NCGNE0547_Rescission Request_0547

Division of Energy, Mineral & Land Resources
Land Quality Section/Stormwater Permitting Program
National Pollutant Discharge Elimination System
Environmental
Quality RESCISSION REQUEST FORM
FOR AGENCY USE ONLY
Date Received
Year
MonthT
Day
1 x`:�
Please fill out and return this form if you no longer need to maintain your NPDES stormwater perRA 1 O
IAA 1011
1) Enter the permit number to which this request applies: DENR-LAND QJF,LITy
Individual Permit (or) Certificate of CovWWAWATER ERM'illT►NG
N I C I S I I I I N I c I s IN E 0 5 14 17
2) Owner/Facility Information: * Final correspondence will be mailed to the address noted below
Owner/Facility Name Smartrac Technology Fletcher Inc (an Avery Dennison Company)
Facility Contact
Street Address
City
County
Telephone No.
Tim Drake
267 Cane Creek Road
Fletcher
Henderson
828 676-4962
State NC ZIP Code 28732
E-mail Address [e-mail]
Fax:
3) Reason for rescission request (This is required information. Attach separate sheet if necessary):
❑ Facility closed or is closing on . All industrial activities have ceased such that no discharges of
stormwater are contaminated by exposure to industrial activities or materials.
❑ Facility sold to
on . If the facility will continue operations under the new owner it
may be more appropriate to request an ownership change to reissue to permit to the new owner.
✓❑ Other: This permit was initially established while the facility was a part of UPM Raflatac Inc; the facility was
aquired by Smartrac Technologies in 2012, and a new no exposure certification was submitted instead of applying for a name change.
The new no exposure permit number for Smartrac Technology is NCGNE0892.
4) Certification:
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.
Signature
Tim Drake
Print or type name of person signing above
Please return this completed rescission request form to:
Date 26-Feb-2021
Quality Engineer
Title
DEMLR - Stormwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Revised 20183an10

SMARTRAC � I
20 September, 2012
Stormwater Permitting Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
RE: No Exposure Certification Form
SMARTRAC Technology Fletcher Inc.
267 Cane Creek Road
Fletcher, NC 28732
To whom it may concern:
As of June 2012, our production facility in Fletcher, NC is operating under new corporate
ownership as SMARTRAC Technology Fletcher, Inc. Enclosed is our new application package,
which will be the first certification efforts for the new business.
Note please that this facility — previously operating as UPM RFID — had an active "No Exposure"
certification (ref. NCGNE0547). Our production technology, hazardous material usage, and
storage/handling conditions have remained unchanged during this business transition.
Please contact me at [phone] or at kristopher.hinzo-smartrac-groua com if I can be of
further assistance. Thanks for your time and consideration.
Sincerely,
j-p-�
Kristopher Hinz
Quality Manager
SMARTRAC Technology Fletcher Inc.
267 Cane Creek Road
Fletcher, NC 28732
Enclosure
Cc: Mike Keen, Operations Manager — SMARTRAC Technology Fletcher Inc.
Laura Cummings, Sustainability & Environmental Manager — UPM Raflatac
Page 1

A
w +AW�
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P.E.
Governor Director
November 26, 2012
Mr. Kristopher Hinz, Quality Manager
SMARTRAC Technology Fletcher, Inc.
267 Cane Creek Road
Fletcher, NC 28732
Subject: No Exposure Certification — Approval
NCGNE0892
SMARTRAC Technology Fletcher, Inc.
Henderson County
Dear Mr. Hinz:
Dee Freeman
Secretary
The Division has reviewed your application for a No Exposure Certification for Exclusion (NE) for the subject
facility. Based on the information provided and a site visit conducted on November 5, 2012, the NE has been
approved.
Please note that you are obligated to maintain no -exposure conditions at your facility. If conditions change such
that your facility can no longer qualify for a NE, you are obligated to immediately obtain NPDES permit coverage
for your stormwater discharge. Otherwise, the discharge becomes subject to enforcement as an un-permitted
discharge. Your NE does not expire. In order to help assure that your facility stays in compliance with all of the
conditions in the Certification, you must self -recertify your facility at least annually. Please see the attachment
for information on self -recertification.
Your conditional exclusion from permitting does not affect your facility's legal requirements to obtain environmental
permits that may be required under other federal, state, or local regulations or ordinances.
If you have any questions or need further information, please contact Susan Wilson at [phone], or at
susan.a.-%N-ilson(dncdenr gov.
Sincerely,
for Charles Wakild, P.E.
Enc.
cc: Stormwater Permitting Unit/Ken Pickle, No -Exposure Files
ARO Files
S:\SWP\Henderson\Stormwater\3-No Exposures\APRVL.SMARTRAC NCGNE0892.11 2012.doc
Location: 2090 U.S Highway 70, Swannanoa. North Carolina 28778
Phone: 828-296A5001 FAX [phone] One
Internet. www nmaterqualo.org NortthCarrrolliina
An Equai Opportunity 1 Affirmative Action Employer N tm N i { y