NCC233033_NOT Signed Certification_20240424

NCGO1 Notice of Termination (NOT) Certification Farm
Directions:
Print this form, complete,scan and upload to the electronic NOT(Rescission)form.
Then, mail the original signed form to the NC DEMLR Stormwater Program at:
Division of Energy, Mineral & Land Resources Stormwater Program
512 N.Salisbury Street, 6th Floor
1612 Mail Service Center
Raleigh, NC 27699-1612
DO NOT MAIL THIS FORM UNTIL YOUR NOT REQUEST HAS BEEN REVIEWED AND APPROVED.
THE FORM YOU MAIL MUST BE COMPLETED WITH AN ORIGINAL SIGNATURE(NOT DIGITAL) [40 CFR 122.221
General Permit Certificate of Coverage (COC) No.: NCC233033
Name of Project: Sam's Xpress Car Wash #328
Per NC General Statute 143-215.6E(i), any person who knowingly makes any false statement, representation, or
certification in any application, record, report,plan, or other document filed or required to be maintained under this
Article or a rule implementing this Article. . .shall be guilty of a Class 2 misdemeanor which may include a fine not
to exceed ten thousand dollars($10,000).
Under penalty of law, I certify that:
I,as an authorized representative, hereby request rescission of coverage under the NPDES Stormwater Permit for
the subject facility, I am familiar with the information contained in this request,and to the best of my knowledge
and belief, such information is true,complete, and accurate.
Legally Responsible Organizational Entity(must match eNOT): SXCW Properties II, LLC
*Legally Responsible Person (must match eNOT): William Vibbert
*Title of Legally Responsible Person: Development Manager
Print Name &Title of Signed if Authorized Individual Differs from Legally Responsible Person:
Anthony Warren is no longer employed with SXCW Properties II,LLC. William Vibbert is an authorzied representative of SXCW Properties II,LLC
*Signature: 7 4_ 4A.• �� ,/�— Date: Z 7/2
* IMPORTANT NOTE: This form must be signed by a responsible corporate officer that owns or operates the
construction activity,such as a president,secretary, treasurer, or vice president, or a manager that is authorized in
accordance with Part IV, Section B, Item (6)of the NCG010000 permit.
For more information on signatory requirements,see Part IV, Section B, Item (6)of the NCG010000 permit.

UNANIMOUS WRITTEN CONSENT AND RESOLUTIONS
OF TI-IE MANAGER PRO TEM OF
LLCs
WHEREAS, the undersigned, Rima Anabtawi, certifies that she, individually, is the
Manager Pro Tern of, among others, each limited liability company set forth on Schedule 1
attached hereto (as Schedule 1 may be amended from time to time, collectively, the "LLCs" and
each a "LLC") and each LLC is a North Carolina limited liability company, having its principal
place of business at 7935 Council Place,Suite 200, Matthews,North Carolina; and
WHEREAS,the undersigned hereby consents in writing,pursuant to the Limited Liability
Company Act of the State of North Carolina (the "Act"), and adopts the following resolution of
the LLCs, all pursuant to the laws of the State of North Carolina; and
WHEREAS, the undersigned, in adopting the resolutions set forth below by signing his
consent hereto (this "Consent"), hereby confirms, ratifies and approves the acts stated in this
Consent and directs that this Consent be filed with the minutes and proceedings of the LLCs.
Without otherwise limiting the generality of the foregoing, this Consent shall be effective, as of
the date set forth below, as if adopted by the vote of the undersigned at a meeting called pursuant
to notice, all as required by the Operating Agreement of the LLCs, at which meeting the
undersigned was present in person.
NOW WHEREFORE, by executing this Consent, as indicated below, the undersigned
agrees to, consents to and approves the following:
RESOLVED, that William Vibbert as Development Manager of Sam's Xpress Car Wash
shall have a limited right,power and authority to execute, sign, verify, acknowledge, deliver, and
accept all construction and development documents and applications submitted to and/or required
by any governmental authority, including but not limited to documents relating to permitting,
building permit applications, site plan approval documents, surveys and plats, storm water
mitigation, zoning applications, variance requests, utility applications, tap fees, applications for
driveways and encroachments, erosion control, grading permit applications and environmental
questionnaires on behalf of the LLCs; and
FURTHER RESOLVED, the undersigned further certifies that the LLCs' Articles of
Organization and Operating Agreement remain in full force and effect and nothing has occurred
to limit the LLCs' ability to enter into or complete the actions contemplated. This Consent is
executed by the Manager Pro Tern of the LLCs for the purposes contemplated.
[Signature Page Follows]

IN WITNESS WHEREOF, the undersigned, as the Manager Pro Tern of the LLCs hereby
executed this Unanimous Written Consent and Resolutions of the Manager Pro Tern of LLCs as of
the date written below.
Rima Anabtawi, as Manager Pro Tern of each LLC
Dated: 01 /0212-6

SCHEDULE 1 TO UNANIMOUS WRITTEN CONSENT AND RESOLUTIONS
OF THE MANAGER PRO TEM OF LLCs
LIST OF LLCS RIIVIA ANABTAWI IS MANAGER PRO TEM OF
AND FOR WHICH WILLIAM.VIBBERT AS DEVELOPMENT MANAGER OF
SAM'S XPRESS CAR WASH
1. Sam's Xpress Car Wash, LLC
2. SXCW Properties, LLC
3. SXCW Properties II,LLC
4. SXCW Properties III, LLC
5. SXCW TEMP,LLC
Rima Anabtawi, as Manager Pro Tern of each LLC
Dated:
County, North Carolina
I certify that the following person(s)personally appeared before me this day, each
acknowledging to me that he or she signed the foregoing document:
Rima Anabtawi .
Name(s)of principal(s)
Date: (Official Seal)
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