NC0073181_Owner (Affiliation Change)_20200714

N1Z- ROY COOPER
Governor
MICHAEL S. REGAN
secremr v
LINDA CULPEPPER
Water Resources Intern):Director
ENVIRONMENTAL QUALITY
PERMIT NAME/OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION:
Permit Number: NC007/3/1/8/1 or NCG5 / / / /
1. Facility Name: River Road Terminal
II. NEW OWNER/NAME INFORMATION:
1. This request for a name change is a result of:
a. Change in ownership of property/company RECEIVED
b. Name change only JUL 14 2020
_X_c. Other(please explain): Change in Responsible Official Only NDDEQ/DWRINPDES
2. New owner's name (name to be put on permit):
3. New owner's or signing official's name and title: Christopher Hamm
(Person legally responsible for permit)
General Manager, Terminals
(Title)
4. Mailing address: 1900 Harbor Access Rd City: Newport News
State: VA Zip Code: 23607 Phone: [phone]
E-mail address: [e-mail]
THIS APPLICATION PACKAGE WILL NOT BE ACCEPTED BY THE DIVISION UNLESS ALL OF THE
APPLICABLE ITEMS LISTED BELOW ARE INCLUDED WITH THE SUBMITTAL.
REQUIRED ITEMS:
1. This completed application form
2. Legal documentation of the transfer of ownership (such as a property deed, articles of
incorporation, or sales agreement)
[see reverse side of this page for signature requirements]
State of North Carolina I Environmental Quality I Water Resources
1617 Mail Service Center I Raleigh,NC 27699-1617
919 807 6300 919-807-6389 FAX
https://deg.nc.gov/ab out/divisions/water-resources/water-resources-permits/wastewater-branch/npdes-wastewater-permits

NPDES Name&Ownership Change
Page 2 of 2
Applicant's Certification:
I, Christopher Hamm, 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 and attachments are not included, this application package will be returned as
incomplete.
Signature: Date: egi7/
THE COMPLET APPLICATION PACKAGE, INCLUDING ALL SUPPORTING
INFORMATION & MATERIALS, SHOULD BE SENT TO THE FOLLOWING ADDDRESS:
NC DEQ/ DWR/ NPDES
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Version 11/2017