NCC190131_Notice of Termination_20201120

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 11/20/2020 6:58:37 AM (NOT Submittal)
Approve by Georgoulias, Bethany 11/23/2020 7:18:20 AM (NOT Request Review- NCC190131)
* eNO1 from Laving and Son for this site submitted 11120.
• The task was assigned to Georgoulias, Bethany. The due date is: November 25, 2020 5:00 PM
11/20/2020 6:58 AM

1 �
NORTH CAROLINA
Enrlronmenral Quallly
Certificate of NCC190131
Coverage (COC) Enter the Certificate of Coverage Ninber
No.*
Information associated with this permit
Project Name
Buncombe CO LF/E Canton LF/Old Chandler LF
Address
Little Piney Mountain Road, Candler, NC
County
Buncombe
Latitude
36.0000
Longitude
-83.0000
Permittee Listed
CDM Smith Inc.
Legally Responsible
Kevin Irby
Individual
NC Reference No.
NCG01-2019-0131
E&SC Plan ID
BUNCO-2019-014
Original NOI
10503
Tracking No.
Date COC Issued
4/30/2019
Prior Rescission
Date populates only if OOCwas already rescinded at tirre of subaittal.
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 *
r Mistake or Invalid Coverage
r Other Financial Responsibility of ESC permit is being transferred to
another party.
Addional
We inforrration about the basis of this request, if needed.
Explanation
Lawing and Son is the contractor performing
the work and is in the process of transferring
the ESC permit in their name so they are the
financially responsible party. I spoke with
Aziza Selkane and she directed me to submit
a Notice of Termination. Lawing and Sons will
submit a Notice of Intent for a new permit.

Supporting upload Supporting Documentation if applicable.
Documentation Mist beFDFformat
Project Close-out Information:
Final Close-out
Inspection Approval
Project Close-out Mast beFDFforrrat
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 Article or a rule implementing this Article; 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 Article 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
Type Name* Kevin Irby
Title * Vice President
Organization* CDM Smith
Date * 11 /20/2020
Email for [e-mail]
Confirmation *
Contact Telephone* 919-325-3516
NOT Certification NCG01-eNOT-Certification-Form-20190508-
Form 200.71 KB
DEMLR-SW.pdf
Mast be FDF Forrrat
Is this COCAlready Ensure this OOChas not been rescinded since subnittal!
Rescinded?
Original Permittee CCdonWtificationEmails
Email [e-mail]
Original Site Contact CCd on Notificaiton Errails
Email [e-mail]