NC0024333_Owner (Name Change)_20240725

NORTH CAROLINA
Environmental Quality
NC DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
WATER QUALITY PERMITTING SECTION
NPDES PERMITTING
PERMIT NAME/OWNERSHIP CHANGE FORM
CURRENT PERMIT INFORMATION:
Permit Number: NC00_2_/_4_j_l_/_L/ 3 or NCG5_/_/_/_/_
1. Facility Name: City of Monroe WWTP
NEW OWNER/NAME INFORMATION:
1. This request for a name change is a result of:
a. Change in ownership of property/company
b. Name change only
X c. Other (please explain): Change in responsible official only
2. New owner's name (name to be put on permit):
3. New owner's or signing official's name and title: Mark Watson
4. Mailing address: P.O. Box 69
(Person legally responsible for permit)
City Manager
(Title)
City: Monroe
State: NC Zip Code: 28111 Phone: [phone]
E-mail address: [e-mail]
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1. Will the waste stream for the facility remain the same as under the previous owner? Yes X No ❑
2. Will the treatment system and discharge location remain the same? Yes X No ❑
"No Responses"
If either or both of these questions are answered "No" then more information will be needed to review the
request. Please attach documentation to describe and explain the changes to the facility activities, waste
stream, treatment process or outfoll location. The Division may not be able to process the Permit
Name/Ownership Change request and may require that the new owner file a new permit application.
D E Q North Carolina Department of Environmental Quality I Division of Water Quality
512 North Salisbury Street 1 1617 Mail Service Center I Raleigh, North Carolina 27699-1617
Moan+ cv:ot�vr,
nep�t m &Ww_ ] a�'i\ �� 919.707.9000

NPDES Name and Ownership Change
Page 2 of 2
THIS APPLICATION PACKAGE WILL NOT BE ACCEPTED BY THE DIVISION UNLESS ALL OF THE
APPLICABLE ITEMS LISTED BELOW ARE INCLUDED WITH THE SUBMITTAL.
REQUIRED ITEMS:
This completed application form
Legal documentation of the transfer of ownership (such as a property deed, articles of
incorporation, or sales agreement)
Information to document facility, waste stream, treatment system or outfall changes as noted in
item III above (if appropriate)
Applicant's Certification:
I, Mark Watson , attest that this application for a name/ownership change 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 and that if all required supporting information and attachments are not
included, this application package will be returned as incomplete. I understand that Permit
Name/Ownership Change can only take place through action taken by the Division of Water Resources
and that no actions on my part or the part of my company result in the automatic transfer of permit
coverage.
Signature: Date
6 7 - / 2 - 2-o Z */'-
THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL SUPPORTING INFORMATION & MATERIALS,
SHOULD BE SENT TO THE FOLLOWING ADDDRESS:
NC DEQ / DWR / NPDES
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Version 07/2021

July 16, 2024
Wastewater Branch
Water Quality Permitting Section
Division of Water Resources
1617 Mail Service Center
Raleigh, NC 27699-1617
Subject: Delegation of Signature Authority
CITY OF MONROE WWTP
NPDES Permit Number NCO024333
To Whom It May Concern:
By notice of this letter, I hereby delegate signatory authority to each of the following individuals for all
permit applications, discharge monitoring reports, and other information relating to the operations at
the subject facility as required by all applicable federal, state, and local environmental agencies
specifically with the requirements for signatory authority as specified in 15A NCAC 2B.0506.
Individual #1 Individual #2 (ifapplicable)
Name:
Scott Clark
Kyle Edwards
Title:
Director
WWTP Superintendent
Mailing Address:
P. O. Box 69
Monroe, Nc 28111
P.O. Box 69
Monroe, Nc 28111
Physical Address:
(if different)
2401 Walkup Ave
Monroe, Nc 28110
775 Treeway Dr
Monroe, Nc 28110
Email Address:
[e-mail]
[e-mail]
Office Phone:
704 - 282 - 4624
704 - 282 - 4612
Mobile Phone:
980 - 315 - 9845
704 - 226 - 6093
If you have any questions regarding this letter, please feel free to contact me at [e-mail]
or 704-282-4624.
Sincerely,
alvi Y4�7
Mark Watson
City Manager
City Of Monroe
P.O. Box 69, Monroe, Nc 28111
[e-mail]
704-282-4501
cc: Mooresville Regional Office, Water Quality Permitting Section