NCGNE0510_Contact_Info.pdf

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Contacts Summary
NC DEMLR has the followin! contact information in our Permit Database for vour permit as of 5/16/2018.
Permit Number: NCGNE0510
Permit Type: Stormwater Discharge No Exposure Certificate
Facility Name: Hubbell ICD
Facility Addressl: 4301 Cheyenne Dr
Facility Address2:
City, State & Zip: Archdale, NC 27263
Owner Information Details:
MUST submit a Change of Name/Ownership form to DEMLR to make any changes to this Owner information.
(C/ick Here for "Change of Name/Ownership"Form)
Owner Name: Hubbell Icd
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: Harry Juncker
Title:
Addressl: 4301 Cheyenne Dr
Address2:
City, State & Zip: Archdale, NC 27263
Work Phone: [phone]
Fax: [phone]
Email Address:
*** Permit Annual Fee Billing ***
Billing Month:
Invoice Number Invoice Date
Invoice Due Date Invoice Amount Invoice Status
Owner Contact Person(s)
Contact Name Title
Address Phone Fax
Email
Facility Contact Person(s)
Contact Name Title
Address Phone Fax
Email
Harry Juncker
4301 Cheyenne Dr, Archdale, NC 27263 336-434-2800 336-434-2801
Permit Contact Person(s)
Contact Name Title
Address Phone Fax
Email
Permit Billing Contact
Contact Name Title
Address Phone Fax
Email
Harry Juncker
4301 Cheyenne Dr, Archdale, NC 27263 336-434-2800 336-434-2801
5/16/2018 Page 1