NCG020242 - Gold Hill Mine

ROY COOPER
Governor
a;
MICHAEL S. REGAN
Secretary
WILLIAM E. TOBY VINSON, JR.
Energy, Mineral Interim Director
and Land Resources
ENVIRONMENTAL QUALITY
January 25, 2018
Mr. J. David McKeown
Meridian Brick, LLC
5100 Brickyard Road
Columbia, S.C. 29203
Subject: NPDES Stormwater Permit NCG020242
Meridian Brick, LLC
Formerly Boral Bricks, Inc.
Rowan County
Dear Mr. McKeown:
Division personnel received your request to revise your stormwater permit Certificate of Coverage to accurately
reflect your new company and/or facility name.
Please find enclosed the revised Certificate of Coverage. The terms and conditions contained in the General
Permit remain unchanged and in full effect. This revised Certificate of Coverage is issued under the
requirements of North Carolina General Statutes 143-215.1 and the Memorandum of Agreement between
North Carolina and the U.S. Environmental Protection Agency.
If you have any questions or need further information, please contact the Stormwater Permitting Program
at [phone].
State of North Carolina I Environmental Quality I Energy, Mineral, and/Land Resources
Central Office 1 1612 Mail Service Center I Raleigh, NC 27609
919 707 9200

Sincerely,
Original Signed by
Robert D. Patterson, P.E.
for William E. Toby Vinson, Jr., PE, CPESC, CPM
Interim Director
Division of Energy, Mineral and Land Resources
cc: Mooresville Regional Office
Stormwater Permitting Program
Central Files

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
GENERAL PERMIT NO. NCG020000
CERTIFICATE OF COVERAGE No. NCG020242
STORMWATER AND WASTEWATER 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,
Meridian Brick, LLC
is hereby authorized to operate approved wastewater treatment system(s) and discharge
stormwater and/or wastewater, as approved in the original permit/application or subsequent
permit modification, from a facility located at:
Gold Hill Mine
15055 Old Beaty Ford Road
Gold Hill
Rowan County
to receiving waters designated as the Little Buffalo Creek, a class C stream in the Yadkin -Pee
Dee River Basin, in accordance with the effluent limitations, monitoring requirements, and other
conditions set forth in accordance in Parts I, II, III, and IV of General Permit No. NCG020000 as
attached.
This certificate of coverage shall become effective January 25, 2018.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day January 25, 2018.
Original Signed by
Robert D. Patterson, P.E.
for William E. Toby Vinson, Jr., P.E., Interim Director
Division of Energy, Mineral, and Land Resources
By the Authority of the Environmental Management Commission

., F I ■1.ERI ®II �.iTM
BRICK
5100 Brickyard Road -
Columbia, South Carolina 29203
meridianbrick.com
May 1, 2017
Central Files
NC DENR
Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27699 —1617
919-807-6397
Rr_CEj'V5-0"
IJaRrII.06) ' Llf f`I7
Re: Change from Forterra Brick, LLC and Boral Bricks Inc. to Meridian Brick LLC
To Whom It May Concern:
This package is being sent in order to change the permit holders of the below -listed stormwater permits
in North Carolina. As background, on October 28, 2016, Boral Bricks Inc. converted to a limited liability
company named Boral Bricks LLC. On April 1, 2017, Boral Bricks LLC and Forterra Brick, LLC merged into
Meridian Brick LLC, with Meridian Brick LLC being the surviving entity. Additionally, Meridian Brick LLC is
the successor in interest to both Boral Bricks LLC an orterra rick, -ICC by operation of law.
Additionally, a letter from Paul Samples, CEO for what was Boral Bricks LLC, Forterra Brick, LLC and is
now Meridian Brick LLC, is included which grants me, J. David McKeown, signatory authority for any
required forms or documents pertaining to this name change that require signature.
This change results in the need for us to change the names on the stormwater permits formerly held by
both Boral Bricks and Forterra Brick to Meridian Brick LLC.
The affected permits are as follows:
NC SW Permit
NC�G070215`
BE BOLD. BE BRICK:
Former Name
Forterra Brick, LLC
Monroe Plant & Mine
Forterra Brick, LLC
Anson County Mine
Forterra Brick, LLC
Howell Mines 1&2
Meridian Brick LLC
Monroe Plant & Mine
Meridian Brick LLC
Anson County Mine
Meridian Brick LLC
Howell Mines 1&2

MERIDIAN -
BRICK
5100 Brickyard Road
Columbia, South Carolina 29203
mendianbrick.com
�- NCG070070-
Forterra Brick, LLC
Roseboro Plant
CG020504 c/ Forterra Brick, LLC
Gulf Mine #3
NCG020437 Forterra Brick, LLC
Sampson Mine II
LNCGQZ01:67� AC+V�oral Bricks Inc.
Salisbury Plant
NCG020242 V
r
NCG020241
NCG020239 V
Boral Bricks Inc.
Gold Hill Mine
Boral Bricks Inc.
Thomas Mine
Boral Bricks Inc.
Panther Creek Mine
Meridian Brick LLC
Roseboro Plant
Meridian Brick LLC
Gulf Mine #3
Meridian Brick LLC
Sampson Mine II
Meridian Brick LLC
Salisbury Plant
Meridian Brick LLC
Gold Hill Mine
Meridian Brick LLC
Thomas Mine
Meridian Brick LLC
Panther Creek Mine
Thank you for your assistance with this matter and if you require any additional information, please do
not hesitate to contact me at 803-691-3121.
Sincerely,
J. David McKeown
BE BOL®. BE BRICK:

State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STATE STORMWATER PERMIT NAME/OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION
1. Stormwater Management Permit Number: NCGo2o242
2. Project Name: Boral Bricks Inc -• Gold Hill Mine SPn�FNR,�,Or{�
3. Current Permit Hold"er's Company Name/Organization:
4. Signing Official's Name: Archie Barron
5. Mailing Address:
City: Salisbury
700 South Long Street
6. Phone: L704 ) 630-4246
Boral Bricks Inc
Title: Plant Manager
State: NC Zip: 28039
Fax:( 04 ) 636-7865
II. PROPOSED PERMITTEE / OWNER / PROJECT / ADDRESS INFORMATION
This request is for: (please check all that apply)
x❑ Name change of the owner (Please complete Items 1, 2 and 3 below)
❑ Name change of project (Please complete Item 5 below)
❑ Change in ownership of the property/company (Please complete Items 1, 2, 3, and 4 below)
❑ Mailing address / phone number change. (Please complete Item 4 below)
❑ Other (plb�ise explain):
1. Proposed permittee's company name/organization: Meridian Brick LLC
2. Proposed permittee's signing official's name: J. David McKeown
3. Proposed permittee's title: Corporate Environmental Manager
4. Mailing Address:
5100 Brickyard Road
City:. Columbia
Phone: [phone]
5. New Project Name to be placed on permit:
State: SC Zip: 29203
Fax: ( 803 ) 786-9703
Meridian Brick LLC - Gold Hill Mine
Please check the appropriate box. The proposed permittee listed above is:
C� HOA or POA (Attach documentation showing that the HOA or POA owns, controls, or has a
recorded easement for all areas that contain stormwater system features. Print name of HOA*or
POA in #1 above and provide name of HOA/POA's authorized representative in #2 above)
© The property owner
❑ Lessee (Attach a copy of the lease agreement and complete Property Owner Information on
page 4)
❑ Purchaser (Attach a copy of the pending sales agreement. Final approval of this transfer will be
granted upon receipt of a copy of the recorded deed)
❑ Developer (Complete Property Owner Information on page 4)
SSW N/O Change Rev24Sept2012 Page 1 of 4

III. REQUIRED ITEMS
A request to transfer a permit will not be approved by the Division of Water Quality (DWQ) unless all
of the applicable required items listed below are included with the submittal. Failure to provide the
listed items may result in processing delays or denial of the transfer.
1. This completed and signed form. This certification must be completed arrd signed by both the
current permit holder and the new applicant if this is a change of ownership.
2. Legal documentation of the property transfer to a new owner.
3. A copy of any recorded deed restrictions, covenants, or easements, if required by the permit.
4. The designer's certification (DWQ Engineer and Designer Certification Forms are available from
each DWQ Regional office), if required by the permit and if not already submitted to DWQ.
5. If the proposed permittee is a firm, partnership, association, institution, corporation, limited liability
company, or other corporate entity, provide documentation showing the authority of the named
representative to act on behalf of the proposed permittee.
6. The $40.00 processing fee. If this is an initial transfer from the original permittee the processing
fee isnot required. Subsequent ownership transfers will require the $40.00 processing fee.
IV. CURRENT PERMITTEE'S CERTIFICATION
Please check one of the following statements. and fill out the certification below that statement.
® Check here if the current permittee -is only, changing his/her/its name, the project name, or mailing
address, but will retain the permit. I, � 14-7_,— , the current
permittee, hereby notify the DWQ that I Un changing my name and/or I am changing my mailing
address and/or I am changing the name of the permitted project. I further attest that this application
for a name/ownership change is accurate and complete to the best of my knowledge. I understand
that if all required parts of this application are not completed or if all required supporting information
and attachments listed above are not included, this application package will,be returned as
incomplete.
❑ Check here if current permittee is transferring the property to a new owner and will not retain .
ownership of the permit.
I, , the current permittee, am submitting this application
for a transfer of ownership for permit # . I hereby notify DWQ of the sale or
other legal transfer of the stormwater system associated with this permit. I have provided a copy of
the most recent permit, the designer's certification for each BMP, any recorded deed restrictions,
covenants, or easements, the DWQ approved plans and/or approved as -built plans, the approved
operation and maintenance agreement, past maintenance records, and the most recent DWQ
stormwater inspection report to the proposed permittee named in Sections II and V of this form. I
further attest that this application for a name/ownership change is accurate and complete to the best
of my knowledge. I understand that if all required parts of this application are not completed or if all
required supporting information and attachments listed above are not included, this application
package will be returned as incomplete. I assign all rights and obligations as permittee to the
proposed permittee named in,Sections II and V of this form. I understand that this transfer of
ownership cannot be approved by the DWQ unless and until the facility is in compliance with the
permit.
Signature:
2
County of
Date:
a Notary -Public for the State of
do hereby certify that
personally appeared before me this the
day of , 20 , and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal,
Notary Signature
SSW N/O Change Rev24Sept2012 Page 2 of 4
(Notary Seal)

V. PROPOSED PERMITTEE CERTIFICATION: (This section must be completed by the
Proposed Permittee for all transfers of ownership)
1'. , , hereby notify the DWQ that I have acquired
through sale, lease or legal transfer, the responsibility for operating and maintaining the permitted
stormwater management system, and, if applicable, constructing the permitted system. I
acknowledge and attest that I have received a copy of: (check all that apply to this permit)
H
the most recent permit
the designer's certification for each BMP
❑ any recorded deed restrictions, covenants, or easements
❑ the DWQ approved plans and/or approved as -built plans
❑ the approved operation and maintenance agreement
Bpast maintenance records from the previous permittee (where required)
. DWQ stormwater inspection report showing compliance within 90 days, prior to this transfer
I have reviewed the permit, approved plans and other documents listed above, and I will comply with
the terms and conditions of the permit and -approved plans. I ;acknowledge and,agree that I .vill
operate and maintain the system pursuant.to the requirements listed in the permit and in the
operation and maintenance agreement. I further attest that this application for a name/ownership
change is accurate and complete to the best of my knowledge. I understand that if all required parts
of this application are not completed or if all required .supporting information and attachments listed
above are not included, this application package will be returned as incomplete.
Signature: __ Date:
I, _, a Notary Public for the State of
Couniy of , do hereby certify that
personally appeared before me this the
day of , 20 , and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal,
(Notary Seal)
Notary Signature
Additional copies of the original permit and the approved Operation and Maintenance agreement can
be obtained from the appropriate Regional Office of the Division of Water Quality.
This completed form, including all supporting documents and processing fee (if required), should be
sent to the appropriate Regional Office of the North Carolina Department of Environment and Natural
Resources, Division of Water Quality, as shown on the attached map.
Please note that if the Proposed Permittee listed above is not the property owner, the property owner
must complete and sign page 4 of this document. Both the lessee /developer and the property
owner will appear on the permit as permittees.
SSW N/O Change Rev24Sept2012 Page 3 of 4

VI. PROPERTY OWNER CONTACT INFORMATION AND CERTIFICATION
If the Proposed Permittee listed in Sections 11 and V of this form is not the Property Owner, the
Property Owner must provide his/her Contact Information below and sign this form:
Printed Name:
Organization:
Title within the Organization:
Street Address:
city:
Mailing Address:
City:
Phone:
Email:
State:
(if different from street address)
State:
Fax:
Zip:
Zip:
I certify that I own the property identified in this permit transfer document and have given permission
to the Proposed Permittee listed in Sections II and V to develop and/or, lease the property. A copy
of the lease agreement or other contract, which indicates the party responsible for the construction
and/or operation and maintenance of the stormwater system, has been provided with the submittal.
As the legal property owner I acknowledge, understand, and agree by my signature below, that I will
appear as a permittee along with the lessee/developer and I will therefore share responsibility for
compliance with the DWQ Stormwater permit. As the property owner, it is my responsibility to notify
DWQ by submitting a completed Narne/Ovfnership Change Form within 30 days of procuring a
developer; lessee or purchaser for the property. I understand that failure to operate and maintain the
stormwater treatment facility in accordance with the permit is a violation of NC General Statute
(NCGS) 143-215.1, and may result in appropriate enforcement action including the assessment of
civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Signature of the property owner
County of
Date:
a Notary Public for the State of
do hereby certify that
personally appeared before me this the
day of , 20 , and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal,
(Notary Seal)
Notary Signature
SSW N/O Change Rev24Sept2012 Page 4 of 4