NCS000101_Permit Contact Update Request_20230907

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 9/7/2023 10:22:40 AM (Permit Contact Update Request)
Approve by Joyce Sanford 10/19/2023 12:25:17 PM (Contact Update Review)
• The task was assigned to DEMLR SW Admin General.The due date is: October 19,2023 5:00 PM
9/7/2023 10:22:46 AM
• The task was assigned to Joyce Sanford by round robin distribution 9/7/2023 10:22:46 AM

DEQIwo NPDES Stormwater -Request
Request Submitted
NPDES Permit Enter your NPDES stormwater permit number or Certificate of Coverage(COC)number.
Number* NCS000101
Begins with NCS,NCG,or NCGNE(no exposure)
Facility Name* Riegelwood Mill
(Used to verify permit number)
Check permit contact information for your permit by running a Stormwater Permit Summary Report.
Guidance for COC holders: Do not enter the General Permit number with all 0's(for example, NCG030000)but instead
your Certificate of Coverge(COC)number.
Check all that Owner Affiliation(Legally Responsible Individual)Update
*
apply: Permit Ownership Transfer or Facility Name Change
Delegation of Signature Authority(DOSA)
Permit Contact Update
Billing Contact Update
Facility Contact Update
Other Contact Update
Permit Contact Update
Provide new permit contact information
This person should REPLACE the current permit contact.
This person should just be added as another permit contact.
New Contact Name* First and Last Name
Wallace Coverdale
E-mail Address* [e-mail]
Phone No.* 9103624590
Mailing Address* International Paper
865 John L Riegel Rd
Riegelwood, NC 28456
Physical Address If different than mailing address
This person should REPLACE the current permit contact.
This person should just be added as another permit contact.
New Contact Name* First and Last Name
Kevin Driscoll
E-mail Address* [e-mail]
Phone No.* 9103624880

Mailing Address* International Paper
865 John L Riegel Rd
Riegelwood, NC 28456
Physical Address If different than mailing address
................................................................................................................................................................................................
Add another permit contact if needed by clicking the'Add'button below
Facility Contact Update
Provide new facility contact information
This person should REPLACE the current facility contact.
This person should just be added as another facility contact.
New Contact Name* First and Last Name
Wallace Coverdale
E-mail Address* [e-mail]
Phone No.* 9103624590
Mailing Address* International Paper
865 John L Riegel Rd
Riegelwood, NC 28456
Physical Address If different than mailing address
This person should REPLACE the current facility contact.
This person should just be added as another facility contact.
New Contact Name* First and Last Name
Stephen Greer
E-mail Address* [e-mail]
Phone No.* 9103623476
Mailing Address* International Paper
865 John L Riegel Rd
Riegelwood, NC 28456
Physical Address If different than mailing address
..................... ................................................................................
This person should REPLACE the current facility contact.
This person should just be added as another facility contact.
New Contact Name* First and Last Name
Colleen Cohn
E-mail Address* [e-mail]
Phone No.* 910-362-3339
Mailing Address* International Paper
865 John L Riegel Rd
Riegelwood, NC 28456
Physical Address If different than mailing address
This person should REPLACE the current facility contact.
This person should just be added as another facility contact.

New Contact Name* First and Last Name
Kevin Driscoll
E-mail Address* [e-mail]
Phone No.* 9103624880
Mailing Address* International Paper
865 John L Riegel Rd
Riegelwood, NC 28456
Physical Address If different than mailing address
Add another facility contact if needed by clicking the'Add'button below
Other Contact Updates
Only use this section if none of the categories above apply.
Provide details about Please remove Kevin Burk,Timothy Gill as Facility Contact Persons. Please remove
another contact Kevin Burk, Kimberly Fail,and Gary Morrow as Permit Signature Authority.
update:*
Submitter's Name* Please enter your FIRST and LAST name
Colleen Cohn
Phone Number* Please enter your phone number
9103623339
Any format is fine.
Email Address* Please enter a valid e-mail address
[e-mail]
A confirmation of submission will be e-mailed to this address.
* By checking the box and signing below, I certify that:
I have given true,accurate,and complete information on this form;
I agree that submission of this form is a"transaction"subject to Chapter 66,Article 40 of the NC General Statutes(the
"Uniform Electronic Transactions Act");
I agree to conduct this transaction by electronic means pursuant to Chapter 66,Article 40 of the NC General Statutes(the
"Uniform Electronic Transactions Act");
I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature(except for any uploaded Owner Affiliation Change or Delegation of Signature of Authority forms,which
also must be mailed in with original signature);AND
I intend to electronically sign and submit this Permit Contact Update Request form.
Signature
601W
Date 9/7/2023
Questions? Contact [e-mail].

Review
Verify Permit No.* Revise permit number below if incorrect.
NCS000101