NCC223057_Contact Update Request (LEG RESP CHANGE)_20240903

NCG01 Legally Responsible Individual Change Form
Use this form when:
The person who is legally responsible for the permit has changed, but there is NO CHANGE in the project name
or ownership.
**If the project name has changed, or if the ownership of the project has changed, do NOT use this form.**
Instead, you must submit a new NCG01 electronic Notice of Intent (eN01).
Directions:
Print this form,complete, scan and upload to the Construction Stormwater Permit MODIFICATION Form.
Then, mail the original form to the NC DEMLR Stormwater Program at:
Division of Energy, Mineral& Land Resources Stormwater Program
512 N. Salisbury Street, 61h Floor(Office 640K)
1612 Mail Service Center
Raleigh, NC 27699-1612
DO NOT MAIL THIS FORM UNTIL YOUR MODIFICATION HAS BEEN REVIEWED AND ACCEPTED AS COMPLETE.
THE FORM YOU MAIL MUST RE COMPLETED WITH AN ORIGINAL SIGNATURE(RIOT DIGITAL) [40 CFR 122.22]
Certificate of Coverage (COC) Number: NCC223057
Name of Project: Park East Pad Ready Site
Legally Responsible Organizational Entity: Wayne County Development Alliance, Inc.
PREVIOUS Legally Responsible Individual: Mark Pope
NEW Legally Responsible Individual: Craig Foucht
The following section is to be completed and signed by the NEW Legally Responsible Individual.
Per NC General Statute 143-215.6E(i), any person who knowingly makes any false statement, representation,
or certification in any application, record, report, plan, or other document filed or required to be maintained
under this Article or a rule implementing this Article . . . shall be guilty of a Class 2 misdemeanor which may
include a fine not to exceed ten thousand dollars($10,000).
Page 1 of 2

NCG01 Legally Responsible Individual Change Form
THE FORM YOU MAIL MUST BE COMPLETED WITH AN ORIGINAL SIGNATURE(NOT DIGITAL) [40 CFR 122.221
Under penalty of law, I certify that(check all boxes to indicate your agreement):
10/ I am the person responsible for the construction activities of this project,for satisfying the
requirements of this permit, and for any civil or criminal penalties incurred due to violations of this
permit.
I will abide by all conditions of the NCGO10000 General Permit and the approved Erosion and
Sediment Control Plan.
If the approved Erosion and Sediment Control Plan is not compliant with Part II (Stormwater Pollution
Prevention Plan) of the NCG010000 General Permit I will nonetheless ensure that all conditions of
Part II of the permit are met on the project at all times.
understand that coverage under this permit will constitute the permit requirements for the
discharge(s) and is enforceable in the same manner as an individual permit.
I This form has been reviewed and is accurate and complete to the best of my knowledge.
*Signature: pate; 09/03/2024
Print Name of Signed: Craig Foucht
Title: President
Mailing Address: PO Box 10397 Goldsboro, NC 27532
Street Address. 218 E. Walnut Street, Goldsboro, NC 27530
Email Address: [e-mail]
Phone Number: 919-731-1503
* IMPORTANT NOTE: This form must be signed by a responsible corporate officer that owns or operates the
construction activity,such as a president, secretary, treasurer, or vice president, or a manager that is
authorized in accordance with Part IV,Section B, Item (6)of the NCGO10000 permit.
For more information on signatory requirements, see Part IV, Section 8, Item (6)of the NCGO10000 permit.
Page 2 of 2

Georgoulias, Bethany
From: Craig Foucht <[e-mail]>
Sent: Tuesday, September 3, 2024 3:56 PM
To: Georgoulias, Bethany; [e-mail]
Cc: Julie Graham; Craig Foucht
Subject: Re: [External] Fw: Construction Stormwater Permit Annual Fee - NCC223057
Attachments: WCDA-NCG01-Legally-Responsible-Change-Form-20210517-DEMLR-SW.pdf
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.
Sorry I left off the attachment.
Best Regards,
Craig Foucht
Director of Business and Project Management
NC Global TransPark Economic Development Region
craig.foucht(cbncgtpedr.com
Office: 252-775-6189
Mobile: [phone]
www.ncgtpedr.com
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• • ••NOMICLOPMENT
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Book meeting with Craig
From: Georgoulias, Bethany<[e-mail]>
Sent:Tuesday, September 3, 2024 3:43 PM
To: Craig Foucht<[e-mail]>;[e-mail]<[e-mail]>
Cc:Julie Graham <[e-mail]>; Craig Foucht<[e-mail]>
Subject: RE: [External] Fw: Construction Stormwater Permit Annual Fee- NCC223057
Please see the attached form that needs to be filled out by the new legally responsible person.You can send back
a scanned copy, but the original signed copy must be mailed in to us.
Thankyou,
Bethany Georgoulias (she/her)
Environmental Engineer, Stormwater Program
DEMLR Laserfiche Administrator
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Division of Energy, Mineral,and Land Resources
N.C. Department of Environmental Quality
919 707 3641 office
[e-mail]
512 N. Salisbury Street, Raleigh, NC 27604 (location)
1612 Mail Service Center, Raleigh, NC 27699-1612 (mailing)
Website: httl2://deq.nc.gov/about/divisions/energy-mineral-land-resources/stormwater
From: Craig Foucht<[e-mail]>
Sent:Tuesday, September 3, 2024 10:02 AM
To:[e-mail]
Cc:Julie Graham <[e-mail]>; Craig Foucht<[e-mail]>; Georgoulias, Bethany
<betha ny.georgoul [e-mail]>
Subject: [External] Fw: Construction Stormwater Permit Annual Fee- NCC223057
You don't often get email from [e-mail] why this is important
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.
H i Tev,
Mark Pope is no longer with the Wayne County Development Alliance, Inc. and the physical address has
changed. The WCDA is still the permit holder but what needs to be done to update the contact information to the
following:
Legally Responsible Person: Craig Foucht
Address: 218 E.Walnut Street, Goldsboro, NC 27530
Site Contact: Craig Foucht
Email: [e-mail]
Site Contact Email: [e-mail]
Best Regards,
Craig Foucht
Director of Business and Project Management
NC Global TransPark Economic Development Region
craig.fouchtPncgtpedr.com
Office: 252-775-6189
Mobile: [phone]
www.ncgtpedr.com
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Book meeting with Craig
From: Mark Pope<[e-mail]>
Sent: Sunday, September 1, 2024 2:44 PM
To: Craig Foucht<[e-mail]>;Julie Graham <[e-mail]>
Subject: Fwd: Construction Stormwater Permit Annual Fee - NCC223057
Sent from my iPhone
Begin forwarded message:
From: laserfiche.ncdenr.gov _ mccicloud.io
Date: September 1, 2024 at 11:51:03 AM EDT
To: Mark Pope <mark.pope a ncgttpedr.com>
Cc: Mark Pope <mark.pope g ncgtpedr.com>, Mark Pope <mark.pope g ncgtpedr.com>,
bethan eorgoulias _ deq.nc.gov, tev.holloman(,'a)deq.nc.gov
Subject: Construction Stormwater Permit Annual Fee - NCC223057
Attached is the 2024 annual fee invoice for your Construction Stormwater NPDES permit,
COC no. NCC223057. When using the ePayment website (https://www.deq.nc.gov/sw-
epayments), be sure to enter ONLY the COC permit number(not the invoice number with "-
2024" after it). Please contact Tev Holloman at tev.ho11oman0bdeq.nc.gov.gov with any
questions.
If this project has been closed out, you must submit a Notice of Termination (NOT)
request here:
https://edocs.deq.nc.gov/Forms/NCGO1-Termination
Permittee: Wayne County Development Alliance, Inc.
Project Name: Park East Pad Ready Site
Project Location: Goldsboro
County: Wayne
Please note that effective October 3, 2023, the annual fee for this general permit has
increased to$120.
Sincerely,
The DEMLR Stormwater Program
This email was automatically generated byLaserfiche. Please do not respond to this email
address, as responses are not monitored.
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Email correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties by an authorized
state official.
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