NCC214093_Contact Update Requests_20221215

Use this form when:
The person who is legally responsible for the permit has changed, but there is NO CHANGE in the project name
or ownership.
**If the project name has changed, or if the ownership of the project has changed, do NOT use this form.**
Instead, you must submit a new NCGO1 electronic Notice of Intent (eNO1).
Directions:
Print this form, complete, scan and upload to the Construction Stormwater Permit MODIFICATION Form.
Then, mail the original form to the NC DEMLR Stormwater Program at:
Division of Energy, Mineral & Land Resources Stormwater Program
512 N. Salisbury Street, 61h Floor (Office 640K)
1612 Mail Service Center
Raleigh, NC 27699-1612
Certificate of Coverage (COC) Number: �Q (f.- C. 2. � + 0 t S
Name of Project•. L y `- < L po � 5 t j Ik-,_ l ✓� S�Yu er��
Legally Responsible Organizational Entity• C- .S a 0�. A
PREVIOUS Legally Responsible Individual: t 7 l j� t
NEW Legally Responsible Individual: O' i L �'�ytC�
The following section is to be completed and signed by the NEW Legally Responsible Individual.
Per NC General Statute 143-215.68 (i), any person who knowingly makes any false statement, representation,
or certification in any application, record, report, plan, or other document filed or required to be maintained
under this Article or a rule implementing this Article ... shall be guilty of a Class 2 misdemeanor which may
include a fine not to exceed ten thousand dollars ($10,000).
Page 1 of 2

Under penalty of law, I certify that (check all boxes to indicate your agreement):
2' 1 am the person responsible for the construction activities of this project, for satisfying the
requirements of this permit, and for any civil or criminal penalties incurred due to violations of this
permit.
Y' 1 will abide by all conditions of the NCG010000 General Permit and the approved Erosion and
Sediment Control Plan.
If the approved Erosion and Sediment Control Plan is not compliant with Part II (Stormwater Pollution
Prevention Plan) of the NCG010000 General Permit I will nonetheless ensure that all conditions of
Part II of the permit are met on the project at all times.
t�1 I understand that coverage under this permit will constitute the permit requirements for the
discharge(s) and is enforceable in the same manner as an individual permit.
LJ" This form has been reviewed and is accurate and complete to the best of my knowledge.
M
ature:
Print Name of Signed:
pc r
Title: C -An 1 C' o --T +c.c-t ( J-s S
Mailing Address: 1,O
Street Address: 1,60 1
Email Address:
Phone Number:
vL l;.O , ,JN G 27-!S;-(E
* IMPORTANT NOTE: This form must be signed by a responsible corporate officer that owns or operates the
construction activity, such as a president, secretary, treasurer, or vice president, or a manager that is
authorized in accordance with Part IV, Section B, Item (6) of the NCG010000 permit.
For more information on signatory requirements, see Part IV, Section B, Item (6) of the NCG010000 permit.
Page 2 of 2

Georgoulias, Bethany
From: Douglas Congdon _ Staff - PlanningConstruction <[e-mail]>
Sent: Thursday, December 15, 2022 11:44 AM
To: Georgoulias, Bethany
Cc: Brandon Williams _ Staff - PlanningConstruction; Mark Strickland _ Staff - Facilities
Subject: RE: [External] RE: Construction Stormwater Permit NCC214093 - Contact Updates
Needed
Attachments: E-51 - NCG01 Form (12.15.22).pdf
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Bethany -
No problem. Here you go.
Thanks
-Douglas
Douglas Congdon
Program Executive
WCPSS Facilities Design & Construction
WAKE COUNTY
PUBLIC SCHOOL SYSTEM
CUMMING
9ulldingvaluc Through Expertise
[e-mail]
[e-mail]
C: 202-321-1013
cumming-group.com
From: Georgoulias, Bethany <[e-mail]>
Sent: Thursday, December 15, 2022 11:19 AM
To: Douglas Congdon — Staff - PlanningConstruction <[e-mail]>
Cc: Brandon Williams — Staff - PlanningConstruction <[e-mail]>; Mark Strickland — Staff - Facilities
<[e-mail]>
Subject: RE: [External] RE: Construction Stormwater Permit NCC214093 - Contact Updates Needed
Doug — sorry for the necessary follow up, but all of the certification boxes on the form need to be checked. Can we
please get a revised copy?
Thank you for the other information.
Bethany Georgoulias (she/her)
Environmental Engineer
1

Stormwater Program, Division of Energy, Mineral, and Land Resources
N.C. Department of Environmental Quality
919 707 3641 office
[e-mail]
512 N. Salisbury Street, Raleigh, NC 27604 (location)
1612 Mail Service Center, Raleigh, NC 27699-1612 (mailing)
Website: http://deq.nc.gov/about/divisions/energy-mineral-land-resources/stormwater
cc. ��� DE
NORTH CAROLINA
Department of Environmental Duality
Email correspondence to and from this address is subject to the North
Carolina Public Records Law and may be disclosed to third parties.
From: Douglas Congdon _ Staff - PlanningConstruction <[e-mail]>
Sent: Thursday, December 15, 2022 11:12 AM
To: Georgoulias, Bethany <[e-mail]>
Cc: Brandon Williams _ Staff - PlanningConstruction <[e-mail]>; Mark Strickland _ Staff - Facilities
<[e-mail]>
Subject: RE: [External] RE: Construction Stormwater Permit NCC214093 - Contact Updates Needed
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Mark Strickland should be listed as the billing contact.
His email is: [e-mail]. Phone number is: [phone].
Thanks
Douglas Congdon
Program Executive
WCPSS Facilities Design & Construction
iI WAKE COUNTY
PUBLIC SCHOOL SYSTEM
CUMMING
EWIld1ngV,i1pe1'hfpugFs ExWt154
[e-mail]
[e-mail]
C: 202-321-1013
cumming-group.com
From: Georgoulias, Bethany<[e-mail]>
Sent: Thursday, December 15, 2022 11:03 AM

To: Douglas Congdon _ Staff - PlanningConstruction <[e-mail]>
Cc: Brandon Williams _ Staff - PlanningConstruction <[e-mail]>; Mark Strickland _ Staff - Facilities
<[e-mail]>
Subject: RE: [External] RE: Construction Stormwater Permit NCC214093 - Contact Updates Needed
You don't often get email from [e-mail]. Learn why this is important
Thank you!
It's currently David Neter's email address and phone. Who do you want listed as the billing contact?
Bethany Georgoulias (she/her)
Environmental Engineer
Stormwater Program, Division of Energy, Mineral, and Land Resources
N.C. Department of Environmental Quality
919 707 3641 office
bethany.georgoulias@ncdenngov
512 N. Salisbury Street, Raleigh, NC 27604 (location)
1612 Mail Service Center, Raleigh, NC 27699-1612 (mailing)
Website: http://deq.nc.gov/about/divisions/energy-mineral-land-resources/stormwater
cc. ��� DE
NORTH CAROLINA p
Department of Environmental Duality
Email correspondence to and from this address is subject to the North
Carolina Public Records Law and may be disclosed to third parties.
From: Douglas Congdon _ Staff - PlanningConstruction <[e-mail]>
Sent: Thursday, December 15, 2022 10:17 AM
To: Georgoulias, Bethany<[e-mail]>
Cc: Brandon Williams _ Staff - PlanningConstruction <[e-mail]>; Mark Strickland _ Staff - Facilities
<[e-mail]>
Subject: [External] RE: Construction Stormwater Permit NCC214093 - Contact Updates Needed
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Good Morning Bethany -
Attached is completed, signed NCG01 form, by Mark Strickland.
Who do you have listed as the billing contact?
Thanks
-Douglas
Douglas Congdon

Program Executive
WCPSS Facilities Design & Construction
WAKE COUNTY
PUBLIC SCHOOL SYSTEM
GUMMING
Building value Through Expertise
[e-mail]
[e-mail]
C: 202-321-1013
cumming-group.com
From: Georgoulias, Bethany<[e-mail]>
Sent: Thursday, December 15, 2022 7:50 AM
To: Douglas Congdon _ Staff - PlanningConstruction <[e-mail]>
Cc: Brandon Williams _ Staff - PlanningConstruction <[e-mail]>; Mark Strickland _ Staff - Facilities
<[e-mail]>
Subject: RE: Construction Stormwater Permit NCC214093 - Contact Updates Needed
Importance: High
Some people who received this message don't often get email from bethany [e-mail]. Learn why this is
important
CAUTION: This email originated from outside of the organization! Proceed with caution!
Good morning,
I am following up on this request sent in August. To date we have not received a response or form to update the legally
responsible individual for this construction COC permit NCC214093
Please see my questions below and address this as soon as possible so that correspondence regarding fees will go to the
right person. Currently the legally responsible person is still listed as David Neter.
Thank you so much,
Bethany Georgoulias (she/her)
Environmental Engineer
Stormwater Program, Division of Energy, Mineral, and Land Resources
N.C. Department of Environmental Quality
919 707 3641 office
[e-mail]
From: Georgoulias, Bethany
Sent: Thursday, August 18, 2022 12:34 PM
To: [e-mail]
Subject: RE: FW: Notice of Deficiency: Unpaid Permit Fee for NCC214093 - Contact Updates Needed
Importance: High
Mr. Congdon,

To update the contacts for this permit, we will need:
1) The attached form to be filled out and signed by the new legally responsible individual (it sounds like that's Mark
Strickland).
2) Information for new Site Contact Brandon Williams (it was previously William Hartley), including phone and
mailing address. You have provided his email below.
3) We only have one other contact associated with Construction Stormwater COCs, and that's the billing contact
that is included on invoice communication. Is that who you want to be designated, Don?
Finally, if there are other WCPSS construction permits with outdated contact information, you'll have to identify those
and provide the same information. We need a signed form in each case there is a change in legally responsible person.
You can scan and email the completed form back to me, but it also has to be mailed in as hard copy for EPA records. I
can take care of the contact updates.
Thanks so much!
Bethany Georgoulias (she/her)
Environmental Engineer
Stormwater Program, Division of Energy, Mineral, and Land Resources
N.C. Department of Environmental Quality
919 707 3641 office
bethany.georgoulias@ncdenngov
512 N. Salisbury Street, Raleigh, NC 27604 (location)
1612 Mail Service Center, Raleigh, NC 27699-1612 (mailing)
Website: http://deq.nc.gov/about/divisions/energy-mineral-land-resources/stormwater
DEQ>
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties
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.
From: Tran, Kieu M <[e-mail]>
Sent: Thursday, August 18, 2022 12:04 PM
To: Georgoulias, Bethany<[e-mail]>
Subject: FW: [External] FW: Notice of Deficiency: Unpaid Permit Fee for NCC214093
Please see below
Mrs. Kieu Tran
Stormwater Program Administrative Assistant

Office: (919) 707- 3640
Kieu.Tran @ncdenr.gov
North Carolina Department of Environmental Quality
Division of Energy, Mineral, and Land Resources Stormwater Program
512 N. Salisbury Street, Raleigh, NC 27604 (location)
1612 Mail Service Center, Raleigh, NC 27699-1612 (mailing)
Website: http//deq.nc.gov/about/divisions/energy-mineral-land-resources/stormwatgr
IC, iA_
,�D_ E
Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed
to third parties
From: Douglas Congdon _ Staff - PlanningConstruction <[e-mail]>
Sent: Thursday, August 18, 2022 8:15 AM
To: Tran, Kieu M <[e-mail]>
Subject: [External] FW: Notice of Deficiency: Unpaid Permit Fee for NCC214093
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Good Morning -
Reaching out regarding the distribution list that the attached Notice of Deficiency was sent to WCPSS:
o William Hartley has retired so please remove him. His replacement is Brandon Williams so please add him. His
email is [e-mail].
o David Neter was the temporary Chief of Facilities until a permanent Chief of Facilities was hired. A new chief is
on board so please remove David Neter. The new chief is Mark Strickland so please add him. His email is
[e-mail].
o Douglas Congdon is the Program Executive for the Facilities Design & Construction department so please add
him. His email is [e-mail].
Please let me know if you have any questions. Thank you.
-Douglas
Douglas Congdon
Program Executive
WCPSS Facilities Design & Construction
WAKE COUNTY
PUBLIC SCHOOL SYSTEM
A
MMI N
Wilding value iivpu9h Expertise

[e-mail]
[e-mail]
C: 202-321-1013
cumming-group.com
From: David Neter _ Staff - AdministrativeSvcs <[e-mail]>
Sent: Wednesday, August 17, 2022 5:09 PM
To: Douglas Congdon _ Staff - PlanningConstruction <[e-mail]>
Cc: Mark Winters _ Staff - Finance <[e-mail]>
Subject: FW: Notice of Deficiency: Unpaid Permit Fee for NCC214093
Appears we need to update their email distribution to WCPSS?
From: [e-mail] <[e-mail]>
Sent: Wednesday, August 17, 2022 3:46 PM
To: David Neter _ Staff - AdministrativeSvcs <[e-mail]>
Cc: [e-mail]; [e-mail]; [e-mail]; William Hartley_Staff-
PlanningConstruction <[e-mail]>
Subject: Notice of Deficiency: Unpaid Permit Fee for NCC214093
CAUTION: This email originated from outside of the organization! Proceed with caution!
This email is to convey a Notice of Deficiency for failure to pay the 2022 annual permit fee per the requirements of NC
General Statute 143-215.3D(a)(4). Please be sure to coordinate payment with other parties copied on this e-mail to
avoid duplicate payments.
Your Certificate of Coverage (COC) under the Construction Stormwater NPDES General Permit was not renewed because
the annual fee payment (Invoice No. NCC214093-2022) was not received. The payment is 16 day(s) overdue. A Notice
of Deficiency is attached.
Please contact the Stormwater Program at [e-mail] or [phone]. Please reference:
COC no. NCC214093
This COC is for Elementary School 51 Site Construction in Wake County, issued to Wake County Board of Education.
Annual fee payment can be made through this website:
https://deg.nc.gov/sw-epayments
If this project has been closed -out, it is important that you submit a Notice of Termination request here:
https://edocs.deg.nc.gov/Forms/NCGOI-Termination
Please visit https://deg.nc.gov/NCG01 for more information about this permit.
The INC DEMLR Stormwater Program
512 N. Salisbury Street, Archdale Building 6th Floor, 1612 Mail Service Center, Raleigh, NC 27699-1612
This email was automatically generated by Laserfiche. Please do not respond to this email address, as responses are not
monitored.