HomeMy WebLinkAboutNCC190742_NOI Signed Certification_20190626New Submission
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N0WrH CAPOLINA
Ereroronmertraf Quality
Construction Stormwater: Notice of Intent (NOI)
National Pollutant Discharge Elimination System (NPDES) application for coverage under North Carolina's
General Permit NCGO10000: STORMWATER DISCHARGES associated with construction activities (or
NCG250000)
A. Project Information I B. Permittee Information I C. Site Contact information I D. E&SC Plan
E. Certification
North Carolina General Statute 143-215.613 (i) provides that:
Any person who knowingly makes any false 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 device or method required to be operated or maintained under this Article or rules of the Commission implementing this Article shall
be guilty of a Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars ($10,000).
Under penalty of law, I certify that:
* OO I am the person responsible for the construction activities of this project, for
satisfying the requirements of this permit, and for any civil or criminal penalties
incurred due to violations of this permit.
* OO The information submitted in this NOI is, to the best of my knowledge and belief,
true, accurate, and complete based on my inquiry of the person or persons who
manage the system, or those persons directly responsible for gathering the
information.
* OO I will abide by all conditions of the NCG010000 General Permit and the approved
Erosion and Sediment Control Plan.
* OO I hereby request coverage under the NCG010000 General Permit and
understand that coverage under this permit will constitute the permit
requirements for the discharge(s) and is enforceable in the same manner as an
individual permit.
Specify if you are:* O The Responsible Person named on this Notice of Intent
C Authorized Responsible Person*
Important: The person who signs this Certification above and signs the NOI Certification Form should be the same
person (or authorized responsible person within the same organization) as listed in Section B (Permittee Information) of
this form. *An authorized individual is a responsible corporate officer who 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.
https://edocs.deq.nc.gov/Forms/NCGO1-NOI 1 /2
6/26/2019 New Submission
https://edocs.deq.nc.gov/Forms/NCG01-NOI 2/2