NCG030617_Rescission Request Form_20211025

FOR AGENCY USE ONLY
Assigned to:
ARO FRO MRO RRO WARO WIRO WSRO
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 stormwater permit.
Directions: Print or type all entries on this application form. Send the original, signed application to: NCDEMLF
Stormwater Program, 1612 Mail Service Center, Raleigh, INC 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:
CORMETECH, Inc.
Mike Mattes, CEO
Street address:
City:
State and zip code:
11707 Steele Creek Road
Charlotte
NC 28273
Telephone number:
Email address:
980-722-1811
[e-mail]
2. Industrial Facility (facility requesting rescission):
Facility name:
CORMETECH, fnc.
Street address:
11707 Steele Creek Road
City:
State:
Zip Code:
County:
Charlotte
I NC
28273
Mecklenburg
Permit Number to which this request applies:
NCG030617
3. Reason for rescission Request
This is required information. Attach separate sheets if necessary
E3 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:
13 Facility sold.
Sold to:
On date:
El Other (please explain):
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4. Applicant Certification:
North Carolina General Statute 143-215.613 (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 from 41RD65 09FFAwateF PeFFRittiA . a change in the NC
General Industrial Permit under which this facility is covered.
Under penalty of law, I certify that:
O 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: Mike Mattes
Title: CEO
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(Signature of Applicant) (Date Signed)
Mail the entire package to: DEMLR— StormwaterProgram
Department of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
Page 2 of 2

11707 Steele Creek Road
Charlotte, North Carolina 28273 USA
Phone 70"14-4621
Fax [phone]
I.plyler@cormetech. corn
Lanette Plyler
Director Environmental, Health & Safety
October 13, 2021
NCDEMLR Stormwater Program
1612 Mail Service Center
Raleigh, NC 27699-1612
Subject: NCDEMLR NPDES Rescission Request Form
Certificate of Coverage NCG030617
CORMETECH, Inc. — Steele Creek Facility
11707 Steele Creek Road, Charlotte NC 28273
NCDEMLR Stormwater Program:
RECEIVED
OCT 2 0 2021
DENR•LAND QUALITY
STORMWATER PERMITTING
Please find attached the completed NCDEMLR NPDES Rescission Request Form for our
CORMETECH, Inc. Facility located at 11707 Steele Creek Road, Charlotte, NC 28273. The
current stormwater permitting Certificate of Coverage for this facility is NCG030617.
Catalyst regeneration activities at this facility ceased in 2016. The property is currently utilized
as the company's corporate offices and for SCR catalyst storage, shipping, and receiving. All
trucking is third -party sourced for shipping and receiving activities; therefore, no truck
maintenance is performed onsite that would necessitate coverage under NC General Industrial
Permit NCG080000. In sum, based on the current use of the property, our Steele Creek facility
no longer requires industrial stormwater permit coverage. The attached form from the Division
of Energy, Mineral, and Land Resources Land Quality Section is being submitted as a request
for guidance on this matter.
Please contact me at 980-722-1811 (cell) or via email at I.plvler(a).cormetech.com if you have
questions or if you require additional information.
Sincerely,
Lane a H. Plyler
Director Environmental, Health & Safety
Enclosures: NCDEMLR NPDES Rescission Request Form
CORMETECH, Inc.