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Sheridan Grand Central PTC Transfer RequestWYOMING DEPARTMENT OF ENVIRONMENTAL QUALITYMATEIR QUALITY DIVISION Chapter 3 PERMIT TO CONSTRUCT TRANSFER REQUEST Water Quality DIAsion,'Department of Environmental Quality Date 1/24/2021 200 W. 17th St,- 4th Floor Cheyenne, WY 82002 Sheridan Grand Central, LLC (Original Owner of Record) Sheridan Grand Central (Facility dame or description) to City of Sheridan (blew Owner of Record) intends to transfer ownership of the facility associated with Permit on 1/24/202 2 (Date) It is requested that the said permit be transferred to the new owner in accordance with Section 12 of Chapter 3, Wyoming, Water Quality Rules and Regulations. The new owner agrees to accept and be bound by the provisions of the new (transferred) permit and any amendments, agrees to construct and operate the facility in accordance with the approved permwwt, and agrees to accept responsibility for the facility's compliance with applicable standards and permit conditions, including the responsibility to perform any necessary corrective actions. The original owner shall retain responsibility for the facility according to the terms of the original permit until the application for permit transfer is approved by the Administrator. Signa a of Original Owner's Representative (A certified copy of a recorded document transferring ownership of the real' estate may be accepted in lieu of the signalure of the original owner.) r Name and Title qV-0-4(utj - & LC -w-- (Please Print) Company Name ,,i,., .r � Address S k x Telephone _.�'� — TZr 6 L.RHibbll0-0001,Dr. C Revised 1/4/2010 Signature of New Owner's Representative Name and Title,o��`( -S ✓' (Please Print) Company Name _ _ Q S + V t &\A Address _GS La\Y.��.l \ \ 2G Telephone ' �,Ql -A - &y'