NCG140387_Rescission Request_20200212

• FOR AGENCY USE ONLY
Division of Energy,Mineral& Land Resources Date Received
Land Quality Section/Stormwater Permitting Program Year Month Day
National Pollutant Discharge Elimination System
Environmental
Quality RESCISSION REQUEST FORM � �' `��
1 ''B 12 2020
Please fill out and return this form if you no longer need to maintain your NPDES stormwater permit.
DENR-L AND QUALITY
1) Enter the permit number to which this request applies:
STORMWATER PERMITTING
Individual Permit (or) Certificate of Coverage•
t t
N C S N C G 1 4 0 3 8 7
2) Owner/Facility Information: *Final correspondence will be mailed to the address noted below
Owner/Facility Name Benton Ready Mix of Brunswick Inc
Facility Contact E Randall Branton
Street Address 197 Barnhill Road NW
City Supply State NC ZIP Code 28462
County Brunswick E-mail Address [e-mail]
Telephone No. 843 234-2872 Fax:
3) Reason for rescission request(This is required information. Attach separate sheet if necessary):
❑ Facility closed or is closing on . All industrial activities have ceased such that no discharges of
stormwater are contaminated by exposure to industrial activities or materials.
E Facility sold to on . If the facility will continue operations under the new owner it
may be more appropriate to request an ownership change to reissue to permit to the new owner.
✓❑ Other: See attached Letter dated February 3, 2017.
4) Certification:
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 acc e.
Signature Date 02/05/2020
E Randall Branton Accounting
Print or type name of person signing above Title
Please return this completed rescission request form to: DEMLR-Stormwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Revised 20183an10

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BENTON READY MIX, INC.
PO BOX 797-CONWAY,SC 29528-0797
3450 Mt.Pisgah Cemetery Road,Conway, SC 29526
TELEPHONE[phone]-FAX[phone]
February 3,2017
To whom it may concern:.
RE:Benton Ready Mix
I am pleased to announce that Benton Ready Mix and Thomas Concrete of South Carolina have agreed
to the terms of sale of the assets of Benton Ready Mix. Effective today,Thomas Concrete has purchased
those assets. Benton Ready Mix'FEI#is 42-1694404.
In conjunction with the sale,please read the meter(s)as soon as possible,and mail the final bill to us at
the above address.
Beginning with subsequent billings,send the bill to:
Thomas Concrete of South Carolina
2500 Cumberland Parkway
Suite 200
Atlanta,GA 30339
770.431.3300
All bills should be mailed to that address. Please do not hesitate to contact me should you have any
questions. In advance,thank you for your help.
6..jek......C.C_______,
Sinc rely,
-
eith Benton,President
•
Benton Ready Mix