HomeMy WebLinkAboutNCC190028_Notice of Termination_20210517Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 5/17/2021 3:47:55 PM (NOT Submittal)
Approve by Morman, Alaina 5/23/2021 9:35:11 AM (NOT Request Review- NCC190028)
• The task was assigned to Morman, Alaina. The due date is: May 20, 2021 5:00 PM 5/17/2021 3:48 PM
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NORTH CAROLINA
Enrlronmenral Quallly
Certificate of NCC190028
Coverage (COC) Enter the Certificate of Coverage Ninber
No.*
2020 Annual Fee Status PAID
2021 Annual Fee Status PAST DUE
Nby be blank (iF not yet billed).
This permittee owes a fee that is PAST DUE and has a pending NOD or NOV. Do not approve this NOT request
until payment is resolved. If this NOT request is acceptable, payment may be waived if applicable, but that action must
be completed first (at the NOD or NOV Review step) to ensure records are routed to the correct folder in the
repository.
However, you can reject the NOT now if it is not acceptable
Information associated with this permit:
Project Name AAA Ministorage
Address 117 Industry Court, Goldsboro, NC
County Wayne
Latitude 35.4165
Longitude-77.9749
Permittee Listed AAA Ministorage
Legally Responsible Paul Williams
Individual
NC Reference No. NCG01-2019-0028
E&SC Plan ID Wayne-2019-025
Original NOI 10022
Tracking No.
Date COC Issued 4/11/2019
Prior Rescission Cate populates only if OOC was already rescinded at tirre of subrrittal.
Date
Reason for Rescission/Termination Request:
Reason for r Project Closed -Out
Termination of r Sale (Another Owner/Operator obtained a newCOC)
Coverage * r Mistake or Invalid Coverage
f Other
Add ional We information about the basis of this request, if needed.
Explanation
Supporting Upload Supporting Ibcurrentation if applicable.
Documentation Mast bePDFforrrat
Project Close-out Information:
Final Close-out 8/11/2020
Inspection Approval
Project Close-out 20200811 sed insp report WAYNE-2019-025 AAA
Approval 171.61 KB
Storage.pdf
Documentation
Mist be Ft7Fforrrat
North Carolina General Statute 143-215.66 (1) provides that:
Anyperson who knowinglymakes anyfalse 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 knowinglymakes a false statement
of a material fact in a rulemaking proceeding or contested case underthis Article; orwho 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 notto exceed ten thousand
dollars ($10,000).
I7 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* Paul Williams
Title * owner
Organization * AAA Ministorage
Date * 05/17/2021
Email for aaaminigold@gmail.com
Confirmation *
Contact Telephone* 919-609-1661
NOT Certification img20210517_15373009.pdf 195.27KB
Form Nbst be PDF Forrrat
Is this COC Already Ensure this CCChas not been rescinded since subrrittal!
Rescinded?
Additional Email 0Cd on Notification Errails
(Optional) jeffrey@kornegaysep.com
Original Permittee 0Cd onNiotificationErrails
Email aaaminigold@gmail.com
Original Site Contact 0Cd on Notificaiton Errails
Email aaaminigold@gmail.com