HomeMy WebLinkAboutNCG180246_COMPLETE FILE - HISTORICAL_20160205STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v��
DOC TYPE
HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ �, (��
YYYYM M D D
Energy, Mineral
and Land Resources
ENVIRONMENTAL OUALITY
Mr. Andrew Coffey aceVE®
Hancock & Moore, BIN"
P.O. Box 3444 I, to t 8 ! U 16
Hickory, NC 28603 FILES
CENTRAL
pWR SECTION
Dear Mr. Coffey:
PAT MCCRORY
Go"""'.
DONALD R. VAN DER VAART
TRACY DAVIS
1)""....
February 5, 20hF(`�=IVED
rrn ,8 116
DWR SECTION
Subject: NPDES Stormwater Permit NCG 180246
Hancock & Moore, LLC
Formerly RHF-HM, Inc.
Alexander County
Division personnel received your request to revise your stormwater permit Certificate of
Coverage to accurately reflect your new company and/or facility name.
Please find enclosed the revised Certificate of Coverage. The terms and conditions contained
in the General Permit remain unchanged and in full effect. This revised Certificate of
Coverage is issued under the requirements of North Carolina General Statutes 143-215.1 and
the Memorandum of Agreement between North Carolina and the U.S. Environmental
Protection Agency.
If you have any questions or need further information, please contact the Stormwater
Permitting Program at (919) 707-9220.
Sincerely,
for Tracy E. avis, P.E., CPM, Director
Division of Energy, Mineral and Land
Resources
cc: Mooresville Regional Office
Stormwater Permitting Program Files
Central Files
State of North Carolina J Environmental Quality I Energy, Mineral and Land Resources
1612 Mail Service Center 1 512 North Salisbury Street I Raleigh, North Carolina 27699-1612
919 707 9220 T
h
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
GENERAL PERMIT NO. NCGI80000
CERTIFICATE OF COVERAGE No. NCGI80246
62CAR Iu►Nv1:101I TO:n i"I
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,
Hancock & Moore, LLC
is hereby authorized to discharge stormwater from a facility located at:
Hancock & Moore, LLC dba Hancock & Moore Plant # 1
166 Hancock and Moore Lane
Hickory
Alexander County
to receiving waters designated as unnamed tributary to Rock Creek, a class C water in the
Catawba River Basin in accordance with the effluent limitations, monitoring requirements, and
other conditions set forth in Parts I, II, III, and IV of General Permit No. NCG180000 as
attached.
This certificate of coverage shall become effective February 5, 2016.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day February 5, 2016.
for Tracy E. DWis, P.E., Director
Division of Energy, Mineral, and Land Resources
By the Authority of the Environmental Management Commission
A� Division of Energy, Mineral & Land Resources
�9 Land Quality Section/Stormwater Permitting
������ National P011utant Discharge Ellimination System
Nam. u. U" o��..E.. a
E—,—,.°�--n-- PERMIT NAME/OWNERSHIP CHANGE FORM
FOR AGENCY USE ONLY
Date Received
Year
I Month
I Day
I. Please enter the permit number for which the change is requested.
NPDESPermit (or) Certificate of Coverage
N G S 0 N C G I 8 0 2 4 6
H. Permit status IjEjIff to requested change.
a. Permit issued to (company name): RI-IF-I-IM. Inc.
In. Person legally responsible for permit: Thomas J O'Connell
First MI Last
Vice President Of finance
RECEIVED
DEC 2.9 2015
DENR-LAND QUALITY
STORMWATER PERMITTING
c. Facility name (discharge):
d. Facility address:
c. Facility contact person:
Title
P.O. Box 3444
Permit Bolder Mailing Address
I-lickory NC 28603
City State Zip
(828)495-8235 (828)495-3473
Phone Fax
RI-11--I-IM, LLC dba Hancock and Moore Plant 1
166 Hancock and Moore Lane
Address
Hickory NC 28603
City State Zip
Joy S. Bailey (828) 495-8235
First / MI / Last Phone
111. ]'lease 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
lfother ple.ase explain
In. Permit issued to (company name): Hancock & Moore, LLC
c. Person legally responsible for permit: Andrew Coffey
First MI Last
Controller
Title
P.O. Box 3444
Permit Holder Mailing Address
Ilickory NC 28603
Ciq' State Zip
(828) 495-8235 andy tNIancockandmoore.com
Phone L-mail Address
d. Facility name (discharge):
Hancock & Moore, LI-C dba Hancock and Moore Plant
e. Facility address:
f. Facility contact person:
166 Hancock and Moore Lane
Address
Hickory NC 28603
City State Zip
Joy S Bailey
First MI Last
Revised Jan. 27, 2014 Kn N
(828) 495-8235 joy@hancockandinoore.com
hancockandmoore.com
Phone F-mail Address
NPDES PERMIT NAME/OWNERSHIP CHANGE FORM
r
Page 2 of 2
IV. Permit contact information (if different from the person legally responsible for the permit)
Permit contact: Joy S Bailey
First MI Last
V
1V I
Purchasing/Safety/13nvironmental
'Pills
P.O. Box 3444
1%9ailing Address
Hickory NC 28603
City State Zip
(828)495-8235 joy a, hancockandmoore.com
Phone E-mail Address
Will the permitted facility continue to conduct the same industrial activities conducted prior
to this ownership or name change?
® Yes
❑ No (please explain)
Required Items: TIIIS APPLICATION WILL BE RETURNED
ARE INCOMPLETE OR MISSING:
UNPROCESSED IF ITEMS
❑ This completed application is required lot- 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.
'file certifications below trust 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.
PERNIn"rFE CERTIFICATION (Permit holder prior to ownership change):
I, Andrew Coffev, 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.
ignature' Date
APPLICANT CERTIFICATION
I, Andrew Coffey, 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 al I 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 incol plete.
Soi/gliature Date
PLEASE SEND TIIE COMPLETE APPLICATION PACKAGE TO:
Division of 13nergy, Mineral and Land Resources
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Revised Jan. 27, 2014
' North Carolina Department of Environmental Quality
Pat McCrory Donald R. van der Vaart
Governor Secretary
November 16, 2015
Mr. Thomas J. O'Connell
RHF-HM, LLC
P.O. Box 3444
Hickory, NC 28603
RECEIVE®
NOV 18 2015
CENTRAL FILES
DWR SECTION
Subject: NPDES General Permit NCG 180246
RHF-HM, LLC
Formerly Hancock and Moore, Inc..
Certificate of Coverage NCG 180246
Alexander County
Dear Mr. O'Connell:
Division personnel received your request to revise your stormwater permit Certificate of Coverage to
accurately reflect your new company and/or facility name.
Please find enclosed the revised Certificate of Coverage. The terms and conditions contained in the
General Permit remain unchanged and in full effect. This revised Certificate of Coverage is issued
under the requirements of North Carolina General Statutes 143-215.1 and the Memorandum of
Agreement between North Carolina and the U.S. Environmental Protection Agency.
If you have any questions or need further information, please contact the Stormwater Permitting
Program at (919) 707-9220.
Sincerely,
for Tracy E. Davis, P.E., CPM, Director
Division of Energy, Mineral and Land Resources
cc: Mooresville Regional Office
Stormwater Permitting Program Files
Central Files
Division of Energy, Mineral, and Land Resources
Energy Section • Geological Survey Section • Land Quality Section
1612 Mail Service Center, Raleigh, North Carolina 27699-1612.919-707-9200 / FAX: 919-715-8801
512 North Salisbury Street, Raleigh, North Carolina 27604 • Internet: http:l/Vortal,nodenr.org/web/Ir/
An Equal Opportunity 1 Affirmative Action Employer- 50% Recycled 110% Post Consumer Paper
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
GENERAL PERMIT NO. NCG180000
CERTIFICATE OF COVERAGE No. NCG180246
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,
RHF-I-IM, LLC
is hereby authorized to discharge stormwater from a facility located at:
RHF-HM, LLC dba Hancock and Moore Plant 1
166 Hancock and Moore Lane
Hickory
Alexander County
to receiving waters designated as unnamed tributary to Rock Creek, a class C water in the
Catawba River Basin; in accordance with the effluent limitations, monitoring requirements, and
other conditions set forth in Parts I, II, 111, and IV of General Permit No. NCG180000 as
attached.
This certificate of coverage shall become effective November 16, 2015.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day Novembei
for Tracy E. Davis, P.E., Director
Division of Energy, Mineral, and Land Resources
By the Authority of the Environmental Management Commission
Agwli;WA Division of Energy, Mineral & Land Resources
�I Land Quality Section/Stormwater Permitting
NCDENR National Pollutant Discharge Elimination System
.�a..o .o. PERMIT NAME/OWNERSHIP CHANGE FORM
m.o.. a wo A D— —T Of �
FOR AGENCY USE ONLY
Date Received
Year
Month
Day
Please enter the permit number for which the change is requested.
NPDGS Permit (or) Certificate ofCoverage
N 10. 1 S. 0 1 1 1 1 1 1 N IGI G I 18 1 0 1 2 4 1 6
II. Permit status 11ijiff to requested change.
a. Permit issued to (company name): Hancock and Moore, Inc.
b. Person legally responsible for permit: Thomas J O'Connell
First MI Last
C. Facility name (discharge):
d. Facility address:
Vice President Of Finance
Title
P.O. Box 3444
Permit I -]older Mailing Address
Hickory NC 28603
City State Zip
(828)495-8235 (828)495-3473
Phone Fax
Hancock and Moore Plant I
166 Hancock and Moore Lane
Address
Hickory NC 28603
City State -Lip
e. Facility contact person: Joy S. Bailey (828) 495-8235
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
Ifo/her please explain
b. Permit issued to (company name):
RI-IF-I-IM, LLC
c. Person legally responsible for permit:
Thomas .I O'Connell
First MI Last
Vice President Of Finance
Title
RECEIVE®
P.O. Box 3444
OCT 23 2015
Permit Holder Mailing Address
Hickory NC 28603
DENR-LAND QUALITY
City State Zip
STORMINATER PEF:10I TiN
(828) 495-8235 tom a,hancockandnloore.com
Phone I mail Address
d. Facility name (discharge):
RI-IRI-IM, LLC clba Hancock and Moore Plant'I
c. Facility address:
166 Hancock and Moore Lane
Address
Hickory NC 28603
City State Zip
F. Facility contact person:
Joy S Bailey
First MI Last
(828)495-8235 joyahancockandmoore.com
Phone Email Addressp�
IV. Permit contact information (iFdiffcrent from the person legally responsible for the permit) nA
Revised Jan. 27, 2014
NPDES PERMIT NAME/OWNERSHIP CHANGE FORM
Page 2 of 2
Permit contact:
S 13ailc
MI Last
I'urchasing/Safety/I:nvi i-onmental
Title
P.O. Box 3444
Mailing Address
NC 28603
City Skate Zip
(828)495-8235 joy n,hancockandnioore.com
Phone B-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: TFIIS APPLICA'riON WILL 13E 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 ofownership (such as relevant pages of a contract (Ieed,
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 holder prior to ownership change):
I, Thomas J. O'Connell, 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
APPLICANT CERTIFICATION
F/9,//.r
Date
I, Thomas J. O'Connell, 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, Ihis application
package will be returned as incomplete.
r/Ju,w Xi1�
Signature
Date
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Division ofEnergy, Mineral and Land Resources
Stormwater permitting program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Revised Jan. 27, 2014
BILL OF SALE
(Hancock & Moore, Inc.)
This Bill of Sale ("Bill of Sale") is dated as of October 5, 2015 by and between Hancock
& Moore, Inc., a North Carolina corporation, with its principal place of business in Alexander
County, ?Forth Carolina ("Seller'), and RAF-HM, LLC, a North Carolina limited liability
company, with its principal place of business in Catawba County, North Carolina ("Purchaser').
RECITALS
Purchaser is a wholly owned subsidiary of RHF Investments; Inc.. a North Carolina
corporation (`RHF"). RH]', Seller and other parties affiliated with Seller entered into an Asset
Purchase Agreement dated as of September j 0 , 2015 (`Purchase Agreement") pursuant to
which Seller has agreed to sell and RHF has agreed to purchase_ or cause one or more affiliates
of Rl-fF to purchase_ substantially all of the assets of Seller. Capitalized terms used in and not
otherwise defined in this Bill of Sale have the meaning assigned to them in the Purchase
Agreement unless the context otherwise requires.
Therefore, in consideration of the foregoing and the other valuable consideration given
by RHF and Purchase to Seller, the receipt and sufficiency of which is hereby acknowledged, the
parties, intending to be legally bound. hereby agree as follows:
AGREEMENT
1. Purchased Assets. Effective as of the date hereof, Seller hereby sells, transfers,
conveys, assigns and delivers to Purchaser, and Purchaser hereby accepts from Seller, all of the
right, title and interest of Seller in and to the Purchased Assets of the Seller.
2. Purchase Price and Allocation. Pursuant to the terms of the Purchase Agreement,
RHF has the right to allocate the purchase price among the Purchased Assets of the Operating
Sellers, including Seller. The allocation of the total purchase price among the Purchased Assets,
including the Purchased Assets of Seller, will be made at a later date.
D. Further Assurances. Seller further covenants and agrees with Purchaser that
Seller will execute and deliver such other bills of sale, transfers. assignments and other
instruments of conveyance and will do such other acts as reasonably requested by the Purchaser
to further vest in Purchaser such title to the Purchased Assets and to fulfill and discharge Seller's
obligations of convevance hereunder and under the Purchase Agreement.
4. Warranties. Seller covenants with Purchaser that Seller owns and has good and
valid title to each of the Purchased Assets owned by it, free and clear of all Liens (other, than
amounts payable pursuant to the Purchased Contracts as expressly contemplated in the Purchase
Agreement), has the right to convey the same, and that Seller will warrant and defend the title to
the same aE ainst the lawful claims of all persons whomsoever, except for the Permitted
Exceptions.
Pa-ae 1 of 2
IN TESTIMONY WHEREOF, Seller and Purchaser have executed this Bill of Sale as
of the day and year first above written.
SELLER:
Hancock S Moore, Inc.
By: T-
imothy L. Rogers
President
PURCHASER:
RHF-HM, LLC
Brandon M. Hucks
Chief Financial Officer
Page 2 of 2
IN TESTLMONY WHEREOF. Seller and Purchaser have executed this Bill of Sale as
of the day and year first above written.
SELLER:
Hancock & Moore, Inc.
Timothy L. Rogers
President
PURCHASER:
RHF-H14, LLLC �/ /�
By: c� d' C !/ 2
Brandon M. Hucks
Chief Financial Officer
Page 2 of 2
PAT MCCRORY
Oorernor
DONALD R. VAN DER VAART
Energy, Mineral
and Land Resources
ENVIFONMENTAL QUALITY
February 5, 2016
Mr. Andrew Coffey
Hancock & Moore, LLC
P.O. Box 3444
Hickory, NC 28603
Secrelaty
TRACY DAVIS
Lhr,00r
Subject: NPDES Stormwater Permit NCG180246
Hancock & Moore, LLC
Formerly RHF-HM, Inc.
Alexander County
Dear Mr. Coffey:
Division personnel received your request to revise your stormwater permit Certificate of
Coverage to accurately reflect your new company and/or facility name.
Please find enclosed the revised Certificate of Coverage. The terms and conditions contained
in the General Permit remain unchanged and in full effect. This revised Certificate of
Coverage is issued under the requirements of North Carolina General Statutes 143-215.1 and
the Memorandum of Agreement between North Carolina and the U.S. Environmental
Protection Agency.
If you have any questions or need further information, please contact the Stormwater
Permitting Program at (919) 707-9220.
Sincerely,
OF G'NAL SIGNED BY
BETHANY GEORGOULIAS
for Tracy E. Davis, P.E., CPM, Director
Division of Energy, Mineral and Land
Resources
cc: Mooresville Regional Office
Stormwater Permitting Program Files
Central Files
State of North Carolina I Environmental Quality I Energy, Mineral and Land Resources
1612 Mail Service Center 1 512 North Salisbury Street I Raleigh, North Carolina 27699-1612
919 707 9220 T
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
GENERAL PERMIT NO. NCG180000
CERTIFICATE OF COVERAGE No. NCG180246
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,
Hancock & Moore, LLC
is hereby authorized to discharge stormwater from a facility located at:
Hancock & Moore, LLC dba Hancock & Moore Plant # 1
166 Hancock and Moore Lane
Hickory
Alexander County
to receiving waters designated as unnamed tributary to Rock Creek, a class C water in the
Catawba River Basin in accordance with the effluent limitations, monitoring requirements, and
other conditions set forth in Parts I, II, III, and IV of General Permit No. NCGI 80000 as
attached.
This certificate of coverage shall become effective February 5, 2016.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day February 5, 2016.
ORIGINAL SIGNED BY
BETHANY GEORGOULIAS
for Tracy E. Davis, P.E., Director
Division of Energy, Mineral, and Land Resources
By the Authority of the Environmental Management Commission
FOR AGENCY USE ONLY
Division of Energy, Mineral &Land Resources Date Received
Land Quality Section/Stormwater Permitting Year Menth Day
NCDENRNational Pollutant Discharge Elimination System
PERMIT NAME/OWNERSHIP CHANGE FORM
Exvinoxn[xr nxo Nauxu. HeSouxces
I. Please enter the permit number for which the change is requested. Certificate of Coverage
NPDES Permit (or) N CG 1 8 0 2 4 6
N. C S_ .0
it. Permit status prior to requested change. RHF-HM, Inc.
a. Permit issued to (company name): J O'Connell
b. Person legally responsible for permit: Thomas
First MI Last
Vice President Of Finance
rue
RECEIVED
DEC 2.9 2015
DENR-LAND tau„ I_m
STORiWWATER PERWYTING
Facility name (discharge):
d. Facility address:
e. Facility contact person:
P.O. Box 3444
Permit I folder Mailing Address
Hickory NC 28603
City State Zip
(828)495-8235 (828)495-3473
Phone I�ae
RHF-HM, LLC dba Hancock and Moore Plant 1
166 Hancock and Moore Lane
Address
Hickory NC 28603
City State Zip
Joy S. Bailey (828) 495-8235
First / MI / Last
Phone
Ill. 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:
LLC Moore,
b. Permit issued to (company name): Hancock & Coffe
c. Person legally responsible for permit: Andrew y
First MI Last
Revised Jan. 27, 2014
Controller
Title
P.O. Box 3444
Permit Holder Mailing Address
Hickory NC 28603
City State Zip
(828) 495-8235 andy@hancockandmoore.com
Phone E-mail Address
Hancock & Moore, LLC dba Hancock and Moore Plant
d. Facility name (discharge):
e. Facility address: 166 Hancock and Moore Lane
Address
Hickory NC 28603
City State Zip
f. Facility contact person: Joy S Bailey
First MI Last
n tit �r� J (828) 495-8235 joyPhancockandmoore.com
(,, 1 Phone F-mail Address
rn ��
NPDES PERMIT NAME/OWNERSHIP CHANGE FORM
Page 2 of 2
IV. Permit contact information (if different from the person legally responsible for the permit)
Joy S Bailey
Permit contact: First MI Last
Purchasin /Safety/Environmental
Title
P.O. Box 3444
Mailing Address
Hickory NC 28603
City State '-iP
(828) 4958235 joy(c,hmcockandmoore.com
Phone F,-mail Address
Will the permitted facility continue to conduct the same industrial activities conducted prior
V. to this ownership or name change?
® Yes
❑ No (please explain)
VI Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSEll 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 holder prior to ownership change):
1, Andrew Coffey, attest that this application for a name/ownership change has been reviewed and is
accurate and complete to the best of my knowledge. 1 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.
I —A Date
ignature
APPLICANT CERTIFICATION
1, Andrew Coffey, 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
M
ill be returned as incoi plete.
gnattire
Date
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Division of Energy, Mineral and Land Resources
Stormwater Permitting Progreun
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Revised Jan. 27, 2014
NORTH CAROLINA
Department of the Secretary of State
To all whom these presents shall come, Greetings:
I, Elaine F. Marshall, Secretary of State of the State of North Carolina, do hereby certify
the following and hereto attached to be a true copy of
ARTICLES OF AMENDMENT
OF
RHF - HM, LLC
WHICH CHANGED ITS NAME TO
HANCOCK & MOORE, LLC
the original of which was filed in this office on the 20th day of October, 2015.
RECEIVED
2 9 2015
CE('R-LAND C�UAt 7V
i=TCRMM,ATER F%Rf
IN WITNESS WHEREOF, I have hereunto set
my hand and affixed my official seal at the City
of Raleigh, this 20th day of October, 2015.
Scan to verify online.
Secretary of State
Document ld: C201529200449
Verify this certificate online at www.secrelary.state.ne.us/verification
SOSID: 1447810
Date Filed: 10/20/2015 8:30:00 AM
Elaine F. Marshall
North Carolina Secretary of State
C20i5 292 00449
State of North Carolina
Department of the Secretary of State
Limited Liability Company
AMENDMENT TO ARTICLES OF ORGANIZATION
Pursuant to §57D-2-22 of the General Statutes of North Carolina, the undersigned limited liability
company hereby submits the following Articles of Amendment for the purpose of amending its Articles
of Organization.
1. The name of the limited liability company is: RHF — HM LLC
2. The text of each amendment adopted is as follows (attach additional pages if necessary):
RESOLVED, that Article 1 of the Articles of Organization of RHF - FDA, LLC
be amended to read as follows:
The name of the limited liability company is Hancock & Moore,
LLC.
3. (Check either a or h, whichever is applicable)\
a. The amendment was duly adopted by the unanimous vote of the organizers of the
limited liability company prior to the identification of initial members of the limited liability
company.
b. XX The amendment was duly adopted by the unanimous vote of the members of the
limited liability company or was adopted as otherwise provided in the limited liability
company's Articles of Organization or a written operating agreement.
4. These articles will be effective upon filing, unless a date and/or time is specified:
This the 15th day of October 2015.
RHF — M4 LLC
Name of Limited Liability Company;
Signature
Brandon M. Hucks Manager
Type or Print Name and Title
NOTES:
1. Filing fee is $50. This document must be filed with the Secretary of State.
CORPORATIONS DIVISION P.O. BOX 29622 RALEIGII,;NC 27626-0622
(RewsedJt ry2014) (Form I,-17)
(PHO 00787160.DOCX )
Division of Energy, Mineral & Land Resources .
;A
Land Quality Section/Stormwater Permitting
NCDENR
National Pollutant Discharge Elimination System
PERMIT NAME/OWNERSHIP CHANGE FORM
R AGENCY USE ONLYDate
Receivedar
P
Month
Day
Please enter the permit number for which the change is requested.
NPDES Permit
(or) Certificate of Coverage
N '0 1 S 10 1 1
1 1 8 0 2 4 6
Permit status IjEjaE to requested change.
a. Permit issued to (company name):
Hancock and Moore, Inc.
b. Person legally responsible for permit:
Thomas J O'Connell
First MI Last
Vice President Of Finance
Title
P.O. Box 3444
Permit Bolder Mailing Address
Hickory NC 28603
City State Zip
(828)495-8235 (828)495-3473
Phone Fax
c. Facility name (discharge):
Hancock and Moore Plant I
d. Facility address:
166 Hancock and Moore Lane
Address
Hickory NC 28603
City State Zip
e. Facility contact person:
Joy S. Bailey (828) 495-8235
First / MI / Last Phone
111. 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:
b. Permit issued to (company name):
RHF-HM, LLC
c. Person legally responsible for permit:
Thomas J O'Connell
First MI Last
Vice President Of Finance
Title
RECEIVED
P.O. Box 3444
OCT 2 3 2015
Permit Holder Mailing Address
Hickory NC 28603
DENR-LAND Ch,^,I_I?Y
City State Zip
STOPoLIVIA?ER PErYivil"iTiiy
(828) 495-8235 tom@hancockandmoore.com
Phone E-mail Address
d. Facility name (discharge):
RHF-14M, LLC dba Hancock and Moore Plant I
e. Facility address:
166 Hancock and Moore Lane
Address
Hickory NC 28603
City State Zip
f. Facility contact person:
Joy S Bailey
First MI Last
(828) 495-8235 oy@hancockandmoore.corn
Phone E-mail Address
a
IV. Permit contact information (if different from the person legally responsible for the permit)[ 'a .bl
Revised Jan. 27, 2014 3-?
NPDES PERMIT NAME/OWNERSHIP CHANGE FORM
Page 2 of 2
Permit contact: Joy S Bailey
First MI Last
Purchasing/Safety/Environmental
Title
P.O. Box 3444
Mailing Address
Hickory NC 28603
City State Zip
(828) 495-8235 joy9hancockandmoore.com
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 holder prior to ownership change):
1, Thomas J. O'Connell, attest that this application for a name/ownership change has been reviewed and is
accurate and complete to the best of my knowledge. 1 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
APPLICANT CERTIFICATION
I, "Thomas J. O'Connell, attest that this application for a name/ownership change has been reviewed and is
accurate and complete to the best of my knowledge. 1 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
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
Revised Jan. 27, 2014
BILL OF SALE
(Hancock & Moore, Inc.)
This Bill of Sale (`Bill of Sale") is dated as of October 5, 2015 by and between Hancock
& Moore, Inc., a North Carolina corporation, with its principal place of business in Alexander
County, North Carolina ("Seller"), and RHF-HM, LLC, a North Carolina limited liability
company, with its principal place of business in Catawba County, North Carolina ("Purchaser").
RECITALS
Purchaser is a wholly owned subsidiary of RHF Investments, Inc., a North Carolina
corporation ("RHF"). RHF, Seller and other parties affiliated with Seller entered into an Asset
Purchase Agreement dated as of September �30 2015 ("Purchase Agreement") pursuant to
which Seller has agreed to sell and RFIF has agreed to purchase, or cause one or more affiliates
of RHF to purchase, substantially all of the assets of Seller. Capitalized terms used in and not
otherwise defined in this Bill of Sale have the meaning assigned to them in the Purchase
Agreement unless the context otherwise requires.
Therefore, in consideration of the foregoing and the other valuable consideration given
by RHF and Purchase to Seller, the receipt and sufficiency of which is hereby acknowledged, the
parties, intending to be legally bound, hereby agree as follows:
AGREEMENT
1. Purchased Assets. Effective as of the date hereof, Seller hereby sells, transfers.
conveys; assigns and delivers to Purchaser, and Purchaser hereby accepts from Seller, all of the
right, title and interest of Seller in and to the Purchased Assets of the Seller.
2. Purchase Price and Allocation. Pursuant to the terms of the Purchase Agreement,
RHF has the right to allocate the purchase price among the Purchased Assets of the Operating
Sellers, including Seller. The allocation of the total purchase price among the Purchased Assets,
including the Purchased Assets of Seller, will be made at a later date.
3. Further Assurances. Seller further covenants and agrees with Purchaser that
Seller will execute and deliver such other bills of sale, transfers, assignments and other
instruments of conveyance and will do such other acts as reasonably requested by the Purchaser
to further vest in Purchaser such title to the Purchased Assets and to fulfill and discharge Sellers
obligations of conveyance hereunder and under the Purchase Agreement.
4. Warranties. Seller covenants with Purchaser that Seller owns and has good and
valid title to each of the Purchased Assets owned by it, free and clear of all Liens (other than
amounts payable pursuant to the Purchased Contracts as expressly contemplated in the Purchase
Agreement), has the right to convey the same, and that Seller will warrant and defend the title to
the same against the lawful claims of all persons whomsoever; except for the Permitted
Exceptions.
Page 1 of 2
IN TESTIMONY WHEREOF, Seller and Purchaser have executed this Bill of Sale as
of the day and year first above written.
SELLER:
Hancock & Moore, Inc.
By:
'timothy L. Rogers
President
PURCHASER:
RHF-HM, LLC
0
Brandon M. Hucks
Chief Financial Officer
Page 2 of 2
IN TESTIMONY WHEREOF, Seller and Purchaser have executed this Bill of Sale as
of the day and year first above written.
SELLER:
Hancock & Moore, Inc.
m
Timothy L. Rogers
President
PURCHASER:
RHF-HM, LLC
By: L/J < U 1
Brandon M. Hucks
Chief Financial Officer
Page 2 of 2
-1% North Carolina Department of Environmental Quality
Pat McCrory Donald R. van der Vaart
Governor Secretary
November 16, 2015
Mr. Thomas J. O'Connell
RHF-HM, LLC
P.O. Box 3444
Hickory, NC 28603
Subject: NPDES General Permit NCG180246
RHF-HM, LLC
Formerly Hancock and Moore, Inc.
Certificate of Coverage NCG 180246
Alexander County
Dear Mr. O'Connell:
Division personnel received your request to revise your stormwater permit Certificate of Coverage to
accurately reflect your new company and/or facility name.
Please find enclosed the revised Certificate of Coverage. The terms and conditions contained in the
General Permit remain unchanged and in full effect. This revised Certificate of Coverage is issued
under the requirements of North Carolina General Statutes 143-215.1 and the Memorandum of
Agreement between North Carolina and the U.S. Environmental Protection Agency.
If you have any questions or need further information, please contact the Stormwater Permitting
Program at (919) 707-9220.
Sincerely,
ORIGINAL SIGNED BY
6cTiiAfv"( GEORGOIJLIAS
for Tracy E. Davis, P.E., CPM, Director
Division of Energy, Mineral and Land Resources
cc: Mooresville Regional Office
Stormwater Permitting Program Files
Central Files
Division of Energy, Mineral, and Land Resources
Energy Section • Geological Survey Section • Land Quality Section
1612 Mail Service Center, Raleigh, North Carolina 27699-1612.919-707-9200 / FAX: 919-715-8801
512 North Salisbury Street, Raleigh, North Carolina 27604 • Internet: http://portal.ncdenr.org/web/Ir/
An Equal Opportunity \ Affirmative Action Employer - 50% Recycled \ 10% Post Consumer Paper
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
GENERAL PERMIT NO. NCGI80000
CERTIFICATE OF COVERAGE No. NCG180246
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 Fedcral Water Pollution Control Act, as amended,
RI-IF-I-IM, LLC
is hereby authorized to discharge stormwater from a facility located at:
RI IF-EIM, LLC dba Hancock and Moore Plant
166 Hancock and Moore Lane
Hickory
Alexander County
to receiving waters designated as unnamed tributary to Rock Creek, a class C water in the
Catawba River Basin; in accordance with the effluent limitations, monitoring requirements, and
other conditions set forth in Parts 1, II, 111, and IV of General Permit No. NCG180000 as
attached.
This certificate of coverage shall become effective November 16, 2015.
This Certificate of Coverage shall remain in effect for the duration of' the General Permit.
Signed this day November 16, 2015.
OE UNAL SICHED °Y
6ETHF.iv (G-PGRG0ULIAS
for Tracy E. Davis, P.E., Director
Division of Energy, Mineral, and Land Resources
By the Authority of the Environmental Management Commission
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG180000
CERTIFICATE OF COVERAGE No. NCG180246
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,
Hancock & Moore, Inc.
is hereby authorized to discharge stormwater from a facility located at
Hancock & Moore, Inc. Plant #1
166 Hancock & Moore Lane
Taylorsville
Alexander County
to receiving waters designated as unnamed tributary to Rock Creek, a class C water in the
Catawba River Basin, in accordance with the effluent limitations, monitoring requirements, and
other conditions set forth in Parts 1, 11, III, IV, V, and VI of General Permit No. NCG180000 as
attached.
This certificate of coverage shall become effective May 15, 2013.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day May 15, 2013.
ORIGINAL SIGNED B1
KEN PICKLE
for Charles Wakild, P.E., Director
Division of Water Quality
By the Authority of the Environmental Management Commission
_, �'� 'Hancock &Moore, Inc. Plant #1
0
W
NCG180246
N
WE
S
Map Scale 1:24,000
Hancock & Moore, Inc.
Hancock & Moore, Inc. Plant #1
Latitude: 350 50' 22.21" N
Longitude: 81018' 12.67" W
County: Alexander
Receiving Stream: LIT to Rock Creek
Index No: 11-62-3
Stream Class: C
Sub -basin: 03-08-32 (Catawba River Basin)
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Facility Location
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NC®ENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Mr. Kenneth Pennell
Hancock & Moore, Inc.
P.O. Box 3444
Hickory, NC 28603
Dear Mr. Pennell:
Division of Water Quality
Charles Wakild, P.E.
Director
May 15, 2013
Subject: General Permit No. NCG180000
Hancock & Moore, Inc.
Hancock & Moore, Inc. Plant 41
COC NCG180246
Alexander County
John E. Skvarla, III
Secretary
In accordance with your application for a discharge permit received on May 6, 2013, 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.
Per the requirements of the Catawba Riparian Buffer Rule, all stormwater drainage to
stream buffers, from portions of this site that have been constructed after June 30, 2001, must be
discharged through a correctly -designed level spreader or another device that meets diffuse now
requirements per 15A NCAC 213 .0243. Diffuse flow requirements are described in Chapter 8 of
the North Carolina Stormwater BMP Manual, available at:
htti):Hi)ortal.ncdenr.org/web/wg/ws/sulbmp-manual.
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 Land Quality Section of the
Division of Energy, Mining and 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 Julie Ventaloro at
telephone number (919) 807-6370, or at Julie.ventaloro cr,ncdenr.gov.
Wetlands and Stormwater Branch
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone: 919-807.63001 FAX: 919-807-64941 Customer Service: 1-877-623-6748
Internet: w .ncwaterquatty.oig
An Equal Opportunity 1 Affirmative Action Employer
NorthCarolina
naturally
Mr. Kenneth Pennell
Hancock & Moore, Inc—NCG180246
May 15, 2013
Sincerely,
ORIGINAL SIGNED B1
KEN PICKLE
for Charles Wakild, P.E.
cc: Mooresville Regional Office, Michael Parker
Central Files
Stormwater Permitting Unit Files
Page 2 of 2
Ventaloro, Julie
From: Parker, Michael
Sent: Tuesday, May 14, 2013 7:44 AM
To: Ventaloro, Julie
Subject: RE: Review Requests NCG180246,180247,180428 Hancock & Moore
Follow Up Flag: Flag for follow up
Flag Status: Flagged
Julie,
I can find no reason to not issue the three GPs.
Michael Parker - Michael.Parker@ncdenr.gov
Regional Supervisor, Surface Water Protection
North Carolina Dept. of Environment & Natural Resources
Division of Water Quality
610 East Center Avenue
Suite 301
Mooresville, NC 28115
Direct Line: (704) 235-2194 Fax: (704) 663-6040
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 unless the content is exempt by statute or other regulation.
From: Ventaloro, Julie
Sent: Monday, May 13, 2013 4:13 PM
To: Parker, Michael
Subject: Review Requests NCG180246,180247,180428 Hancock & Moore
Hi Mike,
We've received NOls for three existing facilities in your region. All of them are owned by Hancock & Moore, Inc., a
furniture manufacturer.
NCG18 — Hancock & Moore
• Plant # 1 (NCG180246) - The site discharges stormwater at three points to an unnamed tributary to Rock Creek
(Class C). The NO1 is attached.
• Plant #t2 (NCG180247)—The site discharges stormwater at five points to Stirewalt Creek (Class C). The NOI is
attached.
• Plant k3 (NCG180248)—The site discharges stormwater at three points to an unnamed tributary to Rock Creek
(Class C). The NOI is attached.
Please let me know if the Mooresville Regional Office has any concerns about issuing these COCs. Please also let me
know of any potential impacts to wetlands. If we don't receive any objections, we'll issue the COCs in 30 days.
Thanks!
Julie Ventaloro
Coordinator, Water Supply Watershed Protection Program
NC Division of Water Quality
Wetlands & Stormwater Branch
1617 Mail Service Center, Raleigh, NC 27699-r617
Phone: (919) 807-6370 Pax: (919) 807-6494
Website http:L/watersuRulywatershed nc aov
E-mail correspondence to and atom this address may be subject to the North Ca'olina Public Records Law and may be disclosed to third
parties.
-4
A74
NCDENR
NCwn, C UNA DE 7Ni OF
E,mnommEw wo No AL R[bunc[a
NOTICE OF INTENT
Division of Water Quality / Water Quality Section
National Pollutant Discharge Elimination System
NCG180000
FOR AGENCY USE ONLY
Date Received
Year
I Month
I Da
Ccnificale ofCovera c
Check M
Amount
Pe nil ssigncd to
cA 5ro
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG180000:
STORMWATER DISCHARGES associated with activities classified as:
SIC 25 Furniture and Fixtures
SIC 2434 Wood Kitchen Cabinets
Standard Industrial Classification Code
(Please print or type)
1) Mailing address .of owner/operator:
Name: Hancock & Moore Inc.
Street Address: P.O. Box 3444
City: Hickory State: NC ZIP Code: 28603
Telephone No.: (828) 495-8235 Fax: (828) 495-3021
Address to which all permit correspondence will be mailed
2) Location of facility producing discharge:
Facility Name: Plant #1
Facility Contact: Kenneth Pennell
Facility Address: 166 Hancock & Moore Lane
City: Taylorsville State: NC ZIP Code: 28681
County: Alexander
Telephone No.: (828) 496-235 Fax: (828) 495-3021
3) Physical Location Information:
Please provide a narrative description of how to get to the facility (use street names, state road numbers, and
distance and direction from a roadway intersection). Two blocks east of NC 127 off Teague Town Road to
Hancock & Moore Lane
(A copy of a county map or USGS quad sheet with facility clearly located on the map is required to be submitted with this application)
SS C'' 2.1-21 " $1 1$ a 1:•to7
4) Latitude 3�§39505 Longitude-81.303522 (degrees, minutes, seconds)
5) This NPDES Permit Application applies to which of the following:
❑ New or Proposed Facility Date operation is to begin
& Existing
6) Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the
activity at this facility
SIC Code: 251
7) Provide a brief narrative description of the types of industrial activities and products
this facility: Manufacture of upholstered furniture
tlusfrial
Page 1 of 4
S W U-233-081511
NCGI80000 N.O.I.
8) Discharge points / Receiving waters:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? 3
9) Receiving waters:
What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the
discharges end up in? Creek is not named I ,-. } Zo c ® CIc
stormwater
If the site stormwater discharges to a separate storm sewer system, name the operator of the separate storm
sewer system (e.g. City of Raleigh municipal storm sewer). NA
10) Does this facility have any other NPDES permits?
0 No
❑ Yes
If, yes, list the permit numbers for all current NPDES permits for this facility:
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
O No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
12) Does this facility employ any best management practices for stormwater control?
❑ No
❑x Yes
If yes, please briefly describe: Included in SWPPP and SPCC Plan
13) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No
O Yes
If yes, when was it implemented?
14) Are vehicle maintenance activities occurring at this facility?
O No ❑ Yes
15) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
0 No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
❑ No X❑ Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
O No ❑Yes
d) If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste: Waste finishing materials
Page 2 of 4
S W U-233-081511
NCG180000 N.O.I.
How is material stored: Drums
Where is material stored: Covered and diked area with sufficient secondary containment
How many disposal shipments per year: -12
Name of transport I disposal vendor: North State Environmental
Vendor address: 917 Beaverdam Road Canton NC 29716
16) Certification:
North Carolina General Statute 143-215.6 b (i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record,
report, plan or other document filed or required to be maintained under Article 21 or regulations of the Environmental
Management Commission implementing that Article, or who falsifies, tampers with or knowingly renders inaccurate
any recording or monitoring device or method required to be operated or maintained under Article 21 or regulations of
the Environmental Management Commission implementing that Article, shall be guilty of a misdemeanor punishable
by a fine not to exceed $10,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C. Section 1001
provides a punishment by a fine of not more than $10,000 or imprisonment not more than 5 years, or both, for a similar
offense.)
I hereby request coverage under the referenced General Permit. I understand that coverage under this permit
will constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an
individual permit.
I certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing: Tom O'Connell
Title: Vice President Finance
(Signature of Applicant) (Date Signed)
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to:
NCDENR
Final Checklist
This application will be returned as incomplete unless all of the following items have been included:
❑x Check for $100 made payable to NCDENR
This completed application and all supporting documents
❑x Copy of county map or USGS quad sheet with location of facility clearly marked on map
Mail the entire package to:
Stormwater and General Permits Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Note
The submission of this document does not guarantee the issuance of an NPDES permit.
Page 3 of 4
SWU-233-081511
r
NCG180000 N.O.I.
For questions, please contact the DWQ Central Office or Regional Office for your area.
DWQ Regional Office Contact Information:
Asheville Office ......
Fayetteville Office ...
Mooresville Office ...
Raleigh Office ........
Washington Office..
Wilmington Office ...
Winston-Salem ......
Central Office ........
(828)296-4500
(910)433-3300
(704)663-1699
(919)791-4200
(252)946-6481
(910) 796-7215
(336)771-5000
(919)807-6300
Page 4 of 4
S W U-233-081511
Hancock & Moore Plant 41 SWPP Plan April 15,2013
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Figure 1-1 General Location Map for the Hancock & Moore Plant #1
2