NCG080952_Owner Affiliation Form_20180627

Division of Energy, Mineral, and Land Resources FOR AGENCY USE ONLY
Date Received
Land Quality Section ! Stormwater Program Year Month Day
National Pollutant Discharge Elimination System (NPDES)
Energy, Mineral & PERMIT OWNER AFFILIATION DESIGNATION FORM
Land Resources
EWPONMENTAL OUALITY (Individual Legally Responsible for Permit)
Use this form if there has been:
NO CHANGE in facility ownership or facility name, but the individual
who is legally responsible for the permit has changed.
If the name of the facility has changed, or if the ownership of the facility has changed,
do NOT use this form. Instead, you must fill out a Name -Ownership Change Form
and submit the completed form with all required documentation.
What does "legally responsible individual' mean?
The person is either:
• the responsible corporate officer (for a corporation);
• the principle executive officer or ranking elected official (for a municipality, state, federal or other public
agency);
• the general partner or proprietor (for a partnership or sole proprietorship);
• or, the duly authorized representative of one of the above.
1) Enter the permit number for which this change in Legally Responsible Individual ("Owner Affiliation")
applies:
Individual Permit
,N - S
2) Facility Information:
Facility name:
Company/Owner Organization:
Facility address:
(or) Certificate of Coverage
N C I G'0 18 10 19 15 12
MURPHY PEC
ROLLING FRITO-LAY SALES
245 NC Highway 141
Address
245 NC Highway 16 NC 28906
City State Zip
To find the current legally responsible person associated with your permit, go to this website:
http•//decd nc gov/about/divisions/energy-mineral-land-resources/energy-mineral-land-permits/stormwater-proaram
and run the Permit Contact Summary Report.
3) OLD OWNER AFFILIATION that should be removed:
Previous legally responsible individual: TRENT WECKWERTH
First MI Last
4) NEW OWNER AFFILIATION (legally responsible for the permit):
Person legally responsible for this permit: JASON C ALEXANDER
First MI Last
Page 1 of 2
S WU-OWNERAFFIIr23March2017

NPDES Stormwater Permit OWNER AFFILATION DESIGNATION Form
(if no Facility Name/Ownership Change)
5) Reason for this change:
A result of:
If other please explain:
n/a
REGIOAL FLEET MANAGER
Title
2200 Riverchase Center, Suite 701
Mailing Address
Birminaham AL 35244
City State Zip
(LUD 4C1-4416 lasun.c.aiexal luer�wpepslcU.b
Telephone E-mail Address
(ria 1
Fax Number
Q Employee or management change
❑ Inappropriate or incorrect designation before
❑ Other
The certification below must be completed and signed by the permit holder.
PERMITTEE CERTIFICATION:
1, Jason Alexander , attest that this application for this change in Owner Affiliation
(person legally responsible for the permit) has been reviewed and is accurate and complete to the best of my
knowledge. I understand that if all required parts of this form are not completed, this change may not be
processed.
Sign ure
Date
PLEASE SEND THE COMPLETED FORM TO:
DEMLR - Stormwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
For more information or staff contacts, please call [phone] or visit the website
at: http://deg.nc.gov/about/divisions/energy-mineral-land-resources/stormwater
Page 2 of 2
S WU-OWNERAFFIL-23Mar2017

Q)
., Frito-Lay
90 dA,W/orgyneW
August 7, 2017
SUBJECT: SIGNATURE DELEGATION AUTHORIZATION
To Whom It May Concern:
In accordance with State and/or Federal regulations and in accordance with our corporate
procedures, I hereby authorize the individuals with the position of Regional Fleet Manager to
sign permit applications (notices of intent), notices of termination, registrations, and other
certifications as necessary for storm water permitting and compliance activities.
If you require any further documentation or if you have any questions, please contact me at
912-596-3228. Thank you for your assistance in this matter.
Sincerely,
Title Supply Chain Vice President RECEIVED
JUN 2 7 2013
DENR-LAND QUALITY
Signature
STORMWATER PERMITTING

Gib
tw Frito-Lay
flood (ottW "* oto
May 30, 2018
Stormwater Permitting Unit Program
Division of Energy, Mineral, and Land Resources
1612 Mail Service Center
Raleigh, North Carolina 27699-1617
Re: Industrial MSGP Facility Contact Change
To whom it may concern:
Designated contact individual for the following Frito-Lay facility has changed. Also please find
enclosed written authorization for the position of Regional Fleet Manager to sign all documents
pertaining to Industrial Stormwater Permitting.
MURPHY PEC 1245 NC Highway 141 1 MURPHY I NC I NCG080952
The PREVIOUS designated contact individual is:
Trent Weckwerth
Rolling Frito-Lay Sales, LP
2800 Silver Star Rd
Orlando, FL 32808
P: 407-961-3285
trent.weckwerth&pepsico.com
The NEW designated contact individual is:
Jason Alexander
Rolling Frito-Lay Sales, LP
2200 Riverchase Center, Suite 701
Birmingham, AL 35244
P:205-421-4427
j ason.c.alexander(a�pepsico.com

All future correspondence should be sent to the above address.
"I certify under penalty of law that this document and all attachments were prepared under my
direction or supervision in accordance with a system designed to assure that qualified personnel
properly gathered and evaluated the information submitted. Based on my inquiry of the person or
persons who manage the system, or those persons directly responsible for gathering the
information, the information submitted is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fine and imprisonment for knowing violations."
Sincerely,
Jason Alexander
Regional Fleet Manager