The URL can be used to link to this page

Home My WebLink AboutNCG080874_Permit Contact Update Request_20240227 Action History (UTC-05:00)Eastern Time(US&Canada) Submit by Anonymous User 2/27/2024 1:25:16 PM (Permit Contact Update Request) Approve by Joyce Sanford 4/9/2024 3:56:00 PM (Contact Update Review) • The task was assigned to DEMLR SW Admin General.The due date is:April 9,2024 5:00 PM 2/27/2024 1:25:22 PM • The task was assigned to Joyce Sanford by round robin distribution 2/27/2024 1:25:23 PM DEQIwo NPDES Stormwater -Request Request Submitted NPDES Permit Enter your NPDES stormwater permit number or Certificate of Coverage(COC)number. Number* NCG080874 Begins with NCS,NCG,or NCGNE(no exposure) Facility Name* Raleigh Transit Operations Facility (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 Owner Affiliation (Legally Responsible Individual) Change Upload a copy of the completed and signed Permit Owner Affiliation Designation Form below.We can begin making updates with this submittal, but please note that you must mail in the original signed copy to our office,in accordance with requirements in 40 CFR 122.22. Staff may contact you to confirm the requested change if this Owner is also associated with other permits in our system. Changes to Owner Affiliation affect all permits tied to that Owner. Owner Affiliation Please upload the signed"Permit Owner Affiliation Designation Form" Change Form Upload Permit Owner Affiliation name change form.pdf 648.7KB pdf only Permit Contact Update Provide new permit contact information This person should REPLACE the current permit contact. This person should just be added as another permit contact. New Contact Name* First and Last Name Bill Wagner E-mail Address* bill.wagner@goraleigh.org Phone No.* 919-996-3899 Mailing Address* 4104 Poole Rd Raleigh NC 27610-2927 Physical Address If different than mailing address 806 Bus Way Raleigh NC 27610 Add another permit contact if needed by clicking the'Add'button below Stormwater Program's Billing Specialist will be notified about the billing update request by email upon approval. Billing Contact Update Provide new billing contact information .......... ........ Note:This person will REPLACE the current billing contact.We can only designate one billing contact in our permitting database. New Contact Name* First and Last Name Bill Wagner E-mail Address* bill.wagner@goraleigh.org Phone No.* 919-996-3899 Mailing Address* 4104 Poole Rd Raleigh NC 27610-2927 Physical Address If different than mailing address 806 Bus Way Raleigh NC 27610 Facility Contact Update Provide new facility contact information ........................................................................................................ 7 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 Bill Wagner E-mail Address* bill.wagner@goraleigh.org Phone No.* 919-996-3899 Mailing Address* 4104 Poole Rd Raleigh NC 27610-2927 Physical Address If different than mailing address 806 Bus Way Raleigh NC 27610 ................................................................................................................................................ Add another facility contact if needed by clicking the'Add'button below Submitter's Name* Please enter your FIRST and LAST name JIM FREI Phone Number* Please enter your phone number 9196619954 Any format is fine. Email Address* Please enter a valid e-mail address jdfrei@stormwatergroup.com 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 iIY�t"V Date 2/27/2024 Questions? Contact bethany.georgoulias@deq.nc.gov. Review Verify Permit No.* Revise permit number below if incorrect. NCG080874