NCC200774_Notice of Termination_20210204

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 2/4/2021 2:28:39 PM (NOT Submittal)
Approve by Morman, Alaina 2/11/2021 4:24:49 PM (NOT Request Review- NCC200774)
• The task was assigned to Morman, Alaina. The due date is: February 9, 2021 5:00 PM
2/4/2021 2:28 PM

1 �
NORTH CAROLINA
Enrlronmenral Quallly
Certificate of NCC200774
Coverage (COC) Enter the Certificate of Coverage Nmber
No.*
2020 Annual Fee Status
2021 Annual Fee Status OPEN
May be blank (if not yet billed).
Information associated with this permit:
Project Name
BMC Truss Manufacturing
Address
2979 Mason Street, Monroe, NC
County
Union
Latitude
34.9880
Longitude
-80.4950
Permittee Listed
BMC East, LLC
Legally Responsible
Donna Thagard
Individual
NC Reference No.
NCG01-2020-0774
E&SC Plan ID
20-00201259
Original NOI
22403
Tracking No.
Date COC Issued
2/26/2020
Prior Rescission
Date populates only if COCwas already rescinded at time of submittal.
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
Addional Nbre information about the basis of this request, if needed.
Explanation
Supporting Upload Supporting Documentation if applicable.
Documentation NlastbeRYforrrat

Project Close-out Information:
Final Close-out 10/30/2020
Inspection Approval
Project Close-out BMC Monroe City Of Monroe Completed
Approval 348.04KB
Certificaiton Form 1-06 10.22.2020.pdf
Documentation
Mast be FDFforrrat
North Carolina General Statute 143-215.66 (1) 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 deice or method required to be operated or maintained under this Article or rules ofthe
Commission implementing this Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine not to exceed ten thousand
dollars ($10,000).
rJ 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* Donna Thagard
Title * SVP / Corporate Controller
Organization* BMC East LLC
Date * 02/04/2021
Email for [e-mail]
Confirmation *
Contact Telephone* 9194311155
NOT Certification 1282_001.pdf
Form Mast be PDF Forrrst
Is this COC Already Ensure this CCChas not been rescinded since subrrittal!
Rescinded?
Additional Email CCd on Notification Errails
(Optional) [e-mail]
Original Permittee CCdonWificationErrails
Email [e-mail]
Original Site Contact CCd on Notificaiton Errails
Email [e-mail]
68.22KB