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HomeMy WebLinkAboutSW8931222_HISTORICAL FILE_20231031 STORMWATER DIVISION CODING SHEET POST-CONSTRUCTION PERMITS PERMIT NO. SW8 q3J2m� DOC TYPE ❑ CURRENT PERMIT ❑ APPROVED PLANS HISTORICAL FILE ❑ COMPLIANCE EVALUATION INSPECTION DOC DATE a 3 /0 3 YYYYMMDD Katherine is out of the office this week, please let me know if you have any questions or need anything further related to this application form. Thank you, Wendy Widener Senior Manager, Stormwater Compliance wendy.widener@walmart.com Cell: 479.256.0156 702 SW 8t'Street Bentonville, AR 72716-0505 Mailstop: 0505 Walmart:;:Global Ethics & Compliance For emergencies,please call the Emergency Operations Center(EOC)at(479) 277-1001 From: Inman, Logan W <logan.inman@dea.nc.goy> Sent:Thursday, September 14, 2023 9:26 AM To: Katherine Yarberry<KYarberry@walmart.com> Subject: EXT: Post Construction Stormwater Permit SW8 931222 EXTERNAL: Report suspicious emails to Email Abuse. Greetings, Attached is a pdf of the first request for additional information for the subject project. Please pay special attention to the due date in the letter,which is October 17th, 2023, and in accordance with 15A NCAC 02H. 1045(4)(a)(i). As noted in the letter, if all the requested information cannot be provided by this due date,the application will need to be returned in accordance with 15A NCAC 02H. 1045(4)(a)(ii)to allow for any additional time needed. Please let me know if you have any questions or concerns. Thank you! Logan Inman Stormwater Permitting Assistant Wilmington Regional Office Division of Energy, Mineral and Land Resources—Post Construction Stormwater Program North Carolina Department of Environmental Equality Office: (910)—796—7318 Email: logan.inman@deo.nc.gov 2 Inman, Logan W From: Inman, Logan W Sent: Tuesday, October 10, 2023 3:06 PM To: Wendy Widener Cc: Katherine Yarberry Subject: RE: tExternal] RE: Post Construction Stormwater Permit SW8 931222 Thank you for the electronic version of the application. Please ensure to mail us the hardcopy version of the application with original signatures to our address: 127 Cardinal Drive Ext., Wilmington, NC, 28405. Our office will notify you when application has been received and accepted and we will notify you if there is any further information required. Thank you! Note: Effective October 3'2023, permit fees have increased as a result of Session Law 2023-134. A full list of the fee adjustments are avaialble on the following DEQ website: Permit Fees 2023 Updates I NC DE Q The website and forms will be updated to reflect these new fees. Logan Inman Stormwater Permitting Assistant Wilmington Regional Office Division of Energy, Mineral and Land Resources—Post Construction Stormwater Program North Carolina Department of Environmental Equality Office: (910)—796—7318 Email: logan.inman@deq.nc.gov Address: 127 Cardinal Drive Ext., Wilmington, NC, 28405 N ;; CAROLINAQEQ�- De" enl of Enviranmemal Dlwliy Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed to third parties. From: Wendy Widener<Wendy.Widener@walmart.com> Sent:Tuesday, October 10, 2023 2:20 PM To: Inman, Logan W <logan.inman@deq.nc.gov> Cc: Katherine Yarberry<KYarberry@walmart.com> Subject: [External] RE: Post Construction Stormwater Permit SW8 931222 CAUTION: EMernal email. Do not click links or open attachments unless verified. Report suspicious emails with the Report Message button located on your Outlook menu bar on the Home tab. Logan, Good afternoon. Please find attached the signed permit renewal application for "Post Construction Stormwater Permit SW8 931222". 1 ROY COOPER Governor ELIZABETH S.BISER y Qau n* Secretary WILLIAM E.TOBY VINSON,JR NORTH CAROLINA lntertm Dtrectur fnrfronmerif it Qaaury September 14", 2023 Via email only: kyarberry(&walmart.eom Sam's East, Inc. Attn: Wendy Brant 702 SW 8' Street, Mailstop#0505 Bentonville, AR 72716 Subject: Request for Additional Information Stormwater Project No. SW8 8931222 Sams Club Jacksonville Store 6573-04 Onslow County Dear Wendy Brant: The Wilmington Regional Office received and accepted a State Stormwater Management Permit Renewal Application for the subject project on September 6", 2023. A preliminary in-depth review of that information has determined that the application is not complete, and that additional information is needed. To continue the review,please provide the following additional information in a single, hard copy submittal package: 1. 15A NCAC 02H.1040(1)(a) and 1045(3)(a)(ii): The application was signed by Wendy Brant; however, the provided documentation from the NC Secretary of State does not identify Wendy Brant as a principle executive officer of at least the level of vice-president of this corporation. In the case of a corporation, the application must be signed by a principal executive officer of at least the level of vice-president. Please either: a. Provide official documentation showing that Wendy Brant is a principle executive officer of at least the level of vice-president and authorized to sign for the corporation; b. Have one of the identified principle executive officers of the corporation sign the application documents; or c. The signature by other agents shall be accepted on the application only if accompanied by a letter of authorization signed by the appropriate authority. Provide a letter of authorization from one of the identified principle executive officers of this corporation authorizing Wendy Brant to sign on their behalf. Please remember to confirm that any revised information is presented consistently throughout the application documents. Please also remember to provide a hard copy of any updated documents per 15A NCAC 02H.1045(3). The requested information should be received in this Office by October 17", 2023, in accordance with 15A NCAC 02H.1045(4)(a)(i). Please note that only two letters requesting additional information is allowed in the State Stormwater Program, this being the first. If the required information is not satisfactorily provided by this date,the project will be returned in accordance with 15A NCAC 02H.1045(4)(a)(ii). If the project is returned and you wish to re-submit later,you will need to resubmit all required items at that time, including the application fee. Please reference the State assigned application number on all correspondence. If you have any questions concerning this matter, please feel free to call me at(910) 796-7215 or email me at logan.inman@deq.nc.gov. Sincerely, ,Llogcus JOCW a Logan Inman Stormwater Permitting Assistant �D_F North Carolina Department of Environmental Quality I Division of Energy.Mineral and Land Resources Wilmington Regional Office 1 127 Cardinal Drive Extension I Wilmington.North Carolina 28405 910.796.7215 State Stormwater Permit No. SW8 931222 Page 2 of 2 DES/lwi: %Stormwater\Pemiits R Projects\1993\931222 HD\20')3 09 addinfo 931222 cc: Wilmington Regional Office Stormwater File E�1 North Carolina Department of EnAronmental Quatlry I Mum of Energy,Mineral and Land Resourus Wilmington Regional Office 1 127 Cardinal Drive Extension I Wilmington North Carolina 28405 ^++ 910.7%.7215 DEMLR USE ONLY Date Received Fee Paid Permit Number NC DEQ Division of Energy, Mineral and Land Resources STATE STORMWATER- PERMIT RENEWAL APPLICATION FORM In accordance with 15A NCAC 2H.1045(3), the current permit holder shall renew their high density permit 160 days prior to its expiration. Renewed permits are valid for a period of 8 years per Session Law 2011-398(S8,781) Section 60.(c). This application form is for permit renewals only. A. PROJECT INFORMATION 1. State Stormwater Permit Number: SW8 931222 2. Project name: Sam's Club Jacksonville Store 6573-04 3. Project street address: 1170 Western Blvd City: Jacksonville County: Onslow Zip : 28546 4. What, if any, changes have been made to the project as permitted? None If the project has changed from the original approved,plans, please complete SWU-101 for a Major Modification or Minor Modification Application form.available ah,htti)s:/Idea nc.goy/about divisi6ns/energy- mi neral-la nd-resources)eneray-mineral-land-rules%stormwater=Droora mloost-construction: B. PERMITTEE INFORMATION', If changes to the permittee or project name have been made, please complete either the Permit Update form or the Permit Transfer form available at.https� deg nadov/about/diyisions/energy-mineral-land- resources/energy-mineral-land-ful6s/stormwater-program/post-construction. State Stormwater Permits do not automatically transfer with the sale of the property. 1. C.Urrenl,Permlt Holder's Company Name/Organization: Sam's East, Inc. 2. Signing Official's Name: Emma Waddell 3. Signing Official's Title: Senior VP,'Walmart U.S. and Sam's Club Compliance 4. Mailing.Address: 702 SW 8thStreet, Mailstop#0505 City: Bentonville State: AR Zip : 72716 5, Street Address: 702 SW 8th Street City. Bentonville State: AR ZIP : 72716 6. Phone: ( 479 ) 430-1103 Email: kyarberrv(rDwalmart cam Stormwater Permit Renewal Form Page 1 of 3 May 11,2018 C. SUBMITTAL REQUIREMENTS Submit the application package to the appropriate DEMLR Regional Office(Coastal, SA Waters)orDEMLR Central Office (Urbanizing Areas Ph 2, USMP, Non-Coastal HQW/ORW). Only applications packages that include all required items listed below will be accepted and reviewed. Initial each item below to indicate that the required information is provided in the application package: X 1. A permit application processing fee of$505.00 payable to NCDEQ. X 2. One original signed hard copy and one electronic copy of this completed form. The signing official named on this application to represent the current permittee must meet one.of the following: a. Corporation-a principle executive officer of at least the level of vice-president; b. Limited Liability Company(LLC)-a manager or company official as those terms are defined in G.S. 57D"North Carolina Limited Liability Company Act;" c. Public Entity-a principal executive officer, ranking official, or other duly authorized employee; d. Partnership or limited partnership-the general partner; e. Sole proprietor;or f. Letter of authorization signed by one of the signatories noted in a-e above authorizing the signature of another entity. N/A 3. One hard copy and one electronic copy of recorded documents required by the original permit that have not yet been received byDEMLR, including: deed restrictions, protective covenants, condominium/planned community declaration and easements. If the project has been built,include documentation that the maximum BUA per lot or maximum total BUA has not been exceeded. If the project has not been built, include a signed agreement that the final recorded deed restrictions and protective covenants will be.submitted at a later date. X 4. O&M Agreements, Please select one: ❑ 1'have a copy of the current recorded O&M Agreement for all SCMs, and I will continue to keep this on file with the permit;or ❑ I'do not have a copy of the current recorded O&M Agreement for all SCMs and am requesting a copy be sent to me. I agree to keep this on file with the permit. X 5. Designer Certifications;Please select one: ❑ A copy of the certification(s)confirming that the project was built in accordance with the approved plans have been previously provided'to the Division;or ❑ A copy of the certification(s)confirming that the project was built in accordance with the approved plans are enclosed; or ❑ The project has not yet been built. X 6. [IF APPLICABLE] If the project has been built, one original hard copy and one electronic copy of,a signed, sealed, and dated letter from a licensed professional stating lhat.the SCMs have been inspected,and that they have been built and maintained in accordance with the permit. X 7. [IF APPLICABLE]When the permittee is a corporation or a limited liability corporation(LLC): Provide one:hard copy and one electronic copy of documentation from the NC Secretary of State, or other official documentation,which supports the titles and positions held by the persons listed in Section C.2 per 15A NCAC:2H. 1043(3)(b). https://www SOS nc gov/online services/search/bv title/ Business, Registration Stormwater Permit Renewal Application Form Page 2 of 3 May 11.2018 D. PERMITTEE'S CERTIFICATION, Emma Waddell the person legally responsible for the permit, certify that I have a copy of The Permit and O&M Agreement on site(or I will obtain a copy and it will be kept on site), that I am responsible for the performance of the maintenance procedures, and the site has been and will be maintained according to the O&M Agreement and approved plans. I agree to notify DEMLR of any problems with the SCMs or built-upon area and to submit the proper forms to modify or transfer the permit prior to any changes to the project, SCMs, or ownership:—Atli ormation provided on this permit renewal application is, to the best of my knowledge,coM ate. Signature: Date: OC TOSER C)2 5 NOTARIZA�TI pON: 1 ( ,64'a � n a Notary Public for the State of �Kani;d� II--`` �ll __ ,County of &11 1 )� , do hereby certify that CIY1lYlA lf. "Ac\t personally appeared before me this the 9 day of, cx�.��l 20_2r_�, and acknowledge the due executlpA r4AM¢Slstrumeq.Witness my hand and official seal, BENTON COUNTY NOTARY PUBLIC'—ARKANSAS i I tv"bn n%zWh Expires Nov.15,20231 1 Commission No.11239 580 Notary Signature. P�jtl fd-WD My commission expires Stormwater Permit Renewal Application Form Page 3 of 3 May 11,2018 10M/23, 1:35 PM North Carolina Secretary,of State Search Results • File an Annual Report/Amend an Annual Report • Upload a PDF Filing • Order a Document Online Add Entity to My Email Notification List• View Filings • Print a Pre-Populated Annual Report form • Print an Amended a Annual Report form Business Corporation Legal Name SAM'S EAST, INC. Information Sosld: 0407286 Status: Current-Active O Date Formed: 10/8/2010 Citizenship: Foreign State of Incorporation: AR Fiscal Month: January Annual Report Due Date: May 15th CurrentAnnual Report Status: Registered Agent: CT Corporation System Addresses https:/tv .sosnc.gav/online services/search/Business_Registm ion Results 112 10/4/23,1:35 PM North Carolina Secretary of State Search.Results Reg Office Reg Mailing Mailing 160 Mine Lake Ct Ste 200 160 Mine Lake Ct Ste.200 702 SW 8th Street Raleigh, NC 27615-6417 Raleigh, NC 27615-6417 Bentonville, AR 72716 Principal Office 702 SW 8th Street Bentonville, AR 72716 Officers Vice President Assistant Treasurer Senior Vice President Secretary Matthew Allen Matthew Allen Gordon Y Allison Gordon Y. Allison 702 SW 8th Street 702 SW 8th Street 702 SW 8th Street 702 SW 8th Street Bentonville AR. 72716 Bentonville AR 72716 Bentonville AR 72716 Bentonville AR 72716 Senior Vice President Assistant Treasurer Assistant Secretary Assistant Secretary Mike Cook Mike Cook Geoffrey Edwards Sarah Little 702 SW 8th St. 702 SW 8th St. 702 SW 8th Street 702 SW 8th Street Bentonville AR 72716 Bentonville AR 72716 Bentonville AR 72716 Bentonville AR 72716 President Vice President Vice President Senior Vice President Kathryn McLay Jessica Rancher Emma Waddell Emma Waddell 702 SW 8th St. 702 SW 8th Street 702 SW 8th Street (702 SW 8th:Street Bentonville AR 72716 Bentonville AR 72716 Bentonville AR 72716 Bentonville AR 72716 Stock https:/hw .sosnc.gov/online_services/search/Business_Registration—Results 2/2 Inman, Logan W From: Inman, Logan W Sent: Tuesday, October 24, 2023 9:18 AM To: Wendy Widener Cc: Katherine Yarberry Subject: RE: [External] RE: Post Construction Stormwater Permit SW8 931222 Greetings, I was reaching back out to see if I could get an update on the status of corrected, physical application with original signatures? Has the package been mailed yet? I will be logging this email correspondence as the second request for additional information. Please note that only two letters requesting additional information is allowed in the State Stormwater Program, this being the second. Please understand the due date of this second request is November 24', 2023, and in accordance with 15A NCAC 02H. 1045(4)(a)(i). Thank you! Note: Effective October 3rtl 2023, permit fees have increased as a result of Session Law 2023-134. A full list of the fee adjustments are ovoialble on the following DEQ website: Permit Fees 2023 Updates I NC DE Q The website and forms will be updated to reflect these new fees. Logan Inman Stormwater Permitting Assistant Wilmington Regional Office Division of Energy, Mineral and Land Resources—Post Construction Stormwater Program North Carolina Department of Environmental Equality Office: (910)—796—7318 Email: logan.inman@deg.nc.gov Address: 127 Cardinal Drive Ext., Wilmington, NC, 28405 No;;r CAaourinME Qe�of EnWmnnce JQuad Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed to third parties. From: Wendy Widener<Wendy.Widener@walmart.com> Sent: Monday, October 16, 2023 11:48 AM To: Inman, Logan W <logan.inman@deq.nc.gov> Cc: Katherine Yarberry<KYarberry@walmart.com> Subject: RE: [External] RE: Post Construction Stormwater Permit SW8 931222 CAUTION: External email.Do not click links or open attachments unless verified.Report suspicious emails with the Report Message button located on your Outlook menu bar on the Home tab. t 10/4/23, 1:35 PM North Carolina Secretary of State Search Results Reg Office Reg Mailing Mailing 160 Mine Lake Ct Ste 200 160 Mine Lake Ct Ste 200 702 SW 8th Street Raleigh, NC 27615-6417 Raleigh, NC 27615-6417 Bentonville, AR 72716 Principal Office 702 SW 8th Street Bentonville, AR 72716 Officers Vice President Assistant Treasurer Senior Vice President Secretary Matthew Allen Matthew Allen Gordon Y. Allison Gordon Y Allison 702 SW 8th Street 702 SW 8th Street 702 SW 8th Street 702 SW 8th Street Bentonville AR 72716 Bentonville AR 72716 Bentonville AR 72716 Bentonville AR 72716 Senior Vice President Assistant Treasurer Assistant Secretary Assistant Secretary Mike Cook Mike Cook Geoffrey Edwards Sarah Little 702 SW 8th St. 702 SW 8th St. 702 SW 8th Street 702 SW 8th Street Bentonville AR 72716 Bentonville AR 72716 Bentonville AR 72716 Bentonville AR 72716 President Vice President Vice President Senior Vice President Kathryn McLay Jessica Rancher Emma Waddell (Emma _Waddell 702 SW 8th St. 702 SW 8th Street 702 SW 8th Street (702 SW 8th Street), Bentonville AR 72716 Bentonville AR 72716 Bentonville AR 72716 /Bentonville AR 72716j Stock https:/AM .sosne.gov/online—services/search/Business_Registration_Results 2/2 1014/23, 1:35 PM North Carolina Secretary of State Search Results • File an Annual Report/Amend an Annual Report • Upload a PDF Filing • Order a Document Online Add Entity to My Email Notification List • View Filings • Print a Pre-Populated Annual Report form • Print an Amended a Annual Report form Business Corporation Legal Name SAM'S EAST, INC. Information Sosld: 0407286 Status: Current-Active O Date Formed: 10/8/2010 Citizenship: Foreign State of Incorporation: AR Fiscal Month: January Annual Report Due Date: May 15th Currentgnnual. Report Status: Registered Agent: CT Corporation System Addresses https:/ti .sosnc.gov/online_services/search/Business_Registration_Results 1/2 Burd, Tina J From: Burd, Tina J Sent: Tuesday, September 12, 2023 3:16 PM To: kyarberry@walmart.com Cc: Inman, Logan W Subject: FW: SW8 931222 - Sams Club Jacksonville Store 6573-04 I apologize, the acceptance date is actually September 6, 2023 and not August 28, 2023 From: Burd,Tina 1 Sent:Tuesday, September 12, 2023 3:06 PM To: kyarberry@walmart.com Cc: Inman, Logan W <logan.inman@deq.nc.gov> Subject: SW8 931222 - Sams Club Jacksonville Store 6573-04 The Wilmington Regional Office of the Division of Energy, Mineral and Land Resources (Stormwater Section) accepted the Stormwater Permit Renewal Application and $505.00 fee for the subject project on August 28, 2023. The project has been assigned to Logan Inman and you will be notified if additional information is needed. If you have any questions about the project or status of the review, please contact Logan Inman (cc'd). Best Regards, Tina Burd Administrative Associate II 910-796-7215 New email: t na_kurd_L@deqf.nc. ov NCDEQ Wilmington Regional Office 127 Cardinal Drive Ext. Wilmington, NC 28405 R qua. _ ;;Jn!.,w1';v.sJ°➢t? ,. . . 'a r.�k'_ ..1. ,dt Sl,,r'Rl(�P Website: http:/fdA—n—c. ov/about/divisions/cnerpy-mineral-land-resourceslstormwater Many employee's are working remotely er are on staggered shifts. Please check with the appropriate staff be{ore Visiting our offices, as thev ntay be able to handle your requests by phone or +.mail. 1 it Burd, Tina J From: Burd, Tina J Sent: Tuesday, September 12, 2023 3:06 PM To: kyarberry@walmart.com Cc: Inman, Logan W Subject: SW8 931222 - Sams Club Jacksonville Store 6573-04 The Wilmington Regional Office of the Division of Energy, Mineral and Land Resources (Stormwater Section) accepted the Stormwater Permit Renewal Application and $505.00 fee for the subject project on August 28, 2023. The project has been assigned to Logan Inman and you will be notified if additional information is needed. If you have any questions about the project or status of the review, please contact Logan Inman (cc'd). Best Regards, Tina Burd Administrative Associate II 910-796-7215 New email: tina.burd(adeq.nc.Pov NCDEQ Wilmington Regional Office 127 Cardinal Drive Ext. Wilmington, NC 28405 Cr—_— .„ �. n f ',j ai=1 U I .45 tz/f ti sf Ate`•^I b EhP Website, hup fldeq.nc.gov/about/divisions/energy-mineral-land-resourceslstormwater Many evtployees are working remotely or are on staggered shifts. Please checl: with the appropriate. stale bell ore visiting our off ices, as they may be able to handle y0u1' requests by phone or email. 1 ' n-T nsf p li lion Comp atepR Re ' Checklist Project Name: ( Date Delivered to WIRO: f Project County/Location: BIMS Received/Accepted Date: �p 'Y 7 Date Given to Admin: p . ��}., Permit Action: New New Permit N': RIMS Acknowledged Date': ' OZ3 Not located in the ETJ of the following delegated and functioning programs: NBC:Carolina Beach/Kure Beach/Wilmington/Wrightsville Beach Bruns: Leland/Navassa(?)/Oak Island Cart: Emerald Isle Onsl: Jacksonville Pend: Surf City Major Mod / Minor Mod / enewal Existing Permit#: (/\ pplicant&Permittee are the same?3 Ex ration Date°: 1 Permit Type: HD LD/LD Overall/HD&LD Combo General it/Offsite/Exempt + Redevelopment �Offsite to SW8: Development Type: ommelrc' Residential/Other �Is Offsite Lot approved in Master Permit?s Subdivided?: Subdivision or vsleTD Rule(s): 1:12017 Coastal 2008 Coastal �7.995 Coastal Phase 11 ersal 01988 Coastal PermitteglType&Documents Needed: o erty Owner(s) Purchaser Lessee E]HCA Developer V' le? Viable? QViable? QViable? QViable? d QPurchase Agmt Lease ElEfection Minutes f ark /�lacation ��//�-/� G: 5(within 6mo) Check#(s):6zW�--/ E]No Feeplement*( � ] newform orfor olderforms:1 original per SCM) FJO&M2 Soils Report(Infil or PP) Calculations(signed/sealed) Deed Restrictions,if subdivided' Project Narrative FlUSGS Map(or on file?) Subject to SA?: Y / N Subject to ORW?: Y / N Plans(2 Sets) NOTES: 'Enter RIMS Acknowledged Date on this Sheet 2For New Projects-Enter New Permit#on Supplements&Deed Restriction Templates. 3 If permittee is different,STOP.Needs to be transferred first.°If w/in 6 months and they are requesting a mod,STOP. Needs a renewal first. slf Lot not approved in master permit,STOP. Master permit needs mod. �( 1` EMAILED ENGINEER DATE: Comments: REVIEWER NAME: G:\\\Reference Library\Procedures\Checklists\Completeness Review Checklist_2021 09 08 V ' O� APEX ENGINEER'S INSPECTION CERTIFICATION FOR NORTH CAROLINA STATE STORMWATER RENEWAL NORTH CAROLINA DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES PERMIT NO.SW7980521 For Walmart#1300 New Bern 3105 MLK Jr. Blvd New Bern, NC 28563 1 HEREBY CERTIFY THAN AN INSPECTION OF THE ABOVE-REFERENCED SYSTEM WAS PERFORMED ON AUGUST 08. 2023. 1 HEREBY CERTIFY THAT ALL COMPONENTS OF THE SURFACE WATER MANAGEMENT SYSTEM FOR THE ABOVE-REFERENCED PROJECT ARE FUNCTIONING IN SUBSTANTIAL CONFORMANCE WITH THE PLANS AND SPECIFICATIONS LICENSED BY BROWARD COUNTY. I HEREBY AFFIX MY SEAL THIS 28t" DAY OF AUGUST 2023. \\\\\ uuCARppq�i SEAL 51869 % MICHP0\•```O• -6z3 - o z8— Engineer's Signature &Seal �� Date Steven M. Veil, P.E. nc P.E. No. 51869 ®® pp EI �H E SEP 0 6 2M BY:_------ sx SfA7p q, ROY COOPER � Govemor ELIZABETH S.B1SER 5ecretary DOUGLAS R.ANSEL NORTH CAROLINA interLm Director Environmental Quality April 19, 2023 Sam's East, Inc. Attn: Kathryn McLay, President 702 SW 8` St. Bentonville, AR 72716 Subject: Stormwater Permit Renewal Request Post-Construction Stormwater Management Permit No. SW8 931222 Sams Club Jacksonville Store 6573-04 Onslow,County Dear Ms. McLay: Post-Construction Stormwater Management Permit SW8 931222 for the subject project expired on 12/5/2022. This is a reminder that permit renewal applications are due 180 days prior to their expiration per 15A NCAC 2H.1045(3).North Carolina General Statutes and the Coastal Stornwater rules require that this property be covered under a stormwater permit. Failure to maintain a permit subjects the owner to assessment of civil penalties. More information about the Post-Construction State Stormwater Program can be found on the following website: deo.nc.gov/SW Please submit a complete permit renewal form along with a$505.00 fee and other submittal requirements within 30 days.The permit renewal form can be found under the Post-Construction section of this website or at: https•//deq nc Gov/about/divisions/enerav-rnineral-and-land-resources/stormwater/stonmwater-program/post- construction-2. If you have any questions regarding this matter,please contact Ashley Smith or Aisia Freeman in the Wilmington Regional Office either via email (ashleymsmithp..ncdenngov or aisia.freeman@ncdenngov)or phone at(910) 796-7215. Sincerely, �Q 5�;Douglas R. 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'fig g� ;� �� � G,t,P ♦ ;JA . KSONVILI V �' \ s � i3 � ♦ l F� general information Acres 13.87 Property Description WESTERN BLVD EXT Physical Address 1170 WESTERN BLVD Subdivision BRYAN R A FOUNDATION INC Neighborhood Code 2279 City Limit JACKSONVILLE Plat Book&Page 30-076 NC PIN 438817104286 Township JACKSONVILLE Improvement Code C Building Value $6,299,160.00 Land Value $4,062,640.00 Assessed Value $10,361,800.00 Total Taxed Value $10,361,800.00 Heated Square Feet Year Built Number of Bedrooms Last Sale Date Price Book Page 09-JUL-02 $0.00 1868 715 Onslow County WARNING:THIS IS NOT A SURVEY. Geographical Information This map is prepared for the inventory of real property found within this jurisdiction,and is ` Services-GIS compiled from recorded deeds, plats,and other public records and data.Users of this map are 234 NW Corridor Blvd hereby notified that the aforementioned public primary information sources should be consulted Jacksonville, NC 28540 for verification of the information contained on this map.The County and mapping company assume no legal responsibility for the information contained on this map. tog, 86811al15 I ZM? JUL -9 M 3 17 O Prepared by and Please Return to: - Romona West 2001 S.E.1i Street Dept 9391 Bentonville,AR 72716-0550 Transfer Tax Exempt Pursuant to N.C.Code§93-186-105-288.29 i Transfer for No Consideration I i WARRANTYDEED WARRANTY DEED made the 31'day o1 October, 1996, between WAL-MART STORES, INC.,a corporation organized and existing under the laws of the state of Delaware,with offices in the county of Benton, State of Arkansas,and a mailing address of 702 S.W. r Street Bentonville,Arkansas 72716 (hereinafter referred to as-Grantor"),and SAWS REAL ESTATE BUSINESS TRUST,a business trust organized and existing under the laws of the State of Delaware,with offices in the county of Benton,State of Arkansas, and a mailing address of 702 S.W. I th Street Bentonville,Arkansas 72716 (hereinafter referred to as-Grantee-), WITH ES SETH: That Grantor,for and in consideration of the sum of Ten and no/100 dollars($10.00)and other good and o I valuable consideration,to it in hand paid by Grantee,the receipt whereof is hereby acknowledged,does hereby forever bargain,sell,convey and confirm to Grantee,and its successors and assigns,a certain bad of land containing 13.87 acres,more or less, situated.lying,and being in the CM of Jacksonville, County of Onslow,State of North Carolina,as more particularly dexrlbed on Exhibit A attached hereto and made a part heroot, TO HAVE AND TO HOLD said land unto Grantee,and its successors and assigns,forever,with all, - tenements appurtenances and hereddaments thereunto belonging. - And said Grantor does hereby warrant the 80e to said land,and will defend the same against the lawful claims of all persons claiming under Grantor, but none other, subject to the easements, encumbrances,and restrictions that exist of record. _ IN WITNESS WHEREOF,the Grantor has caused this instrument to be executed in its name by its Director,,:Wal-Mart Realty and caused its corporate seal attested by its Assistant Secretary to be hereto efFueE.' .,�..., ;(COffPORbjTE,SEAL) WALIAH ST ES,INC. P( I. Watkins Its: Director,Wal-Mart Realty o.. ,'S Misr, ® Ass tanl Secretary . STATE OF ARKANSAS ) COUNTY OF BE��N� /TONN � � ) I,A�,ry r-'y1-'ra, Notary Public for said County and State, certify that Latriece Watkins personally came before ma this day and acknowledged that she is Director, Wal-Mart Realty, a corporation, and that by authority duty given and as the act of the corporation the foregoing instrument was signed in its name by its Dinaccu.Wal-Man Really,Labiate Wall seated with its corporate seal, and attested by Romano West as its Assistant Secretary. Mff 716 Exhibit A / Club#6573,Jacksonville,NC Commencing at an existing N.C.G.S. monument entitled, "Econo" and having N.C. Grid Values of North 377,724.210 and Eastern values of 2,482,751.050; thence leaving the ,aid existing N.C.G.S. monument and running North 37 degrees 43 minutes 3o seconds West and having a Grid distance of 1161.08 feet located in the Northeastern right of way of NCSR 1470 (commonly known as Western Boulevard - 200 foot right of way) ; and running thence along the said Northeastern right of way of NCSR 1470 North 38 degrees 57 minutes 31 seconds West 1101.75 feet to an existing iron stake; thence North 38 degrees 57 minutes 47 seconds West 171.76 feet to a concrete monument, said concrete monument also being THE TRUE, POINT OF BEGINNING; thence from the described beginning and continuing along the said Northeastern right of way of NCSR 1470 North 38 degrees 57 minutes 47 seconds West 500,00 feet to a concrete monument; thence leaving the said Northeastern right of way of NCSR 1470 and running North 51 degrees 02 minutes 13 seconds East 234.00 feet to a concrete monument; thence North 38 degrees 57 minutes 47 seconds West 210.00 feet to a concrete monument; thence North 51 degrees 02 minutes 13 seconds East 680.88 feet to a concrete monument; thence South 38 degrees 57 minutes 47 seconds East 543.29 feet to a c concrete monument; thence South 67 degrees 03 minutes 22 seconds East 56.27 feet to a concrete monument; thence South 38 degrees 57 minutes 47 seconds East 117.07 feet to a concrete monument; thence South 51 degrees 02 minutes 13 seconds West 941.38 feet to the point and place of beginning. Containing 604,184.93 square feet/13.87 acres and being a portion of the property described in Deed Book 460, Page 630, of the Onslow County Registry. The courses contained herein are correct in angular relationship and is referenced to N.C. Grid North. As surveyed by John L. Pierce, R.L.S., L- 2596, on October 21, 1993. I _ 18 6 8 WE 7 17 t WITNESS my nand and official seal,thi day of June,2002. ^' Notary Public •NOTARV SEAL' r Laune G.Millef,Notary Public L. /D Benlon County,Staw o!Arkamas My commission expires 4W 15 .20h'. My COmmissien E*pups W15I2010 Mail Tax Statements To: Sam's Real Estate Business Trust Stare C 6573 702 S.W.60 Street Tax Dept 8013 Bentonville,AR 7271 t38013 Map and Parcel Numbers: 345103 3 r {tt � 44f � i - ROM cutOJwa.ona rase Laurie G Miller Nviul( )JLblic u Iw)vtif d u be i Th " uvmf f vu�W frt rtµu�uvv ud recand Iv �h's Mrt 'u L60tl e,s, 715 _d d 1„ly tl ZA et _M. s' l • File an Annual Report/Amend an Annual Report • Upload a PDF Filing • Order a Document Online Add Entity to My Email Notification List • View Filings • Print a Pre-Populated Annual Report form • Print an Amended a Annual Report form Business Corporation Legal Name SAM'S EAST, INC. Information Sosld: 0407286 Status: Current-Active O Date Formed: 10/8/2010 Citizenship: Foreign State of Incorporation: AR Fiscal Month: January Annual Report Due Date: May 15th Currentgnnual Report Status: Registered Agent: CT Corporation System Addresses Reg Office Reg Mailing Principal Office 160 Mine Lake Ct Ste 200 160 Mine Lake Ct Ste 200 702 SW 8th Street Raleigh, NC 27615-6417 Raleigh, NC 27615-6417 Bentonville, AR 72716 Mailing 708 SW 8th Street Bentonville, AR 72716 Officers Vice President Assistant Treasurer Senior Vice President Secretary Matthew Allen Matthew Allen Gordon Y. Allison Gordon Y. Allison 702 SW 8th Street 702 SW 8th Street 702 SW 8th Street 702 SW 8th Street Bentonville AR 72716 Bentonville AR 72716 Bentonville AR 72716 Bentonville AR 72716 Senior Vice President Assistant Treasurer Assistant Secretary Assistant Secretary Mike Cook Mike Cook Geoffrey Edwards Sarah Little 702 SW 8th St. 702 SW 8th St. 702 SW 8th Street 702 SW 8th Street Bentonville AR 72716 Bentonville AR 72716 Bentonville AR 72716 Bentonville AR 72716 President Vice President Vice President Kathryn McLay Jessica Rancher Emma Waddell 702 SW 8th St. 702 SW 8th Street 702 SW 8th Street Bentonville AR 72716 Bentonville AR 72716 Bentonville AR 72716 Stock • File an Annual Report/Amend an Annual Report • Upload a PDF Filing • Order a Document Online Add Entity to My Email Notification List • View Filings • Print a Pre-Populated Annual Report form • Print an Amended a Annual Report form Business Corporation Legal Name WALMART INC. Prev Legal Name Wal-Mart Stores, Inc. Information Sosld: 0157216 Status: Current-Active O Date Formed: 7/23/1982 Citizenship: Foreign State of Incorporation: DE Fiscal Month: January Annual Report Due Date: May 15th Currentgnnual Report Status: Registered Agent: CT Corporation System Addresses Reg Office Reg Mailing Mailing 160 Mine Lake Ct Ste 200 160 Mine Lake Ct Ste 200 708 SW 8th Street Raleigh, NC 27615-6417 Raleigh, NC 27615-6417 Bentonville, AR 72716 Principal Office 708 SW 8th Street Bentonville, AR 72716 Officers Assistant Treasurer Assistant Secretary Secretary Assistant Treasurer Matthew Allen Gordon Y. Allison Rachel Brand Michael Cook 702 SW 8th Street 702 SW 8th Street 702 SW 8th St. 702 SW 8th St. Bentonville AR 72716 Bentonville AR 72716 Bentonville AR 72716 Bentonville AR 72716 Assistant Secretary Assistant Secretary President Vice President Geoffrey Edwards Sarah Little Douglas c McMillon Jessica Rancher 702 SW 8th Street 702 SW 8th Street 702 SW 8th St. 702 SW 8th Street Bentonville AR 72716 Bentonville AR 72716 Bentonville AR 72716 Bentonville AR 72716 Vice President Emma Waddell 702 SW 8th Street Bentonville AR 72716 Stock Class: 99 SEE CERT Shares: 0 Par Value 0 a STNE c.N'0 ROY COOPER nI�z4 Y Governo, MICHAEL S.REGAN �v u sea emq- WILLIAM E.(TOBY)VINSON,JR. NORTH CAROLINA. interim Direcmr Environmental Quality December 10, 2018 Sam's Cast, Inc. AT'1'N: Mr. John Furner, President 708 SW 8" Street Bentonville, AR 72716 Subject: Permit Extension, Session Laws 2009-406 and 2010-177 Stormwater Management Permit HSW8 931222 Sam's Club Expansion Store No 6573-04 Onslow County Dear Mr. Furnei: Effective August 1, 2013 the State Stormwater progrant was transferred from the Division of Water Quality (DWQ)to the Division of Energy, Mineral and Land Resources (DEMLR). All previous references to DWQ will remain in older storruwater permits issued prior to August 1,2013 until they are modified. Permit Extension: On August 5, 2009, the Governor signed Session Law 2009-406. This law impacted any development approval issued by the former Division of Water Quality under Article 21 of Chapter 143 of the General Statutes, which was current and valid at any point between January 1, 2008, and December 31, 2010. The law extended the effective period of any stormwater permit that was set to expire during this time frame to three (3) years from its current expiration date. On August 2,2010, the Governor signed Session Law 2010-177 which granted an extra year for a total of up to four(4)years extension. Accordingly, State Stormwater Management Permit 9 S W8 931222, which was set to expire on December 5, 2018, is now in effect until December 5, 2022, and includes all available extensions. Please submit the renewal application (Form S`,17U-102) and application fee at least 180 days prior to December 5, 2022 which would be June 5, 2022. A copy of the Renewal Application can be obtained from the following website: hops://deq nc ov/abouUdivisioiis/energy-mineral-land-resources/enemy-mineral-lanrl- rules/stormwater-pro ram/post-construction Copies of Documents: Ms. Kate Tompkins requested copies.of the permit and operation and maintenance agreement which are enclosed. If you need to obtain copies of the plans, please contact Cameron Weaver with our customer service group at 910.796.7265. The following permits have been issued for this project and are enclosed: 1. 3/18/94: Certificate of Compliance (the original permit) 2. 12/5/08: Permit Modification (the Operation and Maintenance Agreement is attached) 3. 3/30/09: Plan Revision 4. 11/6/09: Plan Revision 5. 5/13/09: Plan Revision 6. 8/23/10: Plan Revision 7. M/l/10: Plan Revision I North Carolina Department of Environmental Quality I Division of Energy,Mineral and Land Resources J/ Wilmington Regional Office 1127 Cardinal Urlee Extension I Wilmington.North Carolina 28405 -rn.+.•::.a•iuun\ /`� 910.74b 7215 State Stormwater Permit No. S W8 931222 Page 2 of 2 If you have any questions, please contact the Division of Energy,Mineral and Land Resources in the Wilmington Regional Office at 910-796-7215. Sincerely, i „ J / eor ette Scott Stormwater Supervisor Division of Energy, Mineral and Land Resources - GDS/kpj: A\\StonnwaterTermits& Projects\1993\931222\2018 12 permit extension 931222 enc: 3/18/94: Certificate of Compliance(the original permit) 12/5/08: Permit Modification 3/30/09: Plan Revision 11/6/09: Plan Revision 5/13/09: Plan Revision 8/23/10: Plan Revision 11/l/10: Plan Revision - cc: Ms. Kate Tompkins, Project Coordinator Notch/South Carolina, Restoration and Recovery 4324 South Alston Ave, Suite 202, Durham, NC 27713 (w/attachments) Wilmington Regional Office Stormwater Permit Pile /i Scott, Georgette From: ktompkins@rrstormwater.com Sent: Friday, December 07, 2018 1:25 PM To: Scott, Georgette Cc: Morman, Alaina Subject: RE: [External] 10 year stormwater permits-Walmart, Jacksonville & Southport • E ecn i1301TOMck fin r ea•attachment unle vex fled tl suspicious m i!as an attach to This address is the one to send something to. I can't thank you enough! You've saved me a headache, maybe two if the other store's permit was extended also, and I'm so grateful for your assistance. Any documentation you can forward will be very gladly received and we will both hold a copy here and ensure that Walmart receives this updated information for their records too. I may reach out to you for that customer assistance contact if we uncover more of these and have information gaps. Stay safe this weekend—we're forecasted here for something like 6-10" snow plus ice from this storm... Thanks. Kate Tompkins Project Coordinator, North/South Carolina Restoration and Recovery 4324 South Alston Ave, Suite 202 Durham, NC 27713 (M) 919.448.1809 (0) 888.590.9685 x 704 ktompkins(@rrstormwater.com www.rrstormwater.com From: Scott, Georgette<georgette.scott@ncdenr.gov> Sent: Friday, December 7, 2018 1:16 PM To: ktompkins@rrstormwater.com Cc: Morman, Alaina <alaina.morman@ncdenr.gov> Subject: RE: [External] 10 year stormwater permits -Walmart,Jacksonville &Southport This permit, SW8 931222, originally expired Dec 5, 2018. But I just looked it up in our tracking system and discovered it does not expire until 12/5/2022. That is because all permits that were active when Bev Purdue was governor got a 4 year free extension. So you do not need to send in your application for renewal for this permit until you are within 180 days prior to the new expiration date. Which is 06/05/2022. Give me some time to see if I can find the other permit number. Then I will send you a letter with copies of the permits and 0 & M requirements and all the info you need for renewals. You should keep a copy of these permits on hand at all times. You might want to visit our office and make copies of the plans of the stormwater system for your records Or I 1 can hook you up with our customer assistance folks and they might be able to work with you to get plans copied and sent to you for a fee. Is the address in your email the address to send a letter to you or do I need to send it somewhere else? Georgette Scott State Stormwater Program Supervisor Department of Environmental Quality Office (910) 796 7215 Fax (910) 350-2004 Georgette.Scotto)ncden r.gov 127 Cardinal Drive Ext. Wilmington, NC 28405 !'-'Nothing Compares,...,... Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed to third parties. From: ktompkins@rrstormwater.com <ktompkins@rrstormwater.com> Sent: Friday, December 07, 2018 12:17 PM To: Scott, Georgette <georgette.scott@ncdenr.eov> Cc: Morman, Alaina <alaina.morman@ncdenr.Rov> Subject: RE: [External] 10 year stormwater permits-Walmart,Jacksonville &Southport er em it o n t click I n o en atta-hment unless verified, end all suspicious email as an attar men to Thank you. I've got the form and I'm working on it. Is there any way I can look up when these are actually due?Two unrelated permits due the same day seems arbitrary, but not impossible, and we have not received any external notice to renew yet either... Thanks. Kate Tompkins Project Coordinator, North/South Carolina Restoration and Recovery 4324 South Alston Ave, Suite 202 Durham, NC 27713 (M) 919.448.1809 (0) 888.590.9685 x 704 ktompkins(@rrstormwater.com www.rrstormwater.com From: Scott, Georgette <georgette.scott@ncdenr.eov> Sent: Friday, December 7, 2018 11:20 AM 2 'To: ktompkins@rrstormwater.com Cc: Morman, Alaina <alaina.morman@ncdenr.gov> Subject: RE: [External] 10 year stormwater permits -Walmart,Jacksonville &Southport Kate, Go to this website. Scroll down until you see the Question "Do you need a mod or renewal" question. Click on the Renewal application form. Fill that application out and submit to me at my address to renew permit. SW8931222 https://deg.nc.gov/about/divisions/energy-mineral-land-resources/energy-mineral-land-rules/stormwater- prrogram/post-construction Georgette Scott State Stormwater Program Supervisor Department of Environmental Quality Office (910) 796 7215 Fax (910) 350-2004 Georg ette.Scott(d)ncden r.gov 127 Cardinal Drive Ext. Wilmington, NC 28405 " Nothing Compares�- Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed to third parties. From: ktompkins@rrstormwater.com <ktompkins@rrstormwater.com> Sent: Thursday, December 06, 2018 3:05 PM To:Scott, Georgette <georgette.scott@ncdenr.gov> Cc: Morman,Alaina <alaina.morman(c@ncdenr.eov> Subject: [External] 10 year stormwater permits-Walmart,Jacksonville &Southport e nal em 'l. o not c is Ins o en ttachm is unless verified. end all suspicious email a an ttachment to .. Hi Georgette, I remembered our conversation from earlier this year about annual stormwater reports and I wondered if you could point me with another question. We recently received (internal Walmart) notifications that 10 year stormwater permits for two Walmart stores we contract with were due yesterday. One of these is listed as "NC Division of Water Quality" stormwater discharge permit (Jacksonville, #SW8931222). I have no other information. The other is just listed as a stormwater discharge or operation permit(Southport) with no other information, no permit number available. I'm not even sure where to start with these... do you have any recommendations on how to find out more, or could you direct me to the right person/place? We want to get back into compliance as soon as possible. Thanks! Kate 3 Kate Tompkins Project Coordinator, North/South Carolina Restoration and Recovery 4324 South Alston Ave,Suite 202 Durham, NC 27713 (M) 919.448.1809 (0) 888.590.9685 x 704 ktompkins(@rrstormwater.com www.rrstormwater.com From:Scott, Georgette <georgette.scott@ncdenr.gov> Sent: Monday,June 25, 2018 4:52 PM To: ktompkins@rrstormwater.com Cc: Morman,Alaina <alaina.morman@ncdenr.gov> Subject: RE: [External] annual stormwater inspection report-commercial property in Newport, NC/Carteret County Thank you very much for the report. It was very complete and is exactly what you should be doing for the permittee to ensure the site stays in compliance with the permit. We ask that the permittee keep these inspection reports with their latest State Stormwater permit filed on site because we do not have the file space to keep all the reports for every site we permit. However, when we visit your site our inspectors may ask to see your inspection records to make sure you have been maintaining the site properly as required by the permit. So we do not need you to send us regular inspection reports. But, if there is a specific issue with the site, and you would like our input on how to correct, please send us (me or Alaina) the report with your request and we will be happy to review the issues and provide recommendations to you. Again, thank you for keeping us updated and for your inspection report. Georgette Scott State Stormwater Program Supervisor Department of Environmental Quality Office (910) 796 7215 Fax (910) 350-2004 Geo rg ette.Scott(OJ n cden r.g ov 127 Cardinal Drive Ext. Wilmington, NC 28405 Nothing Compares., Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed to third parties. From: ktompkins@rrstormwater.com [mailto:ktompkinsCa@rrstormwater com] Sent: Monday, June 25, 2018 3:09 PM To: Morman, Alaina <alaina.morman@ncdenr.gov> Cc: Scott, Georgette<georgette.scott@ncdenr.gov> Subject: RE: [External] annual stormwater inspection report-commercial property in Newport, NC/Carteret County 4 Excellent! Thank you so much. Georgette, if you will let me know who should be receiving this report in your office, I will ensure that Walmart is updated and that our internal records contain that information going forward. Thank you, Kate Kate Tompkins Operations Admin Restoration and Recovery 4324 South Alston Ave, Suite 202 Durham, NC 27713 (M) 919.448.1809 (0) 888.590.9685 x 704 ktompkins@rrstormwater.com www.rrstormwater.com From: Morman,Alaina <alaina.morman@ncdenr.gov> Sent: Monday, June 25, 2018 11:55 AM To: ktomgkins@rrstormwater.com Cc: Scott, Georgette <georgette.scott@ncdenr.gov> Subject: RE: [External) annual stormwater inspection report- commercial property in Newport, NC/Carteret County Hi Kate. Thank you for the excellent documentation. You are correct that the state is the permitting authority for this site, but the local Regional Office will be your direct point of contact. I've included Georgette Scott, Environmental Program Supervisor for the Wilmington Regional Office, in this email because she will know which regional staff member is responsible for this site. They'll make sure the report gets properly recorded. ]'hanks for contacting us and let us know if you have any further questions. Best, Alaina Alaina Morman Environmental Specialist Stormwater Program Division of Energy, Mineral, and Land Resources North Carolina Department of Environmental Quality 919-707-9236 Office Physical Office: 5 512 N. Salisbury Street, Suite 942C1, Raleigh, NC 27604 Mail: DEMLR Stormwater Program 512 N. Salisbury Street 1612 Mail Service Center Raleigh, NC 27699-1612 ICNothing Compares. Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed to third parties. From: ktompkins@rrstormwater.com [mai Ito:ktompkins@rrstormwater.com] Sent: Monday, June 25, 2018 11:05 AM To: Morman, Alaina <alaina.morman@ncdenr.eov> Subject: [External] annual stormwater inspection report-commercial property in Newport, NC/Carteret County Good morning Alaina, We are stormwater maintenance and inspection contractors for a commercial retail property (Walmart store) in Newport, NC.This location is outside any local or county regulatory jurisdiction. We have completed a certified annual inspection report for this location—should we be forwarding those for your review? I have attached a copy in case you can direct it (and me) to the right place. Thanks, Kate Tompkins Kate Tompkins Operations Admin Restoration and Recovery 4324 South Alston Ave, Suite 202 Durham, NC 27713 (M) 919.448.1809 (0) 888.590.9685 x 704 ktompkins(@rrstormwater.com www.rrstormwater.com 6 . BUSINESS CORPORATION ANNUAL REPORT :: 7 z0;; NAME OF BUSINESS CORPORATION: SAA'T'S FAST, INC. 0407286 Flinc Otnce Use Only SECRETARY OF STATE ID NUMBER: STATE OF FORMATION: AR E-Filed Annual Report 0407286 REPORT FOR THE FISCAL YEAR END: 1/31/201 7 CA201810704238 4/17/2018 01:24 SECTION A: REGISTERED AGENT'S INFORMATION ❑ Changes 1. NAME OF REGISTERED AGENT: CT Corporation System 2. SIGNATURE OF THE NEW REGISTERED AGENT: SIGNATURE CONSUMES CONSENT TOTHEAPPOINTMENI' 3. REGISTERED OFFICE STREET ADDRESS& COUNTY 4. REGISTERED OFFICE MAILING ADDRESS 160 Mine Lake Ct Ste 200 160 Mine Lake Ct Ste 200 Raleigh, NC 27615-6417 Wake County Raleigh, NC 27615-6417 SECTION B: PRINCIPAL OFFICE INFORMATION 1. DESCRIPTION OF NATURE OF BUSINESS: retail sales through a membership Club 2. PRINCIPAL OFFICE PHONE NUMBER: (479) 277-5827 3. PRINCIPAL OFFICE EMAIL: Privacy Redaction 4. PRINCIPAL OFFICE STREET ADDRESS &COUNTY 5. PRINCIPAL OFFICE MAILING ADDRESS 708 SW 8th Street 708 SW 8th Street Bentonville, AR 72716 Benton County Bentonville, AR 72716 6. Select one of the following if applicable. (Optional see instructions) The company is a veteran-owned small business The company is a service-disabled veteran-owned small business SECTION C: OFFICERS (Enter additional officers in Section E.) NAME: John Furner NAME: Cindy Moehring NAME: Anthony Walker TITLE: President TITLE: Senior Vice President TITLE: Vice President ADDRESS: ADDRESS: ADDRESS: 708 SW 8th Street 708 SW 8th Street 708 SW 8th Street Bentonville, AR 72716 Bentonville,AR 72716 Bentonville, AR 72716 SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a personlbusiness entXnthony Walker 4/17/2018 SIGNATURE DATE Form must be signed by an officer listed or der Seclion C of this form. Anthony Walker Vice President Print or Type Name of Officer Print or Type Title of Officer MAIL 10:Secretary of State, Business Registration Division,Post Office Box 29525,Raleigh,NO 27626-0525 SECTION E: ADDITIONAL OFFICERS NAME: Gordon Y. Allison NAME: Gordon Y. Allison NAME: Michael A. Cook TITLE: Vice President TITLE: ASSIStant. Secretary TITLE: Treasurer ADDRESS: ADDRESS: ADDRESS: 708 SW 8th Street 708 SW 8th Street 708 SW 8th Street Bentonville. AR 72716 Bentonville, AR 72716 Bentonville, AR 72716 NAME: Matthew W. Allen NAME: Andrea Lazenby NAME: Gcofhrey Edwards TITLE: Assistant 'LI"eaSUrer TITLE: Assistaw Secretary TITLE: Assistant Secretary ADDRESS: ADDRESS: ADDRESS: 708 SW 8th Street 708 SW 8th Street 708 SW 8th Street Bentonville, AR 72716 Bentonville.AR 72716 Bentonville.AR 72716 NAME: NAME: NAME: TITLE: TITLE: TITLE: ADDRESS: ADDRESS: ADDRESS: NAME: NAME: NAME: TITLE: TITLE: TITLE: ADDRESS: ADDRESS: ADDRESS: NAME: NAME: Name: TITLE: TITLE: TITLE: ADDRESS: ADDRESS: ADDRESS: NAME: NAME: NAME: TITLE: TITLE: TITLE: ADDRESS: ADDRESS: ADDRESS: MEMORY TRANSMISSION REPORT TIME : 11-02-'10 12:11 FAX NO.1 : 910-350-2018 NAME :DENR Wilmington FILE NO. 871 DATE 11.02 12:09 TO : R 917043330845 DOCUMENT PAGES 2 START TIME j 11.02 12:10\\ END TIME —11.02 12:11 PAGES SENT �: 2 STATUS OK SUCCESSFUL TX NOTICE Strtn of North CaroRvr Depvrlmwne or 6vvtrov mwst wvd[VvlurrL Rwsovrcew Wttmiva<on RRtnvrt t)f}tcw smwrb Ro.iv P rdrr, C.ovwrvor FAX COVER SIfTET fires Frwvvvu. 9ecre:trry 11at0: ��/Z�� No- Pagar(oxnl.coverj: / r« ��U�s Ti'-✓ /�ft TYS atom: Lo�am..ar co: /—/� //1G�i✓-_���r r� m.oaa: ro)o.z96--»sF r-rx: �� �f" .33.3 — Or��i�•S� aa.: rv)o)sso-zoos Ra: -�Am s G�y6 Ex o.oir o✓ -'ra C �57-3-a ��/ G9� /Ci/is'J o✓ /�/90iO �r-cam"- 6G rc+� �®� y� z>tisra:nw)v..e e,.m...:o...w:...r,g....,rir zawo��(s::o)��-�zts-....ea•_,oopom...:t>.wmm..o.e wm:o.,e...worrr State of North Carolina Department of Environment and Natural Resources Wilmington Regional Office Beverly Eaves Perdue, Governor FAX COVER SHEET Dee Freeman, Secretary Date: �'ZZzx No. Pages(excl. cover): / To: //l///S Ti e5� �TTS From: Jo Casmer Co: / /J7Ge>/- 7Grl Phone: (910)796-7336 Fax l a `� 3✓�31 �o �`� Fax: (910)350-2004 Re: ��9iyr s GG�� -F �/IS . o ✓ ���i�' �S73-D �f 127 Cardinal Drive Extension,Wilmington,NC 28405 v(910)796-7215 e An Equal Opportunity Affirmative Action Employer MEMORY TRANSMISSION REPORT TIME :11-02-'10 12:10 FAX NO.1 : 910-350-2018 NAME :DENR Wilmington FILE NO. 870 DATE 11.02 12:09 TO : 8 914792736503 DOCUMENT PAGES 2 START TIME 11.02_12:09 END TIMEi 11.02`12 10 iJ V 0 PAGES SENT 2 STATUS OR \, SUCCESSFUL TX NOTICE Sm<n or Norfb Cnroalp. DapuRmrnt or Bnvlbo et and N.Lu�a Ra.ou�cb wumt.am�R�,�alona om.. B��y Eevna PaNun� Gov.rpo� FA.X COVLR Sfi£ET Dea F Toni ge�rut.ry 1J8[o: ///T�//O No. PaBrA CeBul.auvr>r); To: fc��i 12'!Cnndlnal O'Iva P.auenbion�WIImIn6mn,NC 28103�(910)'1%-'/2If�An HquV ppppwniby A(H� n.live Ac�lon HmptoYe� State of North Carolina Department of Environment and Natural Resources Wilmington Regional Office Beverly Eaves Perdue, Governor FAX COVER SHEET Dee Freeman, Secretary Date: �7i//� No. Pages(excl. cover): To: ////G`J AEG (e�"5y&/y E�' From: Jo Casmer Co: i /n S EfJS Ti .L - Phone: (910) 796-7336 Fax: ��9� �� — �� Fax: (910)350-2004 Re: J!L//1 Gr Z416 �X S>d iE 10.3~7�—D 127 Cardinal Drive Extension,Wilmington,NC 28405 o(910)796-7215 a An Equal Opportunity Affirmative Action Employer