Q General Cable. July 15, ADEQ Water Division 5301 Northshore Drive North Little Rock, AR RE: Permit Transfer Form ADEQ:

Transcription

1 Q General Cable July 15, 2014 ADEQ Water Division 5301 Northshore Drive North Little Rock, AR RE: Permit Transfer Form ADEQ: General Cable Industries, Inc. has acquired Prestolite Wire, LLC located at 1 Prestolite Drive, Paragould, AR effective on June 27, Enclosed is a completed Permit Transfer Form for the facility storm water permit. Please contact me if you have questions or require additional information. Regards; Michael Sharkey Michael Sharkey Director EHS General Cable 7920 Rockville Road Indianapolis, IN msharkey@generalcable.com (317)

2 Please select one of the following options: A. Pennittee (legal name) change DB De PERMIT TRANSFER FORM H. Facility name change DA&B [8JA&C C. Responsible official name change DB&C DA&B&C PERMIT NUMBER: I. CURRENT PERMITTEE INFORMATION Pennittee (legal name): Facility Name: Responsible Official Name (see Section IV below): ARROOA610 --~~--~ Is the pennittee identified above, the owner of the facility? If you mark No, please list the name of the owner: Prestolite Wire, LLC Paragould Plant Emerson C. Moser DYes [8J No General Cable Industries, Inc. II. NEW PERMITTEE INFORMATION Pennittee (legal name): Facility Name (if different from Pennittee Name): Is the permittee identified above, the owner of the facility? If you mark No, please list the name of the owner: General Cable Industries, Inc. [8J Yes D No Responsible Official Name (see Section IV below): Official Title of Responsible Officer: Pennittee Address: Pennittee City: Assistant Secretary Emerson C. Moser emoser@generalcable.com 4 Tesseneer Drive Highland Heights Pennittee State: KY Zip: ;_::_:_:..:;._ Permittee Telephone No.: (859) Owner Type: 0 STATE D PARTNERSHIP 0 FEDERAL [8J CORPORATION* _ 0 SOLE PROPRIETORSHIP Is the new pem1ittee registered with the Arkansas Secretary of State? If yes, please provide the full name of corporation tf different than the legal pennittee name listed above. [8J Yes D No General Cable Industries, Inc. Facility Mailing Address: _l_p_re s_to_l_it_e-'-d-'r_iv_e Facility City: Prestolite Facility State: AR Zip: Facility Contact Person Name: Telephone Number: Invoice Contact Person: Invoice Mailing Address: Invoice Mailing Address: Alexis Sowards Contact Person Title: _E_H--S_M_an_a-!'g._e~r-----,-- _(,_8_7_0)'---2_3 9_-6_1_0_5 Fax Number: Alexis Sowards 1 Prestolite Drive aswords@generalcable. co _m City: Paragould State: AR Zip: Telephone: (870) Cognizant Official Name: Small Telephone Number: (870) I 0 Fax. Number: (870) asmall@generalcable.com ARKANSAS DEPARTMENT OF ENVIRONMENTAL QUALITY 5301 NORTHSHORE DRIVE I NORTH UTILE ROCK I ARKANSAS I TELEPHONE / FAX

3 III. OWNERSHIP CHANGE AGREEMENT PERMIT TRANSFER FORM 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): Prestolite Wire, -=L-=L-=C----,~r----,r-M-r.:>A'--:o.---- Signature of Responsible Corporate Officer: ~ Title of Responsible Corporate Officer: Printed Name of Responsible Corporate Officer: Date: New Permittee (Buyer): Emerson -- -"'- -= -- '-'-'-=--"::. - ~~.)_~~ General Cable Ind:.ccu.::.-stn== e.::cs,,_,i=:n-=c=-. ;,;,gr--~----i~~,_...,~.,.~-:;o Signature of Responsible Corporate Officer: 0, ---- Title of Responsible Corporate Officer: Printed Name of Responsible Corporate Officer: Date: ~ant secret;;ry Emerson C. Moser -=~~~~~~~ _J'-'-u""'ly'--l4_.-=2..c..O_l4 Disclosure Statement: Disclosure Statement must be submitted for new permittee. Disclosure Statement is not required for Stormwater Permits. Is Disclosure Statement enclosed: DYes ~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 Printe.d Name: ~=r = Stgnature: ~""--=::;: _ Title: Assistant Date: July 14,2014 ARKANSAS DEPARTMENT OF ENVIRONMENTAL QUALITY 5301 NORTHSHORE DRIVE I NORTH UTILE ROCK/ ARKANSAS /TELEPHONE I FAX us

4 7/18/2014 Arkansas Secretary of State ARKANSAS SECRETARY ()F STATE?4J_~ Search Incorporations, Cooperatives, Banks and Insurance Companies Printer Friendly Version LLC Member information is now confidential per Act 865 of 2007 Use your browser's back button to return to the Search Results Begin New Search For service of process contact the Secretary of State's office. Corporation Name Fictitious Names Filing# Filing Type Filed under Act Status. GENERAL CABLE INDUSTRIES, INC. BICCGENERAL Foreign For Profit Corporation For Bus Corp; 958 of 1987 Good Standing Principal Address Reg. Agent Agent Address Date Filed Officers Foreign Name Foreign Address State of Origin THE CORPORATION COMPANY 124 WEST CAPITOL AVENUE SUITE 1900 UTILE ROCK, AR /28/1993 SEE FILE, Incorporator/Organizer GREGORY B. KENNY, President JEFFREY J. WHELAN, Secretary BRIAN J ROBINSON, Vice-President STEVEN SKERL, Treasurer JOHN D. WINSTEL, Controller N/A 4 TESSENEER DRIVE, HIGHLAND HEIGHTS, KY X, DE Purchase a CertifiCate of Good Standing for this Entity Pay Franchise Tax for this corporation 1/1

5 'ljefaware PAGE 1 %e :First State I, JEFFREY W. BULLOCK, SECRETARY OF STATE OF THE STATE OF DELAWARE, DO HEREBY CERTIFY "GENERAL CABLE INDUSTRIES, INC. " IS DULY INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE AND IS IN GOOD STANDING AND HAS A LEGAL CORPORATE EXISTENCE SO FAR AS THE RECORDS OF THIS OFFICE SHOW, AS OF THE TWENTY-FIRST DAY OF JULY, A.D AND I DO HEREBY FURTHER CERTIFY THAT THE FRANCHISE TAXES HAVE BEEN PAID TO DATE DATE: You may verify this certificate online at corp.delaware.gov/authver.shtml

6 Permit Change Route Sheet ownership change Facility Name change Responsible official change Project/Facility Name Permit Number Assigned ASII (1 day) Engineer (3 days) AA III (15 days) VYt'Sto ll_tf \tj\yc 0L.--C A \2- \lvda lo ( 0 Activity Application Logged/ Assign to Engineer Completeness and Technical Review/ Enter Update Info to Database Disclosure Statement for ARG N A Check With Enforcement../ ~JI ~).1. Check with SOS../ Check Fee Payments,) Enter Into PDS 1} ~~ Or Merge Change (if applicable) C/0 Form t ~ttee (if applicable) Wait 10-days fo$nse (if applicable) ~ Merger Letter for P~rmittee ' AFIN NO. L <y;> a 00 '60 Initials M77 A\( Date Complete/Entered 1---l<i 7/J.L 1V :b( J Engineer (1 day) Review transfer letter and documents Engineer Supervisor Review all the documents and letter (1 day) Permits Section Review the documents and sign Chief (1 day) Mail original to applicant. Scan complete folder and place in AS II appropriate E-drive folders. Update (1 day) Zylab. Be sure to include this change in weekly report, due every Tuesday by 2:00P.M. ~ ~/L{ 0 o It./ \Lb ~-l Remarks: ~ -?12-' '\:>" : S/) -1 J 2., \ Revised 1/5/11