HomeMy WebLinkAboutNCC191576_Notice of Termination_20210120Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 1/20/2021 5:41:05 PM (NOT Submittal)
Approve by Morman, Alaina 1/25/2021 2:42:17 PM (NOT Request Review- NCC191576)
• The task was assigned to Morman, Alaina. The due date is: January 25, 2021 5:00 PM
1 /20/2021 5:41 PM
1 �
NORTH CAROLINA
Enrlronmenral Quallly
Certificate of NCC191576
Coverage (COC) Enter the Certificate of Coverage Nmber
No.*
2020 Annual Fee Status PAID
2021 Annual Fee Status Nbybeblank (if not yet billed)
Information associated with this permit:
Project Name
Piedmont -Marshall Interconnection
Address
June Dellinger Rd, Catawba Springs, NC
County
Lincoln
Latitude
35.0000
Longitude
-81.0000
Permittee Listed
Williams Gas Pipeline Transco
Legally Responsible
Scott Hallam
Individual
NC Reference No.
NCG01-2019-1576
E&SC Plan ID
Lincoln Co. - Piedmont - Marshall
Interconnection
Original NOI
15252
Tracking No.
Date COC Issued 8/26/2019
Prior Rescission Date populates only if COCwas already rescinded at tirre of submttal.
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 * r Mistake or Invalid Coverage
r Other
Add Tonal IVbre information about the basis of this request, if needed.
Explanation
Supporting upload Supporting Gbcurnentation if applicable.
Documentation NLstbeFOFforrrat
Project Close-out Information:
Final Close-out 12/16/2020
Inspection Approval
Project Close-out LINCO-2020-002_12.16.2020.pdf 57.9KB
Approval Mast be FDFforrrat
Documentation
North Carolina General Statute 143-215.613 (i) 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 device or method required to be operated or maintained under this Article or rules of the
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
Type Name* Kyle W. Marshall
Title * Environmental Specialist
Organization* Transcontinental Gas Pipe Line Company, LLC.
Date * 01 /20/2021
Email for kyle.marshall@williams.com
Confirmation *
Contact Telephone* 713-248-7335
NOT Certification NCG01-eNOT-Certification-Form-Signed.pdf
Form Mast be FDF Format
Is this COCAlready Ensure this OOChas not been rescinded since subrrittal!
Rescinded?
Additional Email CCd on Notification Errails
(Optional)
Original Permittee CCd on Wification Errails
Email scott.hallam@williams.com
Original Site Contact CCd on Notificaiton Errails
Email Julius.Medley@williams.com
1.01 MB