NCS000349_NameOwnership Change request_20150625

Atlanta Environmental Mana_aement Inc.
Environmental Consulting,Engineering.Hydrogeologic Services
June 25, 2015
Mr. Bradley Bennett
Supervisor
Division of Energy, Mineral and Land Resources
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Re: Permit Name/Ownership Change Request
Stormwater NPDES Permit No. NCS000349
North Carolina Renewable Power--Lumberton, LLC
1866 Hestertown Road, Lumberton, North Carolina 28358
AEM Project No. 1507-1401
Dear Mr. Bennett:
On behalf of North Carolina Renewable Power—Lumberton, LLC, enclosed please find
an original signed Permit Name/Ownership Change Request Form for the former Lumberton
Energy, LLC, facility's National Pollutant Discharge Elimination System Stormwater Permit
located at 1866 Hestertown Road, Lumberton, North Carolina. Also included with this request is
a copy of the Special Warranty Deed transferring ownership of the property from Lumberton
Energy, LLC, to North Carolina Renewable Power—Lumberton, LLC.
If you have any questions, please do not hesitate to contact us at 404-329-9006 or via e-
mail at [e-mail].
Sincerely,
Atlanta Environmental Management, Inc.
eo a Miles, CHMM
Senior Project Manager
Janet T. Hart
President
Ikrf
c: Mark Fowler (Green Fuels Energy) via e-mail
Enclosure
2580 Northeast Expressway • Atlanta,Georgia 30345
,�,a3 Telephone:[phone] + Pax:[phone]

i
Division of Energy, Mineral&Land Resources FOR AGENCY USE ONLY
Date Received
Land Quality Section/Stormwater Permitting Year Month Day
National Pollutant Discharge Elimination System
NCDENR
Re¢wacea
—
r� N.��Kro.
Er.Hnonwca.. NutfaLL PERMIT NAME/OWNERSHIP CHANGE FORM
I. Please enter the permit number for which the change is requested.
NPDES Permit (or) Certificate of Coverage
N I C I S 10 10 10 13 14 1 9 1 1 N I C I G
H. Permit status prior to requested change.
a. Permit issued to(company name): Lumberton Investment I,LLC
b. Person legally responsible for permit: Thomas J Mckittrick
First MI Last
Managing Memeber
Title
5320 Old Pinevill Road
Permit Holder Mailing Address
Charlotte NC 28217
City State Zip
[phone] [phone]
Phone Fax
c. Facility name(discharge): Lumberton Investment I,LLC
d. Facility address: 1866 Hestertown Road
Address
Lumberton NC 28358
City State Zip
e. Facility contact person: Steven R. Ingle [phone]
First /MI/Last Phone
III. Please provide the following for the requested change(revised permit).
a. Request for change is a result of: ® Change in ownership of the facility
® Name change of the facility or owner
If other please explain:
b. Permit issued to(company name): North Carolina Renewable Power-Lumberton, LLC
c. Person legally responsible for permit: Steven R Ingle
First MI Last
Vice-President Of Engineering
Title
4599 East Lake Boulevard
Permit Holder Mailing Address
Birmingham NC 32517
City State Zip
[phone] [e-mail]
Phone E-mail Address
d. Facility name(discharge): North Carolina Renewable Power-Lumberton, LLC
e. Facility address: 1866 Hestertown Road
Address
Lumberton NC 28358
City State Zip
f. Facility contact person: Steven R Ingle
First MI Last
[phone] [e-mail]
Phone E-mail 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: Mark Fowler
First MI Last
Title
4599 East Lake Boulevard
Mailing Address
Birmingham NC 32517
City State Zip
[phone] [e-mail]
Phone E-mail Address
V. Will the permitted facility continue to conduct the same industrial activities conducted prior
to this ownership or name change?
❑ Yes
North Carolina Renewable Power-Lumberton,LLC will not use coas a
® No(please explain) fuel source; only biomass and poultry litter. The former maintenance
building is being renovated to store all poultry litter undercover.
VI. Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS
ARE INCOMPLETE OR MISSING:
❑ This completed application is required for both name change and/or ownership change
requests.
❑ 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.
PERMITTEE CERTIFICATION(Permit holder prior to ownership change):
I,Thomas 1 itt 'ck,attest that this application for a name/ownership change has been reviewed and is
accurate comp to to the best of my knowledge. I understand that if all required parts of this
applic ion are n completed and that if all required supporting information is not included,this application
pa age will be eturned s incomplete.
1/
Signature Late
A/eveCn
NT CERTIFICATION
I, . In le attest that this application for a name/ownership change has been reviewed and is
ccurate 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 re ma mplete.
ignature 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 27699-1612
Revised Jan.27,2014

Book I98a Page 14
M5002ass
ROBESON CO.NC FEE$26M
This certifies that PIN: toss 03ootot STATE OF NC REAL ESTATE EXT
is tree of any delinquent ad valorem Tax liens 11300.00
changed to the Robeson County Tax Collector; PR/06/2+tTED: R36 PM tJ
VI015 and does certify that the deed descliption VICKIL LOCKLEA�R
t rnalche3 this PIN, REGISTER OF DEEDS
BY:KYNIAJOHNSON
DEPUTY
15 BK:D 1988
Muprxr..1ocnnI&an Signature Date NC PG:14-16
t Excise Tax:$14.Z200-00 PIN(s):030015086300
i
t
Prepared by and-Retu t"u— ReWrn To:
i Seyfarth Shaw LLP First American Title insurance-NCS
1075 Peachtree St.NE,Sttite 2500 6 Concourse Parkway,Suite 2000
Atlanta,GA 30309 Atlanta,GA 30328
A4wutien:Daniel H.Sherman IV,I Sq. Attn: John 5pet6,*-r
7001142
Brief Description for the Index 13.03 acre parcel in the Township of
Lumberton,Robeson County,NC
0
0
N d NORTH CAROLINA SPECIAL WARRANTY DEED
r:
u+,
e--
c a THIS C)CiT?C7 made this 26th day of March,2015, by turd behvecn
O
fi C
ORANTOR c;RAN•rl-
-2 Lumberton Investments 1,LLC,a
0 North Carolina limited liability company North Carolina Renewable Power-
°J`Y clo Forsite Development, Inc. Lumberton,LLC,a Delaware limited
_a 5320 Old Pineville Roud liability company
Charlotte NC 28217 4599 East bake Boulevard
' Binningltarn,AL 35217
x-AS F.nier in appropriate block for each Marty:mate,address,and,it appropriate,character orentity,e.g.curpurutiun or
partnership.
Z.,
0'd a
N Y
N L
c ]he designation Grantor and Crane,;,as used herein,shall include said parties,their heirs,successors,tmd ttasigns,and shalt
include singular,plu il,masculine,temioine or natter as requiters by context.
s o�
oc! WITNESSF,TH,that Grantor,for and in consideration(if tire stun of'1'C:N DOLLARS
I u; (S10)and other good and valuable consideration in hand paid to the undersigned by Grantee,the
z y receipt and sufficiency of such consideration being hereby acknowledged,has GRAWED,
i t 5 SOLD AND CONVEYED,and by these presents does hereby GRANT,SELL,CONVEY and
CONFIRM unto Grantee that certain real property being more particularly described on Exhibit
A attached hereto mid made a part hereof for all purposes,together with all improvements and
vfixtures situated thereon(collectively,the"Property");SUBJECT TO ull real estate taxes not
w� yet delinquent;covenants,conditions,restrictions,easements,rights of way and other mutters of
a g rr:card; applicable laws,ordinances,statutes,orders,requirements and regulations to which the
Property is subject;and all matters disclosed by an accurate survey of the Property.
N•C rCj
The Property hereinabove described was acquirer!by Grantor by instrumcnt recorded in
Book 1960,Page 235,Instnu-nent No.20144005988,Robeson County Registry.

EXI-11BIT A
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All or a portion of the Property lierein conveyed does not include the primary residence
of(iranlor.
O I IAVE AND TO 1101_1)the Pi-operty,together with all :aid singular the rights,
hereditarnents,and appurtenances thereto in anywise belonging,unto Grantee, its successors and
assigns,and Grantor hereby agrees to WARRANT AND FOREVER DEFEND all and singular
the: Property unto Grantee, its suceessurs and astiign,,against every person whomsoever lawfully
Claiming,or Claim the Saute,or any part therex)f,by,through,or under Grantor but not otherwise.
IN WITNESS MR.-'RE:OF,Grantor has caused this instrument to be signed in its name
this �ilay of tkjY E'I _,2015,aned delivered as of the date indicated on the first page of
this Dccd.
GRANTOR:
GRANTOR:
LiJMB1.1t'1'9 rfN ES'1-VENTS 1, LLC,
a North C olina I sited liability company
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By: I
.County, (,Xz'hV7 i;t.
I certify that the following person personally appeared betitre me this clay and
acknowledged to me that Ira or she voluntarily s'2ned the Corcgo'ng document for the pumosc
stated therein and in the capacity indicated:
)..t)
. tt
Notary I uhlic
Printed Name:,.�i wl
My Commission lApires:
{Affix Notary Stamp or Seal J
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