NCG160059_Revised Signed Rescission Request_20200910

"« Division of Energy, Mineral & Land Resources
Land Quality Section/Stormwater Permitting Program
National Pollutant Discharge Elimination System
Environmental
Qualm' RESCISSION REQUEST FORM
FOR AGENCY USE ONLY
Date Received
Year
Month
Day
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 ofCoverage
ITC I S I I I I I I I I N I C I G 11 16 10 0 5 9
2) Owner/Facility Information: * Final correspondence will be mailed to the address noted below
Owner/Facility Name APAC Atlantic, Inc.
Facility Contact
Street Address
City
County
Telephone No.
Rick Holland
1831 W. Jake Alexander Blvd
Salisbury
Rowan
919 412-6849
State NC ZIP Code 28147-1144
E-mail Address [e-mail]
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.
❑ 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:
Site has new ownership and intended use
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 A2 gke Date / &
Rick Holland
Print or type name of person signing above
Please return this completed rescission request form to:
Plant Manager
Title
DEMLR - Stormwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Revised 2018Jan10

McCoy, Suzanne
From: Josh Dunbar <[e-mail]>
Sent: Thursday, September 10, 2020 9:45 AM
To: McCoy, Suzanne; Ashton Gullickson
Subject: RE: [External] RE: NCG160059_APAC Atlantic - Salisbury (42469)
Attachments: Plant 69 Rescission.pdf
External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
[e-mail]
Suzanne,
Attached is the signed copy. Do you also need this mailed to you as well?
Josh Dunbar, PE I Vice President, Engineering and Environmental Services
The El Group, Inc.
Environmental, Health and Safety Solutions. TM
Direct: 919.459.5266
Office: 919.657.7500
Mobile: [phone]
Fax: [phone]
www.eil.com
Watch EI's Latest Video: "Medical Screeninq to Break the Chain"
From: McCoy, Suzanne <[e-mail]>
Sent: Wednesday, September 2, 2020 10:45 AM
To: Josh Dunbar <[e-mail]>; Ashton Gullickson <[e-mail]>
Subject: RE: [External] RE: NCG160059_APAC Atlantic - Salisbury (42469)
Yes please. Just to keep the record straight.
I've attached a blank form.
You may email it to me and put the original in the mail.
Thank you,
Suzanne McCoy
Stormwater Program Administrative Specialist
Division of Energy, Mineral and Land Resources
North Carolina Department of Environmental Quality
Physical: 512 N. Salisbury Street, Office 640K, Raleigh, NC 27604
Mailing: 1612 Mail Service Center, Raleigh, NC 27699-1612
Email: Suzanne. m000V�ncdenr.goy
Phone: [phone]
Website: http://deg.nc.gov/about/divisions/energy-mineral-land-resources/stormwater
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Wid al E,nnronr�yn�el pgallyy

Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
Before printing this email, please consider your budget and the environment.
Based on the current guidance to minimize the spread of COVID-19, the Department of Environmental Quality has
adjusted operations to protect the health and safety of the staff and public. Many employees are working remotely or
are on staggered shifts. To accommodate these staffing changes, all DEQ office locations are limiting public access to
appointments only. Please check with the appropriate staff before visiting our offices, as we may be able to handle your
requests by phone or email. We appreciate your patience as we continue to serve the public during this challenging
time.
From: Josh Dunbar [mailto:[e-mail]]
Sent: Wednesday, September 2, 2020 10:42 AM
To: Ashton Gullickson <[e-mail]>; McCoy, Suzanne <[e-mail]>
Subject: [External] RE: NCG160059_APAC Atlantic - Salisbury (42469)
External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
[e-mail]
Suzanne,
300 Benbow is the corporate address. 1831 W. Jake Alexander Blvd, Salisbury is the facility address.
Do we need to resubmit this form?
Josh Dunbar, PE I Vice President, Engineering and Environmental Services
The El Group, Inc.
Environmental, Health and Safety Solutions. TM
Direct: 919.459.5266
Office: 919.657.7500
Mobile: [phone]
Fax: [phone]
www.eil.com
Watch El's Latest Video: "Medical Screening to Break the Chain"
From: Ashton Gullickson <[e-mail]>
Sent: Wednesday, September 2, 2020 10:35 AM
To: McCoy, Suzanne <[e-mail]>
Cc: Josh Dunbar <[e-mail]>
Subject: Re: NCG160059_APAC Atlantic - Salisbury (42469)
Hi Suzanne,
I am not sure what to do here. I have copied Josh Dunbar on this email as he would be the one to contact about this.
Thanks!
Ashton Gullickson
On Sep 2, 2020, at 9:58 AM, McCoy, Suzanne <[e-mail]> wrote:

Good morning Ashton.
I left you a voicemail a few minutes ago.
In August we received the attached Rescission request for NCG160059.
I was hoping you could clear up some confusion.
On the form the address for the facility shows as 300 South Benbow Road, however the address for
NCG160059 in our database shows as 1831 W. Jake Alexander Blvd, Salisbury.
We need a new Rescission form filled out with the correct facility address that is being rescinded.
Should I contact Mr. Holland, or would you be the correct person to assist with this?
Suzanne McCoy
Stormwater Program Administrative Specialist
Division of Energy, Mineral and Land Resources
North Carolina Department of Environmental Quality
Physical: 512 N. Salisbury Street, Office 640K, Raleigh, NC 27604
Mailing: 1612 Mail Service Center, Raleigh, NC 27699-1612
Email: Suzanne. m000V�ncdenr.go
Phone: [phone]
Website: http://deg.nc.gov/about/divisions/energy-mineral-land-resources/stormwater
<i mage001.j pg>
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
Before printing this email, please consider your budget and the environment.
Based on the current guidance to minimize the spread of COVID-19, the Department of Environmental
Quality has adjusted operations to protect the health and safety of the staff and public. Many
employees are working remotely or are on staggered shifts. To accommodate these staffing changes, all
DEQ office locations are limiting public access to appointments only. Please check with the appropriate
staff before visiting our offices, as we may be able to handle your requests by phone or email. We
appreciate your patience as we continue to serve the public during this challenging time.
<NCG160059_Rescission Request_20200813.pdf>