NCC201441_Notice of Termination_20201201

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 12/1/2020 11:45:18 AM (NOT Submittal)
Approve by Georgoulias, Bethany 12/1/2020 1:03:07 PM (NOT Request Review- NCC201441)
* Signee listed organization that differed from permitted entity, but it is the same legally responsible
individual.
• The task was assigned to Georgoulias, Bethany. The due date is: December 4, 2020 5:00 PM
12/1/2020 11:45 AM

1 �
NORTH CAROLINA
Enrlronmenral Quallly
Certificate of NCC201441
Coverage (COC) Enter the Certificate of Coverage Ninber
No.*
Information associated with this permit
Project Name
Olam Edible Nuts - Parking Improvements
Address
130 Peanut Drive, Edenton, NC
County
Chowan
Latitude
36.0797
Longitude
-76.5872
Permittee Listed
Seabrook Enterprises Inc.
Legally Responsible
Drew Walton
Individual
NC Reference No.
NCG01-2020-1441
E&SC Plan ID
Chowa-2020-002
Original NOI
24167
Tracking No.
Date COC Issued
4/13/2020
Prior Rescission
Date populates only if OOCwas already rescinded at tirre of subrrittal.
Date
Reason for Rescission/Termination Request:
Reason for F Project Closed -Out
Termination of r Sale (Another Owner/Operator will apply for a new COC)
Coverage * O Mistake or Invalid Coverage
r Other
Addional Mxe inforrration about the basis of this request, if needed.
Explanation
Supporting Upload Supporting Docurrentation if applicable.
Documentation Mist beFDFforrrat
Project Close-out Information:
Final Close-out 11/18/2020
Inspection Approval

Project Close-out 201118 Olam Edible Nuts - Parking Improvements
Approval 251.08KB
CHOWA-2020-002. pdf
Documentation
Mast be FDFforrrat
North Carolina General Statute 143-215.6E (i) provides that:
Pnyperson who knowinglymakes any false statement, representation, or certification in anyapplication, record, report, plan, or other
documentfiled or required to be maintained under this Atide or a rule implementing this Atide; or who knowingly makes a false statement
of a material fact in a rulemaking proceeding or contested case underthis Atcle; or who falsifies, tampers with, or knowingly renders
inaccurate any recording or monitoring device or method required to be operated or maintained under this Prtide or rules ofthe
Commission implementing this Atcle 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
¢�ri �GI.�OiC
Type Name* Drew Walton
Title * Plant Engineering Manager
Organization* Olam Edible Nuts
Date * 12/01 /2020
Email for [e-mail]
Confirmation *
Contact Telephone* 252-312-6640
NOT Certification Notice of Termination 11-30-20.pdf
Form Mast be PDF Forrrst
Is this COC Already Ensure this CCChas not been rescinded since subrrittal!
Rescinded?
Original Permittee CCd on Wification BTails
Email [e-mail]
Original Site Contact CCd on Notificaiton Bmils
Email [e-mail]
61.62KB