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HomeMy WebLinkAboutNCG030401_Name-Owner Change Application_20220429NC DEPARTMENT OF ENVIRONMENTAL QUALITY DIVISION OF Energy, Mineral, and Land Resources STORMWATER PROGRAM NORTH CAROLINA Environmental Quality NPDES STORMWATER PERMIT NAME/OWNERSHIP CHANGE FORM CURRENT PERMIT INFORMATION: Permit Number: or 1. Facility Name: Hercules Steel Co. NEW OWNER/NAME INFORMATION: 2. This request for a name change is a result of: Za. Change in ownership of property/company NCG0 /3 /0 / 0 /1 b. Name change only (Facility and/or Company). New facility name should be listed above. c. Other (please explain): (for example, facility address update) 3. New owner's name (name to be put on permit as Permittee): SteelFab Inc. 5 New owner's or signing official's name and title: Charles Craig (Person legally responsible for permit) Vice President -Operations (Title) Mailing address: 950 Country Club Drive City: fayetteville State: NC Zip Code: 28301 Phone: ( 910 ) 221-0019 E-mail address: ccraig@steelfab-inc.com Effective date of transfer or name change: January 1, 2022 � North Carolina Department of Environmental Quality I Division of Energy, Mineral and Land Resources 512 North Salisbury Street 1 1612 Mail Service Center I Raleigh, North Carolina 27699-1612 NORTH OAROLINA � oe —.[ 919.70T9200 NPDES Stormwater Permit Name/Ownership Change Page 2 of 2 PERMIT AND FACILITY CONTACT INFORMATION 7. New permit contact's name and title: David Morris (Permit Contact) Environmental Manager (Title) 8. Mailing address: 950 Country Club Drive City: fayetteville State: NC Zip Code: 28301 Phone: ( 910 ) 221-0019 Email address: dsmorris@steelfab-inc.com 9. New facility contact's name and title: David Morris (Facility Contact) Environmental Manager (Title) 10. Mailing address: 950 Country Club Drive City: fayetteville State: NC Zip Code: 28301 Phone: ( 910 ) 221-0019 Email address: dsmorris@steelfab-inc.com 11. New billing contact's name: Autumn Hektor (Billing Contact) 12. Mailing address: 950 Country Club Drive City: Fayetteville State: NC Zip Code: 28301 Phone: (910 ) 221-0019 Email address: ahektor@steelfab-inc.com IV. FACILITY ACTIVITIES AND DISCHARGE INFORMATION 1. Wil ustrial activities at the facility remain the same as under the previous owner? Yes�No❑ 2. Will the stormwater discharge location(s) remain the same? Yesz No ❑ NOTE: If either of these questions is answered "No," then more information is needed to review the request. Please attach documentation to describe and explain the changes to the facility activities, storm water discharges, and/or outfall location. Depending on the information provided, the Division may require that the new owner file a new permit application. Last Revised 3/2/2022 NPDES Stormwater Permit Name/Ownership Change Page 2 of 2 THIS APPLICATION PACKAGE WILL NOT BE ACCEPTED BY THE DIVISION UNLESS ALL OF THE ITEMS LISTED BELOW ARE INCLUDED. REQUIRED ITEMS: 1. This completed application form (with original signature) 2. Legal documentation of transfer of ownership (such as relevant pages of a deed or a bill of sale) is required for an ownership change request. Articles of incorporation are not sufficient for an ownership change but can be provided for a name change. 3. Information to document facility, industrial activities, stormwater discharges, or outfall changes as noted in item IV above (if appropriate) Why is this information needed? Regulations in 40 CFR §122.63 allow for minor modifications to NPDES permits for a change of ownership or operational control of a facility, provided that information supports that no other change in the permit are necessary. Why does this form need to be mailed in? Permittees and applicants must fulfill signatory requirements in the NPDES federal regulations in 40 CFR §122.22 (please see those regulations for guidance). Until NCDEQ's electronic submission process meets Cross -Media Electronic Reporting (CROMERR) requirements, this original signed (not digital signature) form must be mailed to the address below. The uploaded copy is stored as part of the permit record in the Division's digital repository. Applicant's Certification: Charles Craig , attest that the application for a name and/or ownership change submitted 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, or if all required supporting information is not included, this application package will be considered incomplete and may be returned. Signature: Date: THE COMPLETED APPLICATION AND ALL SUPPORTING INFORMATION SHOULD BE SENT TO: DEMLR Stormwater Program 512 North Salisbury Street, 61h Floor (Office 640K) 1612 Mail Service Center Raleigh, NC 27699-1612 Last Revised 3/2/2022