HomeMy WebLinkAboutNCG060428_Name-Owner Change Application_20230706 STZI
1- t -I �y, NC DEPARTMENT OF ENVIRONMENTAL QUALITY
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"• � ` ' N DIVISION OF Energy, Mineral, and Land Resources
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,;•, .,,•.;=° STORMWATER PROGRAM
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NORTH CAROLINA
Environmental Quality
NPDES STORMWATER PERMIT NAME/OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION:
Permit Number: NCS / / / /_/_ or NCG °/ 6/ 0/ `// 2 / 8
1. Facility Name(prior to change): f 'EsT/h2 e.4Ams eh%) s- /$96 1+/r!}iii G7y
II. NEW OWNER/NAME INFORMATION:
2. This request for a name change is a result of:
Ixa. Change in ownership of property/company
b. Name change only(Facility and/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):
Urz Otim,try fob , I-L-
4. New owner's or signing official's name and title:
(Pers le r ponsible for permit)�v
--54 D/gEirDP-- &Z v,Rn v tE my'iL ioi.4PZ-tA,Ncc-
(Title)
5. Mailing address: I0D pilot City: /4--, No vt'�'�
State: PA- Zip Code: I7 331 Phone: ( 1 11 ) 96 2- 3064
E-mail address: 1 i+Hej LttZ_.SA,.cfS, CL of.
6. New facility name(if applicable): _ kt06S •N/bunir c-u) �'c-lt-IT7
7. Effective date of transfer or name change: 1j J2..8 /2_b22__-
- North Carolina Department of Environmental Quality I Division of Energy,Mineral and Land Resources
A) 512 North Salisbury Street 11612 Mall Service Center I Raleigh,North Carolina 27699-1612
NORTH CAROLINA
a.n.,u01wa .ru.m� /'� 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: 4-1/, 0 Li ME
(Permit Contact)
See. ��2Et7v& ENS. Ca
(Title)
9. Mailing address: L OD 1fI K S7 City: /IANaV
State: P1" Zip Code: 17 33( Phone: ( l 1 ) I8 2---.30 ,C
E-mail address: k I f u'fZShcte_k-S COvv.
10. New facility contact's name and title: Rpm-A) d A'I.4-
(Facility Contact)
(Title)
J/
11. Mailing address: Z37 11—/.�+� t� �,�-�-- City: k A) c h\-) -
State:At— Zip Code: 28°86 Phone: ( 624) - 7/5Z
E-mail address:_ �£(0.`�` t+ZS 1 -re
12. New billing contact's name: 2,A-A) GA iA-
(Billing Contact)
13. Mailing address: SAME A8 ' City:
State: Zip Code: _ Phone: ( )
E-mail address:
IV. FACILITY ACTIVITIES AND DISCHARGE INFORMATION
1. Will industrial activities at the facility remain the same as under the previous owner?
Yes% No ❑
2. Will the stormwater discharge location(s) remain the same? Yes t "No 0
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,stormwater 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:
Vr:.„1. This completed application form (with original signature)
V 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, 14-0N L. , 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: Date: 7023
THE COMPLETE APPLICATION 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
BK 1871 PG 1889 - 1892 (4) DOC# 200072141
This Document eRecorded: 04/29/2022 12:24:25 PM
Fee: $26.00 Tax: $40,963.00
Cleveland County, North Carolina
Betsy S. Harnage, Register of Deeds
Form of Special Warranty Deed
Excise Tax: $40,963.00 _
Parcel Identifier No. 63181 & 63180 Verified by Cleveland County on the day
of , 2022
By: , . .
Mail/Box to: Utz Quality Foods, LLC
900 High Street
Hanover, PA 17331
This instrument was prepared by: Matthew Weinstein, Esquire,Cozen O'Connor,One
Liberty Place, Suite 2800,
1650 Market Street, Philadelphia, PA 19103
Brief description for the Index: 237 Industrial Drive, Kings Mountain,North Carolina
THIS DEED made this 286 day of April,2022, by and between
GRANTOR GRANTEE
CHIPPY ACQUISITION, LLC, a Delaware . UTZ QUALITY FOODS, LLC, a
limited liability company Delaware limited liability company
do Highlander Partners, LP 900 High Street
300 Crescent Drive, Suite 550 Hanover, Pennsylvania 17331
Dallas,TX 75201
The designation Grantor and Grantee as used herein shall include said parties, their heirs,
successors,and assigns, and shall include singular,plural, masculine, feminine or neuter as
required by context.
WITNESSETH,that the Grantor. for valuable consideration paid by the Grantee, the
receipt of which is hereby acknowledged, has and by these presents does grant, bargain. sell and
convey unto the Grantee in fee simple.all that certain lot or parcel of land situated in Kings
Mountain, Cleveland County,North Carolina and more particularly described as follows:
See Exhibit"A" attached hereto and made a part hereof.
The property hereinabove described was acquired by Chippy Acquisition,LLC,a
Delaware limited liability company by virtue of Special Warranty Deed from GCP-Woodlake
Land, LLC, a Delaware limited liability company, by instrument dated November 4,2020,
submitted electronically by "First American Title Insurance Company - NCS Philadelphia"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Cleveland County Register of Deeds.
BK 1871 PG 1890 DOC# 200072141
recorded in Cleveland County Register of Deeds, in Book 1825, Page 1670,on November 4,
2020.
TO HAVE AND TO HOLD the aforesaid lot or parcel of land above described together
with all and singular the rights, privileges, tenements,appurtenances,and improvements thereto
belonging to the Grantee, its heirs and assigns forever, in fee simple.
And the Grantor covenants with the Grantee,that Grantor has done nothing to impair
such title as Grantor received, and Grantor will warrant and defend the title against the lawful
claims of all persons claiming by, under or through Grantor, other than the following exceptions:
current taxes and assessments not yet due and payable from the date hereof and subsequent
years, and all covenants, conditions, restrictions, reservations, easements and declarations or
other matters of record,to the extent valid and enforceable and still applicable to the above
described premises.
[Signature Page Follows]
BK 1871 PG 1891 DOC# 200072141
IN WITNESS WHEREOF, the Grantor has duly executed the foregoing as of the day and
year first above written.
CHIPPY ACQUISITION, LLC,a
Delaware limited liability company
By: G�
Name: ct,riatt,her•acporIs
Title: Vice President,General Counsel&Secretary
State of T PAS (Official/Notarial Seal)
County of n09 Uci
I certify that the following person personally 4Y'1 , ISABELLA TOWNSEND GODSEY
appeared before me this day, acknowledging to the =• Notary Public,State o1 Texas
:
•
that he signed the foregoing instrument: ;�a•..,+r°.•' Comm.Expires 02-14-2026 i
r� Vl Notary ID /335871/4
Uu4 b� 2�' / f bvt?� , the of
CHIPPY ACQUISITION, LLC, Delaware
limited liability company
Date: Pi'i:rt 2 f 2022
( I
Notary Public
Notary's Printed or T ped Name:
T ibtlaT• G y
My Commission Ex ires: 2/14 •
5
LEGAL°56683055 9
BK 1871 PG 1892 DOC# 200072141
EXHIBIT A
Legal Description
TRACT I
ALL THAT CERTAIN PIECE, PARCEL, OR TRACT OF LAND SITUATE, LYING, AND
BEING LOCATED IN CLEVELAND COUNTY, STATE OF NORTH CAROLINA,
CONTAINING 5.648 ACRES, AS SHOWN ON A PLAT ENTITLED "ALTA!ACSM LAND
TITLE SURVEY FOR RT KINGS MOUNTAIN I, LLC" DATED OCTOBER 26, 2007,
PREPARED BY R. SCOTT BARRETT, PLS, NC REGISTRATION NO. L-4513 AND
ACCORDING TO SAID PLAT BEING MORE PARTICULARLY DESCRIBED AS
FOLLOWS:
BEGINNING AT AN IRON PIN SET 1!2" REBAR LOCATED ON THE SOUTHEASTERN
RIGHT-OF-WAY OF QUALITY LANE AT THE COMMON CORNER OF LANDS OWNED
NOW OR FORMERLY BY KINGS MOUNTAIN ASSOCIATES, DESIGNATED AS
CLEVELAND COUNTY TAX PARCEL IDENTIFICATION NO. 46053,THENCE
RUNNING ALONG THE COMMON LINE OF SAID KINGS MOUNTAIN ASSOCIATES
PROPERTY, SOUTH 4147'45" EAST 983.61 FEET TO AN IRON PIN SET 1.!2" REBAR,
THENCE ALONG A NEW LINE, RUNNING THROUGH LANDS OWNED NOW OR
FORMERLY BY KINGS MOUNTAIN ASSOCIATES, DESIGNATED AS CLEVELAND
COUNTY TAX PARCEL NO. 46053, SOUTH 48'27'34" WEST 250.00 FEET TO AN IRON
PIN SET 112" REBAR, THENCE NORTH 41°47'44" WEST 984.61 FEET TO AN IRON PIN
SET 112" REBAR, LOCATED ON THE SOUTHEASTERN RIGHT-OF-WAY OF QUALITY
LANE,THENCE RUNNING ALONG THE SOUTHEASTERN RIGHT-OF-WAY OF
QUALITY LANE NORTH 48°41'23" EAST 250.00 FEET TO THE POINT OF BEGINNING.
TRACT II
ALL THAT CERTAIN PIECE, PARCEL OR TRACT OF LAND LYING, SITUATE AND
BEING IN THE STATE OF NORTH CAROLINA,COUNTY OF CLEVELAND, BEING
SHOWN AND DESIGNATED AS TRACT 3 CONTAINING 14.779 ACRES, MORE OR
LESS,ON A PLAT ENTITLED "RECOMBINATION& MINOR SUBDIVISION PLAT
PREPARED FOR KINGS MOUNTAIN ASSOCIATES, LLC", PREPARED BY R. SCOTT
BARRETT, PLS, DATED JANUARY 5, 2015 AND RECORDED JANUARY 20, 2016 IN
BOOK 38 AT PAGE 132 IN THE OFFICE OF THE REGISTER OF DEEDS FOR
CLEVELAND COUNTY. FOR A MORE COMPLETE AND PARTICIPATE DESCRIPTION,
REFERENCE IS HEREBY MADE TO THE AFORESAID PLAT