NCG080839_Name-Owner Change Application_20260520

• -' NC DEPARTMENT OF ENVIRONMENTAL QUALITY
P ' -4. } DIVISION OF Energy, Mineral, and Land Resources
STORMWATER PROGRAM
NORTH CAROLINA
Environmental Quality
NPDES STORMWATER PERMIT NAME/OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION:
Permit Number: NCS / / / / / or NCG D / k/ Di Y/ 3 / 9
1. Facility Name: Reworld Asheboro, LLC (Carl Drive Facility)
II. NEW OWNER/NAME INFORMATION:
2. This request for a name change is a result of:
X a. Change in ownership of property/company
X b. Name change only(Facility and/or Company). New facility name should be listed
above.
c. Other(please explain):
(for example,facility address update)
3. New owner's name (name to be put on permit as Permittee):
Reworld Asheboro, LLC
4. New owner's or signing official's name and title: �bi$bLi 1V 4414
(Person legally responsible for permit)
..S1z \b1)o ie_- ,, Lfir.tt..,,%iroa1 1
Title)
5. Mailing address: 2242 Carl Drive City: Asheboro
State: NC Zip Code: 27203 Phone: ( 336 )301 -9226
E-mail address: [e-mail]
6. Effective date of transferor name change: April 16 2024
DE ..._ North Carolina Department or Environmental Quality I Division ofo Energy.Mineral and Land Resources
�— �Jg' S12 North Salisbury Street i tbl2 Mail Scrvice Center Raleigh North Carolina 27699 l 12
a—'+ �� � /'� 919.707.9200

NPDES Stormwater Permit Name/Ownership Change
Page 2 of 3
III. PERMIT AND FACILITY CONTACT INFORMATION
7. New permit contact's name and title: Natalie Stennis
(Permit Contact)
Environmental, Health & Safety Manager
(Title)
8. Mailing address: 2242 Carl Drive City: Asheboro
State: NC Zip Code: 27203 Phone: ( 336 )633-9261
E-mail address: [e-mail]
9. New facility contact's name and title: Natalie Stennis
(Facility Contact)
Environmental, Health & Safety Manager
(Title)
10. Mailing address: 2242 Carl Drive City: Asheboro
State: NC zip Code: 27203 Phone: ( 336 )633-9261
E-mail address: [e-mail]
11. New billing contact's name: Natalie Stennis
(Billing Contact)
12. Mailing address: 2242 Carl Drive City: Asheboro
State: NC Zip Code: 27203 Phone: ( 336 )633-9261
E-mail address: [e-mail]
IV. FACILITY ACTIVITIES AND DISCHARGE INFORMATION
1. Will industrial activities at the facility remain the same as under the previous owner?
Yes No
2. Will the stormwater discharge location(s) remain the same? Yes N No 0
NOTE: If either of these questions is answered"No,"then more information is needed to review
the request. Please attach documentation to describe and explain the changes to the facility
activities, storm water discharges, and/or outfall location. Depending on the information
provided, the Division may require that the new owner file a new permit application.
Last Revised 11/24/2025

NPDES Stormwater Permit Name/Ownership Change
Page 3 of 3
THIS APPLICATION PACKAGE WILL NOT BE ACCEPTED BY THE DIVISION UNLESS
ALL OF THE ITEMS LISTED BELOW ARE INCLUDED.
REQUIRED ITEMS:
1. This completed application form (with original signature)
2. Legal documentation of transfer of ownership (such as relevant pages of a deed or a bill of sale) is
required for an ownership change request.Articles of incorporation are not sufficient for an
ownership change but can be provided for a name change.
3. Information to document facility,industrial activities, stormwater discharges, or outfall changes
as noted in item IV above (if appropriate)
Why is this information needed?
Regulations in 40 CFR§122.63 allow for minor modifications to NPDES permits for a change of
ownership or operational control of a facility, provided that information supports that no other change
in the permit are necessary.
Why does this form need to be mailed in?
Permittees and applicants must fulfill signatory requirements in the NPDES federal
regulations in 40 CFR §122.22 (please see those regulations for guidance). Until NCDEQ's
electronic submission process meets Cross-Media Electronic Reporting (CROMERR)
requirements, this original signed (not digital signature) form must be mailed to the
address below. The uploaded copy is stored as part of the permit record in the Division's
digital repository.
Applicant's Certification:
Bobby Needham
I, , attest that the application for a name and/or ownership
change submitted 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, or if all
required supporting information is not included, this application package will be considered
incomplete and may be returned.
May 20, 2026
Signature: - Date:
THE COMPLETED APPLICATION AND ALL SUPPORTING INFORMATION SHOULD BE SENT TO:
Via USPS: Via Courrier (UPS, FedEx, etc.):
DEMLR Stormwater Program DEMLR Stormwater Program
1612 Mail Service Center - OR - 512 North Salisbury Street
Raleigh, NC 27699-1612 Raleigh, NC 27604
Last Revised 11/24/2025