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HomeMy WebLinkAboutNCGNE1019_Name-Owner Change Application_20230201NC DEPARTMENT OF ENVIRONMENTAL QUALITY DIVISION OF Energy, Mineral, and Land Resources STORMWATER PROGRAM NORTH CAROLINA Environmental Quality NPDES STORMWATER PERMIT NAME/OWNERSHIP CHANGE FORM I. CURRENT PERMIT INFORMATION: Permit Number: NCS����_ /_ or NCG_�L/_�_J_D_LJ 1 / 9 1. Facility Name (prior to change): DSM Protective Materials LLC II. NEW OWNER/NAME INFORMATION: 2. This request for a name change is a result of: a. Change in ownership of property/company X b. Name change only (Facility and/or Company) c. Other (please explain): (for example, facility address update. Include additional attachments if necessary.) 3. New owner's name (name to be put on permit as Permittee): AVIENT Protective Materials LLC 4. New owner's or signing official's name and title: Scott McIntyre (Person legally responsible for permit) Site Director (Title) 5750 Martin Luther King Jr 5. Mailing address: Highway City: Greenville State: NC Zip Code: 27834 Phone:( 252 ) 382 0772 E-mail address: Robert.McIntyre@Avient.com 6. New facility name (if applicable): AVIENT Protective Materials LLC 7. Effective date of transfer or name change: January 16th 2023 North Carolina Department of Environmental Quality I Division of Energy, Mineral and Land Resources . _ D 512 North Salisbury Street 1 1612 Mail Service Center I Raleigh, North Carolina 27699 1612 �� /'� 9197079200 NPDES Stormwater Permit Name/Ownership Change Page 2 of 2 III. PERMIT AND FACILITY CONTACT INFORMATION 8. New permit contact's name and title: Scott McIntyre (Permit Contact) Site Director (Title) 5750 Martin Luther King Jr 9. Mailing address: Highway City: Greenville State: NC Zip Code: 27834 Phone:( 252 ) 382 0772 E-mail address: Robert. McIntyre@Avient . com 10. New facility contact's name and title: Myrna Pacheco (Facility Contact) Environmental Engineer (Title) 5750 Martin Luther King Jr 11. Mailing address: Highway City: Greenville State: NC Zip Code: 27834 Phone:( 252 ) 406 5872 E-mail address: Myrna.pachecoponcedele@Avient.com 12. New billing contact's name: Myrna Pacheco (Billing Contact) 5750 Martin Luther King Jr 13. Mailing address: Highway City: Greenville State: NC Zip Code: 27834 Phone:( 252 ) 406 5872 E-mail address: Myrna . pachecoponcedele@Avient . com IV. FACILITY ACTIVITIES AND DISCHARGE INFORMATION 1. Will industrial activities at the facility remain the same as under the previous owner? Yes ® No ❑ 2. Will the stormwater discharge location(s) remain the same? Yes ® 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, stormwater 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 3/13/2022 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: I, Scott McIntyre , 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 b ret,� . Signature: Date: 1-7 ZTO Qp3 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 3/13/2022 Delaware Page The First State I, JEFFREY W. BULLOCK, SECRETARY OF STATE OF THE STATE OF DELAWARE, DO HEREBY CERTIFY THE ATTACHED IS A TRUE AND CORRECT COPY OF THE CERTIFICATE OF AMENDMENT OF "DSM PROTECTIVE MATERIALS LLC", CHANGING ITS NAME FROM "DSM PROTECTIVE MATERIALS LLC" TO "AVIENT PROTECTIVE MATERIALS LLC", FILED IN THIS OFFICE ON THE THIRTEENTH DAY OF JANUARY, A.D. 2023, AT 11:56 O'CLOCK A.M. AND I DO HEREBY FURTHER CERTIFY THAT THE EFFECTIVE DATE OF THE AFORESAID CERTIFICATE OF AMENDMENT IS THE SIXTEENTH DAY OF JANUARY, A. D. 2023. 3428833 8100 SR# 20230129797 You may verify this certificate online at corp.delaware.gov/authver.shtml Authentication: 202492272 Date: 01-13-23 State of Delaware Secretary of State Dhislon of Corporations Delhered 11:56A310113/2023 AMENDED AND RESTATED FILED 11:56 A,1101 1312023 CERTIFICATE OF FORMATION SR 20230129797 - File\umber 3428833 OF DSM PROTECTIVE MATERIALS LLC This Amended and Restated Certificate of Formation of DSM Protective Materials LLC (the "Company'), a limited liability company organized and existing under the Delaware Limited Liability Company Act (the "Act'), has been duly executed and is being filed in accordance with Section 18-201 of the Act, and is being filed pursuant to Section 18-208 of the Act, in order to amend and restate the Certificate of Formation of the Company originally filed with the Secretary of State of the State of Delaware on October 23, 2003 under the name DSM Dyneema LLC, and as amended from time to time (the "Original Certificate"). The Original Certificate is hereby amended and restated in its entirety to read as follows: 1. The name of the limited liability company is Avient Protective Materials LLC (the "Company„). 2. The address of the registered office of the Company in the State of Delaware is: The Corporation Trust Company, Corporation Trust Center, 1209 Orange Street, Wilmington, New Castle County, Delaware 19801. 3. The name and address of the registered agent for service of process on the Company in the State of Delaware is: The Corporation Trust Company, Corporation Trust Center,1209 Orange Street, Wilmington, New Castle County, Delaware 19801. 4. This Amended and Restated Certificate of Formation shall be effective as of January 16, 2023. [Remainder of Page Intentionally Left Blank] IN WITNESS WHEREOF, the undersigned has caused this Amended and Restated Certificate of Formation to be signed by its duly authorized officer as of the January 13, 2023. Name: Robert K. James Title: Secretary [Signature Page to Certificate of Formation of DSMProtective Materials LLC]