HomeMy WebLinkAboutNCC191736_Notice of Termination_20210305Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 3/5/2021 4:55:09 PM (NOT Submittal)
Approve by Morman, Alaina 3/9/2021 2:54:11 PM (NOT Request Review- NCC191736)
• The task was assigned to Morman, Alaina. The due date is: March 10, 2021 5:00 PM
3/5/2021 4:55 PM
1 �
NORTH CAROLINA
Enrlronmenral Quallly
Certificate of NCC191736
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
TLC Auto Wash Site Modifications and Addition
Address
5011 Ramsey Street, Fayetteville, NC
County
Cumberland
Latitude
35.0000
Longitude
-79.0000
Permittee Listed
TLCV Investments, LLC
Legally Responsible
Thomas Deering
Individual
NC Reference No.
NCG01-2019-1736
E&SC Plan ID
CUMBE-2020-015
Original NOI
15580
Tracking No.
Date COC Issued
9/6/2019
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Cate populates only if COCwas already rescinded at tirre of subrrittal.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 obtained a new COC)
Coverage *
O Mistake or Invalid Coverage
r Other
Ad d i o n a I Nbre information about the basis of this request, if needed.
Explanation
Supporting Upload Supporting Dxurrentation if applicable.
Documentation Mist beFDFformat
Project Close-out Information:
Final Close-out 2/4/2020
Inspection Approval
Project Close-out Ir_silt_sedementation_inspection_report_modifiedP...
Approval 162.95KB
(40).pdf
Documentation
Mast be Ft7Fforrrat
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).
rJ 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* Thomas Deering
Title * Owner
Organization * TLC Auto Wash
Date * 03/05/2021
Email for tdticautowash@gmail.com
Confirmation *
Contact Telephone* 17605865962
NOT Certification NCG01-eNOT-Certification-Form-20201215-
Form 1.01 MB
DEMLR-SW.pdf
Mast be R F Forrrat
Is this COC Already Ensure this CCChas not been rescinded since subrrittal!
Rescinded?
Additional Email
(Optional)
Original Permittee
Email
CCd on Notification Errails
codyvetter@icwg.com
CCd on Notification Erails
tdticautowash@me.com
Original Site Contact CCd on Notificaiton Errails
Email tdticautowash@me.com