HomeMy WebLinkAboutNCG170297_Email re Owner Change Form_20190917r
NCDENR
Division of Energy, Mineral & Land Reu�--
Land Quality Section/Stormw,
National Pollutant Discharge Elh
PERMIT NAME/OWNERSHIP C
I. Please enter the permit number for which thcc ange is re
NPDES Permit (or)
W01§11011
II. Permit status prior to requested change.
a. Permit issued to (company name):
b. Person legally responsible for permit:
c. Facility name (discharge):
d. Facility address:
e. Facility contact person:
�C&� 0 102lq
Certificate of Coverage
G 010 Farr, 1.LG
Nam u1 aq Jus
First MI Last
plans- "aue.r
Title
Pn &L66q 150(o eask Main SAree+
Permit Holder Mailing Address
NA brt NG asrtt.a
City State Zip
(929 )6b9.3alP3 (8�18)(*9 3�W
Phone Fax
�Rc bld Fbfi' 1 LI-G
ltz!p Ecls± min 5trecr
Address
CAA For+ N Cl a tg ba
City State Zip
I�enny Green e (gag) b69.3�103
First / MI / Last Phone
III. Please provide the following for the requested change (revised permit).
a. Request for change is a result of: ❑ ange in ownership of the facility
Tame change of the facility or owner
If other please explain:
b. Permit issued to (cam
c. Person legally respon:
Plain+ l't:nQAer
Title
Po Box UP 150(o East MOL Im �Iteei
Permit Holder Mailing Address
(id,-+ aB�toa
city State Zip
(89S )lold(-3X3 Ke►nu.Areeneeau(laso(tit tons AD
Phope Em&Address
d. Facility name (discharge): AuntL 016 Fbr+71, UPI
e. Facility address: 15-Uo EQ&t MCk In ee
Address
old Fect NC a�76a
City late Zip
£ Facility contact person: rs un\j 9 C)ree n e
First I MI Last
(KKK) bW3..Z3 ,ewu.grmW0urlaaAtthcA&xall
Phone E -mqil Address
IV. Permit contact information (if different from the person legally responsible for the permit)
Revised Jan. 27, 2014
NPDES PERMIT NAME/OWNERSHIP CHANGE FORM
Page 2 of 2
Permit contact: Kenn j 9 Green
First I Ml Last
Human Aexu,rces Man&aer
Title
Pox U A 15Db F1sfMai'n Sireei"
D Fort Mailing Add& /b
City State Zip
( 1t 9r 3AO ka .aruneCraaur►aso1600S.cerr
Phone Ord I Address
V Will the permitted facility continue to conduct the same industrial activities conducted prior
to tbo ownership or name change?
Yes
❑ No (please explain)
Vil Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS
ARE INCOMPLETE OR MISSING:
Rr This completed application is required for both name change and/or ownership change
Mrrequests.
Legal documentation of the transfer of ownership (such as relevant pages of a contract deed,
or a bill of sale) is required for an ownership change request. Articles of incorporation are
not sufficient for an ownership change.
......................................................................................................................
The certifications below must be completed and signed by both the permit holder prior to the change, and
the new applicant in the case of an ownership change request. For a name change request, the signed
Applicant's Certification is sufficient.
PETTEE CERTIFICATION (Permit holder prior to ownership change):
I, attest that this application for a name/ownership change 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 and that if all required supporting information is not included, this application package will be
returned as ' complete.
Signature Date
AP ICANT CERTIFICATION
I, attest that this application for a name/ownership change has been reviewed and is accurate and
complete to the best of my knowledge. I understand that if all required parts of thisapplication are not
completed and that if all required supporting information is not included, this application package will be
returned s incomplete.
Signature Date
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Division of Energy, Mineral and Land Resources
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 276994612
Revised Jan. 27, 2014
NORTHROLINA
'
J.'Department of of
AMENDED CERTIFICATE OF AUTHORITY
I, Elaine F. Marshall, Secretary of State of the State of North Carolina, do hereby certify
that
AURIA OLD FORT II, LLC
is hereby issued an Amended Certificate of Authority evidencing its name change from
IAC OLD PORT II, LLC. A copy of the application for an amended certificate of
authority conforming to the requirements of the general statutes of North Carolina is
attached.
Scav to verify online.
Docnmevt Id: C201800800513
Verify Ihis certificate ogliae et hnpl/vnvwsoanc.gov/verification
IIV 1NITNESS WHH1iEOF, I have hereunto set
my hand and affixed my official seal et the City
of Raleigh, this 8th day of January, 2018.
Secretary of State
SOSID: 1006917
Date Filed: 1/8/2018 2:48:00 PM
Elaine F. Marshall
North Carolina Secretary of State
C2018 008 00513
S'tete of North CaroUnn
Department of the Seerelaq ofAde
APPLICATION FOR AMENDED CERTIFICATE OF AUTHORITY
FORLIMITED LIABILITY COMPANY
Pursuant M §57D•7.04 ofiha l3nneral Statutes oFNodir Cotrolhte, the undersigned limited liabillry acmpany hereby applies for an
Amended Cer08oate of Audrorily to transact business is the State of North Carolins, and for that purpose submits the following
statement •
1. NemeofLimitedLiablllryCompany
The nameoftfie limited lteblllty company axaetly as 1t appears on'the Certificate of Authority ourcen0y on fits with the
North Cmnlina Deportment oftho Secratery of State:
IAC Old Fort If, LLC
b, The fiodtlous name, If ally, of the limited Itebllity company currently on IDo with the NC Department of the Searetsry of
State is:
2, The state or ommtry of 4ormatlon is: p �
3• The data the limited liability company was authorized to trsusuct business in the State of North Carolina is: 10w15=2007
d, The changes being made arro as follows: (Sea (xsh•uc(Iens fa• the speck uses oj(h!s document)
Auria Old Fort II, LLC
5Atleuhedisacedificataofexistence(ordooumentofslmltsrimpmt),dulyauthenticatedbythaSeoretaryofStateorothorofficlel
havlug custody of limited 8eblllly compatly records in the state or oowttry of forniadon, The certificate ofexiatonco must be leas
than six months old. AphotcoopyofthecortiSealioncannot beeccepted.
G. This application will 6e eH'eGive upon filing, unless edate and/or time is apeoi8ed:
'1'histho 3rd aayof January 20 18,
Notre;
I. Filing fee Is S50• This appllratlsn mart bo filed with the Saeralnry ofSlatm
BUSBd893 RBOLSTRAIAON DIVISION
(fiavlaarlJidyTO/y)
P• D, BOX 20622
BA'L[iIOH, NC 27626.Oti22
(Form L-IO)
Delaware Pagel
The First State
S, JEFFREY W. BULLOCK, SECRETARY OF STATE OF THE STATE OF
DELAWARE, DO HEREBY CERTIFY "AURSA OLD FORT IS, LLC" IS DULY FORMED
UNDER THE LAWS OF THE STATE OF DELAWARE AND IS IN GOOD STANDING AND
HAS A LEGAL EXISTENCE SO FAR AS THE RECORDS OF THIS OFFICE SNOW, AS
OF TEE FIFTH DAY OF JANUARY, A.D. 2028,
._� -, ram• ., r : �. - -
II, LLC" WAS FORMED ON THE EIGHTEENTR DAY OF JULY; A.D. 2007.
f7i�!
;•�1R'':'I .1i
391397 8311RN 20180075000
Authentication:
201921179
Date: 01-05-18
North Carolina Department of Environmental Quality
09-22-17
I am writing to inform the NC DEQ
of a
change
in ownership of the property
(Manufacturing
Facility)
located
at
1609
East Main
street Old Pon Nc 28762,
Mailing address:
Auria Manufacturing Old Fort
P.O. Box: 669 Old Fort, NC 28762
Prior to 09-15-17 the property was owned and operated by InternationalAutomotive
Components; as of 12:01 am on 09-15A7 the property is owned and operated by Auria
Solutions USA Inc, and assumed all regulatory and legal responsibilities. The legal name
of the property at 1506 East Main St Old Fort NC is Auria Old Fort LLG,
Please contact me if you have questions or need any additional information.
Sincerety-
Sean P. ReeclY
Regional EH&S Manager
Auria
Mobile: 419-656-9919
Sean.Reedy0aunasolutions,com
www.auriasoluttons.com
Autla Stllutioaa
4778G WestAnchor Cnurt
Plymouth, MI 4D1717
F'itona +t (734) 45G-2800
Fax +t (734) 456-2D29
www.aurias of uti ons.00m
USPS TRACKING #
First -Class -Mail
1111111111111111111111111111111111111111 I Postage &Fees Paid
Permst No. G-10
9590 9402 2375 6249 4844 37
United States.
Postal Service
• Sender: Please print your name, address, and ZIP+4® in this
Burt a, OId For+
Kenny Grcene�
j FXat+ Mat n Sired
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Postal
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Domestic Mail Only
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