NCG150017_COMPLETE FILE - HISTORICAL_20170705

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO. 1V C& I-50" l
-7
DOC TYPE XHISTORICAL FILE
MONITORING REPORTS
DOC DATE ❑ D 7Q
YYYYMMDD

Division of Energy, Mineral, and Land Resources
Land Quality Section 1 Stormwater Program
i
National Pollutant Discharge Elimination System (NPDES)
Energy Mineral & PERMIT OWNER AFFILIATION DESIGNATION FORM
Land Resources
VNVIFtONMENTAL OUALFTY (Individual Legally Responsible for Permit)
Use this form if there has been
FOR AGENCY USE ONLY
Date Recened
Year
Month
Aa
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 rill out a Name -Ownership Change Form
and submit the completed form with all required documentation
What does "legally responsible individual" mean9
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 (or)
N I C I S
2) Facility Information
Certificate of Coverage
N I C I G I I 5 d C) ! —%
Facihtyname O� -pGZVtCl-ion Cr-)"VLr
Company/Owner Organization)0_ Qo
Facility address 4p,N� p��vM 3 via # to►-� cL
�>r� �Q�E� Address
s�oRM Le)etn9+0n i4c 2 7Z9 Z
City State Zip
To find the current legally responsible person associated with your permit, go to this website
http //decl nc gov/about/divisions/energy-mineral-land-resources/enemy-mineral-land-pennits/stonnwater-program
and run the Permit Contact Summary Report
3) OLD OWNER AFFILIATION that should be removed
Previous legally responsible individual Lo Y CaS t or-t
First MI Last
A) NEW OWNER AFFILIATION (legally responsible for the permit)
Person legally responsible for this permit
30h r GrQ�
First M1 Last
SWU OWNFRAPHL 23March2017
Page 1 of 2

NPDES Stormwater Permit OWNER AFFILATION DESIGNATION Form
(if no Facility Name/Ownership Change)
a,,idson Got.A- -y A� pvr4 ",,cn / -CLatrVVx5in
Title
Mailing Address
1-.ext,,94a , /X 2-72'�2
City' , f State {� r IZip J +
( 40) 15(y—~%%7'Y ccm
Telephone E mail Address
( 33(a 95 (,,- -7(d4
Fax Number
5) Reason for this change
A result of Employee or management change
Inappropriate or incorrect designation before
❑ Other
If other please explain
The certification below must be completed and signed by the permit holder
PERMITTEE CERTIFICATION
I, )cL, Gr iL z , 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
Q4511— Awl
—�--/7
Signature Date
PLEASE SEND THE COMPLETED FORM TO
Division of Energy, Mineral, and Land Resources
Stormwater Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
For more information or staff contacts, please call [phone] or visit the website at
htt //deq nc gov/about/divisions/energy-mineral-land-resources/stormwater
Page 2 of 2
SWU OWNERAFFit_ 23Mar2017

Division of Energy, Nflneral & Land Resources
Land Quality Section/Stormwater Permitting
IL
NCDENNational Pollutant Discharge Eltavnation System
PERMIT NAMEIOWNERSHIP CHANGE FORM
er rol:v
no,* iipgo wed
Year
I Month
F Clay
1 Please onto, the lit:im,l number for whtch 11p chungc is m ueatcd
NPDES Permt (or) C4rtificute of Co t3
N C S 4 N S ao t 7
11 Permit status VLjor to requested phange
a Pcmut issued to (company name) Z%VlbjQj3-_CQUIjjC � AtjQF0P-i"_�UTWOrZ1
b Person legally responsible for permit R jE��.M 12 J. I W. 6rQ
First MI bast
Sltlr,
Pcrnjit Holdcr Mailing Adtirgsu
CSC I 3 ; t7 +� !J '2 � 1
City �e,� brut: Zip
Phono I'm
c racility name (discharge) C-G O > ODP-T
d Facility address��_
Addresn
City state Ttp
e 17aciltty contact person _ ( T ) —
First / M1 / Last Phone
III Please provide the following for the requested change (revised permit).
a Request for change is it result of [] Change in owncrship of the lboility
© Name change of the facility or owner
If other please explain Cj� a►b4��� Qrj&SQ!-) -_6 (n4UL_T _f kse2t� S SL e tL r ioZt4 tT
b Pcrnut issued to (company name) _ _
c Person legally responsible for permit G ter'
First Mt !..stet
Title
Pcrntit Holdor Mad Ing Addroas
ex --o "7 9 2
City statt. sip
Phone E mail %ddress
d Facility name (discharge) z5RVt O 432-`
e Facility address
Address
( tty State Lip
i Fac ility t ontact person (L-E 1-- �CA Dr,
2 1-10 hE7 1�
rtrst Mt Last
33(p — 7 7 7 V W L,4 E�*qjqL�4 )tj
Phone E mail Address
IV Permit contact information (if different from the person legally responsible for the permtt)
Revised Jan 2r, 2014

NPOES PERMIT NAMWOWNERSHIP CHANGE FORM
Pne2of2
Permit contact
lhrst ML 1
Title
Madmg.4dita
City Stara gip
Phont; F iriui) Addivu
V Will the permitted facility continue to conduct the sam4 industrial activities conducted prior
to this otvuershlp or name *_hangs'
Yes
No (please oxpidin)
VI Required Items, T1II6 APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS
ARE INCOMPLETE OR MISSING
This completed application is required for both name change and/or ownership change
requests
❑ Legal documentation of the transfer of ownership (such as relevant pages of a contract deed,
or a bill of sale) is „required for an ownership change request Articles of incorporation arc
not sufficient for an uwnt.rship change
1 he certifications below must be completed and signed by both the pernut holder prior to the change, and
the new applicant in the ease of an ownership change request Fora name change request, the signed
Applicant's Certification is sufficient
PERMITTEE CERTIFICATION (Permit holder prior to ownership change)
1, , ¢ttt,st that this application for a narric/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 is not included, this application package will be
returried as incomplete
Signature Date
APPIICANT CERTIFICATION
I, ttest that this application for a name/ownership change has been reviewed and is accurate and
complete to the best of my knowledge T understand that if all required parts of this application are riot
completed and that if all required supporting information is not included, this application packago will be
returned as incomplete
5
.C11gSt3tilTtl I}aitl
PLEASE BEND rRi? COMPLETE APPLICATION PACKAGE TO
Division of Energy, Mincrul and Land Rei.out"x
Stormwater Permitting Program
1612 Mail Soviets Center
Raleigh, North Carolina 27699-1612
Revised Jan 27 2014

9- 1
Division of Energy, Mineral & Land Resources
ATWA_ Land Quality Section/Stormwater Permitting
NC®ENR National Pollutant Discharge Elimination System
lk�C �wu IW-� �R•�.+ `� PERMIT NAMEIOWNERSHIP CHANGE FORM
Gvww�
FQR Ana& Y Use gAy
tmta Rgcm4n4
Year Month as
I Please enter the permit number for which the change is requested
NPDES Pcmitt (or) Gcrttfcatt of CON atago
N C S Q N C S to 10.11 T77
11 Permit status Prior to requested change
a Permit issued to (company name) �Vl DSoo ^Cou T`/ A(gPb27 Ln±O&I
b Person legally responsible for permit �^ ��
--..�AlK� Sdj2L1,V6TDeg
Post Mi Last
TPitl c
Permit NoiderMailino Addr-ams
l_..C7( I fj 67 10 0.j )J e—
Ca[y� .^ ,.,.,. State Lip
Phone Fax
c Facility name (discharge) _ �gy�n�Gi.1 CoLkh iy. At_fe,p'ogx
d Facility address �23--- 1� iJ pq -
Address
Gaty Stnia lap
e Facility contact person
First / MI / Last Phone
III Please provide the following for the requested change (revised permit)
a Request for change is a result of ❑ Change in ownership of the facility
❑ Name change of the facility or owner �
If outer pleare explain r'� p,,� F,e &0.s+oti 1 L e� Cno uL�l i�E5�0� S (PLC �G� i�c'lLfa t 1
b Permit issued to (company name)
c Person legally responsible for permit
L,
rl r °
Faint
MI � � � Last
FJI
o
/J .
Title
l G -7 3_
R v i A-T`, a NJ LJ
Pernut Holder Mailing Address
_lEXli,7s,`ai.�
tJL -- ��a92
Gay
Slate
Zap
�2_
g
Phone
E mail Address
d Facility name (discharge)
NU
S013 Ctx4 Qjk7 > Q-
& 12Q T _
o Facility address
I fo 73
No i 8M o 7
_
Address
vc
N �7
t Facility contact person
Ctt}
State
Zip
First
MI Last
(3S(o)
7
Phone
E-mail Address
IV Permit contact information (if differt nt from the person legally responsible for the permit)
Revised Jan 27 2014

W-1
NPDES PERMIT NAME/OWNERSHIP CHANGE FORM
Gape 2 of 2
Permit contact
kirat Nil Last
Talc
Mailing Addiess
city state zip
Mont, F.-mail Addren
V Will the permitted faculty continue to conduct the saute industrial activities conducted prior
to this ownership or name change"
Yes
No (please explain)
V1. Required Items THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS
ARE INCOMPLETE OR MISSING
This completed application is required for both name change and/or ownership change
requests
❑ Legal documentation of the transfer of ownership (such as relevant pages of a contract deed,
or a bill of sale) is required for an ownership change request Articles of incorporation arc.
not sufficient for an ownership change
The certifications below must be completed and signed by bath the permit holder prior to the change, and
the new applicant in the case of an ownership change request For a name change request, the signed
Applicant's Certification is sufficient
PERMITTEE CERTIFICATION (Permit holder prior to ownership change)
1, , 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 is not included, this application package will be
returned as incomplete
Signature Date
APP^ ICANT CERTIFICATION
I attest that this application fora name/ownership change his 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 is not included, this application package will be
returned as incomplete
Signature
.S`-ice - / 4
Date
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO
Division of Energy, Mineral and Land Resources
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
RensedJan 27 2014

A&T�_K WA
Division of Energy, Mineral & Land Resources
Land Quality Section/Stormwater Permitting
NCDENRNational
Pollutant Discharge Elimination System
C
EM"apu� u,A NCl/tw a
PERMIT NAME/OWNERSHIP CHANGE FORM
FOR AGENCY USE ONLY
Date Received
Year Month
Day
I Please enter the permit number for which the change is requested
NPDES Permit (or) Certificate of Coverage
N I C I. S 10 N I C I G 11 15 0 10! 7
11 Permit status prior to requested change
a Permit issued to (company name) V�)AVi nSOi� COEA c� higpo2T &AT14G&I y
b Person legally responsible for permit PA K iF TLA Q L (,,i 670 ,.i
First MI Last
Title
MAY v 2C i4 Permit Holder Mailing Address
c-i—to iJ rJ L '), 7 2- 9 2
p�ITy City State Zip
_ s�pnrmMretVf &$ f 1 (.%nl,. 1 9C/. — 71.E V
Phone Fax
c
Facility name (discharge)
p�V I [� SG iJ o rJ i `� A,, P- PO A I
d
Facility address
_ /62 73 Piv� Pr i t o_�.1 wpq
Address
Uxj tj a-r© r.3 r--� c 2 -� )- q 2
City State. Zip
e
Facility contact person
( )
First / MI / Last Phone
TIT Please provide the following for the requested change (revised permit)
a
Request for change is a result of
❑ Change in ownership of the facility
❑ Name change of the facility or owner
If other please explain ('�p,4 C-,� p��,
,,, (� [.igt,L�j QEspoiaSiISL� �Gi- i d-tA tR
b
Permit issued to (company name)
c
Person legally responsible for permit
L, p..r , }, C"A/ -�
First MI � c ��`
iPOAAN
Title
-7 3 U A"f Lj
Permit Holder Mailing Address
�E_o QC
City State Zip
( c�)`17;L-01/&2
Phone E-mail Address
d
Facility name (discharge)
ku 1 o SO iJ ip Ct
e
Facility address
/(p %3 qU i em o o tJA,y
Address
►JC—ON 1)
City State Zip
f
Facility contact person
P� (LE L_ ` 6X3 �)e'f2 L—lim o
First MI Last
(33�) qSrp — 7775/
Phone E-mail Address
IV Permit contact information (if different from the person legally responsible for the permit)
Revised Jan 27 2014

NPDES PERMIT NAME/OWNERSHIP CHANGE FORM
Page 2 of 2
Permit contact
hirst Ml Last
Title
Mailing Address
City State Zip
Phone E-mail Address
V Will the permitted facility continue to conduct the same industrial activities conducted prior
to this ownership or name change?
Yes
No (please explain)
Vi Required items THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS
ARE INCOMPLETE OR MISSING
This completed application is required for both name change and/or ownership change
requests
❑ Legal documentation of the transfer of ownership (such as relevant pages of a contract deed,
or a bill of sale) is required for an ownership change request Articles of incorporation are
not sufficient for an ownership change
The certifications below must be completed and signed by both the permit holder prior to the change, and
the new applicant in the case of an ownership change request For a name change request, the signed
Applicant's Certification is sufficient
PERMITTEE CERTIFICATION (Permit Folder prior to ownership change)
1 , 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 is not included, this application package will be
returned as incomplete
Signature Date
APP ICANT CERTIFICATION
1, 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 is not included, this application package will be
returned as incomplete
Signature
s=/_2,-/4
Date
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO
Division of Energy, Mineral and Land Resources
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Rewsed Jan 27 2014

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H Sullins
Governor Director
January 8, 2010
Mr Mike Turlington
Davidson County Airport Authority
1673 Aviation Way
Lexington, NC 27292
Subject General Permit No NCG150000
Davidson County Airport
COC NCG150017
Davidson County
Dear Mr Turlington
Dee Freeman
Secretary
In accordance with your application for a discharge permit received on December 8, 2009,
we are forwarding herewith the subject certificate of coverage to discharge under the subject state
— NPDES general permit This permit is issued pursuant to the requirements of North Carolina
General Statute 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)
Please take notice that this certificate of coverage is not transferable except after notice to
the Division of Water Quality The Division of Water Quality may require modification or
revocation and reissuance of the certificate of coverage
This permit does not affect the lc,gal requirements to obtain other permits which may be
required by the Division of Water Quality or permits required by the Division of Land Resources,
Coastal Area Management Act or any other federal or local governmental permit that may be
required
If you have any questions concerning this permit, please contact Brian Lowther at
telephone number [phone]
Sincerely,
ORIGINAL- SIGNED BY
KEN PICKLE
foi Coleen H Sullins
cc Winston Salem Regional Office
Central Files
Stormwater Permitting Unit Files
Wetlands and Stormwater Branch Otie
1617 Mail Service Center Raleigh North Carolina 27699 1617 NorthCarolina
Location 512 N Salisbury Si Raleigh North Carolina 27604 Naturally
919 807 63001 FAX [phone] Customer Service 1 877-623 6748
Internet www ncwaterquality org

I
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO NCG150000
CERTIFICATE OF COVERAGE No NCG150017
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision 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,
Davidson County Airport Authority
is hereby authorized to discharge stormwater and from a facility located at
Davidson County Airport
1673 Aviation Way
Lexington, NC
Davidson County
to receiving waters designated as Swearing Creek, a class C water in the Cape Fear Rivcr Basin,
in accordance with the effluent limitations, monitoring requirements, and other conditions set
forth in Parts 1, II, Ill, IV, V, and VI of General Permit No NCG150000 as attached
This certificate of coverage shall become effective January S, 2010
This Certificate of Coverage shall remain in effect for the duration of the General Permit
Signed this day January 8, 2010
ORIGINAL SIGNED BY
KEN PICKLE
for Coleen H Sullins , Director
Division of Water Quality
By the Authority of the Environmental Management Commission

LOCATION MAP.
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,N.�'A'J
NCGIS0017
Davidson County Airport Authority
Plymouth Municipal Airport
r I
Lah tude 350 46' S2" N
Longfu ide � 18' 14' W
I
11comty
Owdson
1�
Recce vrng Stream Swean ng Creek
Stream Oass C, Sw
j Fa cil i ty Loca tion
M40 SCale 1 24,WO
Sub -basin 03 07 07 (Yadkin River Basn)

Lowther, Brian
From Carter Jenifer
Sent Wednesday, January 06, 2010 10 48 AM
To Lowther Brian
Subject RE SW General Permit NCG150017
Please proceed with COC Thanks)
lenifer
Before printing this email, please consider your budget and the environment
If you must pant please print only what you need and save ink with the free Eco-Font
NC DENR Winston-Salem Regional Office
Division of Water Quality
585 Waughtown Street
Winston-Salem, NC 27107
Voice [phone]
FAX [phone]
E-mail correspondence to and from this address may be subject to the
North Carolina Public Records law and may be disclosed to third parties
From Lowther, Brun [madto brian Iowther@ncdenr gov]
Sent Tuesday, December 15, 2009 3 33 PM
To Carter, )enifer
Subject SW General Permit NCG150017
3enifer,
We've received an NOI from Davidson County Airport Authority for the Davidson County Airport
The site discharges stormwater into Swearing Creek (C) The NOI is attached
Does the Winston Salem Regional Office have any concerns about issuing this facility a COC
for this general permit, and are there any potential impacts to wetlands? If we don't receive
any objections, we'll issue the CDC in 30 days
Brian
Brian C Lowther
Environmental Engineer
NCDENR I DWQ I Stormwater Permitting Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
512 N Salisbury St, Raleigh, NC 27604
Phone [phone]

Email brian lowthernncdenr oovv
Website http llh2o enr state nc us/suAtormwater html
E-mail correspondence to and from this address may be subject to the North Carolina Public Records
Law and may be disclosed to third parties