NCG050164_Rescission Request_20210503

FOR AGENCY USE ONLY
Date Received:
Division of Energy, Mineral, and Land Resources Land Quality Section
National Pollutant Discharge Elimination System
Rescission Request Form
Please fill out and return this form if you no longer need to maintain your NPDES stormwater permit.
Directions: Print or type all entries on this application form. Send the original, signed application to: NCDEMLR
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 permit correspondence will be mailed):
Name of legal organizational entity:
Legally responsible person as signed in Item (4) below:
Sonoco Products Company
Peggi-Ann Davis
Street address:
City:
State and zip code:
1 North Second Street
Hartsville
SC 29550
Telephone number:
Email address:
843-383- 7991
[e-mail]
2. Industrial Facility (facility requesting rescission):
Facility name:
Sonoco Products Company
Street address:
212 Cook Road
City:
�NC
State:
Zip Code:
County:
IA[arrance
Elon College
27244
Permit Number to which this request applies:
NCG050164
3. Reason for rescission Request
11M, ID ICLjUII CU III I UI IIId LIUII. MUM- 13t:PCII CILC -, ICCLJ II IICL.CJJCII Y.
G) Facility is closed or closing. All industrial activities have ceased such that no discharges of stormwater are contaminated
by exposure to industrial activities or materials.
Date closed/closing: April 21, 2021
0 Facility sold.
Sold to:
On date:
C)Other (please explain):
E0F.11V F D
r=` 03t21
DENR-I..AND QUALITY
STORMWATER PERMITTING

4. Applicant Certification:
North Carolina General Statute 143-215.613 (i) 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
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). 1 hereby request exclusion frorn NPDES stormwater permitting.
Under penalty of law, I certify that:
I] I, 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 and belief
such information is true, complete, and accurate.
Printed Name of Person Signing: Peggi-Ann Davis
Title: Environmental Principal
�J` Ww,✓
(Sign ture of Applicant)
4/29/2021
(Date Signed)
Mail the entire package to: DEMLR— Stormwater Program
Department of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
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