NC0039152_Owner (Affiliation Change)_20210720

SCATS,,,
ROY COOPER
Governor
DIONNE DELLI-GATTI ,!'?47
Secretary Qw 4
S.DANIEL SMITH NORTH CAROLINA RECEIVED
Director Environmental Quality
JUL202021
PERMIT NAME/OWNERSHIP CHANGE FORM
NCDEQ/DWR/NPDES
I. CURRENT PERMIT INFORMATION:
Permit Number: NC0039152 / / / or NCG5 / / / /
1. Facility Name: Ohio Electric Motors
II. NEW OWNER/NAME INFORMATION:
1. This request for a name change is a result of:
a. Change in ownership of property/company
x _b. Name change only
_c. Other(please explain):
2. New owner's name(name to be put on permit):
John Petty
3. New owner's or signing official's name and title: John Petty
(Person legally responsible for permit)
Plant Manager
(Title)
4. Mailing address: 30 Paint Fork RD City: Barnardsville
State:NC_ Zip Code: 28709 Phone: (828 ) 228-6049
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]
' - North Carolina Department of Environmental Quality ( Division of Water Resources
512 North Salisbury Street 11617 Mail Service Center I Raleigh,North Carolina 27699-1617
NORTH C,iLtEP14

NPDES Name&Ownership Change
Page 2 of 2
Applicant's Certification:
I, John Petty , 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: (/(1 Date: (7(20 (
THE COMPLETED APPLICATION ACKAGE,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
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