HomeMy WebLinkAboutNCC202960_Notice of Termination_20210915Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 9/15/2021 3:42:26 PM (NOT Submittal)
Approve by Morman, Alaina 9/19/2021 1:22:55 PM (NOT Request Review- NCC202960)
• The task was assigned to Morman, Alaina. The due date is: September 20, 2021 5:00 PM
9/15/2021 3:42 PM
1 �
NORTH CAROLINA
Enrlronmenral Quallly
Certificate of NCC202960
Coverage (COC) Enter the Certificate of Coverage Nmber
No.*
2020 Annual Fee Status
2021 Annual Fee Status PAID
Nt3y be blank (if not yet billed).
Information associated with this permit:
Project Name
PNG Bryson Park Extension
Address
Hege Road, Lexington, NC
County
Davidson
Latitude
35.9662
Longitude
-80.2745
Permittee Listed
Piedmont Natural Gas Company, Inc.
Legally Responsible
Kevin Sell
Individual
NC Reference No.
NCG01-2020-2960
E&SC Plan ID
DAVID-2021-003
Original NOI
28084
Tracking No.
Date COC Issued
7/14/2020
Prior Rescission
Cate populates only if COCwas already rescinded at time of submittal.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 *
r Mistake or Invalid Coverage
r Other
Additional IVbre information about the basis of this request, if needed.
Explanation
Supporting upload Supporting Documentation if applicable.
Documentation Mist beRYforrrat
Project Close-out Information:
Final Close-out 7/14/2021
Inspection Approval
Project Close-out Inspection Report 07-14-21 (DAVID-2021-003).pdf 136.91 KB
Approval Mast be FDFfornat
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 under this 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 of the
Commission implementing this Artcle 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
Vid
Type Name* Kevin Sell
Title * Manager, Gas Field Operations
Organization* Piedmont Natural Gas Company, Inc.
Date * 09/15/2021
Email for Kevin.Sell@duke-energy.com
Confirmation *
Contact Telephone* 3367267783
NOT Certification Bryson Park NCG01 NOT_signed.pdf
Form Mast be FDF Fornat
Is this COC Already Ensure this OCChas not been rescinded since subrrittal!
Rescinded?
Additional Email OCd on Notification Errails
(Optional) mbare@wkdickson.com
Original Permittee CCd on Wification Bmils
Email Kevin.Sell@duke-energy.com
Original Site Contact CCd on Notificaiton BTails
Email Lee.James2@duke-energy.com
75.66KB