NCG050304_Name-Owner Change Application_20240226

TEIJI
TEIJIN AUTOMOTIVE TECHNOLOGIES
NORTH CAROLINA COMPOSITES,LLC
6701 Statesville Boulevard
Salisbury,NC 28147
February 26, 2024
CERTIFIED MAIL:
7020 0090 0000 7796 8483
NCDEQ-DEMLR Stormwater Program
Attn: Mrs. Bethany Georgoulias
1612 Mail Service Center
512 North Salisbury Street
6`h Floor, Office 640K
Raleigh, NC 27604
RE: Permit No.: NCG 050000
COC No.: NCG 050304
Re-branding, Facility Name Change;
TEIJIN Automotive Technologies North Carolina Composites, LLC
DEMLR Program,
As of September 22,2021,our facility located at 6701 Statesville Boulevard,Salisbury, North Carolina,
operating under the Title V Permit number referenced above, has changed its legal name to Teijin
Automotive Technologies North Carolina Composites, LLC from Continental Structural Plastics, LLC.
The change only applies to our company name,the owner-operator of the facility has not changed.
Communication regarding the above referenced permit or other required authorizations for the
facility should be addressed to:
Tracy Breeding
Plant Manager
Teijin Automotive Technologies
6701 Harpers Road
Salisbury, NC 28147
Respectfully,
Rodn Hopper
EHS Manager

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':� NC DEPARTMENT OF ENVIRONMENTAL QUALITY
�' .' ys Mineral
DIVISION OF Energy, , and Land Resources
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r�yn, STORMWATER PROGRAM
NORTH CAROLINA
Environmental Quality
NPDES STORMWATER PERMIT NAME/OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION:Permit Number: NCS _/ / / /_/_ or NCG (3/ 5/0 /3/0 /4
1. Facility Name(prior to change): CONTI nIEN114L r-jatic ti ielc. rL�kSTI CS,U C
II. NEW OWNER/NAME INFORMATION:
2. This request for a name change is a result of:
a. Change in ownership of property/company
Xb. Name change only OM.nd/or Company)
c. Other(please explain):
(for example,facility address update. Include additional attachments if necessary.)
3. New owner's name (name to be put on permit as Permittee):
)•t !-A — OW Nsr iZ.5rtIP Ilf4S t10-r Q4do er7 Qit/(( 1i1Clc.► 1/ VHF
, I
4. New owner's or signing official's name and title: 'RCy—fS?E-E-DJ rl(
(Person legally responsible for permit)
------- -AINIT ilAnli9- 6-r--
(Title)
5. Mailing address: Lilo I 51 F5✓I Cat tc_.vo City: _5/3(-)32y
State: IJC. Zip Code: 2.$IAr7 Phone: (704 )Co4}5— y650
E-mail address: t. t21f,1G c T/v7, A-t ronianit/E. COA
6. New facility name (if applicable): TeE' i /vrarioflve 7E04N6-Locee- lade, i I AIZoU464 at r6s,h
7. Effective date of transfer or name change: 9124 ZoZ/
D E Qom,_ North Carolina Department of Environmental Quality Division of Energy.Mineral and Land Resources
�J/p 512 North Salisbury Street Ib12 Mall Service Center Raleigh.North Carolina 27b99-Ib12
/ 919.707.9200

NPDES Stormwater Permit Name/Ownership Change
Page 2 of 2
III. PERMIT AND FACILITY CONTACT INFORMATION
8. New permit contact's name and title: AOphiey. l'Tf
npgEgZ
(Permit Contact)
I (Title)
9. Mailing address: (9101 r,4i-e-S✓it.cE-BC-vo City:.�urf3t/+2Y
State: 1k Zip Code:�1[20/4? Phone: (704- ) 6745"" g6277
E-mail address: ��-�-}� 17oP>'E�G TE/ /2' .
10. New facility contact's name and title: )04Cy E 12 t4
(Facility Contact)
r N/mrntt cit-
(Title)
11. Mailing address: Ca74'l rc s✓IC.l E'Et-VP City: c3RL/.53(J
State: t 6- Zip Code: 2e141 Phone: (704 )L04sr'4-a-SO
E-mail address: Ji, ->✓J. -c--pir[ct e- TFi,27it-! urogOTf /E•Cow/
4
12. New billing contact's name: cc/pc/WI-5 413t,E
(Billing Contact) 1
13. Mailing address: 2.55-NFy R06-12 City: ) v5zn1 1—ILLs
State: Yi. ' Zip Code: 4-ca 7lx - Phone: (248 )23- 7860, O?r I-
E-mail address: , T o(t GTs 4-vTonic-av .cc/1
IV. FACILITY ACTIVITIES AND DISCHARGE INFORMATION
1. Will industrial activities at the facility remain the same as under the previous owner?
Yes l No ❑
2. Will the stormwater discharge location(s) remain the same? YesX] No ❑
NOTE: If either of these questions is answered"No,"then more information is needed to review
the request. Please attach documentation to describe and explain the changes to the facility
activities, storm water discharges, and/or outfall location. Depending on the information
provided, the Division may require that the new owner file a new permit application.
Last Revised 3/13/2022

NPDES Stormwater Permit Name/Ownership Change
Page 2 of 2
THIS APPLICATION PACKAGE WILL NOT BE ACCEPTED BY THE DIVISION UNLESS
ALL OF THE ITEMS LISTED BELOW ARE INCLUDED.
REQUIRED ITEMS:
1. This completed application form (with original signature)
2. Legal documentation of transfer of ownership(such as relevant pages of a deed or a bill of sale) is
required for an ownership change request. Articles of incorporation are not sufficient for an
ownership change but can be provided for a name change.
3. Information to document facility,industrial activities, stormwater discharges, or outfall changes
as noted in item IV above (if appropriate)
Why is this information needed?
Regulations in 40 CFR§122.63 allow for minor modifications to NPDES permits for a change of
ownership or operational control of a facility, provided that information supports that no other change
in the permit are necessary.
Why does this form need to be mailed in?
Permittees and applicants must fulfill signatory requirements in the NPDES federal
regulations in 40 CFR §122.22 (please see those regulations for guidance). Until NCDEQ's
electronic submission process meets Cross-Media Electronic Reporting (CROMERR)
requirements, this original signed (not digital signature) form must be mailed to the
address below. The uploaded copy is stored as part of the permit record in the Division's
digital repository.
Applicant's Certification:
I,-1 -Acy- ec P (z? , attest that the application for a name and/or ownership
change submitted 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, or if all
required supporting information is not included, this application package will be considered
incomplete and may be returned.
Signature: L5Ln - Date: . 1D-(.0I
)t-D
THE COMPLETED APP (CATION AND ALL SUPPORTING INFORMATION SHOULD BE SENT TO:
DEMLR Stormwater Program
512 North Salisbury Street, 6th Floor (Office 640K)
1612 Mail Service Center
Raleigh, NC 27699-1612
Last Revised 3/13/2022