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HomeMy WebLinkAboutNCGNE0827_COMPLETE FILE - HISTORICAL_20111213 STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. /V C& Nt U $a9 DOC TYPE 19/1-1ISTORICAL FILE ❑ MONITORING REPORTS DOC DATE ❑ aoli Ia Ic3 YYYYMMDD NCDENR North Carolina Department of Environment and Natural Resources Division of water Quality Beverly Eaves Perdue Coleen H. Sullins Dee Freeman Governor Director Secretary December 13, 2011 Grace Food Distribution, Inc. Attn: Kuong Chung (Ben) Chui, Owner 77 North 1s' Street Brooklyn, NY 11211 Subject: No-Exposure Certification NCGNE0827 Grace Food Distribution, Inc. Wake County Dear Mr. Chui: The.Division has reviewed your submittal of the No-Exposure Certification for Exclusion from NPDES Stormwater Permitting form. Based on your submittal and signed certification of no exposure at the above referenced facility, the Division is granting your conditional exclusion from permitting as provided for under 40 CFR 126.22(g), which is incorporated by reference in North Carolina regulations. We are also hereby rescinding your current permit Certificate of Coverage, NCG060313. Please note that by our acceptance of your no-exposure certification, you are obligated to maintain no-exposure conditions at your facility. If conditions change such that your facility can no longer qualify for a no-exposure exclusion, you are obligated to immediately obtain NPDES permit coverage for your stormwater discharge. Otherwise, the discharge becomes subject to enforcement as an un-permitted discharge. You must self re-certify annually using the included . form, or obtain NPDES permit coverage for any stormwater discharges from your facility. The annual self re-certification does not need to be submitted to DWQ, unless requested. Your conditional exclusion from permitting does not affect your facility's legal requirements to obtain environmental permits that may be required under other federal, state, or local regulations or ordinances. Wetlands and Stormwater Branch One 16617 Mail Service Center,Raleigh,North Carolina 27699-1617 NorthCarolina Location:512 N.Salisbury St.Raieigh,North Carolina 27604 Phone:919-807-63001 FAX:919-807-64941 Customer Service:1-877-623-6748 Naturally Internet:www.ncwalerquality.org An Equal Opportunity 4 Affirmative Action Employer Grace Food Distribution,Inc. Attn: Kuong Chung(Ben)Chui,Owner No-Exposure Certification,NCGNE0827 December 13,2011, Page 2 of 2 If you have any questions or need further information, please contact Ron Boone at (336) 771- 4967, or at ron.boone@ncdenr.gov. Sincerely, for Coleen H. Sullins Attachments: 1. No-Exposure Annual Self Recertification Form cc: L_winston=Salem_Regional Officel. 2. Stormwater Permitting File NCG060313 3. Stormwater Permitting Unit No- Exposure Files 4. Fran McPherson-Budget Office 5, Grace Food Distribution, Inc. Attn: Loy Lee 5646 Stattalon Drive Winston-Salem, NC 27105 6. Kale Engineering Attn: Randall G. Kale, P.E. 3550 Vest Mill Road Winston-Salem, NC 27103 NC®ENR North Carolina Department of Environment and Natural Resources Division of water Quality Beverly Eaves Perdue Coleen H. Sullins Dee Freeman Governor Director Secretary December 13, 2011 Grace Food Distribution, Inc. Attn: Kuong Chung (Ben) Chui, Owner 77 North 15t Street Brooklyn, NY 11211 Subject: No-Exposure Certification NCGNE0827 Grace Food Distribution, Inc. Wake County Dear Mr. Chui: The Division has reviewed your submittal of the No-Exposure Certification for Exclusion from NPDES Stormwater Permitting form. Based on your submittal and signed certification of no exposure at the above referenced facility, the Division is granting your conditional exclusion from permitting as provided for under 40 CFR 126.22(g), which is incorporated by reference in North Carolina regulations. We are also hereby rescinding your current permit Certificate of Coverage, NCG060313. Please note that by our acceptance of your no-exposure certification, you are obligated to maintain no-exposure conditions at your facility. if conditions change such that your facility can no longer qualify for a no-exposure exclusion, you are obligated to immediately obtain NPDES permit coverage for your stormwater discharge. Otherwise, the discharge becomes subject to enforcement as an un-permitted discharge. You must self re-certify annually using the included form, or obtain NPDES permit coverage for any stormwater discharges from your facility. The annual self re-certification does not need to be submitted to DWQ, unless requested. Your conditional exclusion from permitting does not affect your facility's legal requirements to obtain environmental permits that may be required under other federal, state, or local regulations or ordinances. Wetlands and Stornwater Branch One 1 1617 Mail Service Center,Raleigh,North Carolina 27699-1617 NorthCatrolina Locatien'.512 N.Salisbury St.Raleigh,North Carolina 27604 „,y���N���� Phone:919-807'6300 l FAX:919-807-64941 Custom �//�YJer Service:1-877-623-6748 Internet:wvnv.nmaterquality.org AR Equal Opportunity 1 Afrmative Acton Employer Grace Food Distribution,Inc. Attn:Kuong Chung(Ben)Chui,Owner No-Exposure Certification,NCGNE0827 December 13,2011, Page 2 of 2 If you have any questions or need further information, please contact Ron Boone at (336) 771- 4967, or at ron.boone@ncdenr.gov. Sincerely, for Coleen H. Sullins Attachments: 1. No-Exposure Annual Self Recertification Form cc: 1. Winston-Salem Regional Office 2. Stormwater Permitting File NCG060313 �3. _Storm_ water Pe�mittirig=Unit_No.- Exposure Files 4. Fran McPherson-Budget Office 5. Grace Food Distribution, Inc. Attn: Loy Lee 5646 Stattalon Drive Winston-Salem, NC 27105 6. Kale Engineering Attn: Randall G. Kale, P.E. 3550 Vest Mill Road Winston-Salem, NC 27103 FOR AGENCY USE ONLY Division of Water Quality/Surface Water Protection Y= D w `rd n,Y NC®ENR National Pollutant Discharge Elimination System CervrkatoiCacc r.�..M.,,. - NO EXPOSURE CERTIFICATION for Exclusion RECEIVED tirCGINT0000 N.C.Dept.of ENH NO EXPOSURE CERTIFICATION DEC 0 7 2011 National Pollutant Discharge Elimination System application for exclusion from a Slormwater Pe � ytem on NO EXPOSURE: ce Submission of this No Exposure Certification constitutes notification that your facility does not require a permit for stormwater discharges associated with industrial activity In the State of North Carolina because it qualifies for a no exposure exclusion. A condition of no exposure at an Industrial facility means all industrial materials and activities are protected by a storm resistant shelter(with some exceptions)to prevent exposure to rain, snow, snowmelt,and/or runoff. For permitted facilities in North Carolina, DWC must approve your application for No Exposure Certification before this exclusion Is effective. Until you are issued a No Exposure Certification and your NPDES permit is rescinded, your facility must continue to abide by the terms and conditions of the current permit. Industrial materials or activities Include, but are not limited to: material handling equipment or activities, Industrial machinery,raw materials, intermediate products,by-products,final products.or waste products. Material handling activities include the storage, loading and unloading, transportation,or conveyance of any raw material, intermediate product, final product or waste product. A storm resistant shelter is not required for the following industrial materials and activities: drums, barrels, tanks,and similar containers that are tightly sealed,provided those containers are not deteriorated and do not leak. "Seated"means banded or otherwise secured and with locked or non-operational taps or valves;adequately maintained vehicles used in material handling;and final products, other than products that would be mobilized in stormwa ter discharges(e.g., rock salt). A No Exposure Certification must be provided for each facility qualifying for the no exposure exclusion. In addition, the exclusion from NPDES permitting is available an a facility-wide basis only--not for Individual outfalls. if any Industrial activities or materials are, or will be,exposed to precipitation, the facility is not eligible for the no exposure exclusion. By signing and submitting this No Exposure Certification form,you certify that a condition of no exposure exists at this facility or site and are obligated to comply with the terms and conditions of 40 CFR 122.26(g). You are re uired to self re-certify our No Ex osure Exclusion anrtuall . For questions,please contact the DWO Reglonai Office for your area. (See page 6) (Please print or type) 1) Mailing address of ownerloperator(address to which all certification corresponden22 will be mailed): Name _I1t-._Kvong CUn9 �aerl�—�l��ic.� GNQced �isf',�vfitxl Contact /t. l�v6ng C�uhp�hC Street Address _L.S'f' + _-et City `Rfnal</vn. State/ ZIP Code lI z, Telephone No. _.g_f]' $q 8 Fax: :7 j�_ `7e Email Grace. g8 0YQ&2�' aom- 10 Page i of 7 V Swu-NE-12Aug2010 NOV 2 S 2011 • WETLANDS AND STORMWA RBRANCH �r ? C.I�Ci�K i �� a��L?f5� Z+G�!�1t?' Ni�L t��26G'•':�il3i"c �I;il~t5 -�iGii�'rl'r'' : . l�: �C_UC:ZC IYt;E VECEFOVU�, vrf 1i'r tom- 1111.Ft :iCl (7t i 1 + P- r u I r,rf- r^ r. '-� 'if1,F NCGNt000 No Exposure Certi#ication 2) Location of facility producing dlscharge:A'� i Facility Name �raxC _ Od d l5��'i l7u 7�U►� �14< Facility Contact _�C e Facility Street-Address �g G 5TO .S n ll ry City - _ State_ZIP•Code �'71�5 *• County Telephone Al6.'3, - t Email 6 Coin �- 3) Physlcal4ocatlowinformation: N, �. Please•provide:a narrative description.of, to get to,the.faciiity(use street names state road numb s;and distance and direction from a roadway intersection). S�� Lk�]��C�P' �ytc�t� 1><fi&ws ,all r ^xf.,l (A copy of a rriap,with-the facility clearly located on it should be included with the certification application.) t 4) Is the facilit—VOcated-on Native American Lands?,❑Yes;' >(No , >! 1.) r -r s< 5) is this aiFederallfaeility? ❑Yes (' No•. tl IL. it 6) Latitude�6 �q 5A3. . Longltudei0o,17 j$ (deg.,min.,seconds) ? 7) This NPDES No:Exposure Exclusion application applies to which of the following: ❑ New:or'P.roposed Facility r` "'Date operation is to begin t, .a f J Existing=' • � ,.Date operation began r G Renewal,of existing No Exposure Certification,.Certification No.:.NCGNE 8) Was thls facility.'or site ever covered under amNPDES Stormwater Permit? Yes ❑ No If yes,what is the NPbtS°Permit Number?` 0:6Do0o t: 9) Standard IndustrialClas`sificattan ' f'. j. " ` F. Provide the 4 digit Standard lndustrial'Classification Code(SIC Code)that describes the primary industrial activity at this facility SIC Code.u � '.4 , t 1 0) Provide a brief descriptiorll of the types'Of In striaf act vItles a products produced at this facility: I�.ir P� �11• - yi' IrY. L.T, v4 - ti.rsra. 1 .µ _. , v .. w 'r1�!'iw J 11) Does this'facllity have any Non-Discharge permits(ex: recycle permits)? ❑;Yes E if ye5,4 ist the permit numbers for all current Non-Discharge permits for this facility: f(i JP tjga.�.tti �.- ? • v - ,ti "`�,!4 T,�,• •t, . .... .. ..{.���5 t.1 1f l� -�i�l'F-t1Y'l ,'.i_*.:TM a. � ,r_• s J r Page 2 of 7 -SWU AfE-12Aug 10 •i" [� �S i 5 r�, `�, °.'�r?.....`� rJ.^i �" -ram .•r:e ..i4.!- j ..I+s�a r i r is . - �=�� -. , -'SCE� 't` . . F... - -�!�;y� _ ,• �.., .. _ .f - r i l NCGNE0000 No Exposure Certification Exposure Checklists(12. - 14.) 12) Are any of the following materials or activities exposed to precipitation,now or in the foreseeable future?(Please check either"Yes"or"No.") If you answer"Yes"to any of these items,you are not eligible for the no exposure exclusion. a- Using,storing,or cleaning industrial machinery or equipment,and areas where 0 Yes)(No residuals from using,storing or cleaning industrial machinery or equipment remain and are exposed to stormwater b. Materials or residuals on the ground or in stormwater inlets from spills/leaks Cf Yes XNo c.Materials or products from past industrial activity EI Yes )LNo d. Material handling equipment(except adequately maintained vehicles) C3 Yes NfQNo e. Materials or products during loading/unloading or transporting activities ❑Yes )(No f. Materials or products stored outdoors (except final products intended for outside Q Yes ' No use[e.g.,new cars]where exposure to stormwater does not result in the discharge of pollutants) g. Materials contained in open,deteriorated or leaking storage drums, barrels,tanks, 0 Yes)(No and similar containers h. Materials or products handled/stored on roads or railways owned or maintained by ❑Yes )kNo the discharger i. Waste material(except waste in covered, non-leaking containers[e.g.,dumpsters]) ©Yes ')dNo j.Application or disposal of process wastewater(unless otherwise permitted) ❑Yes )<No k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ©Yes X o otherwise regulated(i.e.,under an air quality control permit)and evident in the stormwater outflow 1. Empty containers that previously contained materials that are not properly stored 0 Yes )(No (i.e.,not closed and stored upside down to prevent precipitation accumulation) m. For any exterior ASTs,as well as drums,barrels,tanks,and similar containers ©Yes )(No stored outside, has the facility had any releases in the past three (3) years? 13) Above Ground Storage Tanks(ASTs): If you answer"No"to any.of the following items,you are not eligible for the no exposure exclusion. a. Are exterior ASTs and piping free of rust,damaged or weathered coating,pits,or ❑ Yes ❑ No NIA deterioration,or evidence of leaks? b. Is secondary containment provided for all exterior ASTs? If so,is it free of any ❑Yes 0 No N/A cracks,holes,or evidence of leaks,and are drain valves maintained locked shut? Page 3 of 7 SW U-NE-12Aug201 U NCGNE0000 No Exposure Certification 14) Secondary Containment: If you answer"No"to any of the following Items,you are not eligible for the no exposure exclusion. a. Is secondary containment provided for all single above ground storage ❑ Yes ❑ No N/A containers(including drums,barrels,etc.)with a capacity of more than 660 gallons? b. Is secondary containment provided for above ground storage containers stored ❑ Yes ❑ No N/A in close proximity to each other with a combined capacity of more than 1,320 gallons? c. is secondary containment provided for Title Ill Section 313 Superfund ❑ Yes ❑ No YN/A Amendments and Reauthorization Act(SARA)water priority chemicals'? d. Is secondary containment provided for hazardous substances"designated in 40 ❑ Yes © No )(N/A CFR§116? e.Are release valves on all secondary containment structures locked? ❑ Yes © No IXNIA 15) Hazardous Waste: a. Is this facility a Hazardous Waste Treatment, Storage,or Disposal Facility? ❑ Yes^i(No b. 1s this facility a Small Ouantity Generator(less than 1000 kg.of hazardous waste ❑ Yes XNo generated per month)of hazardous waste? c. Is this facility a urge Quantity Generator(1000 kg.or more of hazardous waste ❑ Yes 1No generated per month)of hazardous waste? / If you answered yes to questions b.or c.,please provide the following information: Type(s) of waste: How is material stored: Where is material stored: How many disposal shipments per year: Name of transport/disposal vendor: Vendor address: Footnotes to Ouestions 14)c. &d. 'Note that amounts below the 660-gallon(single)and 1,320-gallon(combined)bulk storage minimums require secondary containment. However,some exceptions may be made for de minimis amounts of certain substances, and/or other qualifiers,as described in the exemptions from reporting requirements of Title III SARA 313 in 40 CFR §372.38, "Note that amounts below the 660-gallon(single)and 1,320-gallon (combined)bulk storage minimums require secondary containment. However,some exceptions may be made for amounts less than the Reportable Quantities of the hazardous substances listed in 40 CFR§117.3. Page 4 of 7 SWu-NE-12AU92010 NCGNE0000 No Exposure Certification 16) Other information:If you answer"Yes"to any of the following items,you might not be eligible for the no exposure exclusion. A more in-depth evaluation of the site circumstances may be required. a. Does your facility store used,recycled,or otherwise reclaimed pallets outside? ❑ Yes )No b. Does your facility have coal piles on site? ❑ Yes XNo c.Does your facility store other fuel sources outside in piles,such as wood chips, © Yes sawdust,etc.? d. Does your facility have air emissions associated with its industrial activity(e.g., © Yes�No degreasing operations, plating,painting and metal finishing)? if so,describe the industrial activity: e. If you answered yes to d.,are those emissions permitted by an Air Quality Permit? 0 Yes 0 NoXN/A Please specify: f. Please list any other environmental program permits(federal,state,etc.)not specified earlier in this application (such as Hazardous Waste Permits, etc.): Permit: Program: Permit: Program: Permit: Program: Permit: Program: Permit: Program: Permit: Program: Permit: Program: Page 5 of 7 Swu-NE-12Aug20 i 0 " NCGNE0000 No Exposure Certification, .1 Certification: TvI i N 1 ,t .t '' F"�'�i.�r -�r-r I certify under penalty pf w that I have read artd`uhdersta'hd eligibility.requirements for-claiming a condition of`no; AV H-1 q_.I exposure'and obtaining an exclusion from NPDES stormwater"permitting.• I certify under penalty of law that there are no discharges'of stormWater contaminated by exposure to industrial activities or materials from the industrial facility or,site denti#fled to this,document=(except as allowed under}40 CFR t 22-26(g)(2)). understand that I am obligated to annually,self re-cettifv-Ng Exposure and,if'regtiested!submit the re-certification to •. DWQ or the operator of the local.municipal separate storm sewer system(MS4)into which the facility discharges(where { applicable) 1 understand that I must allow the North Carolina Division of Water Quality,or MS4 operator+nitiere the:' uT ,dischargatiVVa,the Focal MS4,to perform inspections to confirm the condition of no exposure and to make such v inspection reports pubficty available upon request. y In the event that the site no longer qualifies for a No Exposure Exclusion,,I understand that I-must obtain coverage under ' } an NPDES permit grior to any noinLAource dl�rharge of stotmwVter"fromi tile?f gitityl Additionally I certi#jr uricier penalty of law that this document and all attachments were prepared under my direction or supervision,tn.accordsrice with a system •. deslgned to assure that qualified personnel property gathered and evaluated the information'sutimitted: Based on my T W OM 3.)iinquiry;of the person or persons who manage the system orithose.persons directly responsible for gathering''Ahe C`, i ' + information;the information submitted is to the best of.m knowled a and belief true,ta66 C to and eom late. l am aware' {Ra i s., y• ., .: gig, P that there are sigrtificarit penalties#or submitting false information;including the possiliI& of fine and imprisonment for knowing violations'. t - ;• `' ', :J ' I certify that I am familiar with the information contained In this applicanon and that to the best gi my knowledge and belief -j µ, such information is true,complete,and accurate- • P.rinledName of,Person Signing: Title: ( (Signature of (Dal rtedJ Please note: This application for the No Exposure Exclusion is subject to approval by the I' NCDENRRegional Office prior to issuance. The Regional Office may inspect your facility for compliance with no exposure conditions prior to that approval.- The Regional Office may also , Inspect your facility at aq time:In-the futurefor compliance with,the No Exposure Exclusion. f E North Carolina General Statute 143-2i5.6 8(0 provides that: Any person who knowingly makes any false statement,representation;or certification in any application,record,repot,plan,or.oth3 f document filed or required to be maintained under this Article or a rule implementing this Article:or who knowingly makes a'alse statement of a material fact in a rulemaking proceeding or ebntesmd case under this Article;or who falsifies,tampers with,or kruswingly renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the It:rtvironmental Management)Commission implementing this Article shall be guilty ot'a Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars($t 0,000). , There is currently no fee fora No Exposure Exclusion. Page 6 of 7 5W U-NE•12Aug2010 T S,. i�'. [;5i��y��/4 i".• � � 1� 5� �a .i � - .. 1_ r'i. 1 '� { 1 _ n � 4 �'� � , -� i ! � 1 _ _ F - i S 4 F � h' I iT}� i �-� r 1 t?� ' c � h , �, � �, . � 1 � t:i �"1 i ' � _ k � � j 1 � 1 I i i(� +j�1'f F+FtzJ � l�4 l .. �'� .1 1 .� 51 � ti .I 1 1 ' , 1 � 1 { I ' ( - r �,J�+� If �� l�} ,', 1� �_ ?��fi .. {� ' L� . � .'i NEQ000 No Exposure Certification Final Checklist This application should include the following items: 0 This completed application and all supporting documentation. 0 A map with the location of the facility dearly marked. 0 If the site currently has an NPDES Stormwater Permit,be sure to indicate the permit number in Question 8. Mail the entire package to: Stormwater Permitting Unit Division of Water Quafliy 1617 Mail Service Center Raleigh,North Carolina 27699-1617 Note The submission of this document does not guarantee the issuance of a No Exposure Exclusion. For questions.please contact the DWO Regional Office for your area. DWO Regional Office Contact information: 4 Asheville Office ...... (828)296-4500 w Fayetteville Office ... (910)433-3300 t Mooresville Office ... (704)663-1699 Raieigh Office ........ (919)791-4200 J�slavitle A{ooroiviile Washington Office...(252)946-6481 Wilmington Office ... (910)796-7215 Winston-Salem ...... (336) 771-5000 f Central Office .........(919)807-6300 � 3 0 Page 7 of 7 Swt1-NE-12Aug2010 L - KALE ENGINEERING 3550 Vest Mill Road WINSTON SALEM,N.C. 27103 PROPERTY SURVEYS MEMBERS OF CONSTRUCTION SURVEYS NATIONAL SOCIETY OF DESIGN OF ROADS AND STREETS PROFESSIONAL.ENGINEERS WATER AND SEWAGE SYSTEMS 336-768-0250 AMERICAN CONGRESS OF SUBDIVISION PLANNING&LAYOUT email kaleengr©bellsouth.net SURVEYING AND MAPPING November 23, 2011 NCDENR Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Subject: NPDES General Stormwater Permit NCG060000,Grace Foods Distribution, Winston Salem, NC References: 1. Letter from Mr. W.Corey Basinger of NCDENR to Mr. Loy Lee of Grace Food Distribution, Inc,Compliance Inspection&Notice of Violation,dated 06/08/1 1. Notice of Violation NOV-201 I-PC-0349. 2. 'Telephone conversations between Mr. Ron Boone and Randall G. Kale of Kale Engineering on Friday 07/29/11 and Monday 08/01/1 1 for this project. Mr. Boone is an employee of NCDENR in the Winston Salem office(Forsyth County). 3. No Exposure Certification Application Form(enclosed). Dear Sir or Madame, Enclosed with this letter is the reference 3 form as requested. To the best of my knowledge, this is what you need. Please review and let me know what you think. Thank you very much for your help in this matter this morning. Should you have any questions, please feel free to call me at 336-768-0250. Sincerely, O��a " Randall G. Kale P.E., P.L. . �D NpV2S 2011 W NDSANDSTpR QUgLlly +4TER aW Cif MR AGENCY-USE ONLY • Division of Water Quality/Surface Water Protection Yr� °��'tra p„ �..� ��''® .,�� National Pollutant Discharge Elimination System t cerdfk--eorcurcrsr 1 *­CC Ix~- NO EXPOSURE CERTIFICATION for Exclusion NCGNEU000 NO EXPOSURE CERTIFICATION National Pollutant Discharge Elimination System application for exclusion from a stormwater Permit based on NO EXPOSURE: Submission of this No Exposure Certification constitutes notification that your facility does not require a permit for stormwater discharges associated with industrial activity In the State of North Carolina because It qualifies for a no exposure exclusion. A condition of no exposure at an Industrial facility means all industrial materials and activities are protected by a storm resistant shelter(with some exceptions)to prevent exposure to rain,snow, snowmelt, and/or runoff. For permitted faci€ities in North Carolina, DW© must approve your application for No Exposure Certification before this exclusion is effective. Until you are Issued a No Exposure Cert€fication and your NPDES permit is rescinded, your facility must continue to abide by the terms and conditions of the current permit. Industrial materials or activities include, but are not limited to: material handling equipment or activities, Industrial machinery, raw materials, intermediate products,by-products, final products, or waste products. Material handling activities include the storage, loading and unloading, transportation, or conveyance of any raw material,intermediate product, final product or waste product. A storm resistant shelter Is not required for the following industrial materials and activities: drums,barrels, tanks,and similar containers that are tightly sealed,provided those containers are not deteriorated and do not leak. "Sealed"means banded or otherwise secured and with locked or non-operational taps or valves;adequately maintained vehicles used in material handling;and final products, other than products that would be mobilized in stormwater discharges(e-g., rock salt). A No Exposure Certification must be provided for each facility qualifying for the no exposure exclusion. In addition, the exclusion from NPOES permitting is available on a facility-wide basis only--not for Individual outfalls. If any industrial activities or materials are, or will be, exposed to precipitation, the facility Is not eligible for the no exposure exclusion. By signing and submitting this No Exposure Certification form, you certify that a condition of no exposure exists at this facility or site and are obligated to comply with the terms and conditions of 40 CFR T 22.26(g). You are required to self re-certity Vour No Exposure Exclusion annual) . For questions,please contact the DWO Regional Office for your area. (See page 6) {Please print or type} 1} Mailing address of owner/operator(address to which all certification correspondence will be mailed): ) Nar11e —M1�,�KLI0, 9 C613—_C 3-e& �l �,L 7 GNQCE FOoc�j}yr�btJ�1�Lti1 Contact v (2>ut Street Address ,LS tte City ,J State ZIP Code _ Ha Telephone No. Cl 17 �� .5�8� S�j� Fax: Email C21' �f_____.atf19 a _CO/A_ Page I of 7 SWU-NE-12Aug2810 �O Ofito EXPOS 'Certtflt #fon 2) UxWIM CO ftdMy VMMxUV .: F=I*tie ' Fodtity Cosstact _ Fad Soest Ad&M i MY Stec ZIP Coda _&%2I0-5 Cowty Tawowft NO. Fax: ,-Zj& EMO Co/!t 3) Phy steM40caSon ttdrtnaft Prue ptoride a wnzflve O=Wm of ftCw to get to the McRy(use sirs t e�sate too .at i d Uom ands,frwn a roa&way wife abors). SCC Q��i(1 IM4 OWdUg &W-S (A ccy of a snap wets te fad dWAy►bcaied on it Stroh be fndvcled vrtttr On ceff=tkm appflca*m.) w 4) to the 18CIRty[acated an ttte a Anwrican Lendfe?❑Yes t+to • 5) to fits a FedMV4 ft~ 0 Yes tuo 9 ` 7) Thts NPDES No Expmm Emdusbn applkdbn appRes,to whtbh of the ice: ❑ Mw or Proposed Fad5ty Bate operalbn to to beglr. - Exis�g tM operation bates � C� t�urst as rxratirrg wo Es�rra Chan C,atl�ion rta:NONE . 8) was this ftetitty or site~covered under an NPOES StotmwaW Perttslt?XYOS 0 No a) Sbmdmd bufusht chmamwftn: P VVW the 4 ftft&W lord h&am cw=Tmwm Code(sr.Code)tit dew gybes the pririmn kxhm mcdvitt►at this f eft • s�tom:�� � ,`. 110)Pnortde a Wei do , tptton of the typas of � PrO& tt;pradLmwd Qt oft Dal 11)Does tads fifty MW :oy Hon4D—Itmua perm€ts(ex;mcicie pemft)7 ❑Yes if yes,list the permit numbers for aH current Nor,-nee peMft ror tfeis f2dW.• . S+an JC-1y L92010 NCGNE0000 No Exposure Certification Exposure Checklists(12. - 14.) 12) Are any of the following materials or activities exposed to precipitation,now or in the foreseeable future?(Please check either"Yes" or"No.") If you answer"Yes"to any of these items,you are no eligible for the no exposure exclusion. a- Using,storing,or cleaning industrial machinery or equipment,and areas where 0 Yes kc, residuals from using,storing or cleaning industrial machinery or equipment remain and are exposed to stormwater b. Materials or residuals on the ground or in stormwater inlets from spills/leaks ❑ Yes N No c. Materials or products from past industrial activity ❑ Yes XNo d. Material handling equipment(except adequately maintained vehicles) ❑ Yes '*,No e. Materials or products during loading/unloading or transporting activities ❑ Yes >�No f. Materials or products stored outdoors(except final products intended for outside ©Yes No use[e.g.,new cars]where exposure to stormwater does-not result in the discharge of pollutants) g. Materials contained in open,deteriorated or leaking storage drums, barrels, tanks, 0 Yes )(No and similar containers h. Materials or products handied/stored on roads or railways owned or maintained by ❑Yes `kNo the discharger i. Waste material (except waste in covered, non-leaking containers[e.g.,dumpsters]) ❑ Yes No j. Application or disposal of process wastewater(unless otherwise permitted) ❑ Yes )(No k. Particulate matter or visible deposits of residuals from roof stacks and/or vents not ❑Yes Xo otherwise regulated(i.e., under an air quality control permit)and evident in the stormwater outflow 1. Empty containers that previously contained materials that are not properly stored 0 Yes )(No (i.e., not closed and stored upside down to prevent precipitation accumulation) m. For any exterior ASTs, as well as drums, barrels,tanks, and similar containers 0 Yes )(No stored outside, has the facility had any releases in the past three(3)years? 13) Above Ground Storage Tanks(ASTs): It you answer"No"to any of the following Items,you are not eligible for the no exposure exclusion. a. Are exterior ASTs and piping free of rust,damaged or weathered coating,pits, or 0 Yes 0 No I N/A deterioration,or evidence of leaks? b. Is secondary containment provided for all exterior ASTs? If so, is it free of any 0 Yes 0 No N/A cracks, holes, or evidence of leaks, and are drain valves maintained locked shut? Page 3 of 7 SWU-NE-12Aug2o10 NCGNE0000 No Exposure Certification 14) Secondary Containment: if you answer"No"to any of the following Items,you are not eligible for the no exposure exclusion. a. Is secondary containment provided for all single above ground storage ❑ Yes o No N/A containers(including drums, barrels,etc.)with a capacity of more than 660 gallons? b. Is secondary containment provided for above ground storage containers stored © Yes 0 No /A in close proximity to each other with a combined capacity of more than 1,320- gallons? c. Is secondary containment provided for Title III Section 313 Superfund © Yes 0 No XN/A Amendments and Reauthorization Act(SARA) water priority chemicals'? d. Is secondary containment provided for hazardous substances"designated in 40 © Yes ❑ No )(N/A CFR§116? e. Are release valves on all secondary containment structures locked? 0 Yes 0 No )(N/A 15) Hazardous Waste: a. Is this facility a Hazardous Waste Treatment, Storage,or Disposal Facility? 0 Yes-�(No b. Is this facility a Small Quantity Generator(less than 1000 kg.of hazardous waste ❑ Yes X No generated per month)of hazardous waste? c. Is this facility a Large Quantity Generator(1000 kg.or more of hazardous waste 0 Yes )<No generated per month) of hazardous waste? If you answered yes to questions b.or c.,please provide the following information: Type(s)of waste: How is material stored. Where is material stored: How many disposal shipments per year: Name of transport/disposal vendor: Vendor address: Footnotes to Questions 14)c.&d. "Note that amounts below the 660-gallon(single) and 1,320-gallon (combined) bulk storage minimums require secondary containment. However, some exceptions may be made for de minimis amounts of certain substances, and/or other qualifiers, as described in the exemptions from reporting requirements of Title III SAl to 313 in 40 CFR §372.38. "Note that amounts below the 660-gallon(single)and 1,320-gallon(combined) bulk storage minimums require secondary containment. However, some exceptions may be made for amounts less than the Reportable Quantities of the hazardous substances listed in 40 CFR§117.3. Page 4 of 7 5Wu•NE-12Aug2010 NCGNE0000 No Exposure Certification 16) Other information: If you answer"Yes"to any of the following items,you might not be eligible for the no exposure exclusion. A more in-depth evaluation ol the site circumstances may be required. a. floes your facility store used, recycled,or otherwise reclaimed pallets outside? ❑ Yes *0 b. Does your facility have coal piles on site? ❑ Yes XNo c. Does your facility store other fuel sources outside in piles,such as wood chips, o Yes '-"-lo sawdust,etc.? d. Does your facility have air emissions associated with its industrial activity(e.g., ❑ Yes�KNo degreasing operations,plating, painting and metal finishing)? If so,describe the industrial activity: e. II you answered yes to d., are those emissions permitted by an Air Quality Permit? ❑ Yes ❑ NoXN/A Please specify: f. Please list any other environmental program permits(federal, state,etc.) not specified earlier in this application(such as Hazardous Waste Permits, etc.): Permit: Program: Permit: Program: Permit: Program: Permit: , Program: Permit: Program: Permit: Program: Permit: Program: Page 5 of 7 swu-NE-Mug201 o a � � ; 65 � f � f � E� �t �! c �p ° i { e a f NE0000 No Exposure Certification IF Checklist This application should include the following items: © This completed application and all supporting documentation. ❑ A map with the location of the facility dearly marked. ❑ If the site currently has an NPDES Stormwater Permit, be sure to indicate the permit number in Question 8. Mail the entire package to: Stormrwatet Permitting Unit Division of Water Quality 1617 Mail Service Center Raleigh,North CaroEina 27699-1617 , • Note The submission of this document does not guarantee the issuance of a No Exposure Exclusion. For questions,please contact the DWO Regional Office for your area. s - DWO Regional Office Contact Information: Asheville Office ...... (828)296-4500 Fayetteville Office ... (910)433-3300 - _ Mooresville;Office...-,-(704)_663-1699 Raleigh Office ........ (919) 791-4200 ! vo `to Washington Office ...(252)946-6481 Y Wilmington Office... (910) 796-7215 W instori-Salem .:..::(336)-77.1-5000 ! �a Central Office ..........(919),807,- 300 Page 7 of 7 SwU-N E-12Aug2o 10 - r A10A NCDENR North Carolina Department of Environment and Natural Resources Division of Water Quality Beverly Eaves Perdue Coleen H. Sullins Dee Freeman Governor Director Secretary October 3, 2011 Grace Food Distribution, Inc. Attn: Loy Lee, Manager 5646 Shattalon Drive Winston Salem, NC 27105 Subject: Evaluation for No Exposure Exclusion NPDES General Stormwater Permit NCG060000 Certificate of Coverage NCG060313 Grace Foods Distribution, Winston-Salem, NC Forsyth County Dear Mr. Lee: 1. Ron Boone of the Winston-Salem Regional Office of the NC Division of Water Quality (DWQ) conducted an evaluation of the subject property for a No Exposure certificate on October 3, 2011 . Your assistance and cooperation, as well as that of Randall Kale, with Kale Engineering, was greatly appreciated. An evaluation form is attached for your records and the findings of the evaluation are summarized below. 2. The facility is located at 5646 Shattalon Drive, in Winston-Salem, Forsyth County, North Carolina. Stormwater related to industrial activity is discharged from the site to Leak Fork, which is currently classified as Class C waters in the Yadkin River basin. 3. Mr. Boone found the site to be in good condition. Only one item remains that needs to be addressed before a No Exposure certification can be granted; the garbage dumpster located on the east side of the facility needs to have a permanent cover and needs to be kept covered at all times when it is not in use. The existing dumpster's cover either needs to be repaired or a new dumpster .with a cover needs to be acquired. Once this is accomplished, provided all site conditions remain as they were during the evaluation, you can submit a No Exposure application to our Central Office in Raleigh and the No Exposure certificate will be granted. North Carolina Division of Water Quality,Winston-Salem Regional Office Location:585 Waughtown St.Winston-Salem,North Carolina 27107 One Phone:336-771-5000 t FAX:336-771-46301 Customer Service:1-8 -M-6748 NorthCarofina Intemet:www.ncwaterquality.org )Vaturally An Equal Opportunity 1 Affirmative Action Employer r Grace Foods Distribution,Inc. Attn: Loy Lee,Manager No Exposure Certifoation Evaluation, NCG060313 101312011, Page 2 of 2 4. Mr. Boone provided you with a copy of the No Exposure application during the evaluation, along with a copy of the annual self recertifcation. Just fill out the application and follow all directions on the form. If you have any questions you may call Mr..Boone or meat anytime at 336-771-5000. Sincerely, W. Corey Basinger Water Quality Regional Supervisor Winston-Salem Region Division of Water Quality Attachments: 1. NEC Evaluation Report cc: 1. SWP —WSRO 2. Central Files 3. Stormwater Permitting Unit E4 Qrace_Foods_Distribution;Inc. CRttn Bbh-Chiu,_President? fD/ l� I is LBy_Fax:_718-782786692 5. Kale Engineering Attn: Randall Kale 3550 Vest Mill Road Winston-Salem, NC 27103 Compliance Inspection Report Permit: NCGO60313 Effective: 07/31/09 Expiration: 1OJ31112 Owner: Grace Food Distribution Inc SOC: Effective: Expiration: Facility: Grace Food Distribution, Inc. County: Forsyth 5646 Sahthalon Dr Region: Winston-Salem Winston Salem NC 27105 Contact Person: Joseph Deluca Title: Phone: 336-661-0291 Directions to Facility: System Classifications: Primary ORC: Certification: Phone: Secondary ORC(s): On-Site Representative(s): Related Permits: Inspection Date: 10/03/2011 Entry Time: 09:00 AM Exit Time: 09:30 AM Primary Inspector: Ron Boone } Phone. 336-771-4967 Secondary Inspector(s): �? /� 31/ 01I Reason for Inspection: Routine Inspection Type:Compliance Evaluation Permit Inspection Type: Food/Tobacco/Soaps/Cosmetics/Public Warehousing Stormwater Discharge COC Facility Status: ❑ Compliant ■ Not Compliant Question Areas: ®Storm Water (See attachment summary) Page: 1 Permit: NCG060313 Owner-Facility: Grace Food Distribution Inc Inspection Date: 1 010 312 01 1 Inspection Type:Compliance Evaluation Reason for Visit:Routine Inspection Summary: Grace Foods is attempting to qualify for a no exposure permit. Made site visit to evaluate their progress. At this point they only need to get a new dumpster with a functioning cover. Other than that the site will qualify. Gave them a copy of the no exposure application for them to fill out and submit to Central Office along with no exposure technical information.Will now await their application and make another short site visit once we receive it to verify that the dumpster has been repaired or replaced. Page: 2 MEMORY TRANSMISSION REPORT TIME : 10-04-r11 09:14 FAX NO.1 : 336-771-4632 NAME :DENR WSRO FILE NO, 260 DATE 10.04 09:13 TO : 8 917187828669 DOCUMENT PAGES 4 START TIME 10.04 09:13 END TIME 10.04 09:14 PAGES SENT 4 STATUS OK *** SUCCESSFUL TX NOTICE * * North Carolina Department of Environment and Natural Resources ❑ivision of Water Quality 0 orly Eav nordue CoEcon H. Sullins Dee rrn©man covarnor ❑irectar Secretary October 3. 201 1 Grace Food Distribution, Inc. Attn: Loy Lao, Manager 5646 Shattalon Drive Winston Salem, NC 27105 Subject: Evaluation for No Exposure Exclusion NPi7ES General Stormwater Permit N0G060000 Certificate of coverage NC-DO6031 a Grace Foods Distribution, Winston-Salem, NC Forsyth County Dear Mr. Lao: 1. Ron Soono of the Winston-Salem Regional Offico of the NC Division of Water Quality (OWQ) coradt,rcted an evaluation of the subject proporty for a No 1=xposuro cortiflcat© on October 3, 201 1. Your assistance and cooperation, as well as that of Randall Kale. with Kale F_nginonring, was grCatly appreciated. An evaluation form is [attached for your rocord9 and the findings of the evaluation aro surnrraarizad below_ 2. Ttte facility is located at 5646 Shattaion ariwv. in Winston.-Salem, Forsyth County, North Carolina. Storrnwater related to industrial activity is discharged from the site to t_aak Fork, which is currently classified as Class C waters in the Yadkin River basin- 3. Mr. Boone found the site to be in flood conciltion- Only one item romnlns that needs to bo addrossed before a No axposura certification can be granted; the gartaago dumpstar located on the east side of the facility needs to havo a permanent cov©r and needs to be kept covered at all tines when it is not in use_ The existing dumpster's cover either needs to bn repaired or a new ciumpster ,with a cover needs to be acquirod- Once this is accomplished, provided all site conditions remain as they were during the evaluation. you can submit a No Exposure application to our Central Offices In Raleigh and the No Exposure Certificate will Be granted_ Npnl,Garalina fJiW stun of Wabr Oaali[y Winston-Salem Repbnsl O/rltc LOGPtivn:5S5 Wau�ihlown St.Winslat-taalom.Nortn Gawllrva 2'/1 �rtc Pngny'J3a-]71-SCIOD l FAX:338-771-630 i Guaw.nar Ralvlca:t-6-Bey-623-6T<a Nox-t11C vr01 i n a Internet:wwvr.ncv+aleryualily.pry An 12 a 1 Oppartunity%Alfir .M,Actio Cnrpbyyr �u` KALE ENGINEERING 3550 Vest Mill Road WINSTON SALEM,N.C. 27103 PROPERTY SURVEYS MEMBERS OF CONSTRUCTION SURVEYS NATIONAL.SOCIETY OF i DESIGN OF ROADS AND STREETS PROFESSIONAL_ENGINEERS WATER AND SEWAGE:SYSTEMS 336-768-0250 AMERICAN CONGRESS OF SUBDIVISION PLANNING&LAYOUT email kateengoa beEtsouth.net SURVEYING AND MAPPING August 9,2011 I Mr. Ron Boone NCDENR Division of Water Quality 585 Wauahtown Street Winston Salem, NC 27107 Subject: NPDES General Stormwater Permit NCG060000 Grace Foods Distribution, Winston Salem. NC References: 1. Letter from Mr. W.Corey Basinger of NCDENR to Mr. Loy Lee of Grace Food Distribution, Inc,Compliance Inspection&Notice of Violation. 2. Telephone conversations between Mr. Boone and Randall G. Kale of Kale Engineering on Friday 07/29/11 and Monday 08/01/11 for this project. 3. No Exposure Certification Application Form. Dear Mr.Boone, I have spoken with Mr. Kuong Chung(Ben)Chiu of Winston Salem Real Estate Holding Inc.concerning the reference I Notice of Violation, which we discussed during the reference 2 conversations,and Mr.Chiu would very much like to pursue the No Exposure Certification. Mr. Chiu is aware that the entire site will need to be cleaned up and that no exposure could be allowed on this site. All of the items strewn across the property as noted in the reference I letter would need to be put indoors or offsite. Thev can not clean out the trailers with water and they can not work on their vehicles in the parking lot due to the petroleum spills. Mr.Chiu is also aware that if they are unable to meet the standards of the reference 3 application,it will be necessary to prepare and administer an SP3 Plan for this site. We will get back with you very shortly with a clean up schedule and a date when we will be ready for a visit from NCDENR, Thank you very much for your help in this matter this morning. It is appreciated. Sincerely, Randall G. Kale P.E., P.L.S. { i .tea NC®ENR North Carolina Department of Environment and Natural Resources Division of Water Quality Beverly Eaves Perdue Coleen H. Sullins Dee Freeman Governor Director Secretary June 8, 2011 CERTIFIED MAIL RETURN RECEIPT REQUESTED 7008-3230-0003-2547-2446 Grace Food Distribution, Inc. Attn: Loy Lee, Manager 5646 Shattalon Drive Winston Salem, NC 27105 Subject: Compliance Evaluation Inspection & Notice of Violation NOV-201 1-PC-0349 NPDES General Stormwater Permit NCG060000 Certificate of Coverage NCG060313 �- - Grace Foods Distribution, Winston-Salem, NC Forsyth County Dear Mr. Lee: 1. Ron Boone of the Winston-Salem Regional Office of the NC Division of Water Quality(DWQ)conducted a compliance evaluation inspection (CEI) at the subject facility on June 2, 2011. Your assistance and cooperation, as well as that of Robert Coppersmith, was greatly appreciated. An inspection checklist is attached for your records and the inspection findings are summarized below. 2. The facility is located at 5646 Shattalon Drive, in Winston-Salem, Forsyth County, North Carolina. Stormwater related to industrial activity is discharged from the site to Leak Fork, which is currently classified as Class C waters in the Yadkin River basin. Documentation & Monitoring Review 3. The following violations were noted: a. The facility does NOT have a Stormwater Pollution Prevention Plan (SP3); b. Analytical monitoring has NOT been accomplished; C. Qualitative monitoring has NOT been accomplished; and, d. Analytical monitoring for vehicle maintenance activities has NOT been accomplished. These are all violations of the NCG060000 general permit. Site Review 4. The permittee had previously been issued a Notice of Violation from the city's Stormwater department for washing out the insides of trailers and allowing the wastewater to run off into the creek. According to Mr. Lee and Mr. Coppersmith, they have stopped this practice and will now take the trailers to a facility in Greensboro where it is legal for them to wash them out. This is also a violation of the NCGO60000 general permit. 5. Other items noted throughout the site were: North Carolina Division of Water Quality,Winston-Salem Regional Office Location:585 Waughtown St.Winston-Salem,North Carolina 27107 One Phone:336-771-50001 FAX:336.771.46301 Customer Service:1-877-623-6748 NorthCarolina Internet:www.ncwatefquality.org Naturally An Equal Opportunity 1 Affirmative Action Employer Grace Foods Distribution,Inc. Attn:Loy Lee, Manager � J Compliance Evaluation Inspection,NCG060313 NOV-2011-PC-0349 619/2011,Page 2 of 2 a. There were several items strewn throughout the property that must be properly disposed such as refrigerant containers, waste oil filter receptacles, paint cans, oil and grease containers, general trash receptacles, miscellaneous junk equipment, junked vehicles, etc. All of these items must be cleaned up and properly disposed, in order to minimize exposure of transportable materials on these items to precipitation and the subsequent pollution of the receiving stream(s). These are also violations of the NCGO60000 general permit. b. There was also evidence of petroleum product spills in and around the vehicle maintenance facility. All such spills must be immediately and properly cleaned up and waste materials properly disposed. Failure to do so eventually leads to the pollution of the surrounding streams by mobilization of the contaminated materials by precipitation. These are also violations of the NCGO60000 general permit. 6. Grace Foods must immediately endeavor to develop and implement a full SP3 for the facility. The Certificate of Coverage (COC) was issued to Grace Foods in July, 2009. You have therefore had nearly two years to become compliant with the permit. It is highly suggested that you employ the services of a professional environmental engineer to develop the SP3 as required as it can become quite complicated and the permit has many technical requirements which may require the services of an engineer. 7. Please reply to this letter in writing within 10 business days of receiving it. Your reply should include a narrative action plan with time schedule to complete the SP3 and correct all the deficiencies noted above. Your written reply will be critical to our further consideration of whether or not to pursue enforcement actions at this time. Please also note that at this point DWQ grants Grace Foods another three months from the date of this letter to have a fully developed and implemented SP3 for the facility; failure to do so will likely result in enforcement action. The due date for the completion of the SP3 is therefore September 8, 2011. 8. You are reminded that violations of the NCGO60000 general permit are subject to civil penalty assessments not to exceed $25,000 per day, per violation. Thank you for your cooperation in this matter. Should you have any questions, please feel free to contact Mr. Boone or me at (336)771-5000. Sincerely, .. u Vr W. Corey Basinger Water Quality Regional Supervisor Winston-Salem Region Division of Water Quality Attachments: 1. BIMS Inspection Checklist cc: 1. [SWP=WSRO 2. Central Files 3. Stormwater Permitting Unit 4. Grace Foods Distribution, Inc. Attn: Ben Chiu, President By Fax: 718-782-8669 5. City of Winston-Salem Stormwater Division Attn: William Baugher P.O. Box 2511 Winston-Salem, NC 27102 Compliance Inspection Report Permit: NCG060313 Effective: 07/31/09 Expiration: 10/31/12 Owner: Grace Food Distribution Inc SOC: Effective: Expiration: Facility: Grace Food Distribution, Inc. County: Forsyth 5646 Sahthalon Dr Region: Winston-Salem Winston Salem NC 27105 Contact Person: Joseph Deluca Title: Phone: 336-661-0291 Directions to Facility: System Classifications: Primary ORC: Certification: Phone: Secondary ORC(s): On-Site Representative(s): Related Permits: Inspection Date: 06/0212011 Ent Time: 01:00 PM Exit Time: 02:00 PM Primary Inspector: Ron Boone -I 1 �) Phone: 336-771-4967 Secondary Inspector(s): r Reason for Inspection: Routine Inspection Type: Compliance Evaluation Permit Inspection Type: FoodFFobaccolSoapslCosmeticslPublic Warehousing Stormwater Discharge COC Facility Status: ❑Compliant ■ Not Compliant Question Areas: Storm Water �Q 16l i (See attachment summary) k, ,(,Q c�.l� d,..�� .•��0 271 f Page: 1 Permit: NCG060313 Owner-Facility: Grace Food Distribution Inc Inspection Date: 06/02/2011 Inspection Type: Compliance Evaluation Reason for Visit:Routine Inspection Summary: Please refer to the attached inspection summary letter- SECTIONSENDER: COMPLETE THIS ■ Complete items 1,2,and 3.Also complete A. signaturY!5� item 4 if Restricted Delivery Is desired. ❑Argent ■ Print your name and address on the reverse X ❑Addressee so that we can return the card to you. B. Received by rr Name) C. Date of Deliver y ' ■ Attach this card to the back of the mailpiece, �—i� r' I or on the front if space permits. D. Is delivery address different from item 17 ❑Yes 1. Article Addressed to: If YES,enter de wery'eddress below: ❑ No DeDL ofErYR jLoy Lee, Manager i 2011 i wMaton-Salem Grace Food Distribution, Inc. _ 5646 Shattalon Drive s. se ice Type Winston-Salem, NC 2�ao5 )Certlfled Mail ❑ Express Mail ❑ egistered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restrict d e r xtra Fee) ❑Yes Page: 2 ?008 3230 0003 2547 2446 _ - � 6 �pl. oI� PC 03'(�} - - N,j6y i PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 Permit: NCG060313 owner-Facility: Grace Food Distribution Inc Inspection Date: 06/02/2011 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? Cl ® n n #Does the Plan include a General Location (USGS) map? n ■ n #Does the Plan include a"Narrative Description of Practices'? n ® Q n #Does the Plan include a detailed site map including outfall locations and drainage areas? n ■ ❑ n #Does the Plan include a list of significant spills occurring during the past 3 years? Q ® ❑ n #Has the facility evaluated feasible alternatives to current practices? ❑ ■ 1) n #Does the facility provide all necessary secondary containment? ❑ ■ n ❑ #Does the Plan include a BMP summary? ❑ ■ n ❑ #Does the Plan include a Spill Prevention and Response Plan (SPRP)? ❑ e n #floes the Plan include a Preventative Maintenance and Good Housekeeping Plan? ❑ ■ n ❑ #Does the facility provide and document Employee Training? 0 C Cl n #Does the Plan include a list of Responsible Party(s)? n ■ n n #Is the Plan reviewed and updated annually? n ® Q #Does the Plan include a Stormwater Facility Inspection Program? n p Cl n Has the Stormwater Pollution Prevention Plan been implemented? ■ n n Comment: Please refer to the attached inspection summary letter. Qualitative Monitoring Yes No NA NE Has the facility conducted its Qualitative Monitoring semi-annually? n ® n fl Comment: Please refer to the attached inspection summary letter. Analytical Monitoring Yes No NA NE Has the facility conducted its Analytical monitoring? n ® n ❑ #Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas? n p 00 Comment: Please refer to the attached inspection summary letter. Permit and Outfalls 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? 8 n n ❑ #If the facility has representative outfall status, is it properly documented by the Division? n n ■ 0 #Has the facility evaluated all illicit(non stormwater)discharges? n ■ ❑ 0 Comment: Please refer to the attached inspection summary letter. Page: 3 Postal Servicev., CERTIFIED y ■ ■ (Domestic Mail Only;No Insurance Coverage Provided) ru r` r Postage $ i�3 rLi certFned Fee �'�� 1� m Poafmark O Retum Recelp!Fee p (Endomemen Requi �—Here v red) 'Jo = Restricted Delivery Fee (Endomement Required) .03149 rn rU Total Pc rn � o Loy Lee, Manager COnb+eer;Aa Grace Food Distribution, Inc. ... ' 0 orPoau, 5646 Shattalon Drive c�i soh Winston-Salem, NC 27105 + , AA NC®ENR North Carolina Department of Environment and Natural Resources Division of Water Quality Beverly Eaves Perdue Coleen H. Sullins Dee Freeman Governor Director Secretary .tune 8, 2011 CERTIFIED MAIL Post-it®Fax Note 7671 Date r RETURN RECEIPT REQUESTED pages 7008-3230-0003-2547-2446 TO pje v� C�ti 4 iu From J b Co./Dept.l7i^!nC G a c12j Co. NC tV i v a# l�06V Grace Food Distribution, Inc. Phone# Attn: Loy Lee, Manager Phone# 3 3 b -7-1 1 y�7 5646 Shattalon Drive Fax# .7 i -�� B��e7 Fax# 33G �`]1 14&Z)C Winston Salem, NC 27105 Subject: Compliance Evaluation Inspection & Notice of Violation NOV-2011-PC-0349 NPDES General Stormwater Permit NCG060000 Certificate of Coverage NCG060313 Grace Foods Distribution, Winston-Salem, NC Forsyth County Dear Mr. Lee: 1. Ron Boone of the Winston-Salem Regional Office of the NC Division of Water Quality(DWQ)conducted a compliance evaluation inspection (CEI) at the subject facility on June 2, 2011. Your assistance and cooperation, as well as that of Robert Coppersmith, was greatly appreciated. An inspection checklist is attached for your records and the inspection findings are summarized below. 2. The facility is located at 5646 Shattalon Drive, in Winston-Salem, Forsyth County, North Carolina. Stormwater related to industrial activity is discharged from the site to Leak Fork, which is currently classified as Class C waters in the Yadkin River basin. Documentation & Monitorina Review 3. The following violations were noted: a. The facility does NOT have a Stormwater Pollution Prevention Plan (SP3); b. Analytical monitoring has NOT been accomplished; C. Qualitative monitoring has NOT been accomplished-, and, d. Analytical monitoring for vehicle maintenance activities has NOT been accomplished. These are all violations of the NCG060000 general permit. Site Review •1 4. The permittee had previously been issued a Notice of Violation from the city's stormwater department for washing out the insides of trailers and allowing the wastewater to run off into the creek. According to Mr. Lee and Mr. Coppersmith, they have stopped this practice and will now take the trailers to a facility in Greensboro where it is legal for them to wash them out. This is also a violation of the NCG060000 general permit. 5. Other items noted throughout the site were: North Carolina Division of Water Quality,Winston-Salem Regional Office Location:585 Waughtown St.Winston-Salem,North Carolina 27107 One Phone:336-771-50001 FAX:336-77146301 Customer Service:1-87U23-6748 NorthCarolina Internet:www.navaterquality.org ;Vahzrally An Equal Opportunity 1 Affirmative Action Employer Grace Foods Distribution,Inc. Attn:Loy Lee, Manager �. Compliance Evaluation Inspection,NCG060313 NOV-2011-PC-0349 619/2011,Page 2 of 2 a. There were several items strewn throughout the property that must be properly disposed such as refrigerant containers, waste oil filter receptacles, paint cans, oil and grease containers, general trash receptacles, miscellaneous junk equipment, junked vehicles, etc. All of these items must be cleaned up and properly disposed, in order to minimize exposure of transportable materials on these items to precipitation and the subsequent pollution of the receiving stream(s). These are also violations of the NCG060000 general permit. b. There was also evidence of petroleum product spills in and around the vehicle maintenance facility. All such spills must be immediately and properly cleaned up and waste materials properly disposed. Failure to do so eventually leads to the pollution of the surrounding streams by mobilization of the contaminated materials by precipitation. These are also violations of the NCG060000 general permit. 6. Grace Foods must immediately endeavor to develop and implement a full SP3 for the facility. The Certificate of Coverage (COC) was issued to Grace Foods in July, 2009. You have therefore had nearly two years to become compliant with the permit. It is highly suggested that you employ the services of a professional environmental engineer to develop the SP3 as required as it can become quite complicated and the permit has many technical requirements which may require the services of an engineer. 7. Please reply to this letter in writing within 10 business days of receiving it. Your reply should include a narrative action plan with time schedule to complete the SP3 and correct all the deficiencies noted above. Your written reply will be critical to our further consideration of whether or not to pursue enforcement actions at this time. Please also note that at this point DWQ grants Grace Foods another three months from the date of this letter to have a fully developed and implemented SP3 for the facility; failure to do so will likely result in enforcement action. The due date for the completion of the SP3 is therefore September 8, 2011. 8. You are reminded that violations of the NCG060000 general permit are subject to civil penalty assessments not to exceed $25,000 per day, per violation. Thank you for your cooperation in this matter. Should you have any questions, please feel free to contact Mr. Boone or me at(336)771-5000. Sincerely, 'Am1&tU't'/r W. Corey Basinger Water Quality Regional Supervisor Winston-Salem Region Division of Water Quality Attachments: 1. BIMS Inspection Checklist cc: 1. SWP—WSRO 2. Central Files 3. Stormwater Permitting Unit 4. LGrace-Foods DistribOtibh,-Ir�c_7) �Attn:_Sen Chiu, President LBy_Fax:_7_18-782=868_9) 5. City of Winston-Salem Stormwater Division Attn: William Baugher P.O. Box 2511 Winston-Salem, NC 27102 { .� Compliance Inspection Report 1. Permit: NCG060313 Effective: 07/31/09 Expiration: 10/31/12 Owner: Grace Food Distribution Inc SOC: Effective: Expiration: Facility: Grace Food Distribution, Inc. County: Forsyth 5646 Sahthalon Dr Region: Winston-Salem Winston Salem NC 27105 Contact Person: Joseph Deluca Title: Phone: 336-661-0291 Directions to Facility: System Classifications: Primary ORC: Certification: Phone: Secondary ORC(s): On-Site Representative(s): Related Permits: Inspection Date: 0610212011 Ent Time: 01:00 PM Exit Time: 02:00 PM Primary Inspector: Ron Boone L 1 l r! Phone: 336-771-4967 Secondary Inspector(s): r f Reason for Inspection: Routine Inspection Type: Compliance Evaluation Permit Inspection Type: Food/Tobacco/Soaps/Cosmetics/Public Warehousing Stormwater Discharge COC Facility Status: n Compliant ■ Not Compliant Question Areas: Storm Water (See attachment summary) Page: 1 w s Permit: NCGO6d313 owner-Facility: Grace Food Distribution Inc L1 Inspection Date: 06I0212011 Inspection Type:Compliance Evaluation Reason for Visit:Routine Inspection Summary: Please refer to the attached inspection summary letter, Page: 2 } 41,E Permit: NCGO60313 Owner-Facility: Grace Food Distribution Inc Inspection Date: 06102/2011 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 M U n #Does the Plan include a General Location (USGS) map? n ® n n #Does the Plan include a"Narrative Description of Practices"? n 0 Cl n #Does the Plan include a detailed site map including outfall locations and drainage areas? 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 ■ f l ❑ #Does the facility provide all necessary secondary containment? n ■ n n #Does the Plan include a BMP summary? n ■ Cl 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 Has the Stormwater Pollution Prevention Plan been implemented? n ® n n Comment: Please refer to the attached inspection summary letter. Qualitative Monitoring Yes No NA NE Has the facility conducted its Qualitative Monitoring semi-annually? n ® n n Comment: Please refer to the attached inspection summary letter. Analytical Monitoring Yes No NA NE Has the facility conducted its Analytical monitoring? Cl ■ n n #Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas? n ® n n Comment: Please refer to the attached inspection summary letter. Permit and Outfails Yes No NA NE #Is a copy of the Permit and the Certificate of Coverage available at the site? ® n 013 #Were all outfalls observed during the inspection? ® ❑ n n #If the facility has representative outfall status, is it properly documented by the Division? n n ® n #Has the facility evaluated all illicit(non stormwater)discharges? n ® n n Comment: Please refer to the attached inspection summary letter. Page: 3 _=__— RE � Aria N.C.oao:,o!ENR NC®NR AUG 0 5 2009 North Carolina Department of Environment and Natural Resources R g,eoaisot,c Division of Water Quality Beverly Eaves Perdue Coleen H. Sullins Dee Freeman Governor Director Secretary July 31, 2009 Mr.Joseph DeLuca Grace Food Distribution Inc. 5646 Shattalon Drive Winston-Salem, NC 27105 Subject: General Permit No.-NCG060000 Grace Food Distribution Inc. COC NCG060313 Forsyth County Dear Mr. DeLuca: In accordance with your application for a discharge permit received on May 22, 2009, we are forwarding herewith the subject certificate of coverage to discharge under the subject state—NPDES general permit. This permit is issued pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement between North Carolina and the US Environmental. Protection Agency dated October 15, 2007 (or as subsequently amended). Please take notice that this certificate of coverage is not transferable except after notice to the Division of Water Quality. The Division of Water Quality may require modification or revocation and reissuance of the certificate of coverage. This permit does not affect the legal requirements to obtain other permits which may be required by the Division of Water Quality or permits required by the Division of Land Resources, Coastal . Area Management Act or any other federal or local governmental permit that may be required. If you have any questions concerning this permit, please contact Cory Larsen at telephone number (919) 807-6365 or cory.iarsen@ncdenr.gov. Sincerely, CRG1NAL SIGNED BY KEN PICKLE. forColeen H. Sullins cc: Winston-Salem Regional Office, Ms. Rose Pruitt Central Files Stormwater Permitting Unit Files Wetlands and Stormwater Branch One 1617 Mail Service Center,Raleigh,North Carolina 27699-1617 NorthCarol Ina Location:512 N.Salisbury S1,Raieigh,North Carolina 27644 �Q�ura��� Phone:919-807-6300 h FAX:919-807-64941 Customer Service:1-877-623-6748 Internet:www.ncwaterquaiity.org An Equal 0000dUnb 1 Atfirniative Adion Ennolover STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF WATER QUALITY GENERAL PERMIT NO. NCG060000 CERTIFICATE OF COVERAGE No. NCG060313 • STORMWATER DISCHARGES NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the Federal Water Pollution Control Act, as amended, GRACE FOOD DISTRIBUTION INC. is hereby authorized to discharge stormwater and from a facility located at Grace Food Distribution Inc. 5646 Shattalon Drive Winston-Salem Forsyth County to receiving waters.designated as Mill Creek, a class C water in the.Yadkin-PeeDee River Basin, in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II, III, IV, V, and VI of General Permit No. NCG060000 as attached. This certificate of coverage shall become effective July 31, 2009. This Certificate of Coverage shall remain in effect for the duration of the General-Permit. Signed this day July 31, 2009. ORIGINAL.SIGNED BY KEN PICKLE for Coleen H. Sullins., Director Division of Water Quality By the Authority of the Environmental Management Commission LOCATION MAP: � s `, i4, _,r�.� \ ,�� F,�-�-r rf�, 1, f' J^�1! SrJ�x. - /�t`•�ir 4 hr���� lilll� .°�,�-.b�"` �t��i���rf/!�J^".`;+'.L�.' J5� •43. � - tr,'it `r t es r �/ —, - f \• �` ��ww.. fit:��� '.""`}� �.t�_ / Jl f�J _�+�• �4 1. f J�. t ��^!+- � i' _ t WN /� of���(J � �[��-' d�• p�,-�� f } � �� S •���� � v 7' '`:� .F � 'x ter+ r •�s i :-� f f -- � jl� ti g r-'. � �.0 � - -•t;'- �: K: ."' �� It1x���r: r �<, ,�, _ •i:r �-•"�—�f f ��� �I�!��� - 'Itl� = :�L J W�r kfd9 5 =l i � °�;r r• 1 -}__ J L /�(, t ti)� 'Ak n� r� ��+ ��1�e �,LLLLLL����—��� ', ��q ;� "R� �n •�Pt r� �� L1'i� �' �� �• • L6 ..i •A�i�'l ,. I 1- r e - 1 4 •k 41, 7 f• }\ `_'rr ,fir f �_ �.�rS � 'R j. 7 3'f`����r� .�� ,.�^• \L�,;=ti*: � � ? ���4M.��J" .�'�k' .'M 4� -.� ,��'-; `� ; ; a _ _ i a»S. � i 44W j� l ..f •� p t• • 77- g i � V.y'-,"`` � .�,x.y . '. G. ,• ' �/ .. - 4 Grace Food Distributior7 � ti� _� �J ! _ :..}�.. • ;}(``e'�sti� ,jr.�' �,�,. •,;',' �� ` i $�#�' L(. � � R�ti, 1�-� ••�, , '� ' 3_•~.sf /yr �, `✓'•f\ ��� -Y� l�r4 — _� �` J � '»s..a�i` m��� � IV�F -'� } �f l �'� 'C e ^i NA:'.a. �_- - y�• -��` ��.r \,��������� l i�••f-r�}r f � 3 ,�`.l• . _ J+p t �� +s �i# 1..,'s` � f�S S '� ��--../,� t. 4�. f �L f� '� -li 5.�,�,�y� y ;��.•i 3�5 :J.� ^I} �f� vV SS ]*":; j'�•'- +f ►:.•N;•� � .sI' •,� Y°r"��\~ice:^` s�:._'i J tsl `3A _ fry . -'.�,.-�;: \ r,: ♦ a..s`t� � ;` � i. .�✓T �' '� �f� �,�� �� f' ~' �f t '(a}g3 Mt4_� (J�"` L 44 ~ f.�3 ,...� u�ti� tti, -.•Rr- a� „ �.^ y.��{"'.'.� �1�,��.�_-..✓"` mil!y: '•4�• , `�1 ���. h �-r .. Ji�J�J S CLL S' ��4, !` •'t'" ���1 f u^ �� Z'1 'tom- }i I�} ��� 1:.t � ley ��� �� ,i S�^.y �t 1 ��\`'���rt1 l J •iice � '`% � �.•. ���r�� ' _�' � ,..i� ��¢r �' _. � ��`� 1 f[p _ ��3 r!� i� �Iy^��1y -ra - K' � '--ter rKi�.[�'���/'�"���+�-_1•�. t ,71�\. _"'f .:�` r� f'- �,� �., r3.3C: 1� .S'y F.• �`+1zi ! I� J ft i_ f` .' ''�'' li` .!,' r--M 'f' NCG060313 Grace Food Distribution, Inc. -' Labtude: 36° 10' 08"N },. Longitude: 800 17' 14" W County: Forsyth Receiving Stream: Mill Creek Stream Class: C flap Scale 1.20,044 Sub-basin: 03-07-04 (Yadkin Pee-Dee River Basin) Facility Location Compliance Inspection Report Permit: NCGO60313 Effective: 07/31/09 Expiration: 10/31/12 Owner: Grace Food Distribution Inc SOC: Effective: Expiration: Facility: Grace Food Distribution, Inc. County: Forsyth 5646 Sahthalon Dr Region: Winston-Salem Winston Salem NC 27105 Contact Person: Joseph Deluca Title: Phone: 336-661-0291 Directions to Facility: System Classifications: Primary ORC: Certification: Phone: Secondary ORC(s): On-Site Representative(s): Related Permits: Inspection Date: 02/2412009 Entry Time: 10:45 AM Exit Time: 11:45 AM Primary Inspector: Rose Pruitt Phone: 336-771-5000 Secondary Inspector(s): Reason for Inspection: Complaint Inspection Type: Compliance Evaluation Permit Inspection Type: Food/Tobacco/Soaps/Cosmetics!Public Warehousing Stormwater Discharge COC Facility Status: 0 Compliant B Not Compliant Question Areas: ®Storm Water (See attachment summary) Page: 1 Permit: NCG060313 Owner-Facility: Grace Food Distribution Inc Inspection Date: 02/24/2009 Inspection Type: Compliance Evaluation Reason for Visit:Complaint Inspection Summary: site visit with city of ws sw inspectors. facility washing out trucks to sw drop inlet. no permit Permit and Outfalls Yes No NA NE # Is a copy of the Permit and the Certificate of Coverage available at the site? ❑ ® n D #Were all outfalls observed during the inspection? ® n n n # If the facility has representative outfall status, is it properly documented by the Division? D D ® D #Has the facility evaluated all illicit(non stormwater)discharges? D ® D D Comment: Discharging w/o a permit. truck wash illicit discharge Page: 2 Compliance Inspection Report Permit: NCG060313 Effective: 07/31/09 Expiration: 10/31/12 Owner: Grace Food Distribution Inc SOC: Effective: Expiration: Facility: Grace Food Distribution, Inc. County: Forsyth 5646 Sahthalon Dr Region: Winston-Salem Winston Salem NC 27105 Contact Person: Joseph Deluca Title: Phone: 336-661-0291 Directions to Facility: System Classifications: Primary ORC: Certification: Phone: Secondary ORC(s): On-Site Representative(s): Related Permits: Inspection Date: 06/02/2011 Entry Time: 01:00 PM Exit Time: 02:00 PM Primary Inspector: Ron Boone f Phone: 336-771-4967 Secondary Inspector(s): !Y1�2Y/Zo rr Reason for Inspection: Routine Inspection Type: Compliance Evaluation Permit Inspection Type: FoodlTobacco/Soaps/Cosmetics/Public Warehousing Stormwater Discharge COC Facility Status: ❑ Compliant ■ Not Compliant Question Areas: 0 Storm Water (See attachment summary) Page: i r Permit: NCG060313 Owner-Facility: Grace Food Distribution Inc Inspection Date: 06/02/2011 Inspection Type: Compliance Evaluation Reason for Visit: Routine Inspection Summary: Please refer to the attached inspection summary letter. Page: 2 Permit: NCG060313 Owner-Facility: Grace Food Distribution Inc Inspection Date: 06/02/2011 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? e D D #Does the Plan include a General Location(USGS)map? D ■ D D #Does the Plan include a"Narrative Description of Practices"? D ■ D D #Does the Plan include a detailed site map including outfall locations and drainage areas? D ■ D D #Does the Plan include a list of significant spills occurring during the past 3 years? ❑ ■ D D #Has the facility evaluated feasible alternatives to current practices? D ■ D #Does the facility provide all necessary secondary containment? r l ■ D D #Does the Plan include a BMP summary? D ■ D D #Does the Plan include a Spill Prevention and Response Plan (SPRP)? D ■ D D #Does the Plan include a Preventative Maintenance and Good Housekeeping Plan? D ■ D D #Does the facility provide and document Employee Training? D ■ D D #Does the Plan include a list of Responsible Party(s)? ❑ ■ 0 D #Is the Plan reviewed and updated annually? D ■ D #Does the Plan include a Stormwater Facility Inspection Program? 0 ■ 0 D Has the Stormwater Pollution Prevention Plan been implemented? D ■ D D Comment: Please refer to the attached inspection summary letter. Qualitative Monitoring Yes No NA NE Has the facility conducted its Qualitative Monitoring semi-annually? ❑ ■ 0 0 Comment: Please refer to the attached inspection summary letter. Analytical Monitoring Yes No NA NE Has the facility conducted its Analytical monitoring? D ■ D D #Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas? ❑ ■ ❑ D Comment: Please refer to the attached inspection summary letter. Permit and Outfalls Yes No NA NE #Is a copy of the Permit and the Certificate of Coverage available at the site? ■ D D ❑ #Were all outfalls observed during the inspection? ■ D 00 #If the facility has representative outfall status, is it properly documented by the Division? D D ■ D #Has the facility evaluated all illicit(non stormwater)discharges? D ■ D D Comment: Please refer to the attached inspection summary letter. Page: 3 - � R,.--7,1•,,ps:a'-:f�t;.f. _ �"[`� -� +.;s.,� „�L-ri �`�� ��:,�� .. n:• x� 1; i { - is < �?:. 0 153. 6/2/2011 '7 oeV ,r Lt :. � t iFAS • " y " -CIT -OF-- Stormwater Inspection ` • E` WINSTOW �`= . SALEM For • • • Distribution Inc. cyi4r. �j y � FAX N The objective of this SWPPP is three-fold:(1) Identify potential sources Z of pollution at Grace food distribution Describe bestnot limited to, a facility inspection, site compliance evaluation, record 3' management practices (BMPs) (3) Provide other elements such as, but F �+ keeping • reporting program review that will help Grace food ✓ � E'er distribution Inc. with the terms an• conditions of • z discharge t'yl� �7 x� Report By s. • /n-Salem Stormwater Inspector t7L; j � .[ {,1'4* R �� � 4.;� -. t b�.ia1.:' F� �� it l:, p.._ ..,.� a.r�- 14 -s.{�S.}n - s �! .Si �•it_ [��x,.. AW e' �1 -l`. •,� .! ..._ �:i�?:�`�2`�.c� z1 T�;�. .��a kin'�x.J�..���,`��.', ' �-1�.. z � "�"�"�Xn'V::.,1:.0 a..u�w.�,{�.. �._ 7 _-.Kz..'' iml•r.F!X't'�_x ,..."�Lw -'�, r' City of Winston-Salem Stormwater Division Surface Water Inspection for Industrial Sites Part 1 — General Informations A. official Company Name: Grace Food Distribution Inc. B. Physical Address: 5646 Shattalon Drive, Winston-Salem, NC 27105 C. Telephone Number: 336.661.0291 D. Mailing Address, If different from above address: Same E. Primary contact who is authorized to represent company in environmental regulatory issues: a. Name: Robert Smith b. Title: operational Manager cis Contact Number(s): 336-661-0291 d:� Email: gracefood888@yahoo.com .n _ F. SIC�Code number of business: 5141014 1 r G. NC.Stormwater NPDES Pi mit Number:1jCG060313 vat. ,Facilrt T e: Food Products`Distribution Warehousin H.'"Any:other control authoyrity Permits) (air quality cantrol,wastewater,.hazardouswaste)& riumber(s)-Mone tj L3Li U I: '' Brief descriptiom oflndustrial activities that occur on-site: Grace Food Distribution,.Inc-engages in=the,wholesale distribution of Chinese food products. . ecei ing Water(s)'%'#MS4: Mill Creek, Winston-Salem MS4 P,.art1� Stormwater�;Control 1. Best management Practices A. List the non/structural controls employed by the facility: 1.Currently they do not have any inplace. B. Are the BMPs reasonable &appropriate for the facility: Yes No^x zz C. Are BMPs installed correctly, maintained, and effective operation condition: Yes No x-x-xl 2. Provide a brief description of other controls that manage/prevent/minimize stormwater runoff(e. g., erosion and sediment controls, inlet protection/control at storm drains, diversion structures): 1.Comments. f Pa_rt:� Miscellaraeaus 1. Any evidence of discharge to receiving waters/MS4? (e.g., stormwater runoff, dry weather discharge, co-mingling of process wastewater): xxx Yes No i. NOV was issued for washing of raw meat waste and bleach into the storm water drainage system. 2. Do the stormwater outfalls on-site correspond with those listed on the site map and in SWPPP? Yes No xxx N/A i. There is currently no map of the facility Part'3, SIIUPPPaRe�iew {cant;becompletediri office) General 1 Is there a SWPPP? Yes No 2) Does SWPPP identify a specific position(s)•for responsible party purposes{e'g)dverall coordination, development, �' SiqD --` - V �� implementation;&prevision a Yes Now q `t �`' 3) Does SWPPPYdesigrtatetfacility:personnel responsible forty implemeritin �SRP? Yes O."No. 4 Does SWPPP"include=atcer.tification statement? Y e s S Nod 5) Are employee training°records regarding stormwater pollution reventi n topics included in=S,WPPP? Yes No ...fir-�J'. Comments .- Site Map NOTES 1 is there a site map? Yes No 2 Drainage patterns/outfalls Yes No 3) Identification of potential pollutants likely to be discharged from each drainage area? Yes No 4 Narrative description and locations of (check if present): 1. Storage practices 2. Unload in /Load ing activities 3. Outdoor processes 4" Particulate generating/control processes R 5. Waste Disposal 5 Name of receivtg.waters or MS4's listed? Yes No 6) Locations of significant materials exposed to stormwater? Yes No 7) Locations and descriptions of major spills occurring within the the 3 previous years (wl corrective actions to prevent future spills)? Yes No Stormwater Controls NOTES 1) Does the SWPPP describe the non-structural controls that will be used to prevent/reduce discharge of pollutants in stormwater runoff? Yes No 2) Does the SWPPP describe the structural controls that will be used to prevent/reduce discharge of pollutants in stormwater runoff? Yes No 3) Does the SWPPP�describe other controls that will be ,� used to prevenUrbd ce,off-site tracking or blow ng7of sediment dust , r'aw final or waste products or other solid materials'an'd fl`oatin tlebris. ' ° ? '� 4) Does the..-SWPPP incorporate the 8zbaseline controls ` 1= (good housekeeping,_BMP�summ4ary feasibiIi turfy, L � K--' PM, SRP procedCjres,.facility inspections, and O o comprehensive.site evaluation employee training, seconds .containment,-,and sediment control? Yes No 5) Does the•SVVPPP'describe-the pollutant or activity to be controlled by`BMPs'and assessed the need of im lementatibnI roug6ata collected? Yes No 6) Does the SWPPP describe the pollutant or activity to be controlled by BMPs and assessed the need of implementation through data collected? Yes No. Non-stormwater Discharges NOTES 1) Certification that the facility has been tested for non- stormwater discharges from the site? Yes No 2) Description of testing method, drainage points, observed results, date, and signature? Yes No Monitoring 1) Are samples collected within 30 minutes of measurable weather events occurring 72 hours after Yes No previous measurable weather event? 2) Were samples collected and preserved in accordance with 40 CFR 136? Yes No 3) Was proper chain-of-custody procedures followed? Yes No 4) Was analytical and qualitative monitoring complete? Yes No 5) Any exceedences of pollutant parameters in regards to benchmark values? Yes No Part 4=iRequiretl Actions fo be c_omt `lep _tedt%y.Facility": v, _ �. - - - 1. Update', WPPP to reflect permit requirements (i.e. feasibility study, site map to scale, Lat/long of utfalls za etc.) q 1 111 2. Site map,heed to be doneao-scale,with Eat/long for each outfall that needs to e,annotated, percentage of:impervious area,need.to'be annotated, potential pollutants-likely to}b� . �. �; 1 ):x� 1RS �� � ��dascharged needsao be marked for each drainage,bAin„and thelMS4 that is used need to be �listed�o_ site map. L-i Li R 3 'SWPPP.-need=nbt:be,in general and needs to address specific, implemented'BMPs _ ._. (41 4: Training'cecords forrspill response and prevention are needed; please submit to thOStormwater Divis on once.traaining has been accomplished. 1�,5„> A'updated�sig6 ertification statement validating your SWPPP, Spill response training logs, a `statement,that,no significant spills have occurred on site for the past 3 years, preventative maintenance records, a non-stormwater discharge certification statement, and a narrative description of potential pollutants which could be expected to be present in stormwater discharge for each outfall. 6. Monitoring needs to be performed. Both analytical and qualitative must be in a six month intervals according to the permit, 2010 monitoring was absent. 7. No qualitative monitoring has been accomplished. 8. Conduct Training and document training, there has not been any conducted. 9. Signed certification statement of SWPPP 10. Conduct feasibility study for the temporary storage tank, which is in the maintains shop a economic feasibility study for improving that includes inclosing, containing potential spills, managing spills and 'improving handling of the oil tank. 11. Develop SOPS for delivery personal of how to unload goods, and action that needs to be emplace in case of a spill, and document that they understand the SOPS and will comply your established SOPs The City of Winston-Salem Stormwater Division is requiring that Items#1-11 to be completed. Grace Foods Incorporated shall keep the Stormwater Division updated on milestones and activities completed in its progression to comply with these required actions this will be done on a monthly basis. The Stormwater Division may conduct follow-up inspections in order to ensure completion of mandated activities. Educational Resources: 1. NC Stormwater Manual for Industrial lasers: a. http://h2o.enr.state.nc.us/su/storm water.html. b. http://portal.ncdenr.org/web/wq/ws/su/bmp-manual Company Representative(s) that participated in inspection name and title(s): Loy Lee Vice President; Robert SmithAperation Manager Start of Inspection: 1:30 PM : . CompletEonf I onspec �#ion: 3:15' ' , _ Q o , 1 Date of nspec6on,.V6 2- 2011 : , F f r �- ,. ` . LQJ Signature-of'Storrriwate.r•Inspector and title: William D. Baugher, Stormwater Inspector 4 n In V s Pruitt, Rose From: Pruitt, Rose Sent: Monday, July 27, 2009 9:58 AM To: Larsen, Cory Subject: RE: Grace Food Distribution NCG060313 Go ahead and issue this permit. They are no longer washing out trucks at the site. *** My email has changed to Rose.Pruitt @ncdenr.gov Rose Pruitt NCDENR-DWQ Winston-Salem Regional Office Division of Water Quality, Surface Water Protection 585 Waughtown Street Winston-Salem, NC 27107 Voice: (336) 771-5000 FAX: (336) 771-4630 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. From: Larsen, Cory Sent: Wednesday, July 22, 2009 3:32 PM To: Pruitt, Rose Subject: Grace Food Distribution NCG060313 Rose, Grace Food has applied for coverage under NCG06. The application is complete. Any comments from your Region on this facility? Thanks. Cory Cory Larsen Environmental Engineer NCDENR I DWQ I Stormwater Permitting Unit 1617 Mail Service Center, Raleigh, NC 27699-1617 512 N. Salisbury St, Raleigh, NC 27604 Phone: (919) 807-6365 Fax: (919) 807-6494 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. 1 rt FOR AGENCY USE ONLY Division of Water Quality/Surface Water Date Received Year Month Da Protection Section 0- L Certificate ofCDveraee r K'""EM National Pollutant Discharge Elirninadon System hecckk# I A omt ' r.�v,x Yr.+*a[u Maws.ra-a.rt:ra NCG060000 Perini:Assiened ro arsy- NOTICE OF INTENT National Pollutant Discharge Elimination System application for coverage under General Per ' 7 NCG060000: m a --�- 9�"1 I 1. STORMWATER DISCHARGES associated with activities classified as: 1'z SIC(Standard Industrial Classification)20 Food arld Kindred Products SIC 21 Tobacco Products » SIC 283 Drugs 9 - SIC 284 Soaps, Detergents, & Cieaning Preparations; Perfumes, Cosmetics, &Other Toilet; arms s Lo SIC 422 Public Warehousing and Storage (except 4226) — L f For questions,please contact the DWQ Regional Office for your area. Seepage (Please print or type) _ 1) Mailing address of ownerloperator(address to which all permit correspondence will be mailed Name _- 611A CP I" d r' Street Address City State_-, PJ,_( ZIPCode Telephone No. 4a'1..n2 4'! Fax: ��G=. ez-1-Ladl 2) Location of facility producing discharge: (Cell 917-4(,D- /7 3,Z Facility Name `� �- zr = ' Facility Contact �jps � Q. L,�,g Street Address City toi State Al. <- _Z1P Code _?7ICJ— mm_ County - Telephone No. �_ (�I'- Fax: Email C C-fl 9/7, 660- /7.3.2 �o;F. � 3) Physical Location Information: Please provide a narrative description of how to get to the facility(use street names, state road numbers, and distance and direction from a roadway intersection). - .z 'd 6Qk 11-r a. ; 'Pe— (A copy of a county map or USGS quad sheet with the facility clearly located must be submitted with this application-} It p i r! 4) Latitude 110V[19.- f A� Longitude 1'7't . ©0(deg, min, sec) i 5) This NPDE Permit Application applies to which of the following: ❑ New or Proposed Facility Date operation is to begin Existing Pagel of 4 S W U-221-071408 Last revised 7/14/07 NCG060000 N.O.I. 6) Standard Industrial Classification: Provide the 4-digit Standard Industrial Classification code (SIC code) that describes the primary industrial activity at this facility. SIC code: -.7- 'z 7) Provide a brief narrative description of the types of industrial activities and products manufactured at this facility: -' G 8) Discharge points 1 Receiving waters: How many discharge points (ditches, pipes,channels, etc.)convey stormwater from the property? What is the name of the Ain 00or bodies of water(creek, stream, river, lake, e e:)-t;at the facility stormwater discharges end up in? Receiving water classification: Is this a 303(d) listed stream? rt0 Has a TMDL been approved for this watershed? If the site stormwater discharges to a separate storm sewer system, name the operator of the separate storm sewer system (e.g. City of Raleigh municipal storm sewer). 9) Does this facility have any other NPDES permits? IdNo ❑ Yes If yes, list the permit numbers for all current NPDES permits for this faeil�ty: 10) Does this facility have any Non-Discharge permits(ex: recycle permit)? V'No ❑ Yes If yes, list the permit numbers for all current Non-Discharge permits for this facility: 11) Does this facility employ any best management practices for stormwater control? lit No ❑ Yes (Show any structural BMPs on the site diagram.) If yes, please briefly describe: 12) Does this facility have a Stormwater Pollution Prevention Plan? C�No ❑ Yes If yes, when was it implemented? 13)Ara vehicle maintenance activities occurring at this facility? ❑ No - Aes 14) Hazardous Waste: y a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility? If No ❑ Yes b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of hazardous waste? MeNo ❑ Yes Page 2 of 4 SWU-221-071408 Last revised 7/14107 NCG060000 N.O.I. c) Is this facility a Large Quantity Generator(1000 kg. or more of hazardous waste generated per month) of hazardous waste? ®[No ❑ Yes d) Is hazardous waste stored in the 100-year flood plain? No ❑ Yes If yes, include information to demonstrate protection from flooding. e) If you answered yes to questions b.or c., please provide the following information: Type(s) of waste: How is material stored: _ Where is material stored: How many disposal shipments per year: Name of transport/disposal vendor: Vendor address: 15) Certification: North Carolina General Statute 143-215.6B (€) provides that: Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan,or other document ailed or required to be maintained under this Article or a rule implementing this Article; or who knowingly makes a false statement of a material fact in a rulemaking proceeding or conlested case under this Article;or who falsifies,tampers with,or knowingly renders inaccurate any recording or monitoring device or method required to be . operated or maintained under this Article or rules of the Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine net to exceed ten thousand dollars($10,000)- hereby request coverage under the referenced General Permit. I understand that coverage under this permit will constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an individual permit. certify that I am familiar with the information contained in this applicatiori and that to the best of my knowledge and belief such information is true,complete, and accurate. Printed Name of Person Signing: J�X'E _iD, L_1 p r A Title: /—/eef /Jfi,7A4�v (Signature of AppGcan (Date Signed) This Notice of Intent must be accompanied by a check or money order for$100.00, made payable to: NCDENR Page 3 of 4 SWU-221-071408 Last revised 7/14107 NCG060000 N.O.I. Final Checklist 4 This application will be returned as incomplete unless all of the following items have been included: 19 Check for$100 made payable to NCDENR, ❑ This completed application and all supporting documents. ❑ A site diagram showing, at a minimum, (existing or proposed): (a)outline of drainage areas, (b) stormwater management structures, (c) location of stormwater outfalls corresponding to the drainage areas, (d) runoff conveyance features, (e) areas where materials are stored, (f) impervious areas, (g) site property lines. ❑ Copy of county map or USGS quad sheet with the location of the facility clearly'marked on the map.. Mail the entire package to: Stormwater Permitting Unit Division of Water Quality 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Note The submission of this document does not guarantee coverage under the General Permit. For questions,please contact the DWQ Regional Office for your area. DWQ Regional Office Contact Information: r Asheville Office ...... (828) 296-4500 Fayetteville Office ... (910) 433-3300 Mooresville Office ... (704) 663-1699 , Raleigh Office ........ (919) 791.4200 Washington Office ...(252)946-6481 Wilmington Office ... (910) 796-7215 � Il �, t Winston-Salem ...... (336) 771-5000 r Central Office .........(919) 607-6300 Y ngipn .f Page 4 of 4 SW U-221-071408 Last revised 7114107 i \� r Mi��'.,ua -tx •ry 4 i � c }'x"s`.iPs'i ,r,.'_ - 'sz-.r�f T OF41y ! \ Scott Services Inc 1:►"=• ^' Clyf J� D.B. 2314, Pg. 1619 M<< 0 �s + 1J �� Block 3452, Lots 204C, 205E, ord 205E II.cC -«. `� 4) RFL�;rCENT�,R ; Pin # 6818-91-3647.00 1 Pir, s 5- s Sp 17', J 5 Shattalon Or 552C = - Zoned LI �4 eRE-z� (PROPER ENT=R OF #AIL S=T `food 1vu� L; "- '- 522.94' N 14.59'25"E EXISTING GRAVEL AREA fr' '` f f f �. --�--•-- Sys„ a TFiNK ACATION Ew SHELTErZ: ' '>, Yr ,tr n� Stiu a4W {c �.� ' GAS , k00, x to0'� ''. RAYE1,`of ,r fr 1 }— , s 1��} - hq zl _ 3 t1 1 Y Eli N ! earrCOCREIE 100 Y - r ? { 1, 11QQ Line, qa r " 1, STORY METAL r�_Ulf D1f3G + } N M ► Q�?�' �t.� z �f3LOCK r r....,r-� r� �r'r•,..!S-i z .- .�;--�• �y ' r 1 ! PP M3 c; '74 C r o�� ��. .. ETe .,. ce.'`-i00�Year='Ftno-d. Lit1e.-. _: , - -• .�1`n. �r r� _U. r Ding Inc FW C7 B ASPHALT P. �IEQ_AREA 76 GAS LINE rt ! 360 EQUIPMENT , a IF i r— S 15.32'21"W 550.68 IF t0.0i� 1114 APPROXIMATE LOCATION j u7 GAS LINE i o Arid Martin; BeJ it j _ �rn D.B. 2446, Pc. 27 ,n 1 Pin # 6828-02-12�' + '`J " `� j v Etcck 6409, Lot e t f- J t ' ! I f 1E Moore 01 r ¢ .�?-17 ka j 5 1 1_-,Q'47"W o5"W 34094r 1 N0 BASES OF REED k � PLACED F TREE Modern Investments LLC \ D.B. 2450, Pg. 2728 Block 6409, Lot 101 Pin # 6828-01-3505.00 54's 5 Kelley-Moore Dr Zoned LI i r T:is `e a�*er>sr:.1c s are da:�t reGr,ue a buffer i to-uva TyCe[V 5uffe Bufferyards. Note tha southern and southwe The owners of the Prc inspector to visit the s 7 ` e iT z _ r _ +a�`. _ � �'=—t "`-. ice- -....�(�,s _� •��gi� � � / /'�. � .� , .��f_.•, ., r A-� } w. �• � • '� � ° Grace Food Distribution • s , ``ti r 4 t�"�f+ Y/ yF-• � I,' •J__.r'- � �`••1� ' �F � �I 1. .�� ��. ��t �� f �:ai'L. SFr, �"'- �T• � � O• [ r .j•^ /.....'\ -�!r r_ ♦� 1r •� - �. �`f • .r, C �I •� ♦ ti. � k� • ,ate- / 11 a• �,. � lll--,__---���♦•. NCG060313 Grace Food Distribution, Inc. Latitude: 360 10' 08" N Longitude: 800 17' 14" W County: Forsyth Receiving Stream: Mill Creek Stream Class: C Map le 1:20,000 Sub-basin: 03-07-04 (Yadkin Pee-Dee River Basin) Facility Location '�'ti a!sy'':3) } ~r�..i #�4'x,�� y" - P ,� n �s,y .� j � ,a ti a '+ � { -' • ?T a ,4 - RECEIVE_Q E}eot.OfFcr. � MAR 18 2M . Win-iton-Salem Regional Ica GPACE FOOD DISTRIBUTION 5646A Shattaion Dr., Winston-&Icm,N.C. 27105 046)�t�zs►t Dade: Avrah iI,2€DOg To Whom it May Cotwwn: This lstW is to inform thw city of VftoWn-Selem public vaster works that Cram Food Dist.will take the following action to eliminate or control and rnoeKared pollution sourcm from g the wa tm of tine state_ Cry Food Dist has created and knpleniGnted a petuanent t40 of sidlon In order to establish a pollution pmm mtkm plan,to conduct good house ks eong to avoid tiood matters or othet..rel&W iftom hom wing the =W*, by educating the employ and i~Mg a wash pit and containment area fet all c1mming gemr and-psoducts and tools. Grace Faced Dist has opcAen with Rick Matdwvm Of Long Construction Company to afsa help us knpMr xmt cet+tein pleas and procedums to stop sad aanf wemiige acgom being WAW against Greve Fond This is base-i of Grace Food Dist intended course of acts is eider to prevent the Fecurromm of similar situations. Thank You f Sincerely /I/OU 'r . Y AgA S NCDENR s North Carolina Department of Environment and Natural Resources Division of Water Quality Beverly Eaves Perdue Coleen H. Sullins Dee Freeman Governor Director Secretary March 10, 2009 Grace Foods Dist. Inc Mr. Loy Lee 5646-A Shattalon Dr Winston Salem,NC 27105 Subject: NOTICE OF VIOLATION And Recommendation to Enforce Grace Food Forsyth County. Dear Mr. Lee: - A complaint investigation was conducted at the Grace Food Dist. facility located at 5646 A Shattalon Drive in Winston Salem NC'on February 24, 2009 by Rose Pruitt of the North Carolina Department of the Environment and Natural Resources Division of Water Quality, Winston-Salem Regional Office and Keith Huff,Don Donadio and John Spainhour . with the City of Winston Salem Stormwater Division. Loy Lee,Vice President and Joey DeLuca,Fleet Manager with Grace Food Dist. were present at the inspection. During the investigation it was noted that this facility was operating without required NPDES wastewater or stonmvater permits. A vehicle wash station had been set up where detergents were used to wash and rinse out trucks that contained leachate and food waste. This waste water flowed to a storm drain to Leak Fork Creek, a class C water in the Yadkin-Pee-Dee River Basin. Serious compliance issues and violations were noted as follows. h (1) Operating without a permit. f 5 The Division of Water Quality issues a General Permit No.NCG060000 to discharge stormwater under the National Pollutant Discharge Elimination.System. Coverage under this general permit is applicable to all owners;- , of stormwater point source discharges associated with activities that are classified as.establishments primarily engaged in activities classified as Food and Kindred Products (standard industrial classification(SIC)20... and Public Warehousing and Storage(SIC 4221-4225). I have enclosed information about this permit and a Notice of Intent or application for coverage under General Permit NCG060000, You trust make application for this permit immediately. (2) Making an illicit outlet to the waters of the state in violation of North Carolina General Statute 143-215.1: § 143-215.1. Control of sources of water pollution; permits required. (a)Activities for Which Permits Required.—No person shall do any of the following things or carry out any of the following activities unless that person has received a permit from the Commission and has complied with all conditions set forth in the permit: (1)Make any outlets into the waters of the State. (2) Construct or operate any sewer system, treatment works, or disposal system within the State. 5 North Carolina Division of Water Qualfty,Winston-Salem Regional Office Location:585 Waughtown St.Winston-Salem,North Carolina 27107 One Phow 336-771-5000 4 FAX:336-771.46301 Customer Service:1-877-623-6748 North Carolina Internet:www.ncwaterquality.org '�' "atura l ff An Equal Opportunity 1 Affirmative Action Employer �/ y 1 (6) Cause or permit any waste, directly or indirectly, to be discharged to or in any manner intermixed with the waters of the State in violation of the water quality standards applicable to the assigned classifications or in violation of any effluent standards or limitations established for any point source,unless allowed as a condition of any permit, special order or other appropriate 5 instrument issued or entered into by the Commission under the provisions of this Article. An illicit discharge of waste water was observed at the time of the inspection. A vehicle wash station had been set up where detergents were used to wash and rinse out trucks that contained leachate and food waste. This waste water flowed to a storm drain to beak Fork Creek, a class C water in the Yadkin Pee-Dee River Basin, This Office requires that violations,as stated above, be abated immediate. Also please note, these violations and any future violations are sub'ect to civil penalty assessments of up to$25 000.00 per day, per violation. This Office requests that.y6u respond to this letter, in writing,within 20 days of receipt of this Notice. Your response should address the following items: (1) You must immediately cease the illicit discharges of process waste water from your facility. -This Office will require documentation of all remedies. (2) You must immediatelv begin the application process for General Permit No.NCG060000 to discharge Stormwater under the National Pollutant Discharge Elimination System. (This is not apermit to discharge process wastewater.) Send a completed copy of your Notice of In_ten_t to this office as well as the Raleigh office indicated on the enclosed forms. (3) Please clearly discuss your efforts to abate/stem impacts to surface_waters. Thank you for your immediate attention to this matter.This office is considering sending a recommendation for enforcement to the Director of the Division of Water Quality. Your response to this correspondence will be considered in this process. Should you have any questions regarding this matter, please contact Rose Pruitt at(336) 771-5000. ASInce ,. Tedder Water Quality Regional Supervisor Winston-Salem Region Division of Water Quality Attachments Cc: Central Files W SRO Brock Turner,Forsyth County Health Dept Keith Huff, Winston Salem Stormwater Division NPS Compliance and Assistance Unit Bradley Bennett, Stormwater Permitting Unit J WA �aG Incident Report r Report Number: 200900632 Incident Type: Complaint On-Site Contact: Category: Surface Water First/MidlLast Name: Joey Deluca Incident Started: 02/23/2009 . Company Name: Grace Foods County: Forsyth Phone: (336)661-0291 City: Pager/Mobile Phone: 1 Farm#: Responsible Party: Reported By: Owner: First/Mid/Last Name: Brock Turner Permit: Company Name: Facility: Address: First Name: Loy Fc Flealth'Dept Middle Name: City/State/Zip: Last Name: Lee Phone: (336)703-3149 Address Grace Foods Pager/Mobile Phone: 1 5646 A Shattalon Dr City/State/Zip: Winston Salem NC 27105 Phone: (336)661-0291 Material Category: Estimated Qty: UOM Chemical Name Reportable Qty. lbs. Reportable Qty. kgs. DD:MM:SS Decimal Position Method: • Latitude: Position Accuracy: Longitude: Position Datum: Location of Incident: Grace Foods Address: 5646-A Shattalon Dr City/State/zip Winston Salem NC 27105 Report Created 03/10/09 07:57 AM Page 1 Cause/Observation: Directions: Owner contacted Health dept for well permit. Wanted well to wash out chicken delivery trucks to storm drain. Action Taken: Comments: Site visit 02/24/2009 @ 10A5-11:45 am with City of WS Met with Loy Lee,Joey DeLuca with Grace Foods. Site is unpermitted Stormwater Keith Huff Don Donadio,John Spainhour. (SW)food warehousing and distribution site with on site vehicle maintenance using>55 gallmo of motor oil. Wash area set up to rinse out delivery trucks with detergent and water drains to stormwater drain. Site has streams on 3 sides and wetland area. Incident Questions: Did the Material reach the Surface Water? Yes - Conveyance: Storm Drain Surface Water Name? Leak Fork Did the Spiil result in a Fish Kill? Unknown Estimated Number of fish? If the Spill was from a storage tank indicate type. (Above Ground or Under Ground) Containment? Unknown Cleanup Complete? Unknown Water Supply Wells within 1500ft: Unknown Groundwater Impacted : Unknown Event T' pe Event Date Due Date Comment Irv�iaent closed Requested Additional Information Report Entered 2009-03-10 08:48:00 Inspection or Site Visit Conducted 2009-02-24 10:45:00 discussed alternatives for truck wa Report Created 03/10/09 07:57 AM Page 2 Report Received 2009-02-23 08:15:00 Referred to Regional Office-Primary Contact 2009-02-23 08:15:00 Incident Start 2009-02-23 0&12:00 Standard Agencies Notified: Agency Name Phone First Name M.I. Last Name Contact Date Other Agencies Notified: Agency Name Phone First Name M.I. Last Name Contact Date City of WS Stormwater (336)747-6965 EA. John Spainhour 2009-02-24 10:45:00 AM DWQ Information: Report Taken By: Report Entered By: Regional Contact: Rose Pruitt Rose Pruitt Rose Pruitt Phone: DaterTime: 2009-02-23 08:15:00 AM 2009-03-10 08:48:00 AM 2009-02-23 08:15:00 AM Referred Via: Phone Phone Did DWQ request an additional written report? If yes,What additional information is needed? Report Created 03/10/09 07:57 AM Page 3 e` ` `�' ��^N � ` of a [ �;� � it 3i� '//yS� uuOa■■■■ LA Feb 24,2009 001 Feb 24,2009 002 Feb 24,2009 003 Feb 24,2009 004 Feb 24,2009 005 .� .y Ila Feb 24,2009 006 ` Feb 24,2009 007 Feb 24,2009 008 Feb 24,2009 009 Feb 24,2009 010 Ru �t F. mat t leg Feb 24,2009 011 Feb 24,2009 012 Feb 24,2009 013 Feb 24,2009 014 Feb 24,2009 015 r� A: Feb 24,2009 016 Feb 24,2009 017 Feb 24,2009 018 Feb 24,2009 019 Feb 24,2009 020 Y' "ja ,c Feb 24,2009 021 Feb 24,2009 022 Feb 24,2009 023 Feb 24,2009 024 Feb 24,2009 025 Feb 24,2009 026 Feb 24,2009 027 Feb 24,2009 028 Feb 24,2009 029 Feb 24,2009 030 �G� Preview C�1� - 1� / r/L ttp://maps2.co.forsy-th,nc.us/geodata%5FO8/printPreview.aspx?Prin... Forsyth County, NC 48% ' ­Nq 8717 1617 0696 }}�' .s'0 g782 y41676� �u �j =5�838 8507' '0595 {• \7�i 3 { �. ,. ��5650 7'2 � 4673 ���{: `• -,a--* � -,..., g2 i '` - >—f3.2_� .;1476 s.T i m a t .• 9218 2147 5248 8112 683B,�9828i 1i369^~~' ��� ��'e •���� • `i� ,s � !�3a t��� �t� '.��+"' 7 •' 6839 9556 r'e.,,t .. Jr s 3647 -Q I.- � 9416' 2314 r88�8 �1e 6828 " . 5247't 930J i.�213 7139 � 528282331 `1 6t43 P 2155 � 1033' .._ '�` �► RtcF�+a as .[ � eR fl4 Q a7955 9923 q a r. N1�115j SS34/ �' .• , ` *) , a 77811745' 2666 7 2780 �" ' 56627693 �i�✓• 7516 - r 4fi44 7516 8621 eea � ,1. T 24588T, go' 1 "'� a' _ .� � ..- A,1Q �r i 4359 6376 8417 ;a; qi g .r w 9332. 6215 7" 4985 U ��!. r .�-,i � � .�g n;'t'ti af.�7109 i, �'a;• �� - - V� �7075 _ "y y 6084 681•7 PIN 6818-91-6360.00 Current Deed Stamps $1,190 Property Address 5650 Shattalon Dr Map Number 618878 Block Lot 3452 114 Assessment Method Income and Expense Additional Lots WIP No Tax Jurisdiction Winston-Salem Land Value $194,704 Anx N Dwelling Value Taxable Owner Name W S Real Estate Holding Inc Commercial Value $450,827 Taxable Owner Name2 Industrial Value Taxable Owner Address 5646 Shattalon Dr Misc Imp Value $32,791 Taxable Owner City St Zip Winston-Salem, NC 27105 Total Value(2005 renal) $705,400 Taxable Deed Bk-Pg 1967-376 Acreage 13.59 Taxable Deed Date 10/1/1997 Sq Ft Living Area(Res) Taxable Deed Stamps $1,190 Gross S-q Ft(Com) 30000 Current Owner Name 1 W S Real Estate Holding Inc Year Built(Res) Current Owner Name2 Year Built(Com) 1990 Current Owner Address 5646 Shattalon Dr Census Tract 27.02 Current Owner City St Zip Winston-Salem, NC 27105 Zoning LI Current Deed Bk-Pg 1967-376 Last Qualified Sale Price S595,000 Current Deed Date 10/1/1997 Disclaimer:Forsyth County cannot guarantee the accuracy of this information, and the Map Scale County hereby disclaims all warranties, including warranties as to the accuracy of this 1 inch=636 feet information. ` 01, 6t , 1 of 1 2/23/2009 8:28 AM North Carol kpa Secretary of State htrp://www.secretary.state.ne.us/corporations/Corp.aspx?Pitemld=47... North Carolina Elaine F. Marshall DEPARTMENT OF�THE zP SECRETARY of STATE Secretary . PO Bax 29622 Raleigh,NC 27626-0622 (919)807-2000 CORPORATIONS Date: 2/23/2009 Corporations Home Click here to: Search By Corporate Name View Document Filings I Sign Up for E-Notifications i Search For New&Dissolved Print apre-populated Annual Report Form i Annual Search By Registered Agent Report Count i File an Annual Report I Important Notice Corporation Names Resale of Tickets Online Corporations FAQ Name Name Type Homeowners' Association FAQ NIC Legal ' Tobacco Manufacturers WINSTON-SALEM Unincorporated Non-Profits REAL ESTATE Dissolution Reports HOLDING, INC. Non-Profit Reports Business Corporation Information Verify Certification SOSID: 0436521 Online Annual Reports Status: Current-Active LINKS&LEGISLATION Date Formed: 9/25/1997 KBBE B2B Annual Reports .SOSID Number Correction Citizenship: Domestic 2001 Bill Summaries State of Inc.: NC 1999 Senate Bills Duration: Perpetual Annual Reports 1997 Registered Agent Corporations 1997 - Register for E-Procurement Agent Name: Chiu, Kuong Chung Dept. of Revenue Registered Office 5732 Shattalon Drive ONLINE ORDERS Address: Winston Salem NC 27105 Registered Mailing 5732 Shattalon Drive Start An Order Address: Winston Salem NC 27105 New Payment Procedures Principal Office 5646a Shattalon Dr CONTACT US Address: Winston Salem NC 27105-1331 Corporations Division Principal Mailing 5646a Shattalon Dr Address: Winston Salem NC 27105-1331 TOOLS Stock Secretary of State Home Secretary of State Site Map Class Shares No Par Value Par Value Printable Page COMMON 100 1 1 of 1 2/23/2009 10:16 AM •, SOSID: 0.138521 Date Filed: 2/26/2007 8:05:00 AM Elaine F. Marshall CD=479.(50) Business Corporation North Carolina Annoy North Carolina Secretary'of State 1>>`19-06 2007 057 02973 This report may be filed online at the Secretary of State websitd: Name of Business Corporation: W?NSTON-SALEM R AL ESTATE HOLDING T Fiscal Year Ending: 12/31/06 State of Incorporation: NC ` MontnfDaylYear Secretary of State AID Number. I hereby certify that the information requested below (required by NCGS 55-1fi-22) has not changed since the most recently filed annual report-and is therefore complete. Nature ofBusiness: r Registered Agent: 4 Registered Office flailing Address: x x -'C'ourity: City[ '' v rSlate_. . Zip Coder . . Registered Office Street Address: County: State: Zip Code: Signature of New Registered Agent:' constduies'cansent to She appoinimenq Principal Office Telephone NumbeF- Principa( Office Mailing Address:. 5646N1A ,SHAPTALON DRIVE r _ City: WIN-STON-.SALiM State: -N(2 'Zip Code: 27305 Principal Office Street Address: 5646;A' SH.A TALON DRIVE :Y City;r'. WINSTON=SALEM State '•NC Zip Code: 27105 Name,Title, and Business Address Principal Officers:." Name: BF-IN K.0`, CHI ' Title: PRESIDENT k Address: 8 NORTH 1ST C., City: BROOKLYN` t" Stale: NY ZIP: 11211 : Name: xC ~` • . Title" .? Address: City: State: ZIP: Name: 'Title: Address: i City: "' State: ZIP: Certification of arnt]af report(Must be corii I&ed by all Business.Corporations). '. Signature(F erh st be s'peCjtiy:an o4icer of corporation) 'Dale Type or Print Name NCCZ050i 11f13U ' rS 4.' a• T ► sInJU