NCG160083_Rescission Request_20210511

FOR AGENCY USE ONLY
Date Received:
Division of Energy, Mineral, and Land Resources Land Qualit IFIVED
National Pollutant Discharge Elimination System MAY 05 2021
Rescission Request Form
DENtR�-LAND QUALITY
Please fill out and return this form if you no longer need to maintain your NPDES storm wA6T P�,e� i-ER PERMITTING
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:
Martin Marietta Materials, Inc.
Ron Kopplin
Street address:
City:
State and zip code:
INC
4123 Parklake Avenue
Raleigh
27612
Telephone number:
Email address:
919-510-4777
[e-mail]
2. Industrial Facilitv (facility reauestina rescission):
Facility name:
Martin Marietta - Matthews Asphalt Plant
Street address:
1215 Sam Newell Road
City:
State:
�NC
Zip Code:
County:
Matthews
28105
Mecklenburg
Permit Number to which this request applies:
NCG160083
3. Reason for rescission Request
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0 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:
0 Facility sold.
Sold to:
On date:
Other (please explain):
Property and associated permits are being held by property lessee, Blythe Construction, Inc.

4. Applicant Certification:
North Carolina General Statute 143-215.6E (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 from NPDES stormwater permitting.
Under penalty of law, I certify that:
El 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: Ron Kopplin
Title: President East Division
VZM V00��
(Signature of Applicant)
4•UP-2)
(Date Signed)
Mail the entire package to: DEMLR — Stormwater Program
Department of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
Page 2 of 2

t
Martin
Marietta
May 3, 2021
Ms. Annett Lucas
NC DEQ DEMLR
Stormwater Program
512 N. Salisbury Street
Raleigh, NC 27604
Jay Nivens
Manager Environmental Engineering
East Division
Via FeclEx Delivery
RE: Martin Marietta Matthews Asphalt Plant NPDES Permit Rescission Request
Dear Ms. Lucas:
This letter is to request the rescission of the NPDES Permit #NCG160083 for the former
asphalt plant located at our Matthews Quarry. The area of the former asphalt plant will be leased
to Blythe Asphalt who operates an asphalt facility immediately adjacent to this property. The
current asphalt plant will be using this site as a RAP storage and processing area. All permit
conditions and requirements will be the responsibility of the Blythe Asphalt.
Should you have any questions or need any additional information, please contact me at 704-
409-1475 or via e-mail at [e-mail].
Sin ly, %
77
Charlotte District Office
8701 Red Oak Blvd. Suite 540, Charlotte, NC 28217
t. [phone] m. [phone] [e-mail]
www.martinmarietta.com

Transmittal Letter
Martin Martin Marietta
8701 Red Oak Blvd. Suite 540
/AMcrje.ttc Charlotte, NC 28217 -
(P) 704-409-1475 (F) 704-527-9283
To:
I NCDEQ - DEMLR
.Stormwater Program
512 N. Salisbury Street
Raleigh, NC 27604
nette Lucas
Wartin Marietta NPIDES Permit
NCG160083
We are sending you
Drawings
Letter
Prints
Change Order
Plans
F] Reproducible
Copies Description
1 NPIDES Permit Rescission- Request Submittal
For Approval
For Your Use
As Requested
Approved as Submitted Resubmit copies for approval
Approved as Noted
Returned for Corrections
Comments:
Copy to:
. . . ........
S'natur4/