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Home My WebLink AboutNCG050209_Owner Affiliation Change_10/16/2019Division of Energy, Mineral, and Land Resources Land Quality Section / Stormwater Program K_ National Pollutant Discharge Elimination System (NPDES) FOR AGENCY USE ONLY Date Received Year Month Day Enet yv Maner l & PERMIT OWNER AFFILIATION DESIGNATION FORM Land Resources (Individual Legally Responsible for Permit) r°ibiRt'SFif9FfiF S?„ qlz.'.,?': Use this form if there has been: NO CHANGE in facility ownership or facility name, but the individual who is legally responsible for the permit has changed. If the name of the facility has changed, or if the ownership of the facility has changed, do NOT use this form. Instead, you must fill out a Name -Ownership Change Form and submit the completed form with all required documentation. What does "legally responsible individual" mean? The person is either: • the responsible corporate officer (for a corporation); • the principle executive officer or ranking elected official (for a municipality, state, federal or other public agency); • the general partner or proprietor (for a partnership or sole proprietorship); • or, the duly authorized representative of one of the above. 1) Enter the permit number for which this change in Legally Responsible Individual ("Owner Affiliation") applies: Individual Permit l ?s 2) Facility Information: Facility name: Company/Owner Organization: Facility address: (or) Certificate of Coverage c I G1015_1075� urH &e.- i' % r 8ZD_ C'w.4,Lj 12iV Address City State Zip To -find the current legally responsible person associated with your permit, go to this website: h ://de .nc. ov/aboutidivisions/encr -mineral-land-resources/ener mineral -land- ermits/stormwater- ro am and run the Permit Contact Summary Report. 3) OLD OWNER AFFILIATION that should be removed: Previous legally responsible individual: C l 4 (5 First MI Last 4) NEW OWNER AFFILIATION (legally responsible for the permit): Person legally responsible for this permit: First MI Last Page 1 of 2 S WU-OWNERAFFIL-23March2017 NPDES Stormwater Permit OWNER AFFILATION DESIGNATION Form (if no Facility Name/Ownership Change) 5) Reason for this change: A result of: If other please explain: Title CCU Cr,� � ,,_► �o�c Mailing Address Lv City State Zip (9/0) ,g9-) G 25-(=, Telephone E-mail Address Fax Number Employee or management change ,T71 Inappropriate or incorrect designation before ❑ Other C / a n "I""" Ui'N ' The certification below must be completed and signed by the permit holder. PERMITTEE CERTIFICATION: I, 1nr10 ' �n , attest that this application for this change in Owner Affiliation (person legally responsible for the permit) has been reviewed and is accurate and complete to the best of my knowledge. I understand that if all required parts of this form are not completed, this change may not be processed. nee_-�l & — — — — /0-/�- 19 Signature Date PLEASE SEND THE COMPLETED FORM TO: DEMLR - Stormwater Program Dept. of Environmental Quality 1612 Mail Service Center Raleigh, North Carolina 27699-1612 For more information or staff contacts, please call (919) 707-9220 or visit the website at: http://deg.nc.gov/about/divisions/energy-mineral-land-resources/stormwater Page 2 of 2 S WU-OWNERAFFIL-23Mar2017 INTERNATIONALe PAPER Greg Wanta SENIOR VICE PRI SIDENT NORTH AMERICAN CONTAINER March 9, 2017 6400 Poplar Ave. Memphis, TN 38197 Business (901) 419-9000 Fax (901) 214-0850 Greg. Wanta(a.0paper.com Subject: Signatory Authority Delegation - International Paper Container Business To: All Concerned As Senior Vice President of International Paper, North American Container, I hereby authorize the Plant General Manager or the Manufacturing Manager (or other similarly -titled individuals with the same site location responsibilities) of each of the facilities listed below to certify and submit in the name of and on behalf of International Paper all environmental applications, reports, documentation, plans or other information relative to their specific facility as required by federal, state, or local permit issuing authorities as allowed under appropriate regulations. Locatiwl ALABAMA Ad d 100 Dickman Road Bay Minette State AL Zip 36507 Bay Minette Container Plant Decatur Container Plant 151 I sco Street Decatur AL 35601 Dothan Sheet Plant 368 Technology Drive Dothan AL 36303 Huntsville Plant 3461 Wall Triana Hn SW Huntsville AL 35824 ARKANSAS Bentonville Retail Center 1703 SW Commerce Dr Ste 3 Bentonville AR 72712 ConwayPlant 730 Ente rise Avenue ConwayAR 72032 Fort Smith Container Plant 4215 Planters Road Fort Smith AR 72908 Fort Smith Container North 4500 Newlon Road Fort Smith AR 72904 Russellville Container Plant 3900 International Drive Russellville AR 72802 Russellville Plant 3019 East 16th Street Russellville AR 72802 ARIZONA Phoenix Container Plant 660 S 83rd Avenue 'Tolleson AZ 85353 Yuma Container Plant 2641 E 24th Street Yuma AZ 85365 CALIFORNIA Anaheim Container Plant 601 E Ball Road Anaheim CA 92805 -Bay Sheets 6791 Alexander Street Gilroy CA 95020 Bell Container Plant 5991 Bandini Blvd Bell CA 90040 Buena Park Kraft Bag Plant 6485 Descanso Avenue Buena Park CA 90620 Buena Park Crockett Cont. 6211 Descanso Avenue Buena Park CA 90620 Camarillo Container Plant 2000 E Pleasant Valley Road Camarillo CA 93015 Carson Container Plant 1350 E. 223rd Street Carson CA 90745 Cerritos Plant 16631 S. Valle View Avenue Cerritos CA 90703 International Paper Signature Delegation, Container the Americas Page 2 of 7 Compton Container Plant Elk Grove Container Plant Exeter Container Plant 19615 S Susana 10268 Waterman Road I I 1 I N Anderson Road Compton Elk Grove Exeter CA CA CA 90221 95624 93221 Gilro Container Modesto Container Plant 1 6400 Jamieson Wily 660 Mariposa Road Gilroy Modesto CA CA 95020 95354 Ontario Container Plant 5110 Juru a Street Ontario CA 91761 Salinas Container Plant 1345 Harkins Road Salinas CA 93901 San Leandro Plant 1950 Marina Boulevard San Leandro CA 94577 Sanger Container Plant 1000 Muscat Avenue SangerCA 93657 Santa Fe Springs Container 11211 Greenstone Avenue Santa Fe Sp rin s Santa Fe 5 rinp CA CA 90670 90670 Santa Fe S rin s Crockett 9211 Norwalk Blvd. Stockton Container Plant 3550 Bozzano Road Stockton CA 95215 Tracy Container 400 W. Val ico Road Tracy CA 95376 COLORADO Golden Wheat Ride CO CO 80403 80033 Golden Container Plant 4565 Indiana Street Wheat Rid a Container 5000 Oak Street CONNECTICUT _ Putnam Container Plant 175 Park Road Putnam CT 06260 FLORIDA Orlando Container 711 E Lancaster Road Orlando FL 32809 Plant City Container Plant 2402 Police Center Drive Plant Cte Tampa FL FL 33566 33610 Tampa Container and Ink 6706 53rd Street Blend GEORGIA Atlanta Container Plant 5115 Pine Tree Street Forest Park GA 30297 Columbus Container Plant 4847 Cargo Drive Columbus GA 31907 Griffin Container Plant 330 Hudson Road Griffin GA 30224 Lithonia Container Plant 6792 Marbut Road Lithonia GA 30058 Savannah Container Plant 1201 West Lanthrop Avenue Savannah GA 31415 SpacekraR, An International Paper Business, Kennesaw Container Plant 980 Cobb Place Boulevard Kennesaw GA 30144 Stone Mountain Ink Plant 4839 Lewis Road Stone Mountain GA 30083 bucker Plant ILLINOIS 5099 IV Ro a: Atlanta Drive Tucker GA 30084 Aurora IL 60504 Aurora Container Plant 4160 Campus Drive Aurora Customer Center 4160 Campus Drive Aurora IL 60504 Aurora Sheet Bedford Park Container Plant 3920 Enterprise Court 5300 W 73rd Street Aurora IL 60504 Bedford Park IL 60638 Bedford Park Plant 7333 S. Lockwood Bedford Park IL 1 60638 Belleville Container Plant 3001 Otto Street Belleville 1L 62226 Carol Stream Container 139 E. Fullerton Carol Stream 1L 60188 Des Plaines Container Plant 100 East Oakton Street Des Plaines IL 60018 Fox Valley Container 2540 Pros Court Aurora IL 60502 International Paper Signature Delegation, Container the Americas Page 3 of 7 Lincoln Container Plant Montgomery Container Plant Chicago Northlake Container Plant Rockford Container Plant tNDIANA 1601 59 Street 1001 Knell Street 401 Northwest Avenue 2100 23rd Avenue Lincoln Montgomery Northlake Rockford IL IL I1., IL 62656 60538 60164 61104 Butler Container Plant 2626 County Road Butler IN 46721 Crawfordsville Container 801 N. Enjzlewood Drive Crawfordsville IN 47933 Fort Wayne Container Plant 3904 Ferguson Road Fort Wayne IN 46809 Indianapolis Customer Ctr 8501 Moller Road Indianapolis IN 46268 Indianapolis Display and Packa in 2135 Stout Field Drive East Indianapolis IN 46241 Indiana oliis Retail Sheet 1255 Roosevelt Avenue Indianapolis IN 46202 Midwest Sheets Spacekraft, An International Paper Business, Indianapolis Container Plant 815 Industrial Drive 4901 West 79th Street Tipton Indianapolis IN IN 46072 46268 Portland Plant 300 Industrial Park Portland IN 47371 Indianapolis Preprint (GRC) 7536 Miles Drive Indianapolis IN 46231 St. AnthonySheet Plant 3565 E. 550 South St. AnthonyIN 47575 IOWA Cedar Rapids Container Plant 920 Shaver Rd NE Cedar Rapids IA 52402 f Waterloo Container Plant 800 West Parker Waterloo iA 50703 KANSAS Garden City Container 2502 E US Hwy 50 Garden City KS 67846 KENTUCKY Bowlin Green Plant 5150 Nashville Road Bowling Green KY 42101 LexingLon Container Plant 2575 Palumbo Drive Lexington KY 40509 Louisville Container Plant 4400 Progress Boulevard Louisville KY 40218 Richwood Print and Graphics 380 Shorland Drive Richwood KY 41094 LOUISIANA Bo lusa Container 501 Avenue U Bogalusa LA 70427 Lafayette Container Plant 204 South Park Road Lafayette LA 70508 -Shreveport Container Plant 1212 Tolmak Road Shreveport LA 71107 Springhill Container Plant 3000 South Arkansas Street Springhill LA 71075 MAINE Auburn Container Plant 175 Allied Road Auburn ME 04210 AHCHIGAN International Pager Signature Delegation, Container the Americas Page 4 of 7 Flint 211 Lapeer Road Flint Ml 48503 Three Rivers Container 1321 Third Street Three Rivers MI 49093 Plant MINNESOTA Minneapolis (Arden Hills) 1300 Red Fox Road Arden Hills MN 55112 Container PIant Austin Container Plant 1900 Ei h Street NE Austin MN 55912 Fridley Plant 350 Northca Drive NE FridleyMN 55432 Minnea o]is Sheet Plant 3558 2nd Street North Minnea olis MN 55412 Shako ee Container 3900 County Road 101 E Shakopee MN 55379 White Bear Lake Container 1699 W Ninth Street White Bear Lake MN 55110 Plant MISSISSIPPI Houston Container Plant 511 Third Street Houston MS 38851 Jackson Container Plant 211 Carrier Boulevard Jackson MS 39218 Ma olia Container PIant 350 Prescott Drive Ma olia MS 39652 Olive Branch Container 8301 Hacks Cross Road Olive Branch MS 38654 Plant NIISSOURI Gateway Sheets 5300 Bircher Blvd St. Louis MO 63120 Kansas City Container 4343 Clary Boulevard Kansas City MO 64130 Plant Maryland Heights Plant H 480 Warnen Road M land Heights MO 63043 North Kansas Ciry Plant 1910 Warren Street North Kansas City MO 64130 St. Joseph Container Plant 4725 Easton Road St. Joseph MO 64503 St. Louis Container 1201 North HighwM Drive Fenton MO 63026 NEBRASKA Omaha Container Plant 7517 F Street Omaha NE 168127 NEW JERSEY Barrington Container PIant 100 E Gloucester Pike Barrington NJ 08007 Bellmawr Container Plant 370 Benigno Boulevard BeIlmawr NJ 08031 International Paper Retail 33 Phoenix Drive Thorofare NJ 08086 .Display and Packaging Milltown Sheet Plant 101 Ford Avenue Milltown NJ 08850 Spotswood Container 140 Summerhill Road Spotswood NJ 08884 NEW YORK Binghamton Container 1240 Conklin Road Conklin NY 13748 Buffalo Sheet Plant 100 Bud -Mil Road Buffalo NY 14206 Rochester Container Plant 200 Boxart Street Rochester NY 14612 Scotia Sheet Plant 803 Corporate Park Glenville NY 12302 Utica Sheet Plant 50 Harbor Point Road Utica NY 13502 NORTH CAROLINA Charlotte Container Plant 5419 Hovis Road Charlotte NC 28208 International Paper Signature Delegation, Container the Americas Page 5 of 7 Charlotte Retail Center 10601 Westlake Drive Charlotte NC 28273 Lumberton Container Plant 820 Caton Road Lumberton NC 28360 Newton Container Plant 1525 Mt Olive Church Road Newton NC 28658 Statesville Container Plant 930 Meacham Road Statesville NC 28677 Warren County Container 967 US Highway1 Manson NC 27553 OTRO Byesville Plant 60700 Hope Avenue B esville OH 43723 Delaware Container Plant 875 Pittsburgh Drive Delaware OH 43015 _Delaware Plant 865 Pittsbu[6 Drive Delaware OH 43015 Eaton Container Plant 900 State Rt 35 W Eaton OH 45320 Madison Retail Plant 3200 County Line Road _ Madison Oil 44057 Marion Container 1600 Cascade Drive Marion OH 43302 Marysville Specialty ink 13307 industrial Parkway Marysville OH 43040 Middletown Container 912 Nelbar Street Middletown OH 45042 Mt. Vernon Container 8800 Granville Road Mt. Vernon OH 43050 Plant Newark Container Plant 1851 Tamarack Road Newark OH 43055 Streetsboro Container 700 Mondial Parkway Streetsboro OH 44241 Wooster Container Plant 689 Palmer Street Wooster OH 44691 OKLAHOMA Oklahoma City Container 4901 West Point Boulevard Oklahoma City OK 73179 Plant OREGON Beaverton Container Plant 5500 SW Western Avenue Beaverton OR 97005 Beaverton Plant 5800 SW Western Avenue Beaverton OR 97005 Beaverton Plant 5570 SW Western Avenue Beaverton OR 97005 Beaverton Plates 5570 SW Western Avenue Beaverton OR 97005 Hillsboro Enhanced Graphics 23950 NW Huffman Street Hillsboro OR 97124 Portland Container Plant Spacekrak An International Paper Business, Salem Plant _ 1601 NE 1921d Avenue 4060 Fairview Industrial Park Dr Portland Salem OR OR 97230 97302 PENNSYLVANIA Bi lerville Container 136 E_ York Street Bi lerville PA 17307 Bi lerville Warehouse 342 E. York Street Bi lerville PA 17307 Eighty Four Container Plant 10 Wilson Road Eighty Four PA 15330 -Gettysburg Warehouse 2895 Old Harrisburg Road Gettysburg PA 17325 Hazleton Container 533 Forest Road Hazleton PA 18202 Kennett Square Sheet Plant 1270 Baltimore Pike Tou hkenamon PA 19374 Littlestown Sheet Plant Lancaster Container PIant 2190 Whitehall Road 801 Fountain Avenue Littlestown Lancaster PA PA 17340 17601 Mt. Carmel Container 2164 Locust Gap Highway I Mt. Carmel PA 17851 International Paper Signature Delegation, Container the Americas Page 6 of 7 SOUTH CAROLINA Georgetown Container Plant 1480 International Drive Georgetown SC 29442 Laurens Container Plant Lexingl2n Container TENNESSEE 21313 Highway 221 North 129 Zenker Road Laurens Lexinpton SC SC 29360 29072 Ashland City Sheet Plant Cleveland Container Plant Elizabethton Sheet Plant 2150 HighfaX 12 S 2401 Blue Springs Road S 152 Iodent Way — Suite A Ashland Ci Cleveland Elizabethton TN TN TN 37015 37311 37643 Morristown Container Plant 5032 S. Davy Crockett Pkwy Morristown TN 37813 Murfreesboro Container Plant 2220 NW Broad Street Murfreesboro TN 37129 TEXAS Amarillo Container Plant 4715 NE 24th Street Amarillo TX TX TX 79107 75006 75006 Belt Line Container 2605 E. Belt Line Road Carrollton I-35 Container Plant 1655 South 1-35 East Carrollton Edinburg Container Plant 1501 North Closner Boulevard Edinburg TX TX TX _ 78 441 — 78541 79907 Edinburg Ink Blending Plant 1501 North Closner Boulevard Edinburg FI Paso Container Plant 9301 Billy the Kid Street El Paso Fort Worth Container Plant 2400 Shamrock Avenue Fort Worth TX 76107 Grand Prairie Container Plant 1200 West N Carrier Parkway Grand Prairie TX 75050 Grand Prairie BM Plant 1302 West N Carrier Parkway Grand Prairie TX 75050 McAllen Container Plant 200 N 26th Street McAllen TX 78501 San Antonio Container I I I I AT&T Center Parkway San Antonio TX 78219 San Antonio Sheet 610 Pop Gunn Drive San Antonio TX 78220 Scaly Container Plant 1485 Silliman Road Sealy TX 77474 Waxahachie Container 200 Butcher Road Waxahachie TX 75165 International Paper Signature Delegation, Container the Americas Page 7 of 7 VIRGINIA Lynchburg Container Plant 3491 Mayflower Drive LynchburgLynchLurg VA 24501 .Petersburg Container 2333 Wells Road Petersburg VA 23805 Richmond Container Plant 2811 Cofer Road Richmond VA 23224 WASHINGTON Moses Lake Container 13594 Wheeler Road NE Moses Lake WA 988 77 Plant 0m is Container Plant 7727 Union Mill Road SE 01 m is WA 98503 Yakima (Union Gap) 600 Ahtanum Road Union Gap WA 98903 Container Plant 2703 Fruitvail Boulevard Yakima Container Yakima WA 98902 Warehouse _W ISCONSINY Fond Du Lac Container 981 S. Hickory Street Fond Du Lac W 1 54935 Plant Manitowoc Container Plant 2000 S 18th Street Manitowoc WI 54220 Please refer any questions or correspondence regarding environmental matters to the local facility. Sincerely, 4 6 Greg Wanta SENIOR VICE PRESIDENT, NORTH AMERICAN CONTAINER INTERNATIONAL PAPER