NCC200802_Notice of Termination_20210409

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 4/9/2021 10:25:15 AM (NOT Submittal)
Approve by Morman, Alaina 4/12/2021 8:44:04 AM (NOT Request Review- NCC200802)
• The task was assigned to Morman, Alaina. The due date is: April 14, 2021 5:00 PM
4/9/2021 10:25 AM

1 �
NORTH CAROLINA
Enrlronmenral Quallly
Certificate of NCC200802
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
AGA TAG Solar IV
Address
2299 Commerce Drive NE, Leland, NC
County
Brunswick
Latitude
34.2730
Longitude
-78.0580
Permittee Listed
ReNew Petra Integrators, Inc.
Legally Responsible
Greg Peterson
Individual
NC Reference No.
NCG01-2020-0802
E&SC Plan ID
BRUNS-2019-031
Original NOI
22482
Tracking No.
Date COC Issued
3/4/2020
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Date populates only if COCwas already rescinded at time of submittal.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 obtained 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 11/25/2020
Inspection Approval
Project Close-out AGA TAG Solar IV - ESC-NPDES Final
Approval 223.25KB
Inspection_1 1-25-2020.pdf
Documentation
Mist be FDFforrrat
North Carolina General Statute 143-215.66 (1) provides that:
Anyperson who knowinglymakes anyfalse 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 knowinglymakes a false statement
of a material fact in a rulemaking proceeding or contested case underthis Article; orwho falsifies, tampers with, or knowingly renders
inaccurate anyrecording or monitoring deice 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 notto 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* Greg Peterson
Title * Chief Executive Officer
Organization * ReNew Petra Integrators, Inc.
Date * 04/09/2021
Email for [e-mail]
Confirmation *
Contact Telephone* 919-961-1640
NOT Certification AGA TAG Solar IV - NOT Certification Form_04-07-
Form 863.18KB
2021.pdf
Mist be FDF Fornat
Is this COC Already Ensure this OCChas not been rescinded since subrrittal!
Rescinded?
Additional Email OCd on Notification Errails
(Optional) [e-mail]
Original Permittee CCdonWificationErrails
Email [e-mail]
Original Site Contact GCB on Notificaiton BTails
Email [e-mail]