NCC191956_Notice of Termination_20211004

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 10/4/2021 10:47:32 AM (NOT Submittal)
Approve by Morman, Alaina 10/11/2021 10:53:48 AM (NOT Request Review- NCC191956)
• The task was assigned to Morman, Alaina. The due date is: October 7, 2021 5:00 PM
10/4/2021 10:47 AM

1 �
NORTH CAROLINA
Enrlronmenral Quallly
Certificate of NCC191956
Coverage (COC) Enter the Certificate of Coverage Nmber
No.*
2020 Annual Fee Status PAST DUE
2021 Annual Fee Status OPEN
ivby 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
Rockingham Resource Center Pond Remediation
Address
185 Enterprise Drive, Rockingham, NC
County
Richmond
Latitude
34.9633
Longitude
-79.8139
Permittee Listed
Piedmont Natural Gas (Duke Energy Progress)
Legally Responsible
Mark Franklin
Individual
NC Reference No.
NCG01-2019-1956
E&SC Plan ID
RICHM-2020-001
Original NOI
16042
Tracking No.
Date COC Issued
9/20/2019
Prior Rescission
Cate populates only if OOC was already rescinded at tirre of submittal.
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
Additional We information about the basis of this request, if needed.
Explanation
Supporting Upload Supporting Ibcurrentation if applicable.
Documentation Mist bePDFformat
Project Close-out Information:
Final Close-out 12/11/2019
Inspection Approval
Project Close-out Rockingham Resource Center Pond
Approval 89.09KB
Remediation_RICHM-2020-001_12-11-19.pdf
Documentation
2021-09-29 PNG-19000 NCG01-eNOT-Certification-
240.49KB
Form signed by ZH.pdf
Mist be Ft7Fforr at
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 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* Zach Huett
Title * Real Estate Portfolio Manager — Carolinas East
Organization* Duke Energy Progress, LLC
Date * 10/04/2021
Email for [e-mail]
Confirmation *
Contact Telephone* [phone]

NOT Certification 2021-09-29 PNG-19000 NCG01-eNOT-Certification-
Form Form signed by ZH.pdf
Mast be PDF Forrrat
Is this COCAlready Ensure this OOChas not been rescinded since subrrittal!
Rescinded?
Additional Email CCd on Notification Ermils
(Optional) [e-mail]
Original Permittee 0Cd on Wification Errails
Email [e-mail]
Original Site Contact CCd on Notificaiton Emils
Email [e-mail]
240.49KB