HomeMy WebLinkAboutNCC190091_Notice of Termination_20200821Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 8/21/2020 1:16:54 PM (NOT Submittal)
Approve by Georgoulias, Bethany 8/21/2020 1:23:47 PM (NOT Request Review- NCC190091)
• The task was assigned to Georgoulias, Bethany. The due date is: August 26, 2020 5:00 PM
8/21/2020 1:17 PM
1 �
NORTH CAROLINA
Enrlronmenral Quallly
Certificate of NCC190091
Coverage (COC) Enter the Certificate of Coverage Nmber
No.*
Information associated with this permit
Project Name
Line 94 MAOP Reclaim WCCT Interconnect Station
Address
Blackjack Church Road, Goldsboro, NC
County
Wayne
Latitude
35.3780
Longitude
-78.0966
Permittee Listed
Piedmont Natural Gas
Legally Responsible
Dave Vena
Individual
NC Reference No.
NCG01-2019-0091
E&SC Plan ID
Wayne-2019-026
Original NOI
10363
Tracking No.
Date COC Issued
4/23/2019
Prior Rescission
Date populates only if OOCwas already rescinded at tirre of subaittal.
Date
Reason for Rescission/Termination Request:
Reason for F Project Closed -Out
Termination of r Sale (Another Owner/Operator will apply for a new COC)
Coverage * O Mistake or Invalid Coverage
r Other
Addional Mxe inforrration about the basis of this request, if needed.
Explanation
Supporting upload Supporting Docurrentation if applicable.
Documentation Mist beFDFforrrat
Project Close-out Information:
Final Close-out 8/11/2020
Inspection Approval
Project Close-out 20200811 sed insp report WAYNE-2019-026 Line
Approval 174.35KB
94 MAOP Reclain WCCT.pdf
Documentation
Mast be FDFforrrat
North Carolina General Statute 143-215.66 (1) provides that:
Anyperson who knowinglymakes any false statement, representation, or certification in anyapplication, record, report, plan, or other
documentfiled or required to be maintained under this Article or a rule implementing this Article; or who knowingly makes a false statement
of a material fact in a rulemaking proceeding or contested case underthis Article; or who falsifies, tampers with, or knowingly renders
inaccurate any recording or monitoring deice or method required to be operated or maintained under this Article or rules ofthe
Commission implementing this Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine not to exceed ten thousand
dollars ($10,000).
17 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.
*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 General Permit. For more information on signatory requirements, see Part IV, Section B,
Item (6) of that permit.
Signature
A4W VSW.4
Type Name* Dave Vena
Title * Project Manager
Organization* Piedmont Natural Gas
Date * 08/21 /2020
Email for dave.vena@duke-energy.com
Confirmation *
Contact Telephone* 7047314496
NOT Certification PNG WCCT NOT Certification (Line 94).pdf
Form Mast be FDF Forrrat
Is this COC Already Ensure this CCChas not been rescinded since subrrittal!
Rescinded?
Original Permittee CCd on Wification BTails
Email Dave.Vena@duke-energy.com
Original Site Contact CCd on Notificaiton Bmils
Email Charlie.Gilman@duke-energy.com
289.9KB