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HomeMy WebLinkAboutNCG170408_Permit Contact Update Request_20240627 (3) Action History (UTC-05:00)Eastern Time(US&Canada) Submit by Anonymous User 6/27/2024 4:09:53 PM (Permit Contact Update Request) Approve by Austin Sanderford 10/2/2024 11:47:13 AM(Contact Update Review) •Updated AAS 10/2/2024 • The task was assigned to DEMLR SW Admin General.The due date is:August 8,2024 5:00 PM 6/27/2024 4:09:57 PM • The task was assigned to Austin Sanderford by round robin distribution 6/27/2024 4:09:57 PM DEQIwo NPDES Stormwater -Request Request Submitted NPDES Permit Enter your NPDES stormwater permit number or Certificate of Coverage(COC)number. Number* NCG170408 Begins with NCS,NCG,or NCGNE(no exposure) Facility Name* Meridian Specialty Yarn Group, Inc. (Used to verify permit number) Check permit contact information for your permit by running a Stormwater Permit Summary Report. Guidance for COC holders: Do not enter the General Permit number with all 0's(for example, NCG030000)but instead your Certificate of Coverge(COC)number. Check all that Owner Affiliation(Legally Responsible Individual)Update * apply: Permit Ownership Transfer or Facility Name Change Delegation of Signature Authority(DOSA) Permit Contact Update Billing Contact Update Facility Contact Update Other Contact Update Stormwater Program's Billing Specialist will be notified about the billing update request by email upon approval. Billing Contact Update Provide new billing contact information Note:This person will REPLACE the current billing contact.We can only designate one billing contact in our permitting database. New Contact Name* First and Last Name Connor Belair E-mail Address* cbelair@msyg.com Phone No.* 828-443-5093 Mailing Address* PO Box Drawer 10 Valdese NC,28690 Physical Address If different than mailing address 312 Colombo Street Sw Valdese NC,28690 Submitter's Name* Please enter your FIRST and LAST name Connor Belair Phone Number* Please enter your phone number 828-443-5093 Any format is fine. Email Address* Please enter a valid e-mail address cbelair@msyg.com A confirmation of submission will be e-mailed to this address. * By checking the box and signing below, I certify that: I have given true,accurate,and complete information on this form; I agree that submission of this form is a"transaction"subject to Chapter 66,Article 40 of the NC General Statutes(the "Uniform Electronic Transactions Act'); I agree to conduct this transaction by electronic means pursuant to Chapter 66,Article 40 of the NC General Statutes(the "Uniform Electronic Transactions Act'); I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature(except for any uploaded Owner Affiliation Change or Delegation of Signature of Authority forms,which also must be mailed in with original signature);AND I intend to electronically sign and submit this Permit Contact Update Request form. Signature �`�GrYA�Ot�Rlt Date 6/27/2024 Questions? Contact bethany.georgoulias@deq.nc.gov. Review Verify Permit No.* Revise permit number below if incorrect. NCG 170408