NCG030240_Contact Information Updates_20210125

McCoy, Suzanne
From: Randleman, Debbie <[e-mail]>
Sent: Monday, January 25, 2021 9:28 AM
To: McCoy, Suzanne
Subject: [External] Minor Changes to NCG030240 & NCG030646 Permit Summary
Attachments: e-DMR information to Suzanne NCDEQ.pptx; 19.03.01 Facility Signature Delegation
11.8.18.pdf
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Good Morning Suzanne,
I need to make a few minor changes to the Permit Summary for both NCG030240 & NCG030646. I have not submitted
the electronic Signature Authority.
The address for NCG030240 is:
Deere -Hitachi Construction Machinery Corporation
Billing Address: P.O. Box 1187 (Zip Code — 27285)
Street Address: 1000 Deere -Hitachi Rd.
Kernersville, NC 27284
NCG030646
Deere -Hitachi Construction Machinery Corporation
Billing Address: P.O. Box 1187 (Zip Code — 27285)
Street Address: 1140 West Mountain St.
Kernersville, NC 27284
I also have a few questions about the eReporting Registration Form.
1. Since I am not the Signature Authority but I always submit the reports, pay the fees, etc. is it acceptable for me
to be listed as the Facility Administrator?
2. Can I be listed as the person with Electronic Signature Authority?
3. Does Mr. Chase still need to register for an eDMR account?
I have attached a copy of the Signature Authority for Deere -Hitachi.
I hate to ask so many questions. I just want to make sure I am doing this correctly.
Thank you,
Debbie Randleman CESCO
Environmental Coordinator
Deere -Hitachi Construction Machinery Corporation
Kernersville, NC 27284
0: [phone] M: [phone]
[e-mail] / [e-mail]
https://deerehitachi.com/

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r
Facility Signature Delegation
Kernersville, NC
Pursuant to a Deere & Company delegation of authority from the Chairman or as designated by statute or
regulation, the President of the facility or the strategic business unit, is authorized to sign documents
required by environmental regulatory agencies.
According to the John Deere Corporate guidelines, the facility president's signature is required on:
• Any required periodic report sent to a governmental agency
• Any environmental permit application submitted to a governmental agency
• Any required exceedance report sent to a governmental agency relating to a NOV (Notice of Violation),
or similar notice
• Stormwater pollution prevention plan (SWPPP)
• Spill prevention, control and countermeasure plan (SPCC)
In some instances, if the President is unavailable for signature, the people holding the following job positions
are authorized to sign in the President's absence:
Job title: Vice-President/CFO (Primary)
Job Title: Manager, Manufacturing Engineer (Secondary)
Signed: _ 0----_---
Title: Jonathan Chase, President
Deere -Hitachi Construction Machinery Corporation
Date: If - '6 - 2 o t

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
SC DQILR has the fonotttor information io our Fermit Database for cour oernat ■% of 1 22.2021.
Permit Number: ',CG030240 Permit Status: Am v
Permit Type: Metal Fabncaton_Stomnater Dscharre COC
Facility Name: Deere Hirarhi Cnnst Mach Co,
Facility Addressi: 10W Deg ­Hitachi Rd
Facility Address2:
City. State & Zip: Ke•ne•s, e. tK 27285
Owner Infomurion netaiIs-
MUST submit a ChRnge o}Name/Owtwmhlpfoem to DEMLR to make any changes to this Owner infoentation.
Owner flame: Deere Hi-achL Corsi Mach Coro ,,
Owner Type: Non-Cxr:ernlnent Owner Type Group: Organization Q Sticky- 1/25/2021, 8:05:59..
e r r Legally Responsible for Permit r r a I FAX # is 336-996-8200
(RerPprgiyte Wrpprete omterl Vrinc'i pie cre,ulire officer ur retaken, elected VrficieljgMrrpl partner pr prpl
or any other person with de"aled spnatory authority from the legally —ponsibte Person.) I
Owner Affiliation: lonathan chase Tide: President & CEO
Addnmsl: PO Box 1187
Address2:
City, State 3 Zip: KemersnBe, NC 27285
Work Phone: - — Fax: 3u473-552 33 96-8200
Email Address:
a• e Permit Annual Fee Billinq e a e
Billing Month; February
Invoice Number Invoice Date
Invoice Due Date Invoice Amount LmPoiot
X I
Q Sticky 1/25/2021,9:21:23..
Owner Contact Peroon(s)
Deer be
Contact rlanse lak
91Ldtess should spelled
Deere I
Facility Contact Person(s)
[—
Contact [lame hLie
IlM D Hitachi RE, Kernrsrie, Nc 33"23-SS17 h�@dlxnsc.aom
27285
Permit Contact Persons)
't
[] S&ky Note - [Rand[ernart,D..1/25/2021, 8:11:17AM X
Contact Hame Tide
Debbie Q
Address
1140 W Mo x,;.
Permit Contact Name: Luke Martin
Randleman
27284
Title: Facilities 8r Environmental Engineer
Address: 1000 Deere -Hitachi Rd.
_
Kernersville NC 27284
Phone: [phone]
E-mail: [e-mail]
NC Division of Energy, MII _Sticky Note- anOdler A/2021,41806AM x
NPDES Stornmate - ---=
NCDDILA hxs the follomo^ information mour Title. Environmental Coordinator
permit Billing Contact(s) Deer should be spelled Deere
Contact flame Title feu
a 1000 Deer Flit" Rd. Kerr t
tianal:-•.,n 27285 .tan
Person(s) with Delegated Signatory Authority
Toe Contact (lame Title Address Pimna Fax tma,i
Sticlry Note- I a[�ndlemar0eTi6ie] 1/25/
Person(s) with Electronic Signature Author
Contact (lame Title Address
F
outfalls
Delegated Signatory Authority
Jonathan Chase
Oudall x: L2,L Outlall Desaiction: Reo Cuda� 01- Unnamed vibA n
oudall Lattitude: ait Q Sticky Note- (Randleman„1/25/2021, 8:14:10 AM
ei Stommwater: _IX Person with electronic Signature Authority
Basin , Debbie Randleman
i
nted by outfall:
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