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Home My WebLink AboutNCG130033_COMPLETE FILE - HISTORICAL_20180712M,Ro STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. /v I DOC TYPE HISTORICAL FILE ❑ MONITORING REPORTS DOC DATE ❑ Qoj� r I VYYYMMDD State of North Carolina Department of Environmental Quality L�O Division of Water Resources D W�,R---.'' SEWER SYSTEM PERMIT OWNERSHIP/NAME CHANGE " Division of Water Resources INSTRUCTIONS FOR FORM: PNOCF 01-16 This form is for ownership changes or name changes of a sewer system permit. Please note that "Permitter" references- the existing permit holder, and that "Applicant" references the entity applying for the ownership/name change. Sewer permits start with a WQ or WQCS apd contain the terms sewer extension or collection system in the subject field. This form should not be used for permits with NC, NCG, SW or other types of non -sewer permits beginning with WQ. For more information, visit the Division's Water Quality Permitting's website: A. Sewer System Permit Ownership/Name Change (FORM: PNOCF 01-16) Application (All Applications): ❑ Submit an original completed and appropriately executed application (PNOCF 01-16). ❑ The Existing Permittee's Certification shall be signed in accordance with 15A NCAC 02T .0106(b). Per 15A NCAC 02T .0106(c), an alternate person may be'designated as the signing official if a delegation letter is provided from a person who meets the criteria in I5A NCAC 02T,OI06(b). ❑ The Applicant's Certification shall be signed in accordance with 15A NCAC 02T .0106(b). Per 15A NCAC 02T .0106(c), an alternate person may be designated as the signing official if a delegation -le ycr pro.v, de frorn a person who meets the criteria in 15A NCAC 02T .0I06(b). �G �1 t.-� RECEIVED/DENR/DWR B. Existing Permit (All Applications): JUL 12 2018 MAR 1-3 2018 ® Submit a copy of the most recently issued permit and certification. C. Property Ownership Documentation (All Applications): CENi1�F�L,I~11~i=w� Water Resources The Applicant shall demonstrate they are the owner of all property containing the sewelr�system facilities: Permitting Section ❑ Legal documentation. of ownership (i.e., GIS, deed, article of incorporation, or contract), or ❑ Written notarized intent to purchase agreement signed by both parties with a plat or survey map, or ❑ Approved board minutes D. Certificate of Public Convenience and Necessity (Ali Applications where the Applicant is a Privately -Owned Public Utility): ❑ Per 15A NCAC 02T ;0115(a)(1), provide one copy of the Certificate of Public Convenience and Necessity from the North Carolina Utilities Commission demonstrating the Applicant is authorized to hold the utility franchise for the area to be served by the non -discharge "system. I=. Operational Agreements (Applications where the Applicant is a Home/Property Owners' Association or Developer of lots to be sold): Home/Pr0 ert - Owners' Association ❑ Per I5A NCAC 02T .01_I5(c}, submit an original properly executed O grational Agreement FORM: HOA . ❑ Per 15A NCAC 02T .01 15(c}, submit an original proposed or approved Articles of Incorporation, Declarations and By- laws that contain the language required by the Operational Agreement. Developers of lots to be sold ❑ Per 15A NCAC 02T .01 15(b), submit an original of the properly executed Operational Agreement (FORM: DEV). 1". Package Submitted in Duplicate ❑ Submit a copy of all required documents in Instructions A-E as required THE COMPLETED APPLICATION AND SUPPORTING DOCUMENTATION SHALL BE SUBMITTED IN DUPLICATE TO: NCDEQ - DWR Water Quality Permitting Section PERCS Unit By U.S. Postal Service: By Courier/Special_ Delivery: 1617 MAIL SERVICE CENTER 512 N. SALISBURY ST. RALEIGH, NORTH CAROLINA 27699-1636 SUITE 925 RALEIGH, NORTH CAROLINA 27604 TELEPHONE NUMBER: (919) 807-6300 INSTRUCTIONS FOR APPLICATION PNOCF 01-16 Page 1 of l State of North Carolina Department of Environmental Quality Division of Water Resources D-W-- ,R SEWER SYSTEM PERMIT OWNERSHIP/NAME CHANGE "Division of Water Resources INSTRUCTIONS FOR FORM: PNOCF 01-16 1. EXISTING 13ERMITTEE INFORMATION: 1. Pennittee's name: International Paper Recycling 2. Signature authority's name: Care,- Pearson per 15A NCAC 02T .0106 b 3. Signature authority.'s title: Plant Superintendent 4. Permittee's mailing address: 201 E. 28"' St., City: Charlotte State: North Carolina Zip: 28206- 5. Permittee's contact information: Phone number: (541) 501-7597 Fax Number {_) Email Address: carey_.parson a,ipaper.com 11. APPLICANT INFORMATION: 1. Applicant's name: 2. Signature authority's name: 3. . Signature authority's title: 4. Applicant's mailing address: _ City: State: 5. Applicant's contact information per 15A NCAC 02T .0106(b) 6. Representative's name: 7. Representative's title: 8. Representative's contact information 111. PERMIT INFORMATION: Zip: - Phone number: {_} Email Address: Phone number: (_) _- Email Address: Fax Number (_) Fax Number (_) l . Existing permit number: NCG 130000 and most recent issuance date: June 1, 2013 2. Reason for the permit application: Select if other, attach detailed explanation 3. Has the facility been constructed? Yes or ❑ No 4. Has the facility been certified per 15A NCAC 02T .01 16? ® Yes or ❑ No FORM: PNOCF01-16 Page 1 of IV. CERTIFICATIONS: Existing Permittee's Certification per 15A NCAC 02T .0106(b): est that this application (Signature Authority's name & title from Application Item 1.2 & 3) has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that prior to reissuance of the permit into the Applicant's name, I will continue to be responsible for compliance with the current permit and any discharge of wastewater from this system to surface waters or the land may result in an enforcement action that may include civil penalties, injunctive relief, and/or criminal prosecution. I will also make rlo claim against the Division of Water Resources should a condition of the existing permit be violated. 1 also understand that if all required parts of this application are note completed and that if all required supporting information and attachments are not included, this application will be returned to me as incomplete. NOTE — In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may include a fine not to exceed $10,000 as well as civil penalties to$25,000 per violation. Signature: Date: Applicant's Certification per 15A 1, L&A-e7f W - F(, (Signature Authority's name & title from Application Item I1.2&3.) that this application has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that after issuance of the permit into the Applicant's name, 1 will be responsible for compliance with the issued permit and any discharge of wastewater from this non - discharge system to surface waters or the land may result in an enforcement action that may include civil penalties, injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a condition of this permit be violated, l also understand that if all required parts of tjis application package are not completed and that if all required supporting information and attachments are not included, this application package will be returned to me as incomplete. NOTE — In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may include a fine not to exceed $10,000 as well as civil penalties up to'$25,000 per violation. r� r Signature: Date: 10 FORM: PNOCF 01-16 Page 2 of 2 Certificate of Coverage Page t of 1 STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF WATER QUALITY GENERAL PERMIT No, NCC130000 CERTIFICATE OF COVERAGE No. NCG130033 STORMWATER 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, Iuternational Paper Company is hereby authorized to discharge stormwater from a facility located at International Paper Co. -Charlotte Recycle Plant 201 E 28th St Charlotte Mecklenburg County to receiving waters designated as Little Sugar Creek, class C water(s) in the Catawba River Basin(s) in accordance with the stormwater pollution management requirements, monitoring and reporting requirements, and other conditions set forth in Parts I, 11, 111 and IV of General Permit No. NCG 130000 as attached. This certificate of coverage shall become effective June 1, 2013. This Certificate of Coverage shall remain effective for the duration of the General Permit. Signed this day June 1, 2013. for Charles Wakild, P.E., Director Division of Water Quality By Authority of the Environmental Management Commission http://portal.ncdenr.org/web/wq/ws/su/permit-renewal 5/23/2013