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HomeMy WebLinkAboutNCS000253_Permit Contact Update Request_20240110 Action History (UTC-05:00)Eastern Time(US&Canada) Submit by Anonymous User 1/10/2024 2:09:32 PM (Permit Contact Update Request) Approve by Austin Sanderford 2/15/2024 8:55:24 AM(Contact Update Review) 41 Updated • The task was assigned to DEMLR SW Admin General.The due date is: February 21,2024 5:00 PM 1/10/2024 2:09:37 PM • The task was assigned to Joyce Sanford by round robin distribution 1/10/2024 2:09:37 PM • Joyce Sanford reassigned the task to Austin Sanderford 2/14/2024 9:21:22 AM DEQIwo NPDES Stormwater -Request Request Submitted NPDES Permit Enter your NPDES stormwater permit number or Certificate of Coverage(COC)number. Number* NCS000253 Begins with NCS,NCG,or NCGNE(no exposure) Facility Name* Southeastern Foundries Corporation (Used to verify permit number) Check permit contact information for your permit by running a Stormwater Permit Summary Report. Guidance for COC holders: Do not enter the General Permit number with all 0's(for example, NCG030000)but instead your Certificate of Coverge(COC)number. Check all that Owner Affiliation(Legally Responsible Individual)Update * apply: Permit Ownership Transfer or Facility Name Change Delegation of Signature Authority(DOSA) Permit Contact Update Billing Contact Update Facility Contact Update Other Contact Update Facility Contact Update Provide new facility contact information This person should REPLACE the current facility contact. This person should just be added as another facility contact. New Contact Name* First and Last Name Bruce Angel E-mail Address* bangel@sefcorp.net Phone No.* 336-299-7211 Mailing Address* 2706 Oakland Avenue Greensboro, NC 27403 Physical Address If different than mailing address 2706 Oakland Avenue Greensboro, NC 27403 Add another facility contact if needed by clicking the'Add'button below Submitter's Name* Please enter your FIRST and LAST name Bruce Angel Phone Number* Please enter your phone number 336-299-7211 Any format is fine. Email Address* Please enter a valid e-mail address bangel@sefcorp.net A confirmation of submission will be e-mailed to this address. * By checking the box and signing below, I certify that: I have given true,accurate,and complete information on this form; I agree that submission of this form is a"transaction"subject to Chapter 66,Article 40 of the NC General Statutes(the "Uniform Electronic Transactions Act'); I agree to conduct this transaction by electronic means pursuant to Chapter 66,Article 40 of the NC General Statutes(the "Uniform Electronic Transactions Act'); I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature(except for any uploaded Owner Affiliation Change or Delegation of Signature of Authority forms,which also must be mailed in with original signature);AND I intend to electronically sign and submit this Permit Contact Update Request form. Signature 'f!!!Y'�' it'JlYI Date 1/10/2024 Questions? Contact bethany.georgoulias@deq.nc.gov. Review Verify Permit No.* Revise permit number below if incorrect. NCS000253