NCG030633_COMPLETE FILE - HISTORICAL_20190409

- -'- ---STORMWATER DIVISION GLIDING SHEET
RESCISSIQNS.
PERMIT NO.
N�
F.DOC-TYPE
COMPLETE FILE- HISTORICAL
DATE OF
RESCISSION
pj
YYYYMMDD

ROY COOPER
Cmvernor
MICHAEL S. REGAN
Secretary
S. DANIEL SMITH
Interim Director
Energy, Mineral
and Land Resources
ENVIRONMENTAL QUALITY
April 9, 2019
Dellner, Incorporated
Attention: Edward Everhart
4016 Shutterfly Road
Charlotte, North Carolina 28217
Subject: Compliance Evaluation Inspection
NPDES Stormwater Certificate of Coverage- Rescission Request — NCG030633
Mecklenburg County, North Carolina
Dear Mr. Everhart:
Enclosed please find a copy of the Compliance Evaluation Inspection Report for the inspection conducted at
8334-H Arrowridge Boulevard, in Charlotte, on April 3, 2019. The report should be self-explanatory; however,
should you have any questions concerning this report, please do not hesitate to contact Angela Lee at (704) 235-
2139 or by email at angela.lee(cr'tncdenr.gov.
Enclosed: Inspection Report
Sincerely,
Zahid S. Khar, , CPM, CPFS`C, CPSWQ
Regional Engineer
Land Quality Section
State of North Carolina I Environmental Quality 1 Energy, Mineral and Land Resources
Mooresville Regional Office 1 610 East Center Ave Ste 301 1 Mooresville, NC 28115
704 663 1699 T

Comliance Inspection Report
Permit: NCGO30633 Effective: 11101/18 Expiration: 05/31/21 Owner: Definer Inc
SOC: Effective: Expiration: Facility: 0elnerInc
County: Mecklenburg 8334-H Arrowridge Blvd
Region: Mooresville
Charlotte NC 28273
Contact Person: Ed Everhart Title: Phone: [phone]
Directions to Facility:
exit 177 at arrowood rd and head east on arrowood rd ro arrowridge business park turn rt onto arrowridge bled continue on
arrowridge bled to 8334-H which on the rt near end of the rd
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date. 04/03/2019 Entry Time: 10:20AM Exit Time: 11:20AM
Primary inspector: Angela Y Lee Phone: [phone]
Secondary Inspector(s):
Matthew J Gigante
Reason for inspection: Other Inspection Type: Technical Assistance
Permit Inspection Type: Metal Fabrication Stormwater Discharge COC
Facility Status: ® Compliant [] Not Compliant
Question Areas:
® Storm Water
(See attachment summary)
Page 1 of 3

l•
permit: NCG030633 Owner- Facility: Dellner Inc
Inspection Date: 0410312019 Inspection Type : Technical Assistance Reason for visit: Other
Inspection Summary:
This inspection was conducted in response to a Rescission Request submitted for NCG030633. Edward Everhart was
present for the inspection. Upon inspection, we recommend that the rescission request be granted. Dellner, Inc. has vacated
the facility.
Page 2 of 3

Division of Energy, Mineral & Land Resources
Land Quality SectinnlStormw•ater Permitting Program
National Pollutant Discharge Elimination System
Environmental
Quality RESCISSION REQUEST FORM
FOR AGENCY USE ONLY
Date ReCelved
Year
Month
Oe
Please fill out and return this form if you no longer need to maintain your NPDES stormwater permit.
a
1) Enter the permit number to which this request applies:
Individual Permit (or) Certificate of Coverage
N I C I S' I I I I J= I N I C I G o 3 10 6 3
2) Owner/Facility Information: • Final correspondence will be mailed to the address noted below
Owner/Facility Name Delloor Inc
Facility Contact
Street Address
City
County
Telephone No.
4016 Shuttedly Road
Charlotte
Mecklenburg
704 605-5989
State NC
E-mail Address
Fax:
ZIP Code 28217
[e-mail]
3) Reason for rescission request (This is required information. Attach separate sheet if necessary):
33 '!- I�
CGLrwok
2� T13
❑✓ Facility closed or is closing on 1219I18 . 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:
1, 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.
+� I B
Signature 1 Date 8-March-20
Edward Everhart
Print or type name of person signing above
Please return this completed rescission request form to:
Quality, Customer Service, and Environmental Manager
Title
DEMLR - Stormwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Revised 20183an10