NCS000250_Email RE Other Contact Updates_20241017

Georgoulias, Bethany
From: Owens, Wesley A
Sent: Thursday, October 17, 2024 12:09 PM
To: Georgoulias, Bethany; Sanford, Joyce
Subject: RE: [External] Permit Contact Update Request for NCS000250
Attachments: NPDES-Name-Owner-Change-NCDOT_Signed_7-31-2024.pdf
Follow Up Flag: Follow up
Flag Status: Flagged
Hi Bethany and Joyce,
I wasn't sure how to complete the "Other Contact Updates"section on the online form.There was not a place to
upload the pdf form where we made these changes on the online form, so I attached it to this email.
Owner Contact Person is currently listed as:
Stephen Morgan
1590 Mail Service Ctr
Raleigh, NC 27699-1590
919-707-6739
[e-mail]
We would like to change that to the current Owner Contact Person,which is:
Matthew S. Lauffer(State Hydraulics Engineer)
1590 Mail Service Ctr
Raleigh, NC 27699-1590
919-707-6703
[e-mail]
The other contact that we needed to change was the Owner Affiliation. It is currently listed as:
J Eric Boyette
919-707-2800
][e-mail]
We would like to change that to the current Owner Affiliation,which is:
J.R. Hopkins(Secretary of Transportation)
919-707-2800
[e-mail]
Hope this email clarifies the changes that need to be made.
Thanks,
Wesley A. Owens, PE
Stormwater Operations Management
Roadside Environmental Unit
North Carolina Department of Transportation
919 707 2924 office
waowens1(cancdot.gov
1

1 South Wilmington Street
1557 Mail Service Center (MAIL)
Raleigh, NC 27699-1557
NO
im
zz
j
From: [e-mail]<[e-mail]>
Sent:Thursday, October 17, 2024 10:14 AM
To: Owens, Wesley A<[e-mail]>
Cc: Georgoulias, Bethany<[e-mail]>; Sanford,Joyce<[e-mail]>
Subject: [External] Permit Contact Update Request for NCS000250
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.
Your Permit Contact Update Request Form for permit no. NCS000250 has been accepted for
processing. In 30 days, please check the following link to verify the change has been made: Permit
Contact Summary Report
If you have any questions about the status, please contact Joyce Sanford at.joyce.sanford(cbdeq.nc.gov.
Be sure to add laserfiche.ncdenr.gov_ mccicloud.io to your contacts to avoid future e-mails from going
into Spam filters.
The NC DEMLR Stormwater Program
512 N. Salisbury Street,Archdale Building 6th Floor(640K), 1612 Mail Service Center, Raleigh,
NC 27699-1612
Email correspondence to and from this sender is subject to the N.C. Public Records Law and may be disclosed to third parties.
2

STATE
a,S7Aip
NC DEPARTMENT OF ENVIRONMENTAL QUALITY
r C[, DIVISION OF Energy, Mineral, and Land Resources
STORMWATER PROGRAM
�Lpw"tTMp•
NOR It CAROLINA
Environmental Quality
NPDES STORMWATER PERMIT NAME/OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION:
Permit Number: NCS_Q_/Q/__(L/_2 / 5 / 0 or NCG_JJ—J_/_/_
1. Facility Name(prior to change): NCDOT Statewide Stormwater MS4
II. NEW OWNER/NAME INFORMATION:
2. This request for a name change is a result of:
_a. Change in ownership of property/company
_b. Name change only(Facility and/or Company)
Correct facility name,changes to ownerlsigning official's name,
x c. Other(please explain): permit contact billing contact&their associated phone#s&emails
(for example,facility address update.Include additional attachments if necessary.)
3. New owner's name(name to be put on permit as Permittee):
no change
4. New owner's or signing official's name and title: J. R. Hopkins
(Person legally responsible for permit)
Secretary of Transportation
(Title)
5. Mailing address: no change City:
State:_ Zip Code: Phone:( 919 ) 707-2800
E-mailaddress: [e-mail]
6. New facility name(if applicable): NCDOT Statewide Stormwater TS4
7. Effective date of transfer or name change: july 31 , 2024
North Carolina Department of Environmental Quality l Division of Energy.Mineral and Land Resources
D_E Q S12 North Salisbury Street 1 1612 Mall Service Center I Raleigh,North Carolina 27699 1612
ae.u. .v'•...+a+n� /'� 919107.9200

I
NPDES Stormwater Permit Name/Ownership Change
Page 2 of 2
III. PERMIT AND FACILITY CONTACT INFORMATION
8. New permit contact's name and title: Matthew S . Lauffer
(Permit Contact)
State Hydraulics Engineer
(Title)
i
9. Mailing address: no change City:
i
State:_ Zip Code: Phone: ( 919 ) 707-6703 �
i
E-mailaddress: mslauffer@ncdot .gov
t
I
10. New facility contact's name and title: no change
(Facility Contact)
no chance
(Title)
i
11. Mailingaddress: no change City:
State:_ Zip Code: Phone: ( ) no change
E-mail address: no change f
12. New billing contact's name: Alexis Palcher
(Billing Contact)
i
13. Mailing address: no change City:
State:_ Zip Code: Phone:( 919 ) 707-6352
E-mail address: no change
I
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® No❑
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
II
i

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:
1. This completed application form (with original signature)
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, J. R. Hopkins 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 nd ay be returned.
Signature: W __ Date:
THE COMPLETED A P CATION AND ALL SUPPORTING INFORMATION SHOULD BE SENT TO:
DEMLR Stormwater Program
512 North Salisbury Street, 6`h Floor (Office 640K)
1612 Mail Service Center
Raleigh, NC 27699-1612
Last Revised 3/13/2022