NCC230085_Contact Update Record_20240307

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by bethany.georgoulias 3/7/2024 2:18:29 PM(Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC230085
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2023-0085
Original NOI No.* 122238
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
D.R. Horton INC
Project Name Middleton Phase 1
Address 4590 Reedy Fork Parkway,Greensboro, NC
County Guilford
Latitude 36.1870
Longitude -79.6930
Date COC Issued* 01/11/2023
Prior Rescission Date This field will populate only if COC has already been rescinded.
Which Contacts Have Billing Only
Changed?* Legally Responsible Individual Only
Site Contact Only
BOTH Legally Responsible Individual and Site Contact
Has Billing Contact Choose'Yes'to revise Billing Contact details.
Changed? Q No
4) Yes
Billing Email [e-mail]
NEW Billing Email [e-mail]
Billing Telephone No. 9194972163
NEW Billing [phone]
Telephone No. (optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Tracey Davis
Individual(Previous)
First Name(New)* Neil
Last Name(New)* Uldrick

NEW Legally Reflects any revisions above
Responsible Neil Uldrick
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No.(Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 7208 Falls of Neuse Road,0, Raleigh, NC
Address(Previous) 27615-3244
NEW Permittee Street Address
Mailing Address* 4150 Mendenhall Oaks Parkway
Address Line 2
City State/Province/Region
High Point NC
Postal/Zip Code Country
27265 US
Permittee Street 7208 Falls of Neuse Road,0, Raleigh, NC
Address(Previous) 27615-3244
NEW Permittee Street Street Address
Address* 4150 Mendenhall Oaks Parkway
Address Line 2
City State/Province/Region
High Point NC
Postal/Zip Code Country
27265 US
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Matt Tanner
(Previous)
Site Contact Title Division NPDES Admin
(Previous)
Organization D.R. Horton Inc
(Previous)
First Name(New)* Matt
Last Name(New)* Tanner
NEW Site Contact* Reflects any revisions above
Matt Tanner

NEW Site Contact Division NPDES Admin
Title
NEW Organization D.R. Horton Inc
This field is not required on the NOI form and may not pre-populate.
Site Contact Email [e-mail]
(Previous)
NEW Site Contact [e-mail]
Email*
Site Contact 336-337-2594
Telephone No.
(Previous)
NEW Site Contact [phone]
Telephone No.*
Site Contact Mailing 7208 Falls of Neuse Road, Suite 201,
Address(Previous) Raleigh, NC 27615-3244
NEW Site Contact Street Address
Mailing Address* 7208 Falls of Neuse Road
Address Line 2
Suite 201
City State/Province/Region
Raleigh NC
Postal/Zip Code Country
27615-3244 US
Change Requested Neil Uldrick via Modification request submitted 3/5/2024.Site contact's email
by:* address corrected.
Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 03/07/2024