WQCS00162_Owner (Affiliation Change)_20240702

North Carolina Department of Environmental Quality
Division of Water Resources
Permit Number: WQCS00162
Permit Type: Collection system management and operation
Facility Name: Fairfield Harbour Collection System
Facility Addressi: Fairfield Harbour
Facility Address2:
City, State & Zip: New Bern, NC 28560
Owner Information Details:
MUST submit a Change of Name/Ownership form to DWR to make any changes to this Owner information.
(Click Here for "Change of Name/Ownership Form)
Owner Name: Carolina Water Service Inc of North Carolina
Owner Type: Non -Government Owner Type Group: Organization
*** Legally Responsible for Permit ***
(Responsible corporate officer/principle executive officer or ranking elected official/general partner or proprietor;
or any other person with delegated signatory authority from the legally responsible person.)
Owner Affiliation: Gary Mack Peacock Title: Director Operations of
Addressl: PO Box 240908
Address2:
City, State & Zip: Charlotte, NC 28224-0908
Work Phone: [phone] Fax:
Email Address: [e-mail]
If any information related to specified contact persons is incorrect or no longer valid, please contact the regional office with jurisdiction
for your facility. Changes must be requested by an individual with signature authority in accordance with 15A NCAC 02T.0106.
Information and area of coverage for regional offices can be obtained at https://deg.nc.gov/contact/regional-offices.
Owner Contact Person(s)
Contact Name Title Address Phone Fax Email
Travis Dupree VP Project 130 S Main St, Ste 800, Greenville, SC 864-203-0233 Travis. [e-mail]
Management & 29601 m
Engineering
Tony Konsul Operations Director 4944 Parkawy Plaza Blvd Ste 375, 704-319-0523 704-525-8174 tony.konsul@carolinawat
Charlotte, NC 28224-0908 erservicenc.com
Donna Stegall Admin. Assistant PO Box 240908, Charlotte, NC 28224 704-319-0506 donna.stegall@carolinaw
aterservicenc.com
Facility Contact Person(s)
Contact Name Title Address Phone Fax Email
Permit Contact Person(s)
Contact Name Title Address Phone Fax Email
Dana D Hill Director of 4944 Parkway Plz Blvd Ste 375, 866-842-8348 dana. hi I I @carol inawaters
Operations Charlotte, NC 28217 ervicenc.com
Permit Billing Contact Person(s)
Contact Name Title Address Phone Fax Email
Martin I Lashua PO Box 240908, Charlotte, NC 704-525-7990
28224-0908
7/1/2024 Page 1

Permit Number: WQCS00162
Permit Type: Collection system management and operation
Facility Name: Fairfield Harbour Collection System
Facility Addressl: Fairfield Harbour
Facility Address2:
City, State & Zip: New Bern, NC 28560
Persons with Signatory Authority
Type Contact Name Title Address Phone Fax
Email
Owner Brent Milliron PO Box 240908, Charlotte, NC 704-319-0504
brent.milliron@carolinaw
28224-0908
aterservicenc.com
Designated Operators
If the designated operators listed below are incorrect or no longer associated with the collection system, the information can be updated by s
'Operator Designation Form" (Click Here for ORC Designation Form). Please provide specific details as to the changes requested, including thi
designated operators; For all other operator questions or issues, please call 919-807-6353,
Facility Classification: CS2
Operator Name Role Cert Type Cert Status Cert #
Effective Date
Mathew Golden ORC CS-2 Active 1002998
2/1 /2019
Stacy Allen Goff Backup CS-3 Active 999872
2/1/2019
7/1/2024 Page 2