NCG080683_Contact Updates_20210728

McCoy, Suzanne
From: McCoy, Suzanne
Sent: Wednesday, July 28, 2021 3:24 PM
To: Robbie Baker
Cc: Robby Stone; Anita Simpson
Subject: RE: [External] Updated eReporting Form and SW Permit Summaries
I have updated the contacts per your request. They will appear on Reports the following day.
Suzanne McCoy
Stormwater Program Administrative Specialist
Division of Energy, Mineral and Land Resources
Department of Environmental Quality
512 N. Salisbury Street, Office 640K, Raleigh, NC 27604
1612 Mail Service Center, Raleigh, NC 27699-1612
919-707-3640
Based on the current guidance to minimize the spread of COVID-19, the Department of Environmental Quality has adjusted operations to protect the health and
safety of the staff and public. Many employees are working remotely or are on staggered shifts. To accommodate these staffing changes, all DEQ office locations are
limiting public access to appointments only. Please check with the appropriate staff before visiting our offices, as we may be able to handle your requests by phone or
email. We appreciate your patience as we continue to serve the public during this challenging time.
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Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
From: Robbie Baker <robbie.baker@high poi ntnc.gov>
Sent: Wednesday, June 30, 2021 12:50 PM
To: McCoy, Suzanne <[e-mail]>
Cc: Robby Stone <robby.stone@high poi ntnc.gov>; Anita Simpson <anita.simpson@high pointnc.gov>
Subject: [External] Updated eReporting Form and SW Permit Summaries
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Good Afternoon Ms. McCoy,
I have attached the updated eReporting Form for our industrial municipal facilities and the Stormwater Permit
Summaries with updated contact information. I have highlighted the information on the Stormwater Permit
Summaries that needs to be corrected. The eReporting Registration form has been completed and signed
copies of forms E and F are included. Thank you with all of your help getting this set up and please let me
know if I need to do anything further on my end.
Sincerely,
Robbie

Robert Baker
CITY OF HIGH POINT
Stormwater Specialist II, Stormwater Division
P.O. Box 2301 High Point, NC 27261
336.883.3085 1 m: 336.870.1328 fax: [phone]
[e-mail] I www.highpointnc.gov
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Public Records Law and may be disclosed to third parties.

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
NC DEMLR has the following information in our Permit Database for your permit as of 2/23/2021.
Permit Number: NCG110019 Permit Status: Active
Permit Type: Municipal WWTP > 1MGD, Stormwater Discharge, COC
Facility Name: East Side WWTP
Facility Addressl: 5898 Riverdale Rd
Facility Address2:
City, State & Zip: Jamestown, NC 27282
Owner Information Details:
MUST submit a Change of Name/Ownership form to DEMLR to make any changes to this Owner information.
(Click Here for "Change of Name/Ownershiv"Form)
Owner Name: City of High Point
Owner Type: Government - Municipal Owner Type Group: Organization
*** Legally Responsible for Permit ***
(Responsible corporate officer/principle executive officer or ranking elected official/general partner or proprietor;
or any other person with delegated signatory authority from the legally responsible person.)
Owner Affiliation: Terry L Houk Title:
Addressl: PO Box 230
Address2:
City, State & Zip: High Point, NC 27261-0230
Work Phone: [phone] Fax: [phone]
Email Address: [e-mail]
*** Permit Annual Fee Billing ***
Billing Month: June
Invoice Number Invoice Date Invoice Due Date Invoice Amount Invoice Status
Owner Contact Person(s)
Contact Name Title Address Phone Fax Email
Facility Contact Person(s)
Contact Name Title Address Phone Fax Email
John Thomas PO Box 230, High Point, NC 27261-0230 336-822-4740 john.thomas@highp
ointnc.gov
Permit Contact Person(s)
Contact Name Title Address Phone Fax Email
Terry L Houk PO Box 230, High Point, NC 27261-0230 336-883-3215 336-883-3490 terry.houk@highpoi
ntnc.gov
2/23/2021 Page 1

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
NC DEMLR has the following information in our Permit Database for vour Dermit as of 2/23/2021.
Permit Billing Contact(s)
Contact Name Title Address Phone
Fax Email
John Thomas PO Box 230, High Point, NC 27261-0230 336-883-4740 john.thomas@highp
ointnc.gov
Person(s) with Delegated Signatory Authority
Type Contact Name Title Address Phone
Fax Email
Person(s) with Electronic Signature Authority
Type Contact Name Title Address Phone
Fax Email
John Thomas PO Box 230, High Point, NC 27261 336-883-4740
[e-mail]
Outfalls
Outfall #: 001 Outfall Description: Richland Creek
Outfall Lattitude: 35.944440 Outfall Longitude:-79.911670
Represented by Outfall:
% Stormwater: 100 % Industrial:
Stream Waterbody
Basin Waterbody Name
Index Number Classification
Cape Fear Richland Creek
17-7-(4) WS-IV;CA:*
Outfall #: 002 Outfall Description: Richland Creek
Outfall Lattitude: 35.944440 Outfall Longitude:-79.911670
Represented by Outfall:
% Stormwater: 100 % Industrial:
Stream Waterbody
Basin Waterbody Name
Index Number Classification
Cape Fear Richland Creek
17-7-(4) WS-IV;CA:*
Outfall #: 003 Outfall Description: Richland Creek
Outfall Lattitude: 35.944440 Outfall Longitude:-79.911670
Represented by Outfall:
% Stormwater: 100 % Industrial:
Stream Waterbody
Basin Waterbody Name
Index Number Classification
Cape Fear Richland Creek
17-7-(4) WS-IV;CA:*
2/23/2021 Page 2

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
NC DEMLR has the following information in our Permit Database for your permit as of 2/23/2021.
Permit Number: NCG240007 Permit Status: Active
Permit Type: Compost Operations Stormwater/Wastewater Discharge COC
Facility Name: City of High Point Ingleside Compost Facility
Facility Addressl: 3001 Ingleside Dr
Facility Address2:
City, State & Zip: High Point, NC 27265
Owner Information Details:
MUST submit a Change of Name/Ownership form to DEMLR to make any changes to this Owner information.
fflickHere for "Change of Name/Ownership"Form)
Owner Name: City of High Point
Owner Type: Government - Municipal Owner Type Group: Organization
*** Legally Responsible for Permit ***
(Responsible corporate officer/principle executive officer or ranking elected official/general partner or proprietor;
or any other person with delegated signatory authority from the legally responsible person.)
Owner Affiliation: Terry L Houk Title:
Addressl: PO Box 230
Address2:
City, State & Zip: High Point, NC 27261-0230
Work Phone: [phone] Fax: [phone]
Email Address: [e-mail]
*** Permit Annual Fee Billing ***
Billing Month: April
Invoice Number Invoice Date Invoice Due Date Invoice Amount Invoice Status
Owner Contact Person(s)
Contact Name Title Address Phone Fax Email
Facility Contact Person(s)
Contact Name Title
Address
Phone
Fax
Email
Mike Spencer
PO Box 230, High Point, NC 27261-0230
336-883-3433
336-883-1785
mike.spencer@highp
nintnrgnv
Permit Contact Person(s)
Contact Name Title Address Phone Fax Email
Terry Houk PO Box 230, High Point, NC 27261 336-883-3218 336-883-3490 [e-mail]
Permit Billing Contact(s)
Contact Name Title Address Phone Fax Email
Mike Spencer PO Box 230, High Point, NC 27261-0230 336-883-3433 336-883-1785 mike.spencer@high
pointnc.gov
2/23/2021 Page 1

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
NC DEMLR has the following information in our Permit Database for your permit as of 2/23/2021.
Person(s) with Delegated Signatory Authority
Type Contact Name Title Address Phone Fax Email
Person(s) with Electronic Signature Authority
Type Contact Name Title Address Phone Fax Email
Mike Spencer PO Box 230, High Point, NC 27261 336-883-3433 336-883-1785 [e-mail]
Outfalls
Outfall #: 001 Outfall Description: UT to Rich Fork
Outfall Lattitude: 35.998330 Outfall Longitude:-80.041390 Represented by Outfall:
Stormwater: 100 % Industrial:
Basin Waterbody Name
Yadkin Rich Fork
Stream
Index Number
12-119-7
Waterbody
Classification
i
2/23/2021 Page 2

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
NC DEMLR has the fo liowinEF information in our Permit Database for vour uermit as of 2/23/2021.
Permit Number: NCG080702 Permit Status: Active
Permit Type: Transportation w/Vehicle Maintenance/Petroleum Bulk/Oil Water Separator Stormwater Discharge COC
Facility Name: High Point City Transit
Facility Addressi: 716 W Martin Luther King Jr. Drive
Facility Address2:
City, State & Zip: High Point, NC 27262
Owner Information Details:
MUST submit a Change of Name/Ownership form to DEMLR to make any changes to this Owner information.
(Click Here for "Change of Name/Ownership" Form)
Owner Name: City of High Point
Owner Type: Government - Municipal Owner Type Group: Organization
*** Legally Responsible for Permit ***
(Responsible corporate officer/principle executive officer or ranking elected official/general partner or proprietor;
or any other person with delegated signatory authority from the legally responsible person.)
Owner Affiliation: Terry L Houk Title:
Addressi: PO Box 230
Address2:
City, State & Zip: High Point, NC 27261-0230
Work Phone: [phone] Fax: [phone]
Email Address: terry. houk highpointnc.gov
*** Permit Annual Fee Billing ***
Billing Month: June
Invoice Number Invoice Date Invoice Due Date Invoice Amount Invoice Status
Owner Contact Person(s)
Contact Name Title Address Phone Fax Email
Facility Contact Person(s)
Contact Name Title
Tim Arnold
Permit Contact Person(s)
Address Phone Fax Email
716 W Martin Luther King Jr. Dr, High 336-889-3069 Tim.arnold@highp
Point, NC 27262
Contact Name Title Address
Terry Houk PO Box 230, High Point, NC 27261
Phone Fax Email
336-883-3218 336-883-3490 [e-mail]
2/23/2021 Page 1

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
NC DEMLR has the followinEF information in our Permit Database for vour uermit as of 2/23/2021.
Permit Billing Contact(s)
Contact Name Title Address
Phone Fax Email
Tim Arnold PO Box 230, High Point, NC 27261-0230
336-883-3069 tim.arnold(@high-
i)ointnc.gov
Person(s) with Delegated Signatory Authority
in Contact Name Title Address
Phone Fax Email
e
Person(s) with Electronic Signature Authority
LM Contact Name Title Address
Phone Fax Email
e
Tim Arnold PO Box 230, High Point, NC 27261
336-883-3069 [e-mail]
Outfalls
Outfall #: 001 Outfall Description: ditch
Outfall Lattitude: 35.953610 Outfall Longitude:-80.013890
Represented by Outfall:
Stormwater: 100 % Industrial:
Stream Waterbody
Basin Waterbody Name
Index Number Classification
Cape Fear Richland Creek
17-7-(0.5) WS-IV:*
2/23/2021 Page 2

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
NC DEMLR has the following information in our Permit Database for your permit as of 2/23/2021.
Permit Number:
NCG120105 Permit Status: Active
Permit Type:
Landfill Stormwater Discharge COC
Facility Name:
Kersey Valley MSW Landfill
Facility Addressl:
3940 Kivett Dr
Facility Address2:
City, State & Zip:
High Point, NC 27265
Owner Information Details:
MUST submit a Change of Name/Ownership form to DEMLR to make any changes to this Owner information.
fflickHere for "Change of Name/Ownership"Form)
Owner Name:
City of High Point
Owner Type:
Government - Municipal Owner Type Group: Organization
*** Legally Responsible for Permit ***
(Responsible corporate officer/principle executive officer or ranking elected official/general partner or proprietor;
or any other person with delegated signatory authority from the legally responsible person.)
Owner Affiliation:
Terry L Houk Title:
Addressl:
PO Box 230
Address2:
City, State & Zip:
High Point, NC 27261-0230
Work Phone:
336-883-3218 Fax: [phone]
Email Address:
[e-mail]
*** Permit Annual Fee Billing ***
Billing Month: August
Invoice Number
Invoice Date Invoice Due Date Invoice Amount Invoice Status
Owner Contact Person(s)
Contact Name Title Address Phone Fax Email
Facility Contact Person(s)
Contact Name Title Address Phone Fax Email
Robby D Stone PO Box 230, High Point, NC 27261 336-883-3217 robby.stone@highp
ointnc.gov
Mike Spencer PO Box 230, High Point, NC 27261-0230 336-883-3433 336-883-1785 mike.spencer@high
pointnc.gov
Permit Contact Person(s)
Contact Name Title Address Phone Fax Email
Terry Houk PO Box 230, High Point, NC 27261 336-883-3218 [e-mail]
2/23/2021 Page 1

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
NC DEMLR has the following information in our Permit Database for your permit as of 2/23/2021.
Permit Billing Contact(s)
Contact Name Title Address Phone Fax Email
Mike Spencer PO Box 230, High Point, NC 27261-0230 336-883-3433 336-883-1785 mike.spencer@high
pointnc.gov
Person(s) with Delegated Signatory Authority
Type Contact Name Title Address
Phone Fax Email
Person(s) with Electronic Signature Authority
Type Contact Name Title Address Phone Fax Email
Mike Spencer PO Box 230, High Point, NC 27261 336-883-3433 [e-mail]
Outfalls
2/23/2021 Page 2

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
NC DEMLR has the following information in our Permit Database for vour Dermit as of 2/23/2021.
Outfall #: SW01
Outfall Description: SDO
Outfall Lattitude:
Outfall Longitude:
Represented by Outfall:
Stormwater:
100 % Industrial:
Stream Waterbody
Basin
Waterbody Name
Index Number Classification
Cape Fear
Richland Creek
17-7-(4) WS-IV;CA:*
Outfall #: SW02
Outfall Description: SDO
Outfall Lattitude:
Outfall Longitude:
Represented by Outfall:
Stormwater:
100 % Industrial:
Stream Waterbody
Basin
Waterbody Name
Index Number Classification
Cape Fear
Richland Creek
17-7-(4) WS-IV;CA:*
Outfall #: SW03
Outfall Description: SDO
Outfall Lattitude:
Outfall Longitude:
Represented by Outfall:
Stormwater:
100 % Industrial:
Stream Waterbody
Basin
Waterbody Name
Index Number Classification
Cape Fear
Richland Creek
17-7-(4) WS-IV;CA:*
Outfall #: SW04
Outfall Description: SDO
Outfall Lattitude:
Outfall Longitude:
Represented by Outfall:
Stormwater:
100 % Industrial:
Stream Waterbody
Basin
Waterbody Name
Index Number Classification
Cape Fear
Richland Creek
17-7-(4) WS-IV;CA:*
Outfall #: SW05
Outfall Description: SDO
Outfall Lattitude:
Outfall Longitude:
Represented by Outfall:
Stormwater:
100 % Industrial:
Stream Waterbody
Basin
Waterbody Name
Index Number Classification
Cape Fear
Richland Creek
17-7-(4) WS-IV;CA:*
2/23/2021 Page 3

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
NC DEMLR has the followinEF information in our Permit Database for vour uermit as of 2/23/2021.
Permit Number:
NCG110018 Permit Status: Active
Permit Type:
Municipal WWTP > 1MGD, Stormwater Discharges COC
Facility Name:
Westside WWTP
Facility Addressi:
1044 W Burton Rd
Facility Address2:
City, State & Zip:
Thomasville, NC 27360
Owner Information Details:
MUST submit a Change of Name/Ownership form to DEMLR to make any changes to this Owner information.
(Click Here for "Change of Name/Ownership" Form)
Owner Name:
City of High Point
Owner Type:
Government - Municipal Owner Type Group: Organization
*** Legally Responsible for Permit ***
(Responsible corporate officer/principle executive officer or ranking elected official/general partner or proprietor;
or any other person with delegated signatory authority from the legally responsible person.)
Owner Affiliation:
Terry L Houk Title:
Addressi:
PO Box 230
Address2:
City, State & Zip:
High Point, NC 27261-0230
Work Phone:
336-883-3218 Fax: [phone]
Email Address:
terry. houk highpointnc.gov
*** Permit Annual Fee Billing ***
Billing Month: June
Invoice Number Invoice Date Invoice Due Date Invoice Amount Invoice Status
Owner Contact Person(s)
Contact Name Title Address Phone Fax Email
Facility Contact Person(s)
Contact Name Title
Dawn Molnar
Permit Contact Person(s)
Address Phone Fax Email
PO Box 230, High Point, NC 27261-0230 336-822-4730 Dawn.molnar@highp
Contact Name Title Address Phone Fax Email
Terry L Houk PO Box 230, High Point, NC 27261-0230 336-883-3215 336-883-3490 terry.houk@highpoi
ntnc.gov
2/23/2021 Page 1

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
NC DEMLR has the followinEF information in our Permit Database for vour uermit as of 2/23/2021.
Permit Billing Contact(s)
Contact Name Title Address Phone Fax Email
Dawn Molnar PO Box 230, High Point, NC 27261-0230 336-882-4730 dawn.molnar(a)high-
pointnc.gov
Person(s) with Delegated Signatory Authority
LM Contact Name Title Address Phone Fax Email
e
Person(s) with Electronic Signature Authority
in Contact Name Title Address Phone Fax Email
e
Dawn Molnar P.O. Box 230, High Point, NC 27261 336-882-4730 [e-mail]
Outfalls
2/23/2021 Page 2

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
NC DEMLR has the following information in our Permit Database for your permit as of 2/23/2021.
Outfall #: 001 Outfall Description: Drains NW of RDT & Sludge Proc. Bldg
Outfall Lattitude: 35.936940 Outfall Longitude:-80.109440
% Stormwater: 100 % Industrial:
Basin Waterbody Name
Yadkin Rich Fork
Outfall #: 002 Outfall Description: Drains NW corner of PTF
Outfall Lattitude: 35.938610 Outfall Longitude:-80.110000
% Stormwater: 100 % Industrial:
Basin Waterbody Name
Yadkin Rich Fork
Outfall #: 003 Outfall Description: Plugged & abandoned
Outfall Lattitude: 35.938060 Outfall Longitude:-80.110560
% Stormwater: 100 % Industrial:
Basin Waterbody Name
Yadkin Rich Fork
Outfall #: 004 Outfall Description: Drains old CB-13 to West
Outfall Lattitude: 35.937780 Outfall Longitude:-80.110830
Stormwater: 100 % Industrial:
Basin Waterbody Name
Yadkin Rich Fork
Outfall #: 005 Outfall Description: Drains S & W sides of plant, combined
Outfall Lattitude: 35.936940 Outfall Longitude:-80.111110
Stormwater: % Industrial: 100
Basin Waterbody Name
Yadkin Rich Fork
Represented by Outfall:
Stream Waterbody
Index Number Classification
12-119-7 C
Represented by Outfall:
Stream Waterbody
Index Number Classification
12-119-7
Represented by Outfall:
i
Stream Waterbody
Index Number Classification
12-119-7 C
Represented by Outfall:
Stream
Index Number
12-119-7
Waterbody
Classification
C
Represented by Outfall:
Stream Waterbody
Index Number Classification
12-119-7 C
2/23/2021 Page 3

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
NC DEMLR has the followinEF information in our Permit Database for vour uermit as of 2/23/2021.
Outfall #: 006 Outfall Description: Drains NE corner from Pri. Inf. & BNR
Outfall Lattitude: 35.936670 Outfall Longitude:-80.107780
% Stormwater: 100 % Industrial:
Basin Waterbody Name
Yadkin Kennedy Mill Creek
Outfall #: 007 Outfall Description: Drains N of Admin. & NE corner of plant
Outfall Lattitude: 35.936390 Outfall Longitude:-80.107780
% Stormwater: 100 % Industrial:
Basin Waterbody Name
Yadkin Kennedy Mill Creek
Represented by Outfall:
Stream
Index Number
12-119-7-2
Waterbody
Classification
C
Represented by Outfall:
Stream
Index Number
12-119-7-2
Waterbody
Classification
C
2/23/2021 Page 4

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
NC DEMLR has the following information in our Permit Database for your permit as of 2/23/2021.
Permit Number: NCG130038 Permit Status: Active
Permit Type: Wholesale Trade of Non-metal Waste and Scrap Stormwater Discharge COC
Facility Name: High Point Material Recovery Facility
Facility Addressl: 5875 Riverdale Rd
Facility Address2:
City, State & Zip: Jamestown, NC 27282
Owner Information Details:
MUST submit a Change of Name/Ownership form to DEMLR to make any changes to this Owner information.
(Click Here for "Change of Name/Ownershiv"Form)
Owner Name: City of High Point
Owner Type: Government - Municipal Owner Type Group: Organization
*** Legally Responsible for Permit ***
(Responsible corporate officer/principle executive officer or ranking elected official/general partner or proprietor;
or any other person with delegated signatory authority from the legally responsible person.)
Owner Affiliation: Terry L Houk Title:
Addressl: PO Box 230
Address2:
City, State & Zip: High Point, NC 27261-0230
Work Phone: [phone] Fax: [phone]
Email Address: [e-mail]
*** Permit Annual Fee Billing ***
Billing Month: June
Invoice Number Invoice Date Invoice Due Date Invoice Amount Invoice Status
2020PR004472 5/5/2020 6/4/2020 $100.00 Overdue
Owner Contact Person(s)
Contact Name Title Address Phone Fax Email
Facility Contact Person(s)
Contact Name Title Address Phone Fax Email
Melanie Bruton 5875 Riverdale Dr, Jamestown, NC 27282 336-883-3517 336-883-3624 melanie.bruton@hig
hpointnc.gov
Permit Contact Person(s)
Contact Name Title Address Phone Fax Email
Terry Houk PO Box 230, High Point, NC 27261 336-883-3218 336-883-3490 [e-mail]
2/23/2021 Page 1

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
NC DEMLR has the following information in our Permit Database for vour Dermit as of 2/23/2021.
Permit Billing Contact(s)
Contact Name Title Address Phone
Fax Email
Melanie Bruton PO Box 230, High Point, NC 27261-0230 336-883-3517 336-883-3624 melanie.bruton@hig
hpointnc.gov
Person(s) with Delegated Signatory Authority
Type Contact Name Title Address Phone
Fax Email
Person(s) with Electronic Signature Authority
Type Contact Name Title Address Phone
Fax Email
Melanie Bruton PO Box 230, High Point, NC 27261 336-883-3517 336-883-3624
[e-mail]
Outfalls
Outfall #: 001 Outfall Description: unnamed tributary to Deep River
Outfall Lattitude: 35.946110 Outfall Longitude:-79.911390
Represented by Outfall:
% Stormwater: 100 % Industrial:
Stream Waterbody
Basin Waterbody Name
Index Number Classification
Cape Fear DEEP RIVER (Randleman Lake)
17-(4) WS-IV;CA:*
2/23/2021 Page 2

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
NC DEMLR has the following information in our Permit Database for your permit as of 2/23/2021.
Permit Number:
NCG080683 Permit Status: Active
Permit Type:
Transportation w/Vehicle Maintenance/Petroleum Bulk/Oil Water Separator Stormwater Discharge COC
Facility Name:
High Point City -Fleet Maintenance Facility
Facility Addressi:
3524 Triangle Lake Rd
Facility Address2:
City, State & Zip:
High Point, NC 27260
Owner Information Details:
MUST submit a Change of Name/Ownership form to DEMLR to make any changes to this Owner information.
fflickHere for "Change of Name/Ownership"Form)
Owner Name:
City of High Point
Owner Type:
Government - Municipal Owner Type Group: Organization
*** Legally Responsible for Permit ***
(Responsible corporate officer/principle executive officer or ranking elected official/general partner or proprietor;
or any other person with delegated signatory authority from the legally responsible person.)
Owner Affiliation:
Terry L Houk Title:
Addressi:
PO Box 230
Address2:
City, State & Zip:
High Point, NC 27261-0230
Work Phone:
336-883-3218 Fax: [phone]
Email Address:
[e-mail]
*** Permit Annual Fee Billing ***
Billing Month: June
Invoice Number
Invoice Date Invoice Due Date Invoice Amount Invoice Status
Owner Contact Person(s)
Contact Name Title Address Phone Fax Email
Facility Contact Person(s)
Contact Name Title
Justin Hix
Address
PO Box 230, High Point, NC 27261-0230
Phone
336-883-3297
Fax
336-883-6699
Email
justin.hix@highpointn
Permit Contact Person(s)
Contact Name Title Address Phone Fax Email
Terry Houk PO Box 230, High Point, NC 27261 336-883-3218 336-883-3490 [e-mail]
Permit Billing Contact(s)
Contact Name Title Address Phone Fax Email
Justin Hix PO Box 230, High Point, NC 27261-0230 336-883-3297 336-883-6699 justin.hix@highpoi
ntnc.gov
2/23/2021 Page 1

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
NC DEMLR has the following information in our Permit Database for your permit as of 2/23/2021.
Person(s) with Delegated Signatory Authority
Type Contact Name Title Address Phone Fax Email
Person(s) with Electronic Signature Authority
Type Contact Name Title Address Phone Fax Email
Justin Hix PO Box 230, High Point, NC 27261 336-883-3598 336-883-3297 [e-mail]
Outfalls
Outfall #: 001 Outfall Description: unnamed tributary to Richland Creek
Outfall Lattitude: 35.960560 Outfall Longitude:-79.948610 Represented by Outfall:
Stormwater: 100 % Industrial:
Basin
Cape Fear
Waterbody Name
Richland Creek
Stream
Index Number
17-7-(0.5)
Waterbody
Classification
WS-IV: *
2/23/2021 Page 2