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HomeMy WebLinkAboutNCG170388_COMPLETE FILE - HISTORICAL_20140310PERMIT NO. DOC TYPE DOC DATE STORMWATER DIVISION CODING SHEET NCG PERMITS IVC.&/-7D33S V HISTORICAL FILE ❑ MONITORING REPORTS r/yo3/v YYYYMM DD STORMWATER DIVISION CODING SHEET 1L�L�I7�;�►►li��� PERMIT NO. ' NCGNE DOC TYPE I ❑ HISTORICAL FILE DOC DATE } ❑ YYYYM M DD v A�WA Division of Energy, Mineral & Land Resources Land Quality Section/Stormwater Permitting NCDENRNational Pollutant Discharge Elimination System CD E� or &N —C=N--- PERMIT NAME/OWNERSHIP CHANGE FORM FOR AGENCY USE ONLY Date Received Year Month Day 1 Please enter the permit number for which the change is requested NPDES Permit (or) Certificate of Coverage N G 1 S 10 1 1 1 1 1 1 1 N 113 1 G I l 1 7 1 0 3 8 8 11 Permit status prior to requested change a Permit issued to (company name) Chambers Fabrics, Inc b Person legally responsible for perinit Ray 1 irst Chambers MI Last President itle P O Box 688 ^ Permit I lolder Mailing Address ;(V"n High Point NC 27261 r: O Cit) State Zip (336) 887-4822 (336) 887-4850 Phone Fax c Facility naive (discharge�Chambers Fabrics Inc d Facility address 1914 South Elm Street Address High Point NC 27261 CaN State Zip e Facility contact person Bill Clark (336) 887-4822 First / MI / Last Phone III Please provide the following for the requested change (revised permit) a Request for change is a result of ❑ Change in o-vNnership of the facility ❑ Name change of the facility or owner If other please explain Facility contact change b Permit issued to (company name) Chambers Fabrics Inc c Person legally responsible for permit Ray Chambers I first MI Last Prident Title P O Box 688 Permit Holder Mailing Address High Point NC 27261 Gty State Zip (336) 887-4822 ofics northstate net Phone E-mail Address d Facility narne (discharge) Chambers Fabrics, Inc e Facility address 1914 South Elm Street Address High Point NC 28054 Cit) State Zip f Facility contact person Joe Holt I first MI Last (336) 887-4822 ofics northstate net Phone E mail Address IV Permit contact information (if different from the person legally responsible for the permit) Revised Jan 27 2014 NPDES PERMIT NAME/OWNERSHIP CHANGE FORM Page 2 of 2 Permit contact Don Ridenhour First MI Last Vn Of Finace/Onerations Title P O Box 688 Maiiing Address Highpoint NC 27261 City State Zip (336) 887-4822 c ham bfab@no rth state net Phone E-mail Address V Will the permitted facility continue to conduct the same industrial activities conducted prior to this ownership or name change? ® Yes ❑ No (please explain) Vl Required Items THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS ARE INCOMPLETE OR MISSING ❑ This completed application is required for both name change and/or ownership change requests ❑ Legal documentation of the transfer of ownership (such as relevant pages of a contract deed, or a bill of sale) is required for an ownership change request Articies of incorporation are not sufficient for an ownership change The certifications below must be completed and signed by both the permit holder prior to the change, and the new applicant in the case of an ownership change request For a name change request, the signed Applicant's Certification is sufficient PERMITTEE CERTIFICATION (Permit holder prior to ownership change) I, , attest that this application for a namelownership change has been reviewed and is accurate and complete to the best of my knowledge I understand that if all required parts of this application are not completed and that if all required supporting information is not included, this application package will be returned as me a ��. Signature Date APPLICANT CERTIFICATION I, Ray Chambers, attest that this application for a name/ownership change has been reviewed and is accurate and complete to the best of my knowledge I understand that if all required parts of this application are not completed and that if all required supporting information is not included, this application package will be re as incomplete C` March 6, 2014 Signature Date PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO Division of Energy, Mineral and Land Resources Stormwater Permitting Program 1612 Mail Service Center Raleigh, North Carolina 27699-1612 r Revised Jan 27 2014 i Don Ridenhour, Enclosed is Chamber s stormwater permit renewal contact information change form Please have signed where indicated and mall in the prepared envelopes by CERTIFIED MAIL ON OR BEFORE MARCH 31ST Also information was submitted electronically with the state of North Carolina Please make a copy for your files If you have any questions, please contact one Uq @ � D 1e Paul W Spangenberg Env Compliance Manager Email pspangenberg@bellsouth net *Owl `,�a Office (919) 846-7492 , QS� Cell (919) 624-0630 NCDENR North Carolina Department of Environment and Natural Resources Division of Water Quality Michael F Easley, Governor William G Ross, Jr, Secretary Alan W Klimek, P E , Director August 4 2004 Henry Leonard Chambers Fabrics Inc PO Box 688 High Point, NC 27261 Subject NPDES Stormwater Permit Coverage Renewal Chambers Fabrics Incorporated COC Number NCG I70388 Guilford County Dear Permittee In response to your renewal application for continued coverage under general permit NCG 170000 the Division of Water Quality (DWQ) is forwarding herewith the reissued stormwater general permit This permit is reissued pursuant to the requirements of North Carolina General Statute 143-215 1 and the Memorandum of Agreement between the state of North Carolina and the U S Environmental Protection Agency, dated December 6, 1983 The following information is included with your permit package • A new Certificate of Coverage • A copy of General Stormwater Permit NCG 170000 • A copy of a discharge monitoring report form • 5 copies of the qualitative monitoring report form Your coverage under this general permit is not transferable etcept after notice to DWQ The Division 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 Department of Environment and Natural Resources, or relieve the permittee from responsibility for compliance with any other applicable federal, state, or local law, rule, standard; ordinance, order judgment or decree If you have an} questions regarding this permit package please contact of the Central Office Stormwater Permitting Unit at (919) 733-5083, ext Sincerely f���t �C/ � rkv "i.�.�-�— foi Alan W Klimek, P E cc Central Files Stormwater Permitting Unit Winston-Salem Regional Office Surface Water Protection Section 1617 Mail Service Center Raleigh North Carolina 276991617 512 N Salisbury St Raleigh North Carolina 27604 Phone 919 733 70151 FAX 919 733 2496 I Internet http IIh2o enr state nc uslsulstormwater html An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper NorthCarohna Naturally STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF WATER QUALITY GENERAL PERMIT NO NCG170000 CERTIFICATE OF COVERAGE No NCG170388 STORMWATER DISCHARGES NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM In compliance with the provision of North Carolina General Statute 143-215 I, other lawful standards and regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the Federal Water Pollution Control Act, as amended, Chambers Fabrics Inc is hereby authorized to discharge stormwater from a facility located at Chambers Fabrics Incorporated 1914 South Elm St High Point Guilford County to receiving «aters designated as Richland Creek, a class C stream in the Cape Fear River Basin in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts 1 11 II1 1V V, and VI of General Permit No NCG 170000 as attached This Certificate of Coverage shall become effective August 1, 2004 This Certificate of Coverage shall remain in effect for the duration of the General Permit Signed this day August 1 2004 for Alan W Klimek, P E , Director Division of Water Quality By Authority of the Environmental Management Commission uepartment of tnvironment and Natural Resources Division of Water Quality Michael F Easley, Governor William G Ross Jr, Secretary Kerr T Stevens, Director July 20, 2001 Mr Randall Wyatt Chambers Fabrics, Inc P O Box 688 High Point, NC 27261 '�AMIFA&M NCDENR NORTH CAROLINA DEPARTMENT Or ENVIRONMENT AND NATURAL, RESOURCES Subject General Permit No NCG 170000 Chambers Fabrics, Inc COC NCG 170388 Guilford County Dear Mr Wyatt In accordance with your application for a discharge permit received on July 5, 2000 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 December 6, 1983 If any parts, measurement frequencies or sampling requirements contained in this permit are unacceptable to you, you have the right to request an individual permit by submitting an individual permit application Unless such demand is made, this certificate of coverage shall be final and binding Please take notice that this certificate of coverage is not transferable except after notice to the Division of Water Quality The Division of Water Quality may require modification or revocation and reissuance of the certificate of coverage This permit does not affect the legal requirements to obtain other permits which may be required by the Division of Water Quality or permits required by the Division of Land Resources, Coastal Area Management Act or any other Federal or Local governmental permit that may be required If you have any questions concerning this permit, please contact Aisha Lau at telephone number (919) 733-5083 ext 578 Sinc el 0R113 N -, E,V Kerr T Stevens cc Winston-Salem Regional Office Central Files Stormwater and General Permits Unit Files 1617 Mail Service Center, Raleigh, NC 27699-1617 Telephone 919-733-5083 FAX 919-733-9919 An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post consumer paper STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF WATER QUALITY GENERAL PERMIT NO NCG170000 CERTIFICATE OF COVERAGE No NCG170388 STORMWATER DISCHARGES NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM In compliance with the provision of North Carolina General Statute 143-215 1 other Iawful standards and regulations promulgated and adopted by the North Carolina Environmental Management Commission and the Federal Water Pollution Control Act as amended Chambers Fabncs, Inc is hereby authorized to discharge stormwater from a facility located at Chambers Fabrics Inc t914 South Elm Street High Point City Guilford County to receiving waters designated as Richland Creek, a class C stream in the Cape Fear River Basin in accordance with the effluent limitations monitoring requirements and other conditions set forth in Parts 1 11 III IV V and VI of General Permit No NCG170000 as attached This Certificate of Coverage shall become effective July 20 2001 This Certificate of Coverage shall remain in effect for the duration of the General Permit Signed this day July 20 2001 Kerr T Stevens, Director Division of Water Quality By Authority of the Environmental Management Commission Markers Name NCG170388 - Chambers Fabrics, Inc Short Name 170388 Coordinates 0350 55' 47 9" N, 0800 00' 39 7" W Comment County Guilford, Map # D18NE, Subbasin 03-06-08, Receiving Stream Richland Creek, Class C