NCG150010_COMPLETE FILE - HISTORICAL_20141002

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
E� HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑
YYYYMMDD

F-lawA
RCDENRNormCdr _!_p€Ru
E�. 011Fnr � 0 Ncl 'L RESOURCES
Division of Enerp,, Mineral and Land Resources
Land Quali", Section / Stormwater Permitting Program
National Pollutant Discharge Elimination System (NPDES)
PERMIT OWNER AFFILIATION DESIGNATION FORM
(Individual legally Responsible for Permit)
Use this form if there has been:
FOR AGENCY USE ONLY
Date Received
Year
Month
Day
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 erson is either
RECEIVED
• the responsible corporate officer (for a corporation);
OCT 02 2014
• the principle executive officer or ranking elected official (for a municipality, state. Pedt& aie�rOpAE ITY
agency); STORMWATER PERMITTING
• 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
N I C I S
2) FaciIity Information:
Facility name:
Company/Owner Organization:
Facility address:
(or) Certificate of Coverage
Ni C I G 1 5 1 D O { a
LRK_P,L0UC- - Mt6tQoe A1gibRT
l-i- of M or, ro e_
,� CiOb 7. Re -(,As br. --
Address
City State Zip
To find the current legally responsible person associated with your permit, go to this website:
http://portal.nedetir.or{_; web/Ir/sNv-permit-contacts and run the Permit Contact Summary Report.
3) OLD OWNER AFFILIATION that should be removed:
Previous legally responsible individual: Ck r is
First MI
4) NEW OWNER AFFILIATION (legally responsible for the permit):
Person legally responsible for this permit:
�Cc'r
First MI
Last
CeVej[
Last
SWU-OWNERAFF IL-25Ju1y2d14
Page 1 of 2

NPDES Stormwater Permit OWNER AFFILATION DESIGNATION Form
(if no Facility Name/Ownership Change)
aW v�A j itle C I Vl S
Mailing ddress
el
City State zip
U'Vcii r n�wfr�r�
Telephone _ E-mail Address
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:
1, rtP.� CjE,\00,'�, ayest that this application for this change in Owner Affiliation
(person legally responsible for the permit)/Iias been reviewed and is accurate and complete to the best of my
knowledge. I under tan tha 'f, required parts of this form are not completed, this change may not be
proces�
'Sept. so, ��o 14
Sip-naturem Date
PLEASE SEND THE COMPLETED FORM TO:
Division of Energy, Mineral and Land Resources
Stormwater Permitting Program
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:
htt a/ iortaLncdenr.or � web/lr/stormwater
Page 2 of 2
SM-OWNERAFF IL-25July2014

NCDENR
N�.+n C ac.irin �rwrrwer+r Of
�++nAw+Mc.+r N+o h'dGR!.L Fee9ounces
Division of Energy, Mineral and Land Resources
Land Quality Section / Storm -water Permitting Program
National Pollutant Discharge Elimination System (NPDES)
PERMIT OWNER AFFILIATION DESIGNATION FORM
(Individual Legally Responsible for Permit)
Use this form if there has been:
FOR AGENCY USE ONLY
Date Receieed
Year
Month
Day
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
N I C I S
2) Facility Information:
Facility name:
Company/Owner Organization
Facility address:
(nr} Certificate of Coverage
N I C I G 11 15 10 10 1110
Charlotte -Monroe Executive Airport
City of Monroe
3900 Paul J. Helms Dr.
Address
- Monroe. NC 28110
city State Zip
To find the current legally responsible person associated with your permit, go to this website:
http://portal.ncdenr.orv-/web/h•/sw-permit-contacts and run the Permit Contact Summary Report.
3) OLD OWNER AFFILIATION that should be removed:
Previous legally responsible individual: Chris
First M ]
4) NEW OWNER AFFILIATION (legally responsible for the permit):
Person legally responsible for this permit:
Peter
First M]
Plate'
Last
Cevallos
Last
S W U-OWN FRAF F I L-25J uly20 14
Page 1 of 2

d" �,b

NPDES Stormwater Permit OWNER AFFILATION DESIGNATION Form
(if no Facility Name/Ownership Change)
Airport Manager
Thle
3900 Paul J. Helms Dr.
Nlailing Address
Monroe NC 28110
CitV State zip
( 704 ) 282-4730 pcevallos [e-mail]
Telephone E-mail Address
)4 ) 226-23
Fax Number
S) Reason for this change:
A result of: K Employee or management change
❑ Inappropriate or incorrect designation before
❑ Other
If other please eW7;'Iair7:
The certification below must be completed and signed by the permit holder.
PERMITTEE CERTIFICATION:
I, Peter GevalloS , 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.
v Sept 29, 2014
Signature Date
PLEASE SEND THE COMPLETED FORM TO. -
Division of Energy. Mineral and Land Resources
Stormwater Permitting Program
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.-
littp:,I/portal.iicdetir.org/web/Ir/storiii%vater
Page 2 of 2
SWU-OWNERAFFI L-25July2014

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Contacts Summary
NC DE,INILR has the foIloK'ine contact information in our Permit Database for -*,our nermil as of91912014
Permit Number: NCG150010
Permit Type: Air Transoortation Stormwater Discharge COC
Facility Name: Charlotte -Monroe Executive Airoort
Facility Addressi: 3900 Paul J Helms Dr
Facility Addressl:
City, State & Zip: Monroe, NC 28110
Ow
MUST submit a Change of Name/Ownership form to DEMLR to retake any changes to this Owner information.
See "Miscellaneous Forms" at h.ttn://i)or.tal.ncdenr.orci/web/lr/rtu Igg-stormwater
Owner Name: Charlotte -Monroe Executive Airp
Owner Type: Non -Government Owner Type Group: Organization
*** Legally Responsible for Permit ***
(Responsible corporate officer/principle executive officer or ranking elected officlal/general partner or Proprietor,
or any other person with delegated signatory authority from the legally responsible person.)
Owner Affi I iation: C",-�..s�-,,�'�_�
Peter Cevallos
Title: Airport Manager
Addressl: 3900 Paul J
Helms Ds
Addressl:
City, State & Zip: Monroe, NC
28110
Work Phone: [phone]
Fax: [phone]
Email Address:
[e-mail]
Owner Contact Person(s)
Contact Name Title
Address
Phone Fax Email
EhFrsP!ate
3900 Paul J Helms Dr, Monroe, NC
'n.� 579 'n�88 epla, .e.
28110
eFg
Faicility,Contact�Person(s)
Contact Name Title
Addres
Phone Fax Email
`hFi Plate
3900 Paul ]Helms Dr, Monroe, NC 2811Q
3900
Inn " 82 S78 Inn ']O'] C700
,�-r-�-�,w ,�-,-tea. EplatE@rner+r�__�=,
Permit Contact Person(s)
Contact Name Title
Address
Phone Fax Email
'gate
3900 Paul J Helms Dr, Monroe, NC 28110
704-282-5780 7G4-282-5786
Permit=Sill,ing;Contact
Contact Name Title Address Phone Fax Email
GhFis- hate 3900 Paul J Helms Dr, Monroe, NC 28110 704-282 5780 'n^-'n, 282S'-CQS eplate@Fnenmeenc a
F§
919/201.4 Page

��
Alexander, Laura
From: Georgoulias, Bethany
Sent: Tuesday, September 09, 2014 8:28 AM
To: Alexander, Laura
Subject: FW: NPDES Stormwater Permit NCG150000 COC Update
Attachments: NCG150010_Permit-Contacts.pdf; NPDES-OwnerAf il-Change-20140725-DEMLR-SW.pdf
Follow Up Flag: Follow up
Flag Status: Flagged
Hi Laura,
Could you update the Permit, Owner, and Facility Contact as Jan specifies below? They will fill out the Owner Affiliation
change forth, so we can wait on changing that. The new contact is Peter Cevallos.
Thanks!
Bg
Bethany Geo goidias, Environmenicil Eirgineer
NCDENR / Division of Ener_v, Mineral, and Land Rcsources
Stormwater Perrnittina Pro -ram
1612 Mail Service Center, Raleigh, NC 27699-1612
512 N. Salisbury Street. Ralei_=h. NC 27604
919 / 807-6372 (plione); 919 / 807-6494 (fax)
Website: http://portal.nedenr.or�hveb/Ir/storm%%,ater
h-nrai! correspondence 1b aw[ f ow rhis address man• he .rrrhjecr m the ,Forth Carolina Nrahfic Records fair and mUY he disclosed to thirdl)(Joies.
From: Georgoulias, Bethany
Sent: Tuesday, September 09, 2014 8:26 AM
To: 'Jan Ball'
Cc: Peter Cevallos; Carmen Crump; Bennett, Bradley; Chris Plate'
Subject: RE: NPDES Stormwater Permit NCG150000 COC Update
No problem, Jan. Thanks for letting me know.
I see that Chris is listed as all the contacts for this permit, including "Owner Affiliation," the person legally responsible for
the permit. (See attached Contact Summary Report. We can change the other contacts with just your e-mail, but we
need Peter to fill out the attached form and send an original signed copy to us to record the Owner Affiliation change in
the permit file. Then we can change that information in our database.
In the meantime, we will change Permit Contact, Facility Contact, Owner Contact, and Billing Contact to Peter.
Also in the meantime, I'd advise Peter to go ahead and follow the on-line renewal instructions (I'll forward those shortly)
— even though he'll see Chris's name come up as the Owner on the website. The Certificate of Coverage will not reflect
Chris's name, so we recommend that Peter goes ahead and renews the permit/prints the COC soon, instead of waiting
for us to get that form back. We will verify when we have made the changes.
If you have any other questions, please let us know.

Nc6-/5(00(b
Thanks,
Bethany
Relha n- Georgoulicis, Eirnironniental Engineer
NCDI-,NR / Division of Energy. Mineral, and Land Resources
Storrwater Permitting- Pro -rain
1612 Mail Service Center, Raleiah, NC 27699-1612
512 N. Salisbury Street, Raleigh: NC 27604
919 / 807-6372 (phone), 919 / 807-6494 (fax)
Website: littp://12oi-tal.ncdenr.org web/Ir/stormwater
E-mail correspondence to and,f •om this address ❑ruv he subje ct to lire Norllr Carolina Public Records lair and urm• be disclosed to third partie.%,
From: ]an Ball [mailto:[e-mail]]
Sent: Monday, September 08, 2014 2:24 PM
To: Georgoulias, Bethany
Cc: Peter Cevallos; Carmen Crump; Bennett, Bradley; Munger, Bridget; Chris Plate'
Subject: NPDES Stormwater Permit NCG150000 COC Update
Importance: High
Hi Bethany,
Hope you are doing well. I am forwarding your email below to the new Airport Manager for Charlotte -Monroe Executive
Airport, Peter Cevallos. Pleas remove Chris Plate from your email list and contact list for the airport. Peter Cevallos'
contact information is listed below. Also, please email Peter the unique PIN and instructions for renewing the COC on-
line.
Peter Cevallos
Airport Manager
Charlotte -Monroe Executive Ai port
3900 Paul J. Helms Drive
Monroe, NC 28110
[phone]
r)ceva I los(@ monroenc.ore
Please copy Carmen Crump at [e-mail] on emails that are sent to Peter.
Thanks so much and have a great day!
Best regards,
Jan Ball
Economic Development Specialist
Monroe -Union County Economic Development
3900 Paul J. Helms Drive
Monroe, North Carolina 28110
[phone]
www.developunion.com

From: Georgoulias, Bethany[maiIto: bethan}[e-mail]]
Sent: Monday, September 08, 2014 2:06 PM
To: Jan Ball
Subject: NPDES Stormwater Permit NCG150000 COC Update
Dear Stormwater Permit On-line Renewal Contact:
We have sent the permit contact persons on record for Certificate of Coverage (COC) No. NCG150010 (Chris Plate) a
unique PIN and instructions for renewing the COC on-line. You may be the same person that received that
information. However, we always send a courtesy e-mail to the person who submitted the renewal request to let him or
her know this information was distributed.
A complete permit package (General Permit, Monitoring Forms, Technical Bulletin) is available from our website
at: http://portal.ncdenr.org/web/`Ir/stormwater/2014-gps. We have also provided this website to the permit contact
named above.
If you'have any questions or concerns, please contact:
Bethany Georgoulias, E-mail: bethany.georgouliasencdenr.gov Telephone: [phone], or
Bradley Bennett, E-mail: bradley.bennett(@ncdenr.Rov Telephone: [phone], or
Bridget Munger, E-mail: [e-mail] Telephone: [phone],
Bethany Georgoulias, Environmental Engineer
NCDENR I DEMLR I Stormwater Permitting
1612 Mail Service Center, Raleigh, NC 27699-1617
512 N. Salisbury St, Raleigh, NC 27604
Phone: [phone]
Fax: [phone]
Website: http://porta1.ncdenr.org/web/ir/stormwater
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.
3

r. Aia ®m
NC®ENR
North Carolina Department of Environment and Natura
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins,
Governor Director
March 26, 2010
Mr. R. Christopher Plate, Executive Director
Charlotte -Monroe Executive Airport
3900 Paul J. Helms Drive
Monroe, North Carolina 28110
Subject
._ Dear Mr. Plate:
Resources
Dee Freeman
Secretary
General Permit No. NCG 150000
Charlotte -Monroe Executive Airport
COC No. NCG150010
Union County
In accordance with your application for a discharge permit received on December 8, 2009, we are
forwarding herewith the subject certificate of coverage (COC) 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).
If any parts, measurement frequencies, or sampling requirements contained in this permit are
unacceptable to you, you have the right to request an individual permit by submitting an individual permit
application. Unless such demand is made, this certificate of coverage shall be final and binding.
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 -Bill Diuguid at telephone number
[phone].
f
cc: Mooresville `Flegional Office
Central Files'
Stormwater Permitting Unit Files
Attachments
Smcb&'INAL SIGNED BY
KEN PICKLE
Colleen H. Sullins
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St, Raleigh, North Carolina 27604 1�TOne
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748 1 � ofth i �-+ . aroli n a
Internet www.ncwaterqualily.org - '�j'J��"�� /�I ,
An Equal Opportunity\Allirmalive Action Employer � �/ !l ` ✓U

e'
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG150000
CERTIFICATE OF COVERAGE No. NCG150010
STORMWATER DISCHARGES
TIONAL 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,
Charlotte -Monroe Executive Airport
is hereby authorized to discharge stormwater from a facility located at
Charlotte -Monroe Executive Airport
3900 Paul J. Helms Drive
Monroe
Union County
to receiving waters designated as Bearskin Creek, a Class C water body, Catawba River Basin; in accordance with
the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, I1, 111, IV, V and VI of
General Permit No. NCG 150000, as attached.
This Certificate of Coverage shall become effective March 26, 20I0.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day March 26, 2010.
ORIGINAL SIGNED BY
KEN PICKLE
Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

Charlotte -Monroe
Executive Airport
Quad Map .
2000 1000 0 2000
SCALE IN FEET
1' = 2000'
60PAnVATRAMBOUMAMsusM
CHAVIOM'CARMMA nnT
rnrO74 a sATjtol.�

Diu uid, Bill
From: Bou-ghazale, Samar
Sent: Monday, February 08, 2010 2:22 PM
To: Diuguid, Bill
Subject: FW: NCG150010 Charlotte -Monroe Executive Airport NOI
From: Sou-ghazale, Samar
Sent: Monday, February 08, 2010 2:20 PM
To: Krebs, Rob
Subject: RE: NCG150010 Charlotte -Monroe Executive Airport NOI
Bill,
We offer no objections to the issuance of the COC for the subject facility.
Thanks
Samar
From: Krebs, Rob
Sent: Monday, January 25, 2010 10:14 AM
To: Bou-ghazale, Samar
Subject: FW: NCG150010 Charlotte -Monroe Executive Airport NOI
Samar,
Please handle this NOL
From: Diuguid, Bill
Sent: Monday, January 25, 2010 9:48 AM
To: Krebs, Rob
Subject: NCGI50010 Charlotte -Monroe Executive Airport NOI
Rob Krebs, Mooresville Regional Office:
Please review the attached NOI application with the objective of responding to me with a recommendation to issue the
permit. I recognize that you may not visit each new permittee during this NOI review, but it affords you the opportunity
to log the permit into your regional database and add the facility to a future monitoring and compliance visit schedule.
Therefore, your recommendation now to issue the permit serves as your acknowledgement that (1) the facility is located
in your region, (2) that there are no current complaints outstanding about the facility that have not been dealt with, and
(3) that the facility may ultimately be inspected by the regional staff. I've also attached a scanned copy of the NOI and a
location map for your review.
COC #
Facility
Location
City/County
NCG150010
r4
Charlotte -Monroe Executive Airport
3900 Paul !.-Helms Drive _
Monroe/Union
If you need anymore info, give me a call. If you could send me a recommendation to issue the permit by 02/25/2010,
1

I'd appreciate it, so I can issue their COC. I cannot issue the permit until the respective regional office reviews and
comments back to me with a recommendation to issue the permit.
Thanks
Bill
Bill Diuguid, AICP, Stormwater Planner
Stormwater Permitting
NCDENR Div. of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Phone: [phone]
Fax: [phone]
Website: http://_h2o.enr.state.nc.us/su
Please note: my e-mail address has changed to bill.diuguid a ncdenr.gov
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.