NCC190989_Notice of Termination_20201014

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/14/2020 4:35:01 PM (NOT Submittal)
Approve by Georgoulias, Bethany 10/15/2020 9:22:15 AM (NOT Request Review- NCC190989)
• The task was assigned to Georgoulias, Bethany. The due date is: October 19, 2020 5:00 PM
10/14/2020 4:35 PM

1 �
NORTH CAROLINA
Enrlronmenral Quallly
Certificate of NCC190989
Coverage (COC) Enter the Certificate of Coverage Nmber
No.*
Information associated with this permit
Project Name
Duke Energy Castle Hayne Replace Switch 22
Address
Holly Shelter Road, Castle Hayne, NC
County
New Hanover
Latitude
34.3538
Longitude
-77.8928
Permittee Listed
Duke Energy Progress
Legally Responsible
Thomas Williams Jr., PE
Individual
NC Reference No.
NCG01-2019-0989
E&SC Plan ID
NEWHA-2020-001
Original NOI
13540
Tracking No.
Date COC Issued
7/17/2019
Prior Rescission
Cate populates only if COCwas already rescinded at tirre of subrrittal.
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 9/9/2020
Inspection Approval

Project Close-out NEWHA-2020-001 20200909.pdf 20.57KB
Approval Mast be RYfornil
Documentation
North Carolina General Statute 143-215.66 (1) provides that:
Any person who knowingly makes anyfalse 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; or who knowingly makes a false statement
of a material fact in a rulemaking proceeding or contested case under this 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 of the
Commission implementing this Article shall be guilty ofa Class 2 misdemeanor which may include 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
t-
Type Name* Thomas Williams Jr.
Title * Manager Transmission Engineering
Organization* Duke Energy Progress
Date * 10/14/2020
Email for [e-mail]
Confirmation *
Contact Telephone* 919-546-2354
NOT Certification Notice of Termination.pdf 47.49KB
Form Mast be FDF Forrrat
Is this COC Already Ensure this CCChas not been rescinded since subrrittal!
Rescinded?
Original Permittee CCd on Wification Errails
Email [e-mail]
Original Site Contact CCd on Notificaiton Errails
Email [e-mail]