NCG510522_Owner name change_20150918

ATA
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Ms. Maureen Jackson
Cardno, Inc.
2512 Independence Blvd, Ste 200-34
Wilmington, NC 28412
Dear Ms. Jackson:
Donald R. van der Vaart
Secretary
September 18, 2015
Subject: Certificate of Coverage (CoC) NCG510522
NPDES General Permit NCG510000
Ownership change modification
The Pantry #161
Alamance County
The Division received your request to transfer ownership of the subject CoC on September 16th. We do not
object to your request, made on behalf of Circle K Stores, Inc. Therefore, we are forwarding herewith an
updated version of NCG510522. This CoC is issued pursuant to the requirements of North Carolina General
Statue 143-215 .1 and the Memorandum of Agreement between North Carolina and the US Environmental
Protection agency dated October 15, 2007 (or as subsequently amended).
If any parts, measurement frequencies or sampling requirements contained in this general permit are
unacceptable to you, you have the right to request an individual permit by submitting an individual permit
application. Unless such demand is made, the certificate of coverage shall be final and binding.
Please note that this COC is not transferable except after notice to the Division. The Division may require
modification or revocation and reissuance of the CoC. This permit does not affect the legal requirements to
obtain other permits which may be required by any other Federal, State, or Local government regulation.
If you have any questions about this action, please contact Charles Weaver of the NPDES program at
telephone number [phone] or via e-mail [[e-mail]].
ely,
for S. Jay Zimmerman, Director
Division of Water Resources
cc: NPDES General Permit Files
Winston-Salem Regional Office
Brent Puzak / Circle K [305 Gregson Dr, Cary, NC 27511]
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 512 North Salisbury Street, Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] / http://portal.ncdenr.org/web/wq
An Equal Opportunity/Affirmative Action Employer-50/o Recycled/10°k Post Consumer Paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER RESOURCES
CERTIFICATE OF COVERAGE NCG51o533
GENERAL PERMIT NCG550000
TO DISCHARGE PETROLEUM -CONTAMINATED GROUNDWATER AND SIMILAR
WASTEWATERS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provisions of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
Circle K Stores, Inc.
is hereby authorized to discharge from an existing groundwater remediation system located at
The Pantry # 161
1031NCHwy87N
Elon
Alamance County
to receiving waters designated as an unnamed tributary to Travis Creek [stream segment 16-12],
currently classified a WS-V NSW stream within subbasin 03-06-02 of the Cape Fear River Basin,
in accordance with the effluent limitations, monitoring requirements, and other conditions set
forth in Parts I, II, III, and IV of General Permit NCG510000, as attached.
This certificate of coverage shall become effective September 18, 2015.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day September 18, 2015
ay Zimmerman, Director
Division of Water Resources
By Authority of the Environmental Management Commission

September 16, 2015
Mr. Charles Weaver
North Carolina Department of Environment and Natural Resources
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Subject: NPDES Permit Ownership Change
NPDES General Permit NCG510000
Dear Mr. Weaver:
CB) Cardne
Shaping the Future
Cardno, Inc. (ATC) is providing you information on changes to the ownership and the
consultant/system operator for The Pantry #161 NPDES General Permit NCG510000, dated
October 12, 2011. Effective September 14, 2015, Circle K Stores, Inc. (Circle K) retained ownership
of The Pantry. The necessary documentation is attached. Additionally, please update the
consultant/system operator to Cardno ATC. When the permit was last renewed, this information
was not correct. Cardno ATC provides the environmental consulting services to Circle K for the
Pantry #161 located 1031 North NC Highway 87 in Elon, North Carolina. Cardno ATC maintains
the remediation treatment systems at this location.
If you have any questions, please do not hesitate to contact me at [phone].
Sincerely,
CARDNO, INC.
)11iwo_i_4ace-
Maureen Jackson, P.G.
Project Manager
Cardno
Direct Line [phone]
Email: [e-mail]
Australia • Belgium • Canada • Colombia • Ecuador • Germany • Indonesia • Italy •
Kenya • New Zealand • Papua New Guinea • Peru • Philippines • Tanzania •
United Arab E(Orates • United Kingdom • United States • Operations in 85 countries
Cardno (NC), Inc
2512 Independence Blvd.
Suite 200-34
Wilmington, NC 28412
USA
Phone: [phone]
Fax: [phone]
www.cardno.com

ZIA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Resources
Pat McCrory S. Jay Zimmerman Donald R. van der Vaart
Govemor Director Secretary
NOTICE OF RENEWAL INTENT
(Required by 15A NCAC 02H .0127(d)1; [term definition see 15A NCAC 02H .0103(19)1
Application for renewal of existing coverage under General Permit NCG510000
Existing Certificate of Coverage (CoC): NCG510 522
(Please print or type)
1) Mailing address of site Owner: (address to which all correspondence should be mailed)
Company Name Circle K Stores, Inc.
Company Contact Brent Puzak
Street Address 305 Gregson Drive
City Cary State NC ZIP 27511
Telephone # [phone] Fax # [phone]
Email Address [e-mail]
2) Location of remediation site producing discharge:
Facility Name Pantry #161
Facility Contact Brent Puzak
Street Address 1031 Highway 87 North
City Elon State NC ZIP 27244
County Alamancc
Telephone # [phone] _ Fax# [phone]
3) System operator / Consultant ID: (if different from Owner)
Company Name Cardno ATC
Company Contact Maureen A. Jackson. P.G.
Street Address 2512 Independence Boulevard, Suite 200-34
City Wilmington State: NC ZIP 28412
County New Hanover
Telephone # [phone] Fax # [phone]
Email Address maurccn. jacksonu,cardno.com
Page 1 of 2 Revised 9/1/2015

NCG510000 Renewal Application
4) Site ranking & ID: GW incident # 22846
Site Ranking (if available) aigh 2380
Date of most recent discharge Currently discharging
Additional Application Requirements:
The following information must be included in duplicate [original + 1 copy] with this application or it
will be returned as incomplete.
• Site map: Clearly showing the path of the remediation system effluent from the site to its
discharge point
> Authorization for representatives. If this application will be submitted by a consulting
engineer (or engineering firm), include documentation from the Permittee showing that the
consultant submitting the application has been designated an Authorized Representative of
the applicant.
CERTIFICATION
I certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing: Brent Puzak
Title:
(Signature of Applicant): (Date Signed)
North Carolina General Statute 143-215.6 b (i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan or other document fled or
required to be maintained under Article 21 or regulations of the Environmental Management Commisslon implementing that Article, or who falsifies, tampers
with or knowingly renders inaccurate any recording or monitoring device or method required to be operated or maintained under Article 21 or regulations of
the Environmental Management Commission implementing that Article, shall be guilty of a misdemeanor punishable by a fine not to exceed $25,000, or by
imprisonment not to exceed six months, or by both. (18 U.S.C. Section 1001 provides a punishment by a fine of not more than $25,000 or imprisonment not
more than 5 years, or both, for a similar offense.)
♦ ♦ ♦ ♦ ♦
This Notice of Renewal Intent does NOT require a separate fee.
The permitted facility already pays an annual fee for coverage under NCG510000.
♦ ♦ ♦ ♦ ♦
Mail this application and one copy of the entire package to:
NC DENR / DWR / Water Quality Permitting Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Attn: Charles Weaver
Page 2 of 2 Revised 9/1:2015

Corporations Section
P.O.Box 13697
Austin, Texas 78711-3697
Office of the Secretary of State
September 10, 2015
Corporation Service Company
211 E. 7th Street, Suite 620
Austin, TX 78701 USA
RE:
CIRCLE K STORES INC ( File Number: 10697700 )
Carlos H. Cascos
Secretary of State
It has been our pleasure to approve and place on record the filing instrument effecting a merger. The
appropriate evidence of filing is attached for your files. Payment of the filing fee is acknowledged by
this letter.
If we can be of further service at any time, please let us know.
Sincerely,
Corporations Section
Business & Public Filings Division
Enclosure
Phone: [phone]
Prepared by: Virginia Tobias
Come visit us on the Internet at http://www.sos.state.tx.us/
Fax: [phone] Dial: 7-1-1 for Relay Services
TID: 10339 Document: 629455350002

Corporations Section
P.O.Box 13697
Austin, Texas 78711-3697
Office of the Secretary of State
CERTIFICATE OF MERGER
Carlos H. Cascos
Secretary of State
The undersigned, as Secretary of State of Texas, hereby certifies that a filing instrument merging
The Pantry, Inc.
Foreign For -Profit Corporation
Delaware, USA
[Entity not of Record, Filing Number Not Available]
Into
CIRCLE K STORES INC
Domestic For -Profit Corporation
[File Number: 10697700]
has been received in this office and has been found to conform to law.
Accordingly, the undersigned, as Secretary of State, and by the virtue of the authority vested in the
secretary by law, hereby issues this certificate evidencing the acceptance and filing of the merger on
the date shown below.
Dated: 09/09/2015
Effective: 09/13/2015 11:01 pm
Phone: [phone]
Prepared by: Deborah Rogers
OLAue
Carlos H. Cascos
Secretary of State
Come visit us on the Internet at http://www.sos.state.tx.us/
Fax: [phone] Dial: 7-1-1 for Relay Services
TID: 10343 Document: 629597130001

State
Form 623
(Revised 05/11)
Return in duplicate to:
Secretary of State
P.O. Box 13697
Austin, TX 78711-3697
512 463-5555
FAX: [phone]
Filing Fee: see instructions
This space reserved for office use.
FILED
In the Offf Statof Texas
Secretary
Parent -Subsidiary
Certificate of Merger
Business Organizations Code. Corporations Section
SEP 0, 9 205
Parties to the Merger
Pursuant to chapter 10 of the Texas Business Organizations Code, andthe title applicable to each domestic filing entity
identified below, the undersigned parties submit this certificate of merger.
The name, organizational form, and state of incorporation or organization, and file number, if any,
issued by the secretary of state for the parent and subsidiary organization(s) are as follows:
Parent
Circle K Stores Inc.
Name of Organization
The organization is a for -profit corporation It is organized under the laws of.
Specify organizational form (e.g.. for profit corporation)
Texas United States The file number, if any, is 10697700
Country Texas Secretary of State file number
If not a domestic entity, its registered or principal office address in its jurisdiction of formation is:
Street Address
Subsidiary 1
The Pantry, Inc.
City
State Country
Name of organization
The organization is a: for -profit corporation It is organized under the laws of:
Specify organizational form (e.g.. jar profit corporation)
Delaware Untied States The file number, if any, is N/A
Stare Country Texas Secretary of State file number
If not a domestic entity, its registered or principal office address in its jurisdiction of formation is:
2711 Centerville Road, Suite 400
Street Address
Wilmington DE USA
City State Country
The number of outstanding ownership interests of each class or series and the number and percentage
of ownership interests of each class or series owned by the parent organization are as follows:
Number of ownership interests outstanding Class
Series Number owned by parent Percentage Owned
1,000 Common N/A 1,100 100%
❑ The organization will survive the merger. ❑✓ The organization will not survive the merger.
Subsidiary 2
Name of organization
The organization is a:
Form 623
Specifyorganl attonal form (e.g., for -profit corporation)
5
It is organized under the laws of:

The file number, if any, is:
State Country Texas Secretary of State file number
If not a domestic entity, its registered or principal office address in its jurisdiction of formation is:
Street Address City State Country
The number of outstanding ownership interests of each class or series and the number and percentage
of ownership interests of each class or series owned by the parent organization are as follows:
Number of ownership interests outstanding Class Series Number owned by parent Percentage Owned
❑ The organization will survive the merger. ❑ The organization will not survive the merger.
Subsidiary. 3
Name of Organization
The organization is a: It is organized under the laws of:
Sped organizational form (e.g., for profit corporation)
The file number, if any, is:
State Country Texas Secretary of State file number
If not a domestic entity, its registered or principal office address in its jurisdiction of formation is:
Street .Address City State Country
The number of outstanding ownership interests of each class or series and the number and percentage
of ownership interests of each class or series owned by the parent organization are as follows:
Number of ownership interests outstanding Class Series Number owned by parent Percentage Owned
❑ ;The organization will survive the merger. ❑ The organization will not survive the merger.
Resolution of Merger
© ;A copy of the resolution of merger is attached.
The attached resolution was adopted and approved by the governing authority of the parent
organization as required by the laws of its jurisdiction of formation and by its governing documents.
The resolution was adopted by the parent organization on 09/04/2015
Organizations Created by Merger
mm/ddly»y
The name, jurisdiction of organization, principal place of business address, and entity description- of
each entity or other organization to be created pursuant to the resolution of merger are set forth below.
The certificate of formation of each new domestic filing entity to be created is being filed with this
certificate of merger.
Nance of New Organisation 1
Jurisdiction Entity Type (See instructions)
Principal Place of Business Address City State Zip Code
Form 623
•

Nance of Nen. Organisation 2 Jurisdiction Enti ry Type (See instructions)
Principal Place of Business Address
City State Zip Code
Name of New Organization 3
Jurisdiction Entiry Tjpe (See instructions)
Principal Place of Business Address
City State 'Lip
Effectiveness of Filing (Select either A, B, or C.)
A. ❑ This document becomes effective when the document is accepted and. filed by the secretary of
state,
B. ✓❑ This document becomes effective at a later date, which is not more than ninety (90) days from
the date of signing. The delayed effective date is: September 14, 2015 at 12:01 a.m. eastern time
C. ❑ This document takes effect on the occurrence of the future event or fact, other than the
passage of time. The 90th day after the date of signing is:
The following event or fact will cause the document to take effect in the manner described below:
Tax Certificate
❑ Attached hereto is a certificate from the comptroller of public accounts that all taxes under title
2, Tax Code, have been paid by the non -surviving filing entity.
In lieu of providing the tax certificate, one or more of the surviving, acquiring or newly created
organizations will be liable for the payment of the required franchise taxes.
Execution
The undersigned signs this document subject to the penalties imposed by law for the submission of a
materially false or fraudulent instrument. The undersigned certifies that the statements contained
herein are true and correct, and that the person signing is authorized under the provisions of the
Business Organizations Code, or other law applicable to and governing the parent organization, to
execute the filing instrument.
Date: September 9, 2015
Circle K Stores Inc.
Parent organization Name
Signature of authorized person (see i
Sylvain Aubry, Corporate • - cretary
Printed or typed name -of authorized person
Form 623 7

EXHIBIT A
RESOLUTIONS OF THE
BOARD OF DIRECTORS OF
CIRCLE K STORES INC.
September 4, 2015
"Short Form" Merger with The Pantry, Inc.
WHEREAS, the Company owns 100% of the outstanding capital stock of The
Pantry, Inc., a Delaware corporation (the "Subsidiary");
WHEREAS, Section 10.006 of the Texas Business Organizations Code, as
amended (the "TBOC"), and Section 253 of the Delaware General Corporation Law, as amended
(the "DGCL"), permit a parent company to merge its subsidiary with and into the parent company
with the approval of the parent's board of directors; and
WHEREAS, the Board of Directors of the Company has determined that it is in the
best interest of the Company that the Subsidiary be merged with and into the Company upon the
terms and conditions set forth in these resolutions;
NOW, THEREFORE, BE IT RESOLVED THAT:
1. The Merger. At the Effective Time (as hereinafter defined), the Subsidiary
shall be merged with and into the Company and the separate corporate existence of the Subsidiary
shall thereupon cease (the "Mercer"). The Company shall be the surviving corporation in the
Merger (sometimes hereinafter referred to as the "Surviving Corporation") and shall continue to be
governed by the TBOC, and the separate corporate existence of the Company with all of its rights,
privileges, immunities, powers and franchises shall continue unaffected by the Merger. The
Merger shall have the effects specified in the TBOC and the DGCL.
2. Effective Time. The Company shall cause Certificates of Merger to be filed
with the . Secretary of State of Texas pursuant to the TBOC and with the Secretary of State of
Delaware pursuant to the DGCL. The effective time of the Merger (the "Effective Time") shall be
the effective time specified in such Certificates of Merger.
3. Articles of Incorporation of the Surviving Corporation. The Articles of
Incorporation of the Company in effect immediately prior to the Effective Time shall be the
Certificate of Incorporation of the Surviving Corporation, until duly amended in accordance with
the terms thereof and the TBOC.
A-1

4. By -Laws of the Surviving Corporation. The By -Laws of the Company in
effect immediately prior to the Effective Time shall be the By -Laws of the Surviving Corporation,
until duly amended in accordance with the terms thereof and the TBOC.
5. Directors and Officers of the Surviving Corporation. The directors and
officers of the Company holding office at the Effective Time shall, from and after the Effective
Time, be the directors and officers of the Surviving Corporation until their respective successors
have been duly elected or appointed and qualified.
6. Conversion or Cancellation of Shares in the Merger. The manner of
converting or cancelling shares of the Constituent Corporations in the Merger shall be as follows:
(a) At the Effective Time, each share of the Subsidiary's Common Stock, par
value $0.01 per share, that is issued and outstanding immediately prior to the Effective Time shall,
by virtue of the Merger and without any action on the part of the holder thereof, be canceled and
extinguished and shall cease to exist without any cash or other consideration being paid therefor.
(b) Each share of the Company's capital stock that is issued and outstanding
immediately prior to the Effective Time shall remain outstanding and shall not be converted,
cancelled or otherwise affected by the Merger in any way.
7. Service of Process in Delaware. As required by Section 253(a)(1) and
Section 252(d) of the DGCL, the Surviving Corporation may be served with process in the State of
Delaware in any proceeding for enforcement of any obligation of the Subsidiary in the State of
Delaware, as well as for enforcement of any obligation of the Surviving Corporation arising from
the Merger, and shall irrevocably appoint the Secretary of State of Delaware as its agent to accept
service of process in any such suit or other proceedings in accordance with the requirements of the
DGCL.
8. Subsequent Actions. If, at any time after the Effective Time, the Surviving
Corporation shall consider or be advised that any deeds, bills of sale, assignments or other actions
or things are necessary or desirable to vest, perfect or confirm in the Surviving Corporation its
right, title or interest in and to any of the rights, properties or assets of either of the Constituent
Corporations acquired or to be acquired by the Surviving Corporation as a result of, or in
connection with, the Merger or otherwise to carry out the purposes and intents of these resolutions,
the officers and directors of the Surviving Corporation shall be authorized to execute and deliver,
in the name and on behalf of each of the Constituent Corporations, all such deeds, bills of sale and
assignments and to take and do, in the name and on behalf of each of the Constituent Corporations,
all of such other actions and things as may be necessary or desirable to vest, perfect or confirm any
and all right, title and interest in and to such rights, properties or assets in the Surviving
Corporation or otherwise to carry out the purposes and intents of these resolutions.
A-2

Further Assurances; Miscellaneous
RESOLVED, that the officers of the Company are hereby authorized to execute
and deliver on behalf of the Company any and all such agreements, instruments, certificates or
other documents, make such filings and give such notices, and take any and all such other actions,
as they may deem necessary or desirable to consummate and make effective the transactions
contemplated by these resolutions, and otherwise to implement the purposes and intents of these
resolutions.
FURTHER RESOLVED, that all actions taken by any officer or director of the
Company in connection with any of the transactions contemplated by these resolutions are hereby
authorized, approved, ratified and confirmed in all respects.
FURTHER RESOLVED, that this Written Consent may be executed in the original
or by telecopy or other electronic means in any number of counterparts, each of which shall be an
original but all of which together shall constitute one and the same instrument.
A-3