NCGNE0677_COMPLETE FILE - HISTORICAL_20110118

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCGNE
DOC TYPE
HISTORICAL FILE
DOC DATE
❑ �'�� � � I `
YYYYMMDD

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0F W ArFRvG Beverly Eaves Perdue, Governor
y Dee Freeman, Secretary
7 North Carolina Department of Environment and Natural Resources
o
Coleen 14. Sullins, Director
Division of Water Quality
SURFACE VATERi PROTECTION SECTION}
PERMIT NAME/OWNERSHIP CHANGE_ FORM":,
Please enter the permit number for which the change is requested.
NPDES Permit (or) Certificate of Coverage
N I G 1 'S 10 1 1 1 1 1 1 1 N I C10 1 N 1 la 1 0 6 7 7
Permit status prior to requested change.
a. Permit issued to (company name): SPX
b. Person legally responsible for permit: William T "Taylor
First MI Last
General Manager
Title
S1200 West Ash Street
Permit Holder Mailing Address
d,�Av Goldsboro NC 27530
City State Zip
(919) 5 81-1 100 (919) 5 81-1103
` Phone Ftr.K
SPX
1200 West Ash Street
Address
i Goldsboro NC 27530
City State Zip
Billy R Radford [phone]
First / MI / Last Phone
11. 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):
c. Person legally responsible for permit:
99 9 W 12 N
JAN 18 2011
SPX Flow Technology Systems, Inc
William T Taylor
First MI Last
General Manager
Title
1200 West Ash Street
Permit Holder Mailing Address
Goldsboro NC 27530
City Slate Zip
[phone] spx.com
Phone I; -mail Address
SPX Flow Technology Systems
1200 West Ash Street
Address
Goldsboro NC 27530
City State Zip
f. Facility contact person: Billy R Radford
first M1 Last
(919)_ 581-1 100 b i I ly. rad ford a spx.com
Phone E-mail Address
Revised 812008
`t

PERMIT NAME/OWNERSHIP CHANGE FORM
Page 2 of 2
IV. Permit contact information (if different from the person legally responsible for the permit)
Permit contact: Billy R Radford
First MI Last
Facilities Engineering Manager
Title
1200 West Ash Street
Mailing Address
Goldsboro NC 27530
City state rip
(919) S 18-1 100 [e-mail]
Phone t 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, , 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, William T. Taylor, 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.
X ��
Signature
1/10/2011
Date
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Division of Water Quality
Surface Water Protection Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Revised 712008