NCC190470_Contact Update Request and Form (II)_20210707

Georgoulias, Bethany
From: Ashlee Cateni <[e-mail]>
Sent: Wednesday, July 7, 2021 6:11 PM
To: Georgoulias, Bethany
Cc: Selkane, Aziza; Amanda Phillips
Subject: RE: [External] Fwd: Construction 2021 Annual Fee Invoice for NCC190470 Due
Attachments: NCG01- Legally- Responsible-Change-Form-20201205-DEMLR-SW - signed.pdf
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Hi Bethany,
See attached.
We have two site contacts. The information is below:
Diamondback Investment Group
Ashlee Cateni — 803-230-8508 — [e-mail]
610 Pembroke Rd, #10007 Greensboro, NC 27408
KT Grading
Vincent Solomon — 336- 212-7186 — [e-mail]
610 Pembroke Rd, #10007 Greensboro, NC 27408
Let me know if you need anything further!
Best,
Ashlee
6 Ashlee Cateni
a�aMowae,�H Diamondback Investment Group, LLC
[e-mail]
www.diamondbackinvestmentgroup.com
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From: Georgoulias, Bethany <[e-mail]>
Sent: Wednesday, July 7, 2021 2:26 PM
To: Bob Westall <[e-mail]>; Ashlee Cateni <[e-mail]>

NCG01 Legally Responsible Individual Change Form
Use this form when:
The person who is legally responsible for the permit has changed, but there is NO CHANGE in the project name
or ownership.
**If the project name has changed, or if the ownership of the project has changed, do NOT use this form.**
Instead, you must submit a new NCG01 electronic Notice of Intent (eNOI).
Directions:
Print this form, complete, scan and upload to the Construction Stormwater Permit MODIFICATION Form.
Then, mail the original form to the NC DEMLR Stormwater Program at:
Division of Energy, Mineral & Land Resources Stormwater Program
512 N. Salisbury Street, 61" Floor (Office 640K)
1612 Mail Service Center
Raleigh, NC 27699-1612
DO NOT MAIL THIS FORM UNTIL YOUR MODIFICATION HAS BEEN REVIEWED AND ACCEPTED AS COMPLETE
Certificate of Coverage (COC) Number: NCC190470
Name of Project: Doggett Road Subdivision
Legally Responsible Organizational Entity: Doggett Road 41, LLC
PREVIOUS Legally Responsible Individual: Paul Holst
NEW Legally Responsible Individual: Zach Tran
The following section is to be completed and signed by the NEW Legally Responsible Individual.
Per NC General Statute 143-215.6E (i), any person who knowingly makes any false statement, representation,
or certification in any application, record, report, plan, or other document filed or required to be maintained
under this Article or a rule implementing this Article ... shall be guilty of a Class 2 misdemeanor which may
include a fine not to exceed ten thousand dollars ($10,000).
Page 1 of 2

NCG01 Legally Responsible Individual Change Form
Under penalty of law, I certify that (check all boxes to indicate your agreement):
7 I am the person responsible for the construction activities of this project, for satisfying the
requirements of this permit, and for any civil or criminal penalties incurred due to violations of this
permit.
® I will abide by all conditions of the NCG010000 General Permit and the approved Erosion and
Sediment Control Plan.
If the approved Erosion and Sediment Control Plan is not compliant with Part II (Stormwater Pollution
Prevention Plan) of the NCG010000 General Permit, I will nonetheless ensure that all conditions of
Part II of the permit are met on the project at all times.
XI1 I understand that coverage under this permit will constitute the permit requirements for the
discharge(s) and is enforceable in the same manner as an individual permit.
This form has been reviewed and is accurate and complete to the best of my knowledge.
*Signature:
Print Name of Signed: Zach Tran
Title: Division President
Mailing Address: 610 Pembroke Road #10007 Greensboro NC 27408
Street Address: 610 Pembroke Road #10007 Greensboro NC 27408
Email Address: [e-mail]
Phone Number: 919-696-2644
Date:
7/7/21
*IMPORTANT NOTE: This form must be signed by a responsible corporate officer that owns or operates the
construction activity, such as a president, secretary, treasurer, or vice president, or a manager that is
authorized in accordance with Part IV, Section 8, Item (6) of the NCG010000 permit.
For more information on signatory requirements, see Part IV, Section 8, Item (6) of the NCG010000 permit.
Page 2 of 2

NCG01-Legal ly-Responsible-Change-Form-202
01205-DEMLR-SW
Final Audit Report
Created: 2021-07-07
By: Diamondback Investment Group ([e-mail])
Status: Signed
Transaction ID: CBJCHBCAABAAzGumnh9ty5WOF7LMFW3vWXITdV-x9y-G
2021-07-07
"NCG01-Legal ly-Responsible-Change-Form-20201205-DEMLR-
SW" History
Document created by Diamondback Investment Group ([e-mail])
2021-07-07 - 10:04:10 PM GMT- IP address: 76.222.72.252
Document emailed to Zach Tran ([e-mail]) for signature
2021-07-07 - 10:04:31 PM GMT
Email viewed by Zach Tran ([e-mail])
2021-07-07 - 10:04:56 PM GMT- IP address: 174.193.14.255
&0 Document e-signed by Zach Tran ([e-mail])
Signature Date: 2021-07-07 - 10:05:23 PM GMT - Time Source: server- IP address: 174.193.14.255
Agreement completed.
2021-07-07 - 10:05:23 PM GMT
0 Adobe Sign

Cc: Selkane, Aziza <[e-mail]>
Subject: RE: [External] Fwd: Construction 2021 Annual Fee Invoice for NCC190470 Due
Ashlee, we will also need revised Site contact information then, including:
name, organization, phone number, email, and mailing address for the new Site Contact.
That can be provided via email when you send the paperwork need to update responsibility.
Thank you,
Bethany Georgoulias
Environmental Engineer
Stormwater Program, Division of Energy, Mineral, and Land Resources
N.C. Department of Environmental Quality
919 707 3641 office
bethany.georgoulias@ncdenngov
512 N. Salisbury Street, Raleigh, NC 27604 (location)
1612 Mail Service Center, Raleigh, NC 27699-1612 (mailing)
Website: http://deq.nc.gov/about/divisions/energy-mineral-land-resources/stormwater
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties
Based on the current guidance to minimize the spread of COVID-19, the Department of Environmental Quality has
adjusted operations to protect the health and safety of the staff and public. Many employees are working remotely or
are on staggered shifts. To accommodate these staffing changes, all DEQ office locations are limiting public access to
appointments only. Please check with the appropriate staff before visiting our offices, as we may be able to handle your
requests by phone or email. We appreciate your patience as we continue to serve the public during this challenging
time.
From: Bob Westall[mailto:[e-mail]]
Sent: Wednesday, July 7, 2021 2:23 PM
To: Ashlee Cateni <[e-mail]>
Cc: Selkane, Aziza <[e-mail]>; Georgoulias, Bethany<[e-mail]>
Subject: Re: [External] Fwd: Construction 2021 Annual Fee Invoice for NCC190470 Due
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
And take my name off the document. Thomas Stanley Grading and I had nothing to do with this job besides showing up
at the pre con to sign paperwork and was released from the job by the owners before it started.
Thanks,
Bob Westall
336-382-5878
Sent from my iPhone

On Jul 7, 2021, at 12:09 PM, Ashlee Cateni <[e-mail]> wrote:
Hello,
Please remove Paul Holst from these documents. He is no longer an employee with our company. Please
send over any paperwork necessary to transfer the contact information.
Thanks.
Best,
Ashlee
<image001.png> Ashlee Cateni
Diamondback Investment Group, LLC
[e-mail]
www.diamondbackinvestmentgroup.com
CONFIDENTIALITY NOTICE: This email communication may contain private, confidential, or legally privileged information
intended for the sole use of the designated and/or duly authorized recipient(s). If you are not the intended recipient or have
received this email in error, please notify the sender immediately by email and permanently delete all copies of this email
including all attachments without reading them. If you are the intended recipient, secure the contents in a manner that
conforms to all applicable state and/or federal requirements related to privacy and confidentiality of such information.