NCGNE1397_Name-Owner Change Confirmation_20220606

Tran, Kieu M
From:
Tran, Kieu M
Sent:
Monday, June 6, 2022 7:42 AM
To:
[e-mail]
Subject:
Stormwater Permit Name/Owner Change Confirmation for NCGNE1396 and
NCGNE1397
Attachments: NCGNE1396 NPDES SW Permit Summary Report.pdf, NCGNE1397NPDES SW Permit
Summary Report.pdf
Good morning,
We have processed the Name/Ownership change for this permit. Please review the attached Permit Summary Report
and verify that the new information is accurate. Please let me know if there are any other necessary updates.
Thank you,
Mrs. Kieu Tran
Stormwater Program Administrative Assistant
Office: (919) 707- 3640
Kieu. Tran @ncdenr.gov
North Carolina Department of Environmental Quality
Division of Energy, Mineral, and Land Resources Stormwater Program
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
D- E
Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed
to third parties

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
NC DEMLR has the following information in our Permit Database for your permit as of 6/6/2022.
Permit Number: NCGNE1397 Permit Status: Active
Permit Type: Stormwater Discharge, No Exposure Certificate
Facility Name: Ready Refresh Greensboro
Facility Addressl: 10553 #3 Randleman Rd
Facility Address2:
City, State & Zip: Randleman, NC 27317
Owner Information Details:
MUST submit a Change of Name/Ownership form to DEMLR to make any changes to this Owner information.
(Click Here for "Change of Name/Ownershka"Form)
Owner Name: Bluetriton Brands LLC
Owner Type: Non -Government Owner Type Group: Organization
*** Legally Responsible for Permit ***
(Responsible corporate officer/principle executive officer or ranking elected official/general partner or proprietor;
or any other person with delegated signatory authority from the legally responsible person.)
Owner Affiliation: Haven Sions Title: Sr SHE Development
Addressl: 900 Long Rdg Rd Building 2
Address2:
City, State & Zip: Stamford, CT 06902
Work Phone: [phone] Fax:
Email Address: [e-mail]
*** Permit Annual Fee Billing ***
Billing Month:
Invoice Number Invoice Date Invoice Due Date Invoice Amount Invoice Status
Owner Contact Person(s)
Contact Name Title Address Phone Fax Email
Facility Contact Person(s)
Contact Name Title Address Phone Fax Email
Marques Greene 703-463-8425 marques.greene@w
aters. nestle. corn
Permit Contact Person(s)
Contact Name Title Address Phone Fax Email
6/6/2022 Page 1

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
NC DEMLR has the followinLy information in our Permit Database for vour Dermit as of 6/6/2022.
Permit Billing Contact(s)
Contact Name Title Address
Phone Fax Email
Marques Greene
703-463-8425 marques.greene@w
aters. nestle. corn
Person(s) with Delegated Signatory Authority
Type Contact Name Title Address
Phone Fax Email
Person(s) with Electronic Signature Authority
Type Contact Name Title Address
Phone Fax Email
Outfalls
Outfall #: Outfall Description:
Outfall Lattitude: Outfall Longitude:
Represented by Outfall:
Stormwater: % Industrial:
Stream Waterbody
Basin Waterbody Name
Index Number Classification
6/6/2022 Page 2