NCGNE1205_Rescission Request_20210804

FOR AGENCY USE ONLY
Assigned to:
ARO FRO MRO RRO
WARO WIRO WSRO
RECEIVED
AUG 0 4 2021
DENR-LAND QUALITY
STORMWATER PERMITTING
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 storm water 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 recission of your NPDES stormwater permit. Prior to the recission of your NPDES stormwater permit, 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:
Consolidated Metco, Inc.
Rick Linville
Street address:
City:
State and zip code:
171 Great Oak Drive
Canton
NC 28779
Telephone number:
Email address:
7042540590
[e-mail]
2. Industrial Facilitv (facility reauestine rescission):
Facility name:
Consolidated Metco
Street address:
655 Scotts Creek Road
City:
State:
Zip Code:
County:
Sylva
NC
28716
Jackson
Permit Number to which this request applies:
NCGNE1205
3. Reason for rescission Request
I Ills Is 1egU11t:U IIIIVIIIIa L1U11. llttacl separate sleets It necessary.
lD 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: 8/2/2021
I] Facility sold.
Sold to:
On date:
© Other (please explain)

A. Applicant Certification, e �
North carofina,General Statute 143-215.6g {i} provides that: Anj, perInn >+rhra kl';W'Ilgt� makes anyfai
representation, or ccrtaffirrany appttratibti, riccird, rePOrt, oian, 01 nthr.c cicr"r€rr'op n, f lcd or ,quired to brr rs'a,rs t r
under this Artr�.le or a rule impdemetr'Eing jhj5, iCje shai[ bF= r;LO� ',° ,f «I CI J,> 2 =rr@sd_ canflc which r a t ei t�
to cxcceti ten thausand OoUars i$a10,0011. t hereby teque
Under penatty of taw, f certify that:
Cl i, as an authorized reoresen0t—', hMr+Y request recismon of ccvot' t;e- rrr, Ee ehe;dPl f� r= a er f e °r ii i
subject hiplitf- I am familiar kvith vj1 , rrr€:arrnation coat. feed in 'fate requ+ , r ,and to th L14?-t of my knowledgC a.'n c--§r�'
such inform ation is true, cornplr�re, and accurate.
Printed Name of Peron Signing: Rick Lravrlle
Trtle; Sri, Corr fiance NI
(Sienature of,Appticant) i�a't r ne€1
fe,ail the entire package to_ DEtNILi; — Stcarngw iter Program
Department of EnvirOnMerital Quality
1612 hlaiiServlce Center
Raleigh, NC 27699-1612