NPDES Stormwater Permit Name/Owner Change Request

Facility Name*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
NPDES Permit Number*field type single line
Enter your NPDES stormwater permit number or Certificate of Coverage (COC) number.Begins with NCS, NCG, or NCGNE (no exposure)
Input blocked. Maximum character limit of 9 characters reached.
Check Permit Number*field type single line
This field is hidden (used in Field Rules)
Input blocked. Maximum character limit of 4000 characters reached.
This field contains a calculation error.
References: NPDES Permit Number

Guidance for COC holders: Do not enter the General Permit number with all 0's (for example, NCG030000) but instead your Certificate of Coverge (COC) number.

Check current owner and facility information for the permit by running a Stormwater Permit Summary Report.

Name/Owner Change Application Upload

Upload a copy of the completed and signed Permit Name/Owner Change Form below. We can begin making updates with this submittal, but please note that you must mail in the original signed copy to our office, in accordance with requirements in 40 CFR 122.22.

Name/Owner Change Form Upload*

Please upload the signed "Permit Name/Owner Change Form"

Drop files here

pdf only

Supporting Documents Upload

Please upload any supporting documents (if separate from above)

Drop files here

pdf only

Stormwater Industrial Permit holders who must submit discharge monitoring reports (DMRs): Once ownership transfer for your permit is completed, be sure to complete the Six Step Process for eDMR registration.

Submitter's Name

Please enter your FIRST and LAST name

Phone Number*

Please enter your phone numberAny format is fine.

Email Address*

Please enter a valid e-mail addressA confirmation of submission will be e-mailed to this address.

By checking the box and signing below, I certify that:

I have given true, accurate, and complete information on this form;

I agree that submission of this form is a “transaction” subject to Chapter 66, Article 40 of the NC General Statutes (the “Uniform Electronic Transactions Act”);

I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the “Uniform Electronic Transactions Act”);

I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature (except for the completed Name/Owner Change Form, which also must be mailed in with original signature); AND

I intend to electronically sign and submit this Name/Ownership Change Request form.

Signature*

Date*

Date will be captured on form submission

Questions? Contact bethany.georgoulias@deq.nc.gov.