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HomeMy WebLinkAboutNCG200452_Rescission Request Form_20200504ROY COOPER Governor MICHAEL S. REGAN Secretary BRIAN WRENN Acting Director Mary Mitchell Action Al Recycling Inc. PO Box 98 Clover, SC 29710 NORTH CAROLINA Environmental Quality April 20, 2020 Subject: Action Al Recycling, Inc. Gaston County North Carolina Stormwater Permit NCG200452 We received your note indicating that in 2017 you called and cancelled this permit. Please complete and return the enclosed Rescission Request Form for Permit NCG200452. Your assistance in this matter is greatly appreciated, Sincerely, T5-4--� I'll Suzanne McCoy Administrative Specialist Enclosure D E Q`J/ North Carolina Department of Environmental Quality I Division of Energy, Mineral and Land Resources iie�' vvv 512 North Salisbury Street 1 1612 Mail Service Center I Raleigh, North Carolina 27699-1612 5;w.° .' ""°"" .OuN�� 919.707.9200 Division of Energy, Mineral & Land Resources FOR AGENCY USE ONLY Date Received Land Quality Section/Stormwater Permitting Program Year Montn Day N National Pollutant Discharge Elimination System Environmental Quality RESCISSION REQUEST FORM Please fill out and return this form if you no longer need to maintain your NPDES stormwater permit. 1) Enter the permit number to which this request applies: Individual Permit (or) Certificate of Coverage N C SN C G D 2) Owner/Facility informatio : i *Final correspondence will be mailed to the address noted below RECEIVED Owner/Facility Name \ MAY 0 4 207q Facility Contact Street Address City County Telephone No. State ZIP Code E-mail Address Fax: DENR-LAND QUALITY STORMWATER PERMITTIN(- 3) Reason for rescission request (This is reauired 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. 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: 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 accurate. Signature y`'— Date Cam' Print or type name of person signing above Title Please return this completed rescission request form to Revised 2018]an10 DEMLR - Stormwater Program Dept. of Environmental Quality 1612 Mail Service Center Raleigh, North Carolina 27699-1612