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HomeMy WebLinkAboutNCG080612_COMPLETE FILE - HISTORICAL_20060918STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. /v C& bp (P � d� DOC TYPE C�- HISTORICAL FILE ❑ MONITORING REPORTS DOC GATE ❑ a006 Ali 9 � YYYYMMDD O�QF W A r,�9 pG Michael R Easley, Governor William G. Ross Jr., Secretary r North Carolina Department of Environment and Natural Resources J � Q Alan W. Klimek, RE, Director Division of Water Quality August 18, 2006 �C9[E �/ Mx. Fred C. Jones AUG 2 2 Z006 Dewey Development, Inc. PO Box 8 �y Dudley, NC 28333 DWO,-1 ARO Subject: NPDES General Permit NCGO80000 Certificate of Coverage NCG080612 Dewey Development, Inc. Formerly Aaron Smith Trucking, Inc. Wayne County Dear Mr. Jones: Division personnel have reviewed and approved your request to transfer coverage under the General Permit, received on July 10, 2006. Please find enclosed the revised Certificate of Coverage. The terms and conditions contained in the General Permit remain unchanged and in full effect. This revised Certificate of Coverage is issued under the requirements of North Carolina General Statutes 143-215.1 and the Memorandum of Agreement between North Carolina and the U.S. Environmental Protection Agency. If you- have any questions, please contact the Stormwater Permitting Unit at (919) 733-5083, extension 502. Sincerely, SIGNED S`! KEN PICKLE Alan W. Klimek P. E. cc: DWQ Central Files Washington Regional Office, Water QuaUty Section Stormwater Permitting Unit 1Vo Carolina Naturally North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Phone (919) 733-7015 Customer Service Internet h2o.enr.state.nc.us 512 N. Salisbury St. Raleigh, NC 27604 FAX (919) 733-2496 1-877-623-6748 An Equal OpportunitylAffinmative Action Employer— 50% RecycledilG% Post Consumer Paper . :. STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF WATER QUALITY GENERAL PERMIT NO. NCGO80000 CERTIFICATE OF COVERAGE No. NCGO80612 STORMWATER DISCHARGES NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the Federal Water Pollution Control Act, as amended, DEWEY DEVELOPMENT, INC. is hereby authorized to discharge stormwater from a facility located at DEWEY DEVELOPMENT, INC. 1106 SOUTH GEORGE STREET GOLDSBORO WAYNE COUNTY to receiving waters designated as the Neuse River, a class C NSW, in the NeuseRiver Basin in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II, 111, IV, V, and VI of General Permit No. NCG080000 as attached. This certificate of coverage shall become effective August 18, 2006. This Certificate of Coverage shall remain in effect for the duration of the General Permit. Signed this day August 18, 2006. ORIGINAL SIGNED S`! KEN PICKLE Alan W. Klimek, Director Division of Water Quality By Authority of the Environmental Management Commission y j ` 7.5 MINUTE SERIES (TOPOGRAPHIC) lop WILSON 26 Mi. 2'30" 769 770i 2290000' FEET 771 PIKEVILLE 2.5 Mt. 1772 78°00r 22'30 J f / i _ _ _ . • / q 7-1 • �� RAVEL _° ."� '•!C i - • ULD 0. 03918 5; —-s`.- :� p o - / % il: • Park 590 000 FEET ;[[ 73 Golf Course `lj . • oP 4 "17 4 0 Emmaavel Ln $tea 1 i ffl Allied South .Goldsboro 12Z2 ' \ �.andpit X _, �. o , r ," • _ ,�---� ��. -,; GIs j`1925 Ramp /.ter l .•l�� `': Dom--. �aPS •\ /•\ •j�SM74 fj „�� O ✓ �. Riv 7 Pit4 0 0 shy .� �. �. �•f\� /.. 4.0 1 �! � Trailer . e•. � ti � , \ fX• •• Park 1� / OP 3915 �f /ram McArthur'. Park Lake I O � !� �''•�s_-i—•err- ��1 � �� � -•b•. ��ra�el-' ��• ••la ° � i-:�' Sewage >.� ���� �J. '••'� � ••;M � /Trailer Love Hemp Ch Park 1926./'e 1130 ewage posal `\ Ponds J `� �.J f� J \r `J .,•..•�� Fairgrounds z' : hj' • es.o % �,r �` % \ �— 1, •Ge '`' i :i' — " / 1421, •/% �rI �111 rj(/ yf� 3913 � � i • a •r' � • a rie �J f1 ,1 ��� � 'j , j,1��; �'� I ; � ��}� f ��` � 1 r, G,, G ch i So//.5'�:�%. NE Al X 4fAl df7761-,�? �q R,14, "R�Va uiO&S V W U cJ G� /�A2 �Gd �CG'D•s/ �ti JUL0 3 2006 DWQ-WARD �ep,/ a/" , %� _ 44�� d ,/��,�°� ,dry -err c 4VOW, bt- r� A-5f ' f-,;tle 1 fix; jr) C 40,p, SKr �40lr�� u ��.._...�........-- A� a r DA& a tel to ,r is4/ ,o . /P � ,�� �� !�/��✓ .If �' ,�' � Cry �'�f D� �� ` Ave 7lir' 04; jl;� 4&e O�O� W A r�9QG c177 s ^i E June 21, 2006 Mr, Aaron Smith P.O. Box 482 Dudley, NC 28333-0482 Michacl F. Easley, Governor William O_ Ross.lr., Secretary Forth Carolina Department of Encironntcnt and Natural Resources Alan W. Klimek. P.E. Director Division of Water Quality Subject. Permit Name/Ownership Change Form Stormwater'General Permit NCGO80000 COC # NCGO80612 Dear Mr. Smith: As per your request, I'm sending you the Permit Name/Ownership Change Form. Please fill out the form as explained, then contact Mr. Fred Smith, so he can fill out his part. He is expecting you to contact him. For your information, you can reach him at 919-920-0125. After finishing with the form, please mail it to address shown on page 2 of the form. Thank you for your cooperation in this matter. If you have any questions, please do not hesitate to contact Samir Dumpor, at (252) 948-3959. Sincerely Samir Dumpor Environmental Engineer Surface Water Protection Unit Encl. CC: WaRO files North Carolina Division of Water Quality Intemer. h2o.enr.state.nc.us 943'Aashington Square Mall Phone:252-946-6481 One Washington, NC 27889 FAX 252.946-9215 NOrthCarOlina An Equal OpDortunitvlAffirmative Action Emolcver — 50% Rec vded110% Post Consumer Paper Natumllu acna i i. Easi% •. Gol,mor William G. Ross Jr., Secretary Forth Carolina Deparu� ent of Environment and Natural Resources Alan W. Klimek-- P.E. Director. Division of Water Quality, June 12, 2006 Mr. Aaron Smith AST Transportation, Inc. P.O. Box 482 Dudley, NC 28333-0482 Subject: Stormwater General Permit NCG080000 Operations and Maintenance Reminder AST Transportation, Inc. COC Number NCGO80612 Wayne County Dear Permittee: Our records indicate that you have been issued a Stormwater General Permit and a Certificate of Coverage for your facility. These permits have speck conditions that must be met in order for you to be in compliance with your permit. It is your responsibility, as the permit holder, to read and comply with the conditions contained in the permit. It is our responsibility, as the issuing authority, to make sure that the operation and maintenance of your facility complies with the conditions contained in your permit. To assist you in complying with these conditions, we are attaching a Technical Bulletin speck to your permit requirements. We are currently in the process of developing our inspection schedule. Therefore, you should have all of your records up to date as we may be contacting you in the near future to set up an inspection of your facility. If you have any questions, please do not hesitate to contact Samir'Dumpor, Pat Durrett or myself at (252)946-6481. Si cerely Al Hodge, Supervisor Surface Water Protection Unit Encl. CC: WaRO files North Carolina Division of Water Quality Intemet h2o.enr,state,nc.us 943 Washin^ton Square Mall Phone: 252-946-6481 Washington, NC 27889 FAX 252-946-9215 An Equal Opportunity/Affirmative Action Employer— 50% Recycledl10% Post Consumer Paper NorthCarolina Natumlly Mr. Aaron Smith AST Transportation, Inc. -Goldsboro; NC-275-30-- Dear Permittee: i t✓ Michael F. Easley, Governor William Cr. Ross Jr„ Secretary Carolina Department of Environment and Natural Resources Alan W. Klimek, P,E. Director Division of Water Quality May 24, 2006 �r 9 - 735— 0835 Did l'e-r ruc 2� 333- 04 1:" z Subject: Stormwater General Permit NCG080000 Operations and Maintenance Reminder AST Transportation, Inc. COC Number NCG080612 Wayne County . Our records indicate that you have been issued a Stormwater General Permit and a Certificate of Coverage for your facility. These permits have specific conditions that must be met in order for you to be in compliance with your permit. It is your responsibility, as the permit holder,. to read and comply with the conditions contained in the permit. It is our responsibility, as the issuing authority, to make sure that the operation and maintenance of your facility complies with the conditions contained in your permit. To assist you in complying with these conditions, we are attaching a Technical Bulletin specific to your permit requirements. We are currently in the process of developing our inspection schedule. Therefore, you should have all of your records up to date as we may be contacting you in the near future to set up an inspection of your facility. If you have any questions, please do not hesitate to contact Samir Dumpor, Pat Durrett or myself at (252)946-6481. Encl. CC: WaRO files 1 \\ Sincerely AI Hodge, Supervisor Surface Water Protection Unit hVNorth Carolina Division of Water Quality Internet: h2o.enr.state.nc.us 13 Washington Square Mall Phone: 252-946-6481 ashington, NC 27889 FAX 252-946.9215 Equal Opportunity/Affirmative Action Employer— 50% Recycled110% Post Consumer Paper ose NhCarohna NaturallY (� WA Michael F. Easley, Governor 9pG William G. Ross Jr., Secretary North Carolina Department of Environment and Natural Resources Alan W. Klimek, P.E., Director D}Vi"sTbFi f'Wat r uality August 23, 2002 AUG 2 9 2002 AARON SMITH DWQ- ARO AARON SMITH TRUCKING CO INCORPORATED 1 106 SOUTH GEORGE STREET GOLDSBORO, NC 27530 Subject: NPDES Stormwater Permit Renewal Aaron Smith Trucking Co Incorporated COC Number NCGO80612 Wayne County Dear Permittee: In response to your renewal application for continued coverage under general permit NCG080000, the Division of Water Quality (DWQ) is forwarding herewith the reissued stormwater general permit. This permit is reissued pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum or Agreement between the state of North Carolina and the U.S. Environmental Protection Agency, dated Decemher 6, 1983. The following information is included with your permit package: A new Certificate of Coverage A copy of General Stormwater Permit NCGO80000 A copy ol' a Technical Bulletin for the general permit Your coverage under this general permit is not transferable except after notice to DWQ. The Division may require modification or revocation and reissuance or the Certificate of Coverage. This permit does not affect the legal requirements to obtain other permits which may be required by DENR or relieve the permittee From responsibility for compliance with any other applicable federal, state, or local law, rule, standard, ordinance, order, judgment, or decree. If you have any questions regarding this permit package please contact Delonda Alexander of the Central Office Stormwater and General Permits Unit at (919) 733-5083, ext. 584 Sincerely, Bradley Bennett, Supervisor Stormwater and General Permits Unit cc: Centrai Files Stormwater & General Permits Unit Files Washington Regional Office e*� NCDENR N. C. Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 (919) 733-7015 Customer Service 1-800-623-7748 Michael F. Easley, Governor William G. Ross Jr., Secretary North Carolina Department of Environment and Natural Resources w a r�RQ� r1J � December 27, 2001 AARON SMITH AARON SMITH TRUCKING CO INCO RPORATE'D 1 106 SOUTH GEORGE ST GOLDSBORO, NC 27530 Dear Permittec: Gregory J. Thorpe, Ph.D. Acting Director ICE ECE 0 'E" .r;D, oI Water Quality FEB 2 7 2002 DWQ-WARQ Suhjcct: NI1l Storniw,ner Permit Renewal AARON SMITH TRUCKING CO INCORPORATED COC Nunthe' NCG080612 Wayne County Your facility IS currently CovCrcd fur slorntwaler discharge under General Permit NCG080000. This perrnit expires On August 3 L 2002, The Division SWIT is CurrCntly in the process of rewriting this permit and is scheduled to havC the hCrntil rCissucd by late summer of 2002. Once file permit is rciSSucd, }'Our i'acility would be eligible for continued coveragrC under 1111C reissued Pcr-mil. In order IO assure your continued cxwcraOC under the general perrnit, you must apply to the Division of- Water Quality {DWQ} for renewal ol'y�ur pernrit awera��c. TO nnrke this renewal process easier, we arc informing y()u in advance that your permil will be expiring. Enclosed you will find a General Permit Coverag-e Rencival Application Furni. Tlic application roust be completed and returned by March 4. 20112 in order to assurC conlinued coverago under the general permit. Failure io request r'C11CWnl within this time period pray result in a civil assessment of at least $250.00, Larger penalties may be,rssessed delxrnding o❑ the ciclinqucncy Ol the rcyuCS1. Discharge of stormwaler from your facility Without COve-age uncle- A valid stormwatcr NPDLS perrnil would constitute a violation OI'NCGS 143-215.1 ;rod could result in aSscssmCntS Of civil penaltieS of up to $10,000 per clay. Please note that recent I'Cdcral le"islation has extended the "no Cxpnsure exclusion" tO all Operators of industrial facifilics in any of'tile1 1 categories ol- "Stor-ill watu- discharges associated with industrial activity." (CXCel)t construction activities). II-yOu ICCI yOur Grcihty can Certify ,r COnditiOn of 110 CxpOstu-c", i.e. the facilty irrduslrial tnalcrials and Operations are nut cxpOSed ur StormwatCr, you can apply for the rro CxposurC C.XCIUSiun. For additional information contact the Central Office Stormwater Staff inunbe' listed below or check (lie Storinwater & General ]'grants Unil Web Site al hupa/h2o.car.slate.nc.us/su/stolntw.rter.httn! II- the Subject sturmwate' discharge to waters of the state has been te'minaled, please complete the enclosed Rescission Retluest Form. Mailing instructions are listed on the holto n ol'lhe form. You will he notified when the rescission process lilts been complcUd. If you have any questions regarding the permit renewal procedures please contacl Robert Tankard of the Washinglon Regional OflicC at 252-946-6481 or Delonda Alexander of the Central Office Stormwalcr Unit at (9l9) 733-5083. cxt. 584 Sincerely. 1� Bradlcy 13cnnctt, Sry)u'visor StOrntwatCr and G4'r1Cr,rl PCr'rnit"; Unil cc: CCnu-al Fifes Washin"ton lzeoioml Ufl,icu ern NCDENR N. C. Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 (919) 733-7015 Customer Service 1- 800-623-7748 I" — State of North Carolina Department of Environment and Natural Resources Division of Water Quality James B. Hunt, Jr., Governor Wayne McDevitt, Secretary A. Preston Howard, Jr., P.E., Director October 30, 1998 Mr. Aaron Smith Aaron Smith Trucking Co., Inc. 1106 South George Street Goldsboro, North Carolina 27530 Subject: General Permit No. NCGN Aaron Smith Trucking Co., COC NCGO80612 Wayne County Dear Mr. Smith: — IVA .A� K��4.44V NCDENR NOV - 2 1998 WASHINGTON REGIONAL OFFICE OWO In accordance with your application for discharge permit received on June 1, 1998 we are forwarding herewith the subject certificate of coverage to discharge under the subject state - NPDES general permit. This permit is issued pursuant to the requirements of North Carolina General Statute 143-215 .1 and the Memorandum of Agreement between North Carolina and the US Environmental Protection agency dated December 6, 1983. If any parts, measurement frequencies or sampling requirements contained in this permit are unacceptable to you, you have the right to request an individual permit by submitting an individual permit application. Unless such demand is made, this certificate of coverage shall be final and binding. Please take notice that this certificate of coverage is not transferable except after notice to the Division of Water. Quality. The Division of Water Quality may require modification or revocation and reissuance of the certificate of coverage. This permit does not affect the legal requirements to obtain other permits which may be required by the Division of Water Quality or permits required by the Division of Land Resources, Coastal Area Management Act or any other Federal or Local governmental permit that may be required. .If you have any questions concerning this permit, please contact Aisha Lau at telephone number 919/733- 5083 ext. 578. Sincerely, ORIGINAL SIGNED BY WILLIAM C. MILLS A. Preston Howard, Jr., P. E. cc: CWasfiirngton Regional�Office> P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone 919-733-5083 FAX 919-733-9919 An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF WATER QUALITY GENERAL PERMIT NO. NCG080000 CERTIFICATE OF COVERAGE No. NCGO80612 STORMWATER DISCHARGES NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the Federal Water Pollution Control Act, as amended, Aaron Smith Trucking Company, Inc. is hereby authorized to discharge stormwater from a facility located at Aaron Smith Trucking Company, Inc. 1106 South George Street Goldsboro Wayne County to receiving waters designated as the Neuse River, a class C NSW stream in the Neuse River Basin in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II, 111, IV, V and VI of General Permit No. NCG080000 as attached. This Certificate of Coverage shall become effective October 30, 1998. This Certificate of Coverage shall remain in effect for the duration of the General Permit. Signed this day October 30, 1998. ORIGINAL SIGN® BY WILLIAM G MILLS A. Preston Howard, Jr., P.., Duector Division of Water Quality By Authority of the Environmental Management Commission �.� m11vu1>" �CK1J~5 (1UVUUt(Ak1fq ') 2'30" • 769 770 2 290 000 FEET 7 wrLSON 25 Mr. 78° 00, 1 1 T] P7KEVILLE 2.5 MI. 1 rTP 35'22'30" O -,► � � � r~r �� �f l ice' � � I ° ry _. Ik Radio J` ' - ' err .... •. -4 .. � / 1 YI�C/D \ �� I ••��`4 .. I �� 3918 QEL 0 0 0 '�_J tom=_, �, e - . i%� j ` �II- • Park 000 '� j 1 !; J. • _ _:i .. FEET 73 Course Ch i� ti _ � 5 0 1 Emmanuel - \6e \Xiy�.i� jra Allied • `` South .- V� "'.Goldsboro 3916 ra �• '� \ N Rive 7 PitQ Q a "s`. �, \`t\_ / ✓ 1�� Trailer ° ti• V �.,Jr 1,0 a �/ v �P La,kerthxcr \� J ••�� \ J Sewage j love memo k • �;^ (Trailer j - Park �� `:1 1`/ �• BK87 3914 _�� IIJO' �} 1 • } �y--'�. ewage Disposal `� r ~•� / "' Ponds 16 Fairgrounds b IIi; r' ?Gen — • o �� = �� 48 t ' �� ,l a r� �� i92� .'�✓ � � /�. � { \ 13 Y. lrierii3a' , ��• � rl e 1 ,' �"J_ : � �`�. C � � : /�-�' i � `` 7j;11� / �"\ •{ _ A �PkENT.ao�a,�a:�a�=a�aCEs II2 IIIII0IIIIIIIIII�0 1I0INVOICE IIIIIIIIIII Annual Permit Fee This annual fee is required by the North Carolina Administrative Code. It covers the administrative costs associated with your permit. It is required of any person holding a permit for any time during the annual fee period, regardless of the facility's operating status. Failure to pay the fee by the due date will subject the permit to revocation. Operating without a valid permit is a violation and is subject to a $10,000 per day fine. If the permit is revoked and you later decide a permit is needed, you must reapply, with the understanding the permit request may be denied due to changes in environmental, regulatory, or modeling conditions. Permit Number: NCGO80612 Wayne County AST Transportation Inc Aaron Smith President AST Transportation Inc 1106 S George St Goldsboro, NC 27530 Annual Fee Period: 2005-09-01 to 2006-08-31 Invoice Date: 10/13/05 Due Date: 11/12/05 Annual Fee: $80.00 Notes: 1. A $25.00 processing fee will be charged for returned checks in accordance with the North Carolina General Statute 25-3-512. 2. Non -Payment of this fee by the payment due dale will initiate the permit revocation process. 3. Remit payment to: NCDENR - Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 F;04, Should you have any questions regarding this invoice, please comtact the Annual Administering and Compliance Fe919-733-5083 extension 210 — — — — — — — — — — — — -- — — — — — — — — — — — — — — — (Return This Portion With Check) ANNUAL PERMIT INVOICE Permit Number: NCG080612 Wayne County AST Transportation Inc Aaron Smith President AST Transportation Inc 1106 S George St Goldsboro, NC 27530 ���II�V�IIIIIIIIIIIIIIIIInIIV Annual Fee Period: 2005-09-01 to 2006-08-31 Invoice Date: 10/13/05 Due Date: 11/12/05 Annual Fee: $80.00 Check Number: Yl 9'' &/ a 35 lllc�3AO V Michael F. EUL-Y, Ciovmnor a N William Q Rosa Jr., t ° ° tent of tnnVimrk wk and NaturalRaou Ahn W, Klimek P.E. DirwW Division of Watar Quality SUWA" WA3 ER PROTECTION SECTI0TXq PE MUT NAWJQWNMMW CHA}KGt1E� i�(} �. Pie+ RM enter the Pernllt number for which the change h requested. NPDE5 Permit aEOZTKI8ro a 4 (or) Certificate of Coverage N f G d 8 4 t5 M. FtrMilt atatualdff to tta#ms thasoc a. Permit issued to (company rta-w); AA4 vnr s: l %l ' 7 b. Person legally responsible for permit; d Nrn.� Flnt / W / iaetir DuJ zV e Me 1� �emtit l MsilfnB Address 9 EN A 7o State.,33, Phone C. Facility name ( 8e)• if (e lvif 577, dL FacWty addrewL a Facility contact person: chy TkP dnJ /�1/N/Y i �% First F Ad ; t snPIXIM iQ. i?t�se provide the Mle" for the requested cha>s V (rav%aed penwt� a Rapmat for dwage is a result of; a Change in owneramp of the facility 0 Name change of the ply or owner If other please explain- b. Permit issued to (coat my same): c. Ptmm'kfay rmMmaibte for permit: Fnim I Rdr If cast d. Facility namt (discharge): M Facility ad&M-. f. Facility contact ptmson: Permit Boma mat mw hman City —Staft -- 7jp { ) Ph" — FA ►it Area U. city state Zip First 1 Mt ! last Revised 7rM5 Phone E-mail Addt�aa PERMIT NAMBIOWNEitSHIp CHANGE FOR, Page 2 of IV. P"tact laforma ilea: (if di eronr pe*rnit contact: from the person legally rImPonsible for the permit) /r4A4(, zip rtt� V WMt* Aar, this owaa� or name chaange?ngel na to ma Indust"&' acdvittee conducted prior to Q Yes 0 No (please explain) VL RegUired Iton': THISAPPLICA17ON A?LL BE RETURNED UNPROCAWD IF ITEMS ARE INCOMPLETE OR MISSfiW.- * e I I:] This completed application is required for bath name change and/or owm%4 crhmp rwpims. Q Legal dmnnentation of the transfer of ownership (such as relevant pages of a contact deed, Ora bill of sale) is for an ownership change request. Articles of inomporation are not sufficiens for an ownership change. ••I.a••I••.•1♦•..aa...a......aa4..a.la!!.!•!•.!!!l..111..1.................. •............. be... A... A. The certifications below must be completed and signed by AM the t holder permit prior to the change, and the new s¢tlsttt sit lice case oCas, ovrsskip rnlue9t, far a c'bamge xcquoeal, the signed Alrplit�arrt's Certification is sufficient. PERMITTEE CERTIFICATION (Permit holder prior to ownership champ): A S o .' atest *at this applic a ion for a narrWownership cteange,bas been reviewed and fs accurate and complete to the best of my knowledge. 1 undmtmd that if all required parts of Ns WbcBdm are not caanp *d aM that if 0 mqukod supporting kforrnatioa is not iwMod, this application package will be returned as incomplete. s naw APPLICANT CERTIFICA [TON: 1, - _ , attest that this application for a naraclownership ehaW has been revewW and is awmate and complete to the best of my knowledge. I understand that if all required parts of this application are not completed and that if all required supporting information is not included, this applicatian package will be returned as iftwMP16ft. Date PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO: Division of Water QualiV Surface Water Protection Section 1617 Mail Service Center Raleigh, Nordt Carolina 276W-1617 Rwitbab ;r"?. 5