NCC205883_Notice of Termination_20210604

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 6/4/2021 12:52:25 PM (NOT Submittal)
Approve by Morman, Alaina 6/9/2021 2:04:07 PM (NOT Request Review- NCC205883)
• The task was assigned to Morman, Alaina. The due date is: June 9, 2021 5:00 PM 6/4/2021 12:52 PM

1 �
NORTH CAROLINA
Enrlronmenral Quallly
Certificate of NCC205883
Coverage (COC) Enter the Certificate of Coverage Nmber
No.*
2020 Annual Fee Status
2021 Annual Fee Status May be blank (if not yet billed)
Information associated with this permit:
Project Name
Henderson - VEPCO Kerr Dam Plant 115kV - Replace OHGW
Address
Watson Drive, Henderson, NC
County
Vance
Latitude
36.3097
Longitude
-78.4262
Permittee Listed
Duke Energy Progress, LLC
Legally Responsible
Randy Veltri
Individual
NC Reference No.
NCG01-2020-5883
E&SC Plan ID
VANCE-2018-003
Original NOI
39287
Tracking No.
Date COC Issued
12/22/2020
Prior Rescission
Date populates only if COCwas already rescinded at tirre of submittal.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 *
U Mistake or Invalid Coverage
r Other
Ad d i o n a I Nbre information about the basis of this request, if needed.
Explanation
Supporting Upload Supporting Docurrentation if applicable.
Documentation Mist beFDFformat

Project Close-out Information:
Final Close-out 6/3/2021
Inspection Approval
Project Close-out VANCE-2018-003_20210603_lnspRpt.pdf 175.17KB
Approval Mist be FDFforrrat
Documentation
North Carolina General Statute 143-215.66 (1) provides that:
Anyperson who knowinglymakes any false 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 knowingly makes a false statement
of a material fact in a rulemaking proceeding or contested case underthis Article; or who falsifies, tampers with, or knowingly renders
inaccurate any recording or monitoring deice or method required to be operated or maintained under this Article or rules ofthe
Commission implementing this Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine not to 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* Randy Veltri
Title * Director Transmission Permitting
Organization* Duke Energy Progress, LLC
Date * 06/04/2021
Email for [e-mail]
Confirmation *
Contact Telephone* 704-382-2741
NOT Certification NCG01 Notice of Termination (NOT) Certification
Form Form _Signed.pdf
Mist be RY Forrrat
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]
350.76KB