150
Winston Salem, NC 27127
RE: Project: Stormwater
Pace Project No.: 92292254
Dear Mr. Secrist:
Enclosed are the analytical results for sample(s) received by the laboratory on April 01, 2016. The
results relate only to the samples included in this report. Results reported herein conform to the
most current TNI standards and the laboratory's Quality Assurance Manual, where applicable, unless
otherwise noted in the body of the report.
Analyses were performed at the Pace Analytical Services location indicated on the sample analyte
page for analysis unless Otherwise footnoted.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Liamm Harrison
[e-mail]
Project Manager
Enclosures
cc: Ms. Ouida Campbell, Foltz Concrete Pipe Company
NC6�
r
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of PaceAnalytical Services, Inc..
Page 1 of 10

,�acmnalyfical'
www.Pacalabs.cam
Project: Stormwater
Pace Project No.: 92292254
Pace Analytical Services, Inc.
9800 KlnceyAve ,*Suite 100'
Huntersville, NC 28078
[phone]
Asheville Certification IDs
2225 Riverside Drive, Asheville, NC 28804
FloridalNELAP Certification #: E87648
Massachusetts Certification #: M-NC030
North Carolina Drinking Water Certification #: 37712
CERTIFICATIONS
North Carolina Wastewater Certification #: 40
South Carolina Certification #: 99030001
VirginiaNELAP Certification #: 460222
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc.. Page 2 of 10

aceAnalytical.
www.p8ca7ebsown
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
SAMPLE ANALYTE COUNT
Project: Stormwater
Pace Project No.: 92292254
Analytes.
Lab ID Sample ID Method Analysts Reported Laboratory
92292254001 OUTFALL #1 SM 2540D MSH 1 PASI-A
EPA 9040 MLS 1 PASI-A
i
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in fuil,
without the written consent of Pace Analytical Services, Inc.. Page 3 of 10

,�www.pamitibs.comeAnalytical"
ANALYTICAL RESULTS
Pace Analytical Services, Inc.
9800 Kincey Ave.' Suite 100"
Huntersville, NC 2BO78
(7 04 )875-9092
Project: Stormwater
Pace Project No.: 92292254
Sample: 0UTFALL#1 Lab ID: 92292254001 Collected: 04/01/16 08:00 Received: 04/01/16 15:00 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qua[
25400Total Suspended Solids Analytical Method: SM 2540D
Total Suspended Solids 4.2 mg1L 2.5 1 04/04/16 22:12
9040 pH Analytical Method: EPA 9040
pH 7.3 Std. Units 0.10 1 04/04/16 12:55 H6
Date: 04/07/2016 08:11 AM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical services, Inc..
Page 4 of 10

U
eAnal ical
t+vvw.pecelab&wm
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NG 28078
[phone]
QUALITY CONTROL DATA
Project: Stormwater
Pace Project No.: 92292254
OC Batch: WET144007
Analysis Method:
SM 2540D
QC Batch Method: SM 25400
Analysis Description:
2540D Total Suspended Solids
Associated Lab Samples: 92292254001
METHOD BLANK: 1701550
Matrix: Water
Associated Lab Samples: 92292254001
Blank Reporting
Parameter
Units
Result Limit
Analyzed Qualifiers
Total Suspended Solids
mg/L
ND
2.5 04/04/16 22:08
LABORATORY CONTROL SAMPLE: 1701551
Spike LCS
LCS % Rec
Parameter
Units
Conc. Result
% Rec Limits Qualifiers
Total Suspended Solids
mg1L
250 244
98 90-110
SAMPLE DUPLICATE: 1701552
92292298001 Dup
Parameter
Units
Result Result
RPD Qualifiers
Total Suspended Solids
mg1L
200
172 15 D6
SAMPLE. DUPLICATE: 1701553
92292311005 Dup
Parameter
Units
Result Result
RPD Qualifiers
Total Suspended Solids
mg/L
ND
ND
Results presented on this page are In the units Indicated by the "Units" column except where an alternate unit Is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 04/07/2016 08:11 AM without the written consent of Pace Analytical Services, Inc.. Page 5 of 10

aceAnalytrcal
wwwpacafabs.com
QUALITY CONTROL DATA
Project: Stormwater
Pace Project No.: 92292254
QC Batch: WET143992 Analysis Method: EPA 9040
QC Batch Method: EPA 9040 Analysis Description: 9040 pH
Associated Lab Samples: 92292254001
SAMPLE DUPLICATE: 1700877
92291971002 Dup
Parameter Units Result Result RPD Qualifiers
pH Std. Units 6A 6.5 0 H6
Pace Analytical Services, Inc.
9800 Ki ncey Ave.' Su ite 100'
Huntersville, NC 28078
[phone]
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 04/07/2016 08:11 AM without the written consent of Pace Analytical Services, Inc..
Page 6 of 10

aCeAnal r'cal.
wwwpacwabs.com
Pace Analytical Services, Inc.
9800 KinceyAve. Suite 100
Huntersville, NC 28078
[phone]
QUALIFIERS
Project: Stormwater
Pace Project No.: 92292254
DEFINITIONS
OF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot.
NO - Not Detected at or above adjusted reporting limit.
J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit.
MOL - Adjusted Method Detection Limit.
PQL - Practical Quantitation Limit.
RL - Reporting Limit.
S - Surrogate
1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each analyte is
a combined concentration.
Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values.
LCS(D) - Laboratory Control Sample (Duplicate)
MS(D) - Matrix Spike (Duplicate)
DUP - Sample Duplicate
RPD - Relative Percent Difference
NC - Not Calculable.
SG - Silica Gel - Clean -Up
U - Indicates the compound was analyzed for, but not detected.
Acid preservation may not be appropriate for 2 Chloroethylvinyl ether, Styrene, and Vinyl chloride.
A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis ofAcrolein and Acrylonitfile by EPA
Method 8260.
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270, The result reported for
each analyte is a combined concentration.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TNI - The NELAC Institute.
LABORATORIES
PASI-A Pa ce An a lytical Services - Asheville
ANALYTE QUALIFIERS
D6 The precision between the sample and sample duplicate exceeded laboratory control limits.
H6 Analysis initiated outside of the 15 minute EPA required holding time.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 04/07/2016 08:11 AM without the written consent of Pace Analytical Services, Inc.. Page 7 of 10

Pace Analytical Services, Inc.
,A�eAnalytical ® 9B00Hun a sville, NC128078`
ac
www.pacelabs.rom
[phone]
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: Stormwater
Pace Project No.: 92292254
Analytical
Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch
92292264001 OUTFALL #1 SM 2540D WET/44007
92292254001 OUTFALL #1 EPA 9040 WET/43992
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 04/07/2016 08:11 AM without the written consent of Pace Analytical Services, Inc., Page 8 of 10

uocumeni rvame:
Sample Condition Upon Recel
aceAnalytical ` Document No.:
F-CHR-CS-003-rev,18
uucurnenr nevisru:lorcowlo
Page 1 of 2
Issuing Authority:
Pace Huntersvllle Quality Office
Client Name:
Project #;
�0{ f t 1 .om
Courier: ❑F d Ex [-]UPS❑USPS CIle t
❑ Commercial V Pace [--]Other:
—
Custody Seal Present? []Yes [�No, Seals Intact? C ?Yes []No
ld0#:92292254
11111111:11111111111111
92292254
Date/initials Person Examining Contents: I it I j.(i
Packing Material:_ []Bubble Wrap ❑Bubble Bags [None []Other:
Thermometer: ❑ 3,rj Type of Ice: Wet ['�1505 ❑Blue ❑None ❑Samples on ice, cooling process has b un
Correction Factor: O.0'C Cooler Temp Corrected ('C): 31 Biological Tissue Frozen? [:]Yes[:]No/A
Temp should be above frq&ing to 6'C
USDA Regulated Soil ( En N/A, water sample)
Did samp!2!,Prlglnate in a quarantine zone within the United States: CA, NY, or SC (check maps)? Did samples originate from a foreign source (intern tonally,
❑Yes No Including Hawaii and Puerto RICO)? ❑Yes PNo
COMMENTS:
Chain of Custody Present?
♦ZYes
©No ❑N/A
1.
Chain of Custody Filled Out?
Yes
[]No M
N/A
2.
Chain of Custody Relinquished?
0<S
❑No
N/A
3.
Sampler Name and/or Slgnature an COC?
Efyes
[:]No ❑N/A
4.
Sam ies Arrived within Hold Time?
Zyes
QNQ
N/A
S.
Short Hold Time Analysis 1<72 hr.)?
s
No ❑N/A
b.
Rush Turn Around Time Requested?
❑Yes
dNo ❑N/A
7.
Sufficient Volume?
Llves
[I No ❑N/A
8,
Correct Containers Used?
Eyes
❑No ❑N/A
9.
-Pace Containers Used?
t_1) s
[:]No ❑N/A
Containers Intact?
Yes
ONO 1:1 NIA
10.
Filtered Volume Received for Dissolved Tests?
❑Ye"s
❑No
N/A
11, Note If sediment is visible in the dissolved container
Sample Labels Match COC7
s
No (--]N/A
12. ;u 0 A0C-{V5' 1S On C 0 G
-Includes Dateltime/ID/Anal sis Matrix: r
All containers needing acid/base preservation have been
checked?
[]Yes
❑No
N/A
13
All.containers needing preservation are found to be In
compliance with EPA recommendation?
(HNO3, H2SO4, HCI<Z; NaOH >9 Sulfide, NOCH>12 Cyanide)
[]Yes
[:]No W/A
Exceptions: VOA, Coliform, TOC, Oil and Grease,
DRO/8015 (water) DOC,LLHg
❑Yes
❑No E
/A
Samples checked for dechlorination
Yes
[:]No
/A
14.
Heads ace In VOA Vials (>5-6mm)?
❑Yes
❑Na dflA
15.
Trip Blank Present?
❑Yes
❑No /A
16,
T`rip Blank Custody Seals Present?
[_-]Yes
[:]NO WN/A
Pace Trfp l3lank lot H (if purchased):
CLIENT NOTIFICATION/RESOLUTION
Person Contacted:
Date/Time:
Field Data Required? [-]Yes []NO
_... Comments Resolution. - ------
Project Manager SCURF Review: �-.V\ Date: t L \ - V l —� `P
Project Manager SRF Review: _ �$\ Dater 0 L J —0ZL -I iG.
Note: Whenever there is a discrepancy affecting North Carolina compliance samples, a copy of this form will be sent to the North Carolina DEHNR Certification Office (i.e.
,Out of hold, Incorrect preservative, out of temp, Incorrect containers)
Page 9 of 10

i,
CHAIN -OF -CUSTODY / Analytical Request Document
re
The Chain -of -Custody is a LEGAL DOCUMENT. All relevant fields must be completed accurately.
Section A Section a Section C
Required Client Information: Required Project Infornialion: Invoice Information: Pa 8 :
1 Of 1
Company- Folrz Concrete Pipe Company Report To: pew Secrisl Ananliom
Address: 11875 North NC Highvray 150
Copy To:
Company Name:
Winston Salem, NC 27127
Address:
ra2i si ELF ,h li F
!O
FI
Email: derek,seuist- ads- ipe.cem
Purchase Order #:
Face Quote:
'- E
Phene: (336j7644D341 JFax
Project Narne: Slormwater
Pate Project Manager: liamm.harrise pacelabs.00m,
Requested Due Date'
Project #; .
Pace Profile -#;, 3979.1
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STOROVIWATER POLLUTION PREVENTION PLAN
Foltz Concrete Pipe Co., LLC
11875 North Highway 150
Winston-Salem, NC 27127
1. Maps
A general location map based on USGS quadrangle map and site map have been attached.
2. Stormwater Management Plan
A) Feasibility Study
Liquid materials that are stored outside and that could potentially contaminate stone water are
housed in tanks with secondary containment.
Other externally stored materials are stone and sand used in the manufacture of concrete. These
are placed in outside bins with retaining walls. The material is then placed in a hopper with a
loader and transported by conveyor belt into the elevated holding hoppers.
A biodegradable form oil is stored in a dip tank in the plant or in spray tanks in the plant. There
are no floor drains in the plant, so any spill would be cleaned up without any material leaving the
building.
There are no additional plans to address material storage at this time.
B) Secondary Containment Schedule
Liquid materials that are stored outside consist of:
Diesel fuel: 1- 10,000 gallon tank not currently being used but has secondary containment and
is under roof.
Diesel fuel: 1 - 1000 gallon tank for off -road diesel and has secondary containment.
The secondary containment areas do not have drains. The containment area is observed and
pumped out as needed to maintain adequate capacity. Any stormwater that accumulates in the
containment area is visually observed for color, foam, outfall staining, and visible sheens, prior
to release of the accumulated stormwater. Accumulated stormwater is released if found to be
uncontaminated by the material stored within the containment area. Records documenting the
individual making the observation, the description of the accumulated stormwater and the date
and time of the release are kept for a period of five years.
C) BMP Summary
The containment schedule for the external diesel fuel storage is discussed in part B.
1 Foltz Concrete Pipe Co., LLC 12/15/10

Cement silo is fully contained. Cement is blown directly from tanker truck into sealed silo.
Cement is hen augered into weigh hopper and discharged into mixer.
Fly ash silo is fully contained. Fly ash is blown directly from tanker truck into sealed silo. Fly
ash is then augered into weigh hopper and discharged into mixer.
A biodegradable form oil is stored in a dip tank in the plant or in spray tanks in the plant. There
are no drains in the plant, so any spill would be cleaned up without any material leaving the
building.
Other materials stored outside are the stone and sand used in the manufacture of concrete. These
are placed in outside bins with retaining walls. The material is then placed in a hopper with a
loader and transported by conveyor belt into the elevated holding hoppers.
All pipe is manufactured inside a building, then transported outside after curing. The pipe is
staged in the yard for final inspection and preparation to ship, then stacked in piles to await
shipment. Precast is poured outside on a concrete slab and moved to the storage yard after
curing.
Dust is generated by the movement of vehicles across the yard. This is being controlled by the
application of water. Additional dust suppressants are being investigated. Additionally, catch
basin inserts have been installed in all yard catch basins to treat yard runoff for total suspended
solids and oil and grease.
3. Spill Prevention and Response Plan
Responsible personnel — Derek Secrist - [phone].
The storage of external liquid sources is performed within tanks that are secondary contained.
Dry materials that could potentially contaminate storm water are contained within silos and
transported to within the plant via conveyors.
There are no floor drains within the building that discharge to the external storm water sources.
Based on the above, there is little to no potential of pollutant sources coming in contact with
storm water. at the site.
4. Preventative Maintenance and Good Housekeeping Program
The secondary containment areas do not have drains_ The containment area is observed and
pumped out as needed to maintain adequate capacity. Any stormwater that accumulates in the
containment area is visually observed for color, foam, outfall staining, and visible sheens, prior
to release of the accumulated stormwater. Accumulated stormwater is released if found to be
uncontaminated by the material stored within the containment area.
2 Foltz Concrete Pipe Co., LLC 12/15/10

The yard catch basin inserts are visually inspected semi annually and records kept of the level of
collected material. Once the level of collected material reaches 3/4 of the capacity of the filter or
%4 freeboard is remaining, the inset will be replaced.
Records documenting the individual making the observations and descriptions of the
accumulated stormwater and collected materials and the date and time of the activities are kept
for a period of five years.
5. Employee Training
Responsible personnel — Derek Secrist - [phone].
Training is provided for all employees on an annual basis for proper spill response and cleanup /
procedures and preventative maintenance activities.
6. Responsible Party
Responsible personnel Derek Secrist - [phone].
Personnel shall be responsible for the overall coordination, development, implementation, and
revision to the Plan.
7. Plan Amendment
The Plan shall be amended whenever there is a change in design, construction, operation, or
maintenance, which has a significant effect on the potential for the discharge of pollutants to
surface waters.
The Stormwater Pollution Prevention Plan shall be reviewed and updated on an annual basis.
8. Facility Inspection Program
All BMP's and stormwater systems will be inspected on a semiannual schedule, once in the fall
(September -November) and once during the spring (April - June). The inspection and any
subsequent maintenance activities performed will be documented, with date and time of
inspection, individual(s) making the inspection, and any comments recorded.
Records of these inspections have been incorporated into the Stormwater Pollution Prevention
Plan.
Stormwater discharge characteristic monitoring is also being performed in addition to facility
inspections and records have been incorporated into the Stormwater Pollution Prevention Plan.
3 Foltz Concrete Pipe Co., LLC 12/15/10

CERTIFICATION STATEMENT

Compliance Inspection Report
Permit: NCG140014 Effective: 07/01/11 Expiration: 06/30/16 Owner: Foltz Concrete Pipe Cc LLC
SOC: Effective: Expiration: Facility: Foltz Concrete Pipe Cc LLC
County: Davidson 11875 N NC Hwy 150
Region: Winston-Salem
Winston Salem NC 27127
Contact Person: Eric Parrish Title: Plant Manager Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
On -site representative Derek Secrist Phone: [phone]
Related Permits:
Inspection Date: 0310612012 Entry Time: 11:25 AM Exit Time: 12A5 PM
Primary Inspector: Jenifer Carter Phone: [phone]
Secondary Inspector(s):
Reason for Inspection: Complaint Inspection Type: Compliance Evaluation
Permit Inspection Type: Ready Mix Concrete StormwateriWastewater Discharge
COC
Facility Status: © Compliant Not Compliant
Question Areas:
10 Storm Water ti
(See attachment summary)
Page: 1

Permit: NCG140014 Owner - Facility: Foltz Concrete Pipe Co LLC
Inspection Date: 03/06/2012 Inspection Type: Compliance Evaluation Reason for Visit: Complaint
Inspection Summary:
This is inspection prompted by a complaint of milky colored water. After the inspection, the complaintant said she
regretted calling after realizing the 'milkyness' was from sediment possible from construction of nearby Dollar General, but
that the problem disappeared a long time ago.
The entire site was walked during the inspection to look for potential releases. At the upstream -most side of the site,
there was a storm drain that looks to have overtopped during recent rains, though the water leaving the site was clear
during the visit. Mr. Secrist agreed to take corrective actions to reinforce the outlet protection already in place.
No other problems were noted. They currently monitor two outfalls, though one is upstream of the other, meaning only
the downstream most outfall is required by the permit to be monitored.
Page: 2

Permit: NCG1a0014 Owner - Facility: Foltz Concrete Pipe Cc LLC
Inspection Date: 0310612012 Inspection Type: Compliance Evaluation
Reason for Visit: Complaint
Stormwater Pollution Prevention Plan
Yes
No
NA
NE
Does the site have a Stormwater Pollution Prevention Plan?
®
n
n
n
# Does the Plan include a General Location (USGS) map?
®
n
n
n
# Does the Plan include a "Narrative Description of Practices"?
®
n
n
n
# Does the Plan include a detailed site map including cutfall locations and drainage areas?
®
n
n
n
# Does the Plan include a list of significant spills occurring during the past 3 years?
®
n
n
n
# Has the facility evaluated feasible alternatives to current practices?
®
n
n
n
# Does the facility provide all necessary secondary containment?
®
n
n
n
# Does the Plan include a BMP summary?
®
n
n
n
# Does the Plan include a Spill Prevention and Response Plan (SPRP)?
®n
n
n
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
®n
n
n
# Does the facility provide and document Employee Training?
®
n
n
n
# Does the Plan include a list of Responsible Party(s)?
®
❑
n
n
# Is the Plan reviewed and updated annually?
®
n
n
n
# Does the Plan include a Stormwater Facility Inspection Program?
®
n
n
n
Has the Stormwater Pollution Prevention Plan been implemented?
®
n
n
n
Comment:
Qualitative Monitoring
Yes No
NA
NE
Has the facility conducted its Qualitative Monitoring semi-annually?
® n
n
n
Comment:
Analytical Monitoring
Yes No
NA
NE
Has the facility conducted its Analytical monitoring?
0 n
n
n
# Has the facility conducted Its Analytical monitoring from Vehicle Maintenance areas?
n n
®
n
Comment: Lab results show that benchmark valises met. Settleable Solids had not
been done, so discussed changes to renewed permit.
Permit and Outfalls Yes No NA NE
# Is a copy of the Permit and the Certificate of Coverage available at the site?
m
n
n n
# Were all outfalls observed during the inspection?
o
n
n n
# If the facility has representative outfall status, is it properly documented by the Division? n n
# Has the facility evaluated all illicit (non stormwater) discharges? M n n n
Comment:
Page: 3

THIS NAP IS SUBJECT TO ANY
CASEMENTS OR RIGHTS -OF -WAY OF
RECORD PRIOR TO THE DATE OF
THIS MAP WHETHER VISIBLE OR NOT
TITLE SEARCH NOT PROVIDED.
Z4�QiR'� E S,Sj��ifyq i
SEAL-
L-- 3320
'r'.i '1�
:y�. : Cj
P
n
NOTES,
1. Entire area within property line Is
drainage area
2. There are no stormwater/wastewater
treatment structures on site.
3. Entire site is impervious except for
roof surfaces There Is no pavement
on site,
4. There have been no significant splUs
reported over the last 3 years
r= -• --
/ now or formerly
SSgO /
NORTH LAKE OWNERS
41.
ASSGCIATI❑N
ff f DB 1661 PG 1397
I
f
`S5. / PB 39 PG 97
/ \ ewm„wet .nt,m S 89'-11'-50" E >
447.80'
►ee aa.
moor ewlt .nn
�
\ 11 f /��arrl.q to'
O
�
waJtery
J
I AI
3
t
T
I
iG)Y
1 o N
Rock
n n
L} o
Storage
n
our
t o I O
❑�
cn
o0: In 1
(
I
Sand
v
Coo
Storage
/
Cement
❑
/
Storage
r
!
I
1
now or Formerly f ❑
ent L
NORTH LAKE OWNERS ASSOCIATION !C7
jFty
AshD8
1661 PG 1397 i rage
PB 39 PG 97 %
4ef
1
/
❑ � �
N
APRq,gMATE ROUNDRY 1
FOR DRAINAGE AREAS /
/ rrn o ¢L
! TFUS LOT 2D � 21
/ 9.816 Ae.+/-
! Tl
l
j
J
Sand Storage
S 1'-56'-15" W
71.15'
Rock Storage
S 20•-26'-17' w
73.32'
now or Formerly
HUBBARD REALTY
DB 985 PG 348
< N 87'-06'-51' W 289.02' — — —
180.56' 08.46' — — -
I
� now or formerly
WILLIAM REEVES, JR.
ltil now or formerly ➢B 477 PG 491
N
/ / . v
N
/ % s /9) Diesel Fuel
ter_ 1{'r'Sf' Storage
Seco d
LEGEND
now or formerly
Line Surveyed (or calculated)
13NIIBEl889 IFTY, LLC
605
Line Not Surveyed —
— — — — —
Iron Found
c
Iron Set
C
Point not monumented
Stream or Creek -...—...—...-
Concrete monument
t7
Power Pole
U -
Sanitary Sewer Man Hale
Qs
Well
0
Electric Overhead Line
r
Street Address
m Storwater Outfoll
0
Stormwater Catch Basin inlet
Property Line
- - - - - - -
JACOB ADER heirs I
DB 477 PG 916
no* or formerly
fCONCEPCI❑N REEVES
DB 1884 PG 548
n my o
Contained
p-
J
/iial vb . .
/ �P1` �4 e.mu�edt .lei
/ 3.5
N
W
TOTAL AREA
13.338 Ac.+/-
1 VICINITY tno stole,
'Ye
100 50 0 M '
NAP FOR
E❑LTZ CONCRETE PIPE C❑,,LLC SITE PLAN
1" - �2PIEIISION
BY COORDINATES
22 MA1 10,000 +
DAVIDSON CO. NC. ARCADIA TOWNSHIP TAX MAP 3 TAX LOT 21
REF:DS 1064 PG 1899 TAX LOT 2D REF:DB 1034 PG 1916 P/0 TAX LOT 2DA
REF:DB 1889 PG 605 owners:DOROTHY SOWERS & ONE FIFTY, LLC_
COE FORESTRY & SURVEYING F-01411 JOB !
-
P.O. BOX J6 10044

Compliance Inspection Report
Permit: NCG140014 Effective: 08/01/09 Expiration: 06/30/11 Owner: Foltz Concrete Pipe Co LLC
SOC: Effective: Expiration: Facility: Foltz Concrete Pipe Co LLC
County: Davidson 11875 N NC Hwy 150
Region: Winston-Salem
Winston Salem NC 27127
Contact Person: Tim Hege Title: VP Phone: [phone]
Directions to Facility:
System Classifications:
Primary ORC:
Secondary ORC(s):
On -Site Representative(s):
On -site representative
Related Permits:
Certification:
Phone:
Eric Parrish - F f Phone: [phone]
C16►&,A- ben. f�lrY �.--
f
1C - co 14 - 416 - 006-0
Inspection Date: 06/03/2010 Entry Time: 10:10 AM Exit Time: 11:30 AM
Primary Inspector: Jenifer Carter
Secondary Inspector(s):
Phone: [phone]
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Ready Mix Concrete Stormwater/Wastewater Discharge
COC
Facility Status: r1 Compliant 0 Not Compliant 0�
Question Areas:
® Storm Water
(See attachment summary)
Page: 1

l
Permit. NCG140014 Owner - Facility: Foltz Concrete Pipe Co LLC
Inspection Date: 0610312010 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
The site drains to a UT to Miller Creek (class C water).
They found a copy of their permit but there was no SPPP and no monitoring records. They seemed very eager to learn
and implement the permit requirements.
Outfall #1: Drainage from a majority of the site, including the parking area. There is a pipe draining to a grassy ditch,
along the side of the pond, which also leads to this same outfall.
Outfall #2: The back side of the site, including the plant drains to this outfall. Two strorm drains along the back hill lead to
this outfall, as well.
Equipment washing takes place inside, but drains to the outside... to outfall #2.
There was no evidenence of adverse effects to water quality.
A list of labs and a link to permit text/monitoring forms was provided after the visit.
A deadline of December 3, 2010 was given for:
Developing and implementing an SPPP
Conducting monitoring as required.
Email [e-mail]
F
A
Page: 2

Permit: NCG140014 Owner - Facility: Foltz Concrete Pipe Co LLC
Inspection Date: 06/03/2010 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?
n
®n
n
# Does the Plan include a General Location (USGS) map?
n
®
n
n
# Does the Plan include a "Narrative Description of Practices"?
n
®
n
n
# Does the Plan include a detailed site map including outfall locations and drainage areas?
n
®
n
D
# Does the Plan include a list of significant spills occurring during the past 3 years?
n
®
n
n
# Has the facility evaluated feasible alternatives to current practices?
Cl
®
Cl
n
# Does the facility provide all necessary secondary containment?
n
®
n
n
# Does the Plan include a BMP summary?
n
®
n
n
# Does the Plan include a Spill Prevention and Response Plan (SPRP)?
n
®
n
n
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
n
®
n
n
# Does the facility provide and document Employee Training?
n
®
n
n
# Does the Plan include a list of Responsible Party(s)?
.n
®
n
n
# Is the Plan reviewed and updated annually?
n
®
n
n
# Does the Plan include a Stormwater Facility Inspection Program?
n
®
n
n
Has the Stormwater Pollution Prevention Plan been implemented?
n
®
n
n
Comment:
Qualitative Monitoring
Yes
No
NA
NE
Has the facility conducted its Qualitative Monitoring semi-annually?
n
®
n
n
Comment!
Analytical Monitoring
Yes
No
NA
NE
Has the facility conducted its Analytical monitoring?
n
n
❑
n
# Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas?
n
n
n
n
Comment:
Permit and Outfalis
Yes
No
NA
NE
# Is a copy of the Permit and the Certificate of Coverage available at the site?
®
n
n
n
# Were all outfalls observed during the inspection?
®
n
n
n
# If the facility has representative outfall status, is it properly documented by the Division?
n
n
0
n
# Has the facility evaluated all illicit (non stormwater) discharges?
®
n
In
n
Comment:
Page: 3

Carter, Jenifer
From: Greg Baryluk [Greg. [e-mail]]
Sent: Friday, September 10, 2010 1:49 PM
To: Carter, Jenifer���
Subject: RE: NPDES Permit Info
Jenifer:
I have received the information that you had sent regarding the NPDES permit info. Thank you for your follow up and
attention to the matter. I will be working on a response and will get back to you shortly.
Please feel free to contact me with any questions or if you need additional information.
Regards,
Greg Baryluk, PE
Advanced Drainage Systems, Inc
4640 Truman Blvd.
Hilliard, H 43026-2438
Office 614.658.0126
Cell 508.735.8724
Greg. Bar Iy [e-mail]
-----Original Message -----
From: Carter, Jenifer[mailto:[e-mail]]
Sent: Thursday, June 03, 2010 3:41 PM
To: [e-mail]
Subject: NPDES Permit Info
Jeff, Jeff and Eric,
It was a pleasure meeting all of you.
5,ZOtu
V
In the following link, you will find the permit text you need (NCG140000). The forms for'Qualitative Monitoring' and
NCG140000 Stormwater/Wastewater DMR (Discharge Monitoring Report) are located further down the same page:
http://Portal.ncdenr.org/web/wq/ws/su/npdessw
I've attached the most updated list of certified laboratories, as well.
For your info, your site drains to an unnamed tributary (UT) to Miller Creek (Class C Waters), which is NOT on the State's
303(d) list for impaired waters. The GPS Coordinates (NAD27) are N 350 59' 25.32" and W 800 16' 22.98"
Best of luck. Please call with questions.
Jenifer Carter
V

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NC DENR Winston-Salem Regional Office
Division of Water Quality
585 Waughtown Street
Winston-Salem, NC 27107
Voice: [phone]
FAX: [phone]
E-mail correspondence to and from this address may be subject to the
North Carolina Public Records Law and may be disclosed to third parties.

�• 's. [-FRIECEIVED .i
N.C. Oeot. of £NR I. ,
I f
MAY 2 5 2010 i
Winston-SalemA70qn I V
Regional OY
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Land Resources
Land Quality Section
James D. Simons, PG, PE Beverly Eaves Perdue, Governor
Director and State Geologist Dee Freeman, Secretary
May 25, 2010
NOTICE OF VIOLATIONS OF THE
SEDIMENTATION POLLUTION CONTROL ACT
CERTIFIED NIAIL7008 1300 0000 6359 1854
RETURN RECEIPT REQUESTED
Foltz Concrete Pipe Company, LLC
ATTN: George Sowers, Registered Agent
11875 North NC Hwy 150
Winston Salem, NC 27127-9182
CERTIFIED MAIL7008 1300 0000 6359 1878
RETURN RECEIPT REQUESTED
Spartan Concrete, Inc.
4640 Trueman Blvd.
Hilliard, OH 43026
CERTIFIED MAIL7008 1300 0000 6359 1892
RETURN RECEIPT REQUESTED
One Fifty, LLC
ATTN: Edward R Green
702 Shadow Lane
Winston Salem, NC 27107
RE: Project Name: FOLTZ CONCRETE
Project ID: DAVID-2010-032
Countv: Davidson
Compliance Deadline: June 0l, 2010
or 5 days from receipt
CERTIFIED MAIL7008 1300 0000 6359 1861
RETURN RECEIPT REQUESTED
North Lake Owners Association, Inc.
ATTN: Bryan C Thompson, Registered Agent
100 North Main St
Suite 1500
Winston Salem, NC 27101
CERTIFIED MAIL7008 1300 0000 6359 1885
RETURN RECEIPT REQUESTED
Spartan Concrete; Inc.
CT Corporation System, Registered Agent
150 Fayetteville St. Box 1011
Raleigh, NC 27601
Winston-Salem Regional Office
585 WaLightown Street, Winston-Salem, North Carolina 27107 Phone: [phone] Fax: [phone]
IM"

Notice of Violations
Project: FOLTZ CONCRETE
May 25, 2010
Page 2 of 4
Dear Sir or Madam:
On May 24, 2010, personnel of this office inspected a project located on N. NC HWY 150,
ARCADIA in Davidson County; North Carolina. This inspection was performed to determine
compliance with the North Carolina Sedimentation Pollution Control Act (Act) of 1973. The
inspection revealed a land -disturbing activity of approximately 2.0 acres being conducted.
It is our understanding that you and/or your firm are responsible for this land -disturbing
activity. The purpose of this letter is to inform you that this activity Nvas found to be in violation of
the Act, G.S. 113A-50 to bb, Title 15A, North Carolina Administrative Code (NCAC), Chapter
4. If you feel that you are not responsible for the following violations, please notify this office
immediately.
The violations that were found are:
1. Failure to file an erosion and sedimentation control plan with this office 30 or more days prior to
initiating any land -disturbing activity that will disturb more than one acre on a tract, failure to
secure this office's prior approval of the plan for any land -disturbing activity prior to beginning
the land -disturbing activity. G.S. 113A-54(d)(4), G.S. I I3A-57(4) and 1 SA NCAC 4B. 0107(c).
2. Failure when a land -disturbing activity that will disturb more than one acre is undertaken on a
tract, to install sedimentation and erosion control devices sufficient to retain the sediment
generated by the land -disturbing activity within the boundaries of the tract during construction
upon and development of the tract. G.S. I I3A-57(3).
Failure to take all reasonable measures to protect all public and private property from damage by
such land -disturbing activities. 15A NCAC 4B .0105.
4. Failure to retain alone a lake or natural watercourse a buffer zone of sufficient width to confine
visible siltation by natural or artificial means within the 25 percent of that portion of the buffer
zone nearest the land -disturbing activity. G.S. 113A-57(1).

Notice of Violations
Project:- FOLTZ CONCRETE
May 25, 2010
Page 3 of 4
To correct these violations, you must:
Submit three (3) copies of an approvable sedimentation and erosion control plan and the
appropriate plan review fee to this office. Until the required plan has been approved, no
land -disturbing activity may be conducted; except that which is necessary to bring the site into
compliance. until an erosion and sedimentation plan has been approved; any land -disturbing
activity, except that which is necessary to bring the site into compliance, will constitute
additional violations of the Act. Following our review of the plan within 30 days of receipt,
this office will notify you that the plan has been approved, approved with modifications or
disapproved. Following approval of the plan, all land -disturbing activity on the site must be
conducted in accordance with the terms of the approved plan, the Act and the implementing
rules.
2. Install all sedimentation and erosion control measures as shown plan upon plan
approval.
Install temporary sedimentation and erosion control measures under direction of an
engineer to stop sediment loss.

Notice of Violations
Project: FOLTZ CONCRETE
May 25, 2010
Page 4 of 4
The violations cited herein may be referred to the Director of the Division of Land Resources (James
D. Simons, PG, PE) for appropriate enforcement action, including civil penalty assessments for an
initial one -day violation and/or a continuing violation. The penalty for an initial one -day violation
may be assessed in an amount not to exceed S5,000.00. The Division of Land Resources is not
required to provide a time period for compliance before assessing an initial penalty for the violations
cited herein. Please be advised that a civil penalty may be assessed for the initial day of violations
regardless of whether the violations are corrected within the time period set out below.
In addition, if the violations cited herein are not corrected within 5 days of receipt of this notice or
before June 01, 2010, whichever term is longer, this office may request that the Director take
appropriate legal action against you for continuing violations pursuant to NCGS 113A-61.1 and
113A-64. A penalty maybe assessed from the date of the violation, pursuant to NCGS
13A-64(a)(1), and for each day of the continuing violation in an amount not to exceed $5,000.00 per
day_
Please be advised that any new land -disturbing activity associated with this project should not begin
until the area presently disturbed is brought into compliance with the Act. When corrective actions
are complete, you should notify this office so that work can be inspected. You should not assume
that the property is in compliance with the Act until we have notified you. After installation, all
erosion control measures must be maintained in proper working order until the site is completely
stabilized.
We solicit your cooperation, and would like to avoid taking further enforcement action. At the same
time, it is your responsibility to understand and comply with the requirements of the Act. Copies of
the relevant statute and administrative rules may be examined at this office or will be sent to you
upon request. Should you have questions concerning this notice or the requirements of the Act
please contact either Brian Lambe or me at your earliest convenience.
Sincerely,
Matthew E. Gantt, PE
Regional Engineer
Land Quality Section
Enclosures: Sedimentation Inspection Report
Financial Responsibility Form
Erosion Control Plan Checklist
cc: State Sedimentation Specialist
.-Regional Water Quality Supervisor

Forth Carolina Department of Environment and Natural Resources
Land Quality Section: 585 'G'Graughtown Street. Winston-Salem, \tC 27107 [phone]
County: Davidson Project: FOLTZ CONCRETE
Person Financially responsible: Foltz Concrete Pipe Company, LLC
Address: 11575 Noah NC H«rt! 150, Winston Salem, NC
1. Project Location: N. NC HWY 150, ARCADIA
Pictures: Yes - Digital
2.
3.
4.
5.
6.
Weather and soil conditions: 60's Cloudy Muddy
Is site currently under notice of violation? No
River basin: Yadkin-PeeDee
Project #: DAVID•2010-032
Initial inspection: Yes
Is the site in compliance with S.P.C.A. and rules? No If no, check violations below:
Violations:
✓ a. No approved plan, G.S. 113A 57(4) and 15 A NCAC 4B .0107(c)
✓ e. insufficient measures to retain sediment on site, G.S. 113A-57(3)
✓ f. Failure to take all reasonable measures, 15A NCAC 4B .0105
✓ g. Inadequate buffer zone; G.S. 113A-57(l)
Potential NPDES Permit Violation? Yes
Describe: No Plan, greater than one acre disturbed
7. Has sedimentation damage occurred since last inspection? Yes If Ycs; where? (check all that apply)
✓ Other Property
Description: Beyond slope at three points
Degree of damage: Moderate
8. Contact made with (name):
Inspection report: Sent Repor-E
9. Corrective action needed:
Title:
Date given/sent: May 25, 2010
1. Submit an adequate sedimentation and erosion control plan for approval, covering all areas disturbed
or to be disturbed.
2. Install all sedimentation and erosion control measures as shown plan upon plan approval.
3. Install temporary sedimentation and erosion control measures under direction of an engineer to stop
sediment loss.
10. Comments:
Reported by: Brian Lambe
Date of inspection: May 24, 2010
M
Others present: 1%4att Poling, PE
Time arriving on site: 9:50 AA.l Time leaving site: 10:20 AM