NCG130001_Rescission Request-20210413

R E iF
FOR AGENCY USE ONLY -,D
Date Received: APR 13 2021
Division of Energy, Mineral, and Land Resources Land Quality SeMORLAND QUALITY
National Pollutant Discharge Elimination System STORMWATER PERMITTING
Rescission Request Form
Please fill out and return this form if you no longer need to maintain your NPDESstormwater permit.
Directions., Print or type all: entries on this application form. Send the original, signed application to; NCD'EMLR
Stormwater Program, 1612 Mail Service Center, Raleigh, NC 27699-1612. The submission of this form does not
guarantee exclusion from NPDES stormwater permitting. Prior to exclusion from NPDES stormwater permitting a
site inspection will be conducted.
1. Owner/Operator (to whom all hermit corresoondence will be mailedi:
Name of legal organizational entity:
Legally responsible person as signed in Item (4),below;
Wall Recycling., LLC
Dan Wall
Street address:
City-
State and zip code;
2310 Garner Road
Raleigh
INC 27610
Telephone number:
Email address-
(.919,) 552-2149
[e-mail]
2. Industrial Facility (facility requestinR rescission):
Facility name!
Wall Rep din LLO, Durham
Street address*,
227 S. Holman Str.e
City: Stags.
--127702
Zip co:
county
INC
Durham
PermitPermit Number to*hK'fi this request applies:
,NCG1 30001 Non -Metal Waste & Scrap
3. Reason for rescission Request
This is required information. Attach separate sheets if necessary.
0 Facility is closed or closing. All Indu
strial activities have ceased such that no discharges of stormwater are contaminated
by exposure to Industrial activities or materials,
Date closed/closing:
01'atility sold.
Sold to-,
On date:
Other (please explain)
Changed permit for site 'to permit# NCG200467 - Scap Metal, No longer need the above permit.

4. Applicant
C cant ertification-
North Carolina General Statute 143-215.615 (1) provides that, 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
Undor this Article or 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). 1 hereby request exclusion from NPDES stormwater permitting.
'Unoer penalty of law, I certify that:
Erli as an authorized representative, hereby request recission 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 a.nd belief
such information is true, complete, and accurate.
Printed Name of Person 5igning: Dan Wall
Title: MemberManager
Y�'5�'q I
(Signatur V (Date I SigneA)
Mail the entire package to: DEMLR — Stormwater Program
Departin6fit of Eriviro' rimental'QUality
1612 - Mail Service: Center
:kaleigh, NC 27699-1612
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