ROGERS GROUP, INC. P.O. BOX Nashville, TN Phone (615)

Transcription

1 ROGERS GROUP, INC. P.O. BOX Nashville, TN Phone (615) May 8, 2013 Mr. Mo Shafii ADEQ- Water Division- NPDES Branch 5301 Northshore Drive North Little Rock, AR RE: Rogers Group, Inc. - Farmington Quarry NPDES -Water Permit Transfer AFIN ARR Dear Mr. Shafii: Please find enclosed the completed Permit Transfer Form for the permit listed above. Rogers Group, Inc. has entered into a partnership with Northwest Arkansas Quarries to form a new company to be known as Hunt-Rogers Materials with Rogers Group Inc. being the managing partner. If you have any questions or need any additional information hesitate to contact myself at (615) cc: Tim Gorman, VP of Arkansas Operations Enclosures An Equal Opportunity Employer. M/ F/ V/ 0

2 Please select one of the following options: A. Permittee (legal name) change DB De PERMIT TRANSFER FORM B. Facility name change DA&B DA&C C. Responsible official name change DB&C DA&B&C PERMITNUMBER: ~A=R=R=0~00=2~4~3 I. CURRENT PERMITTEE INFORMATION Permittee (legal name): Rogers Group, Inc. Facility Name: Farmington Quarry Responsible Official Name (see Section IV below): Van Medlock Is the permittee identified above, the owner of the facility? ~ Yes D No If you mark No, please list the name of the owner: II. NEW PERMITTEE INFORMATION Permittee (legal name): Facility Name (if different from Permittee Name): Is the permittee identified above, the owner of the facility? ~ Yes D No If you mark No, please list the name of the owner: Hunt-Rogers Materials LLC, Managing Partner Rogers Group, Inc. Responsible Official Name (see Section IV below): Van Medlock Official Title of Responsible Officer: Dir. ofenv. Services van.medlock@rogersgroupinc.com Owner Type: Permittee Address: 421 Great Circle Road D STATE ~PARTNERSHIP Permittee City: Nashville D FEDERAL D CORPORATION* Permittee State: TN Zip: D SOLE PROPRIETORSHIP Permittee Telephone No.: Is the new permittee registered with the Arkansas Secretary of State? If yes, please provide the full name of corporation if different than the legal permittee name listed above. ~Yes D No Facility Mailing Address: Hamstring Rd WC 842 Facility City: Fayetteville Facility State: AR Zip: Facility Contact Person Name: -=D...:.w:.=a:Ly.:..:.ne.:...=G~a=-bb::..:a.:..:.r.=.d Contact Person Title: Superintendent dwayne.gabbard@rogersgr Telephone Number: _:..:...:...:...:...:..::...:.=c::...:...: Fax Number: oupinc.com Invoice Contact Person: Van Medlock City: Nashville Invoice Mailing Address: 421 Great Circle Road State: _T_:_N::_: Zip: Invoice Mailing Address: Telephone: Cognizant Official Name: --=.T.::irn:..:...:G:...:o:..:.rm=an::..:... Cognizant Official Title: VP of AR Operations tim.gorman@rogersgroupi Telephone Number: :_c:...::.c..::..=...:...:..c::...:...: Fax Number: _::nc.:..:.=..co::..:m.:..:... ARKANSAS DEPARTMENT OF ENVIRONMENTAL QUALITY 5301 NORTHSHORE DRIVE I NORTH UTILE ROCK I ARKANSAS I TELEPHONE I FAX

3 PERMIT TRANSFER FORM III. OWNERSHIP CHANGE AGREEMENT Please note you must complete this Section (Ill.) only if the permit has a new owner or a new ownership. Please specify the closing date for this transaction: Current Permittee (Seller): Signature of Responsible Corporate Officer: Title of Responsible Corporate Officer: Printed Name of Responsible Corporate Officer: Date: New Permittee (Buyer): Signature of Responsible Corporate Officer: Title of Responsible Corporate Officer: Printed Name of Responsible Corporate Officer: Date: Disclosure Statement: Disclosure Statement must be submitted for new permittee. Disclosure Statement is not required for Stormwater Permits. Is Disclosure Statement enclosed: [gl Yes D No Financial Assurance: Please note that if Financial Assurance is required for the current permittee then the new permittee may have to provide new Financial Assurance before the permit maybe transferred.. Land Use Contract: For land application permits you must submit a new land use contracts for all the sites permitted under the current permit for land application. The new land use contract must be signed by the new permittee and land owner. IV. CERTIFICATION OF NEW PERMITTEE "I certify that the cognizant official designated in this Permit Transfer Form (Section II) is qualified to act as a duly authorized representative under the provisions of 40 CFR Part (b). If no cognizant official has been designated, I understand that the Department will accept reports signed by the applicant. I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations." In addition, I certify that there will be no operational changes that warrant a permit modification. (Please note that if there are changes that warrant a permit modification, then you must submit a complete application, updated plans, design calculations and specifications, and the permit modification fee along with this Ownership Change Form. The transfer may be made effective prior to permit modification.) Typed or Printed Name: :.Tc..:ilc..:ll...:G :::;.,{:c..:,r::::n;;; l a;:;.n;.. -r~~a' Signature: ~,-;a..;~ -- -~ /-c.- Title: VP of AR Operations Date: _.::.:5/-=8:...:/1-= :-- ARKANSAS DEPARTMENT OF ENVIRONMENTAL QUALITY 5301 NORTH SHORE DRIVE I NORTH UTILE ROCK I ARKANSAS I TELEPHONE I FAX

4 Instructions for the Completion of this Document: A. Individuals, firms or other legal entities with no changes to an ADEQ Disclosure Statement, complete items 1 through 5 and 18. B. Individuals who never submitted an ADEQ Disclosure Statement, complete items 1 through 4, 6, 7, and 16 through 18. C. Firms or other legal entities who never submitted an ADEQ Disclosure Statement, complete 1 through 4, and 6 through 18. Mail to: ADEQ DISCLOSURE STATEMENT [List Proper Division(s)] 5301 Northshore Drive North Little Rock, AR Hand Deliver to: ADEQ DISCLOSURE STATEMENT (List Proper Division (s)] 5301 Northshore Drive North Little Rock, AR APPLICANT: (Full Name) Hunt-Rogers Materials, LLC 2. MAILING ADDRESS (Number and Street, P.O.Box Or Rural Route) : 421 Great Circle Road 3. CITY, STATE, AND ZIPCODE: Nashville, Tennessee (check all that apply.) D Individual [8] Corporate or Other Entity [8] Permit D License D Certification D Operational Authority D New Application D Modification D Renewal Application (If no changes from previous disclosure statement, complete number 5 and 18.) [8] Air [8]water D Hazardous Waste [8] Regulated Storage Tank [8]Mining D Solid Waste D Environmental Preservation and Technical Service 5. D~laratiao afr~a Changes: The violation history, experience and credentials, involvement in current or pending environmental lawsuits, civil and criminal, have not changed since the last Disclosure Statement I filed with ADEQ on Signature oflndividual or Authorized Representative of Firm or Legal Entity (Also complete #18.)

5 8. List all officers of the Applicant (Add additional pages, if necessary.) SEEATIACHMENT 1 ' 9. List all directors of the Applicant. (Add additional pages, if necessary.) SEE ATIACHMENT List all partners of the Applicant. (Add additional pages, if necessary.) STREET STREET 11. List all persons employed by the Applicant in a supervisory capacity or with authority over operations of the facility subject to this application. Tim Gorman 1223 Front Street Conway, Arkansas VP, SMA Manager, Arkansas Darin Matson 421 Great Circle Road Nashville, Tennessee Vice President, Arkansas

6 16. List any person who is not now in compliance or has a history of noncompliance with the environmental laws or regulations of this state or any other jurisdiction and who through relationship by blood or marriage or through any other relationship could be reasonably expected to significantly influence the Applicant in a manner which could adversely affect the environment. _N_O_N_E List all federal environmental agencies and any other environmental agencies outside this state that have or have had regulatory responsibility over the Applicant. EPA, States of Indiana, Kentucky, Alabama, Mississippi, North Carolina, & Tennessee

7 ATTACHMENT A ROGERS GROUP, INC. is the Managing Member of the Applicant, Hunt-Rogers Materials, LLC. Below are the officers and directors of Rogers Group, Inc. ROGERS GROUP, INC.- OFFICERS President and Chief Executive Officer Chief Financial Officer and Corporate Controller Gerard V. Geraghty James A. Patton, Jr. Vice President Finance and Treasurer ---- Vice President- Business Development, And Information Systems Vice President, General Counsel and Secretary Vice President, Human Resources, Safety and Aviation Division Vice President, Central Division Division Vice President, Eastern Division Division Vice President, South Central Division Division Vice President, Mid-Central Division and Senior Construction Executive Vice President and Strategic Market Area Manager, Indiana Central Kentucky Carolina Western Kentucky Alabama Stephen P. Masie Daniel C. Rose Kye W. Hudson Darin M. Matson Mark A. Stephens Randy A. Butler Richard N. Turner Andrew W. Williams Leslie A. Geralds, Jr. David W. Rechter Laura R. Harper Derek M. Roberts Timothy S. Gorman

8 From: To: Subject: Date: Temple, Jessica Burrow, Kealey FW: Transfer of ARR00C371, ARG500064, ARR00C123, ARR Tuesday, August 29, :23:19 PM Can you please save this with the transfer form for each of the permit numbers listed? Thanks, Jessica From: Van Medlock Sent: Thursday, May 16, :52 AM To: Temple, Jessica Subject: RE: Transfer of ARR00C371, ARG500064, ARR00C123, ARR Each facility should have its own name as Springdale Quarry, Lowell Quarry, and Farmington Quarry. You can drop the managing part of the title below. From: Temple, Jessica Sent: Thursday, May 16, :58 AM To: Van Medlock Subject: Transfer of ARR00C371, ARG500064, ARR00C123, ARR Van, I have a question for you. We received transfer forms for the following permits: ARR00C371, ARG500064, ARR00C123, ARR The blank for the new facility name was left empty. When that is the case, we usually put the Permittee (legal name) as the facility name. If we do the same as the Permittee name, all of the permits would have the same facility name. I can do that if you want, but I just thought I would check since that could be confusing. Also, do you want the Permittee to be listed exactly as Hunt-Rogers Materials LLC, Managing Partner Rogers Group, Inc? Thanks, Jessica Temple Engineer ADEQ-Water Division

9 Permit change Route sheet ownership change 0 Facility Name Change D Responsible Official Change 0 Project/Facility Name K-o~e;rs GYO.A10 } VlC. Permit Number.A\?_ tood24s AFIN NO. Assigned Activity Initials Sect. (1 day) Application Logged/ Assign to Engineer ~~ Completeness and Technical Review Engineer (3 days) Enter Update Info to Database v Disclosure Statement for ARG J 'Jt AA (15 days) Enter Into PDS v Merge Change of5j/ Fr m (if applicable 1 I 3,-6 C/0 Form to Jom ~ ittee (if applicable) 5 11 I~ Wait 10-days for response (if applicable) Merger Letter for Permittee -rd./"\ Engineer (1 day) Review transfer letter and documents lj rj) Engineer Supervisor Review all the documents and letter (1 day) Permits Section Review the documents and sign l.:/ Chief (1 day) Mail original to applicant. Scan complete folder and place in Sect. appropriate E-drive folders. Update (\) (1 day) Zylab. Be sure to include this change in weekly report, due every Tuesday ~. 2:00P.M. ll-0 ({Q\ Date Complete/Entered S- 10)--fJ <;-1 ~-ts 5fltol Ql\,~ j~uvl) )--1 /!J /""' S-l.C\~\~ Remarks: Revised 1/5111