NCC200722_NOT Request No 1 Rejection Clarification_20210302

Morman, Alaina
From: Morman, Alaina
Sent: Tuesday, March 2, 2021 9:51 PM
To: [e-mail]
Subject: RE: NOT Request Not Approved
Hi Mr. Mozingo,
I misspoke in the rejection email —the NOT Certification Form was signed, but it was not dated. Please date the form and
then upload it into a new NOT.
Please let me know if you have any questions.
Thank you,
Alaina
Alaina Morman (she/her)
Environmental Specialist
Division of Energy, Mineral and Land Resources
North Carolina Department of Environmental Quality
Phone: [phone]
Email: alai na.morman(cl-ncdenr.gov
Physical Address: 512 North Salisbury Street
Mailing Address: 1612 Mail Service Center
Raleigh, NC 27699-1612
:h DEQ>
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
From: [e-mail] [mailto:[e-mail]]
Sent: Tuesday, March 2, 2021 9:47 PM
To: [e-mail]
Cc: Morman, Alaina <[e-mail]>; [e-mail]
Subject: NOT Request Not Approved
This email is to notify you that your request to rescind COC No. NCC200722 for the project Wakefield
Meadows Lot 56 was not approved for the following reason:
Everything looked great, except the NOT Certification Form wasn't signed. Please sign the form and then
upload it into a new NOT.
Contact [e-mail] with questions. Thank you.
If you have any questions, please contact The NC DEMLR Stormwater Program at [phone].
This email was automatically generated by Laserfache. Please do not respond to this email address, as
responses are not monitored.

NCG01 Notice of Termination (NOT) Certification Form
Directions:
Print this form, complete, scan and upload to the electronic NOT (Rescission) form.
Then, mail the original form to the NC DEMLR Stormwater Program at:
Division of Energy, Mineral & Land Resources Stormwater Program
512 N. Salisbury Street, 6" Floor
1612 Mail Service Center
Raleigh, NC 27699-1612
General Permit Certificate of overage (COC) o.: 21.
Name of Project:
71
Per NC General Statute 143-215.6E (i), any person who knowingly makes any false statement, representation,
or certification in any application, record, report, plan, or other document filed or required to be maintained
under this Article or a rule implementing this Article ... shall be guilty of a Class 2 misdemeanor which may
include a fine not to exceed ten thousand dollars ($10,000).
Under penalty of law, I certify that:
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.
Legally Responsible Organizational Entity:
*Legally Resi
Title of Leg
*Signature:
4 40me�5 luv c-
Print Name and Title of Signed (only if authorized inaiviauai signing ain-ers jrom cegauy Kesponsivie reis�rri:
* IMPORTANT NOTE: 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 NCGO10000 permit.
For more information on signatory requirements, see Part IV, Section B, Item (6) of the NCGO10000 permit.
,�D E