NCC200358_Notice of Termination_20200205

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 2/5/2020 8:25:17 AM (NOT Submittal)
Approve by Georgoulias, Bethany 2/5/2020 2:01:25 PM (NOT Request Review- NCC200358)
* COC No. NCC200458 was issued with the corrected project name on 21512020.
• Georgoulias, Bethany reassigned the task to Georgoulias, Bethany 2/5/2020 10:16 AM
• The task was assigned to McCoy, Suzanne by round robin distribution 2/5/2020 8:25 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: February 10, 2020 5:00
PM 2/5/2020 8:25 AM

1 �
NORTH CAROLINA
Enrlronmenral Quallly
Certificate of NCC200358
Coverage (COC) Enter the Certificate of Coverage Nmber
No.*
Information associated with this permit
Project Name
SWEETWATER SUBDIVISON LOTS:25, 26,
27, 28, 29, 30, 31, 32, 33, 34, 35, 37, 38, 4
Address
Sweetwater Ln, Sweetwater Ln, NC
County
Wake
Latitude
35.7362
Longitude
-78.4934
Permittee Listed
SATTERWHITE CONSTUCTION INC
Legally Responsible
JESSE SATTERWHITE JR
Individual
NC Reference No.
NCG01-2020-0358
E&SC Plan ID
SEC-029804-2019
Original NOI
21244
Tracking No.
Date COC Issued
1/31/2020
Prior Rescission
Date populates only if COCwas already rescinded at tirre of submttal.
Date
Reason for Rescission/Termination Request:
Reason for
r Project Closed -Out
Termination of
r Sale (Another Owner/Operator will apply for a new COC)
Coverage *
F Mistake or Invalid Coverage
r Other
Add ional Nbre inforrration about the basis of this request, if needed.
Explanation Project name was to long, some information
were not included
Supporting Upload Supporting Dc)cun-entation if applicable.
Documentation NLstbeFOFfornrat
Project Close-out Information:

Final Close-out
Inspection Approval
Project Close-out Mast bePDFfornat
Approval
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 Artide or a rule implementing this Artide; 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 Artide 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
,Tessa it?
Type Name* Jesse Satterwhite JR
Title * President
Organization* Satterwhite Construction INC
Date * 02/05/2020
Email for [e-mail]
Confirmation *
Contact Telephone* 919-266-0033
NOT Certification NCG01-eN0T-[SIGNED].PDF 936.47KB
Form Mast be RY Forrrat
Is this COCAlready Ensure this OOChas not been rescinded since subrrittal!
Rescinded?