NCG140400_Rescission Request_20210316

Division of Energy, Mineral & Land Resources
I. cl� Land Quality Section/Stormwater Permitting Program
National Pollutant Discharge Elimination System
FOR AGENCY USE ONLY
Date Received
Year
Month
Day
Environmental
Quality RESCISSION REQUEST FORM `�° F
.-_.
Please fill out and return this form if you no longer need to maintain your NPDES stormwaJA&A.' 2021 A. ,
DENR-LAND QiIJ LIT Y
1) Enter the permit number to which this request applies: STORMWATER PERMITTING,
Individual Permit (or) Certificate of Coverage
N I C I S I I I I I I I I N I C I G 11 14 10 14 10 0 1
2) Owner/Facility Information: "Final correspondence will be mailed to the address noted below
Owner/Facility Name Brandon Dills / Smoky Mtn Ready Mix
Facility Contact
Street Address
City
County
Telephone No.
Brandon Dills
4460 Hyw 19 W
Bryson City
Swain
828 736-1812
State NC
E-mail Address
Fax: N/A
ZIP Code 28713
[e-mail]
3) Reason for rescission request (This is Muired information. Attach separate sheet if necessary):
Facility closed or is closing on 2013 . All industrial activities have ceased such that no discharges of
stormwater are contaminated by exposure to industrial activities or materials.
Southern Concrete Materials 12/11I2020
✓� 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.
Q Other: Southern Concrete Materials has purchased the equipment and it will be removed from the site
no later than 05/21 /2021. It has been non operational since 2013.
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
Brandon Dills
Print or type name of person signing above
Please return this completed rescission request form to:
Date March 8, 2021
President
Title
DEMLR - Stormwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Revised 20183an10