HomeMy WebLinkAboutNCG140346_COMPLETE FILE - HISTORICAL_20170627STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
qo 3/ U/
DOC TYPE
L9 HISTORICAL FILE
❑ MONITORING REPORTS
DDCDATE
❑ aID) -7
YYYYMMDD
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NC,DENR
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Division of Energy, Mineral and Land Resources
Land Quality Section 1 Stormwater Permitting Program
National Pollutant Discharge Elimination System (NPDES)
PERMIT OWNER AFFILIATION DESIGNATION FORM
(Individual Legally Responsible for Permit)
FOR AGENCY USE ONLY
Date Received
Year
MonthDay
if NO CHANGE in company or facility ownership or name has occurred.
If a.Name Change and/or. Ownership Transfer at the facility has prompted this, change;' do
Ndf use this form. You must till out the -Name -,Ownership Change Form and provide all -
necessary supporfing documenta[ion instead.
1) Enter the permit number for which this change in Legally Responsible Individual ("Owner
Affiliation"). applies:
Individual Permit
LN_;C`iLIX�
2) Facility Information:
Facility name:
Company/Owner Organization
Facility address:
(or) Certificate of Coverage
N{ CG 1 1 1 4 -- -- --
Various
Chandler Conceete Co-, Inc.
—Various _
Address
City state Zip
To find the current legally,responsible person associated with your permit, go to this: website:
http:/Iportal.iicdenr:org/webllrlsw=permit=contacts and run the Permit Contact Summary Report.
3) OLD OWNER AFFILIATION that should be removed:
Previous legally responsible individual: ;wines J. Woody
First M1 Last
4) .NEW OWNER AFFILIATION (Legally responsible for the permit):
Person legally responsible for this permit:
C1401°( yC6-NOOK
61MOO hC6~jg03V�
G-I�o�S/ C6_1googI
Cr 1 06. hcC-/ V D a -I 0
Cr��{00�
Cry Do1 �5t
Kenneth E. Wae erle
First MI Last
�('arpnrate EHS Manager
Title
PO ROX-131 ._
Mailing Address
Ilurlingfoon, NC 17216
City State Zip
(336 )226-1181, lren.waeuerle@chandl rcnnerefe_c6M
Telephone E-mail Address
( 336 )570-0557
Fax Number
Page 1 of 2
14
NPDESStormwater Permit OWNER AFFILATION DESIGNATION Form
(if no Facility Name/Ownership Change)
5) Reason for this change:
A result of:
Xf other please explain:
What does "legally responsible person" mean?
Thai person is either:
® Employee or management change
❑ Inappropriate or incorrect designation before
❑ Other
•. -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 that person above.
The certification below must be completed and signed by the permit
holder.
PERMITTEE CERTIFICATION:
1, Kinneih E. Wacgcrle attest that this application for this change in Owner Affiliation
(person legally responsible.f& the permit) has been reviewed an`d 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.
IutiC.27,..2017
Date
PLEASE SEND THE COMPLETED FORM TO:
Division of Energy, Mineral and Land Resources
Stormrvater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
For more information or staff contacts, please visit our website:
http://portal.ncdenr.org/web/lr/stormwater
Page 2 of 2
SWU4:)WNERAFFI L-22May2014
\,NA)- Michael F. Easley, Governor
\O�0 RpG William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
co r Alan W. Klimek, P.E.
Director
.� Division of Water Quality
June 25, 2004
Mr. James J. Woody
Chandler Concrete Co., Inc.
1006 S. Church St.
Burlington, NC 27215
Subject: General Permit No. NCG140000
Chandler Concrete Co., Inc.
COC NCG 140346
Durham Cot.tnty
Dear Mr. Woody:
In accordance with your application for a discharge permit received on June 4, 2004 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 May
9, 1994 (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 legal 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 Jonathan Diggs at telephone number
(919) 733-5083 ext. 537.
SrdRIGI lWAL SIGNED 13 fr
WILLIAM C, MILLS
Alan W. Klimek, P.E.
cc: Raleigh Regional Office
Central Files
Stormwater and General Permits Unit Files
N. C. Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 (919) 733-7015
aA7
A
0%ENA
Customer Service
1 800 623-7748
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAI, PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE No. NCG140346
STORMWATER AND PROCESS WASTEWATER 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.
Chandler Concrete Co., Inc.
is hereby authorized to construct and operate a process wastewater treatment system, and is hereby authorized to
discharge process wastewater and stormwater from a facility located at
Chandler Concrete Co.. Inc.
Ellis Road
Durham
Durham County
to receiving waters designated as UT to Third Fork Creek, a class C, NSW water in the Cape fear River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts 1, 11, 1II,
IV, V, and V1 of General Permit No. NCG140000 as attached.
This certificate of coverage shall become effective June 25, 2004.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day June 25, 2004.
GRIGINAt SIGNED By
WILLIAM C. MILLS
Alan W. Klimek, Director
Division of Water Quality
By Authority of the Environmental Management Commission
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Uopyrigrit (C;) lyy/, M3plecn, Inc.
Markers
Name: Chandler Concrete NCG140346
Short Name: Chndlr
Coordinates: 0350 57' 38 0" N, 0780 52' 25.8" W
Comment: Chandler Concrete Ellis Road Plant #606, subbasin (03-06-05), Cape Fear River
Basin, Durham County, UT to Third Fork Creek, Class C, NSW, USGS quad D23NW