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HomeMy WebLinkAboutNCC204830_Notice of Termination_20211206Action History (UTC-05:00) Eastern Time (US & Canada) Submit by Anonymous User 12/6/2021 10:15:14 AM (NOT Submittal) Approve by Morman, Alaina 12/6/2021 4:51:44 PM (NOT Request Review - NCC204830) • The task was assigned to Morman, Alaina. The due date is: December 9, 2021 5:00 PM 12/6/2021 10:15 AM NORTH CAROLINA Rrf OmFkm&tral Qualrly Certificate of NCC204830 Coverage (COC) No.* Enter the Certificate of Coverage Number 2020 Annual Fee Status 2021 Annual Fee Status PAID May be blank (if not yet billed). Information associated with this permit: Project Name South Brunswick High School ROTC Addition Address 280 Cougar Road, Boiling Spring Lakes, NC County Brunswick Latitude 34.0000 Longitude -78.0000 Permittee Listed Brunswick County Schools Legally Responsible Craig Eckert Individual NC Reference No. NCG01-2020-4830 E&SC Plan ID BRUNS-2020-075 Original NOI Tracking 33812 No. Date COC Issued 10/27/2020 Prior Rescission Date Date populates only if COC was already rescinded at time of submittal. Reason for Rescission/Termination Request: Reason for Project Closed -Out Termination of Sale (Another Owner/Operator obtained a new COC) Coverage* Mistake or Invalid Coverage Other Additional More information about the basis of this request, if needed. Explanation Supporting Upload Supporting Documentation if applicable. Documentation Must be PDF format Project Close-out Information: Final Close-out 7/27/2021 Inspection Approval Project Close-out FNL DEQ INSP.pdf 20.3KB Approval Must be PDF format Documentation North Carolina General Statute 143-215.613 (1) 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; 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 device or method required to be operated or maintained under this Article or rules of the Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars ($10,000). * 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 NCGO10000 General Permit. For more information on signatory requirements, see Part IV, Section B, Item (6) of that permit. Signature r6� ,,-C��7r` Type Name* CRAIG ECKERT Title* DIRECTOR OF CAPITAL PROJECTS Organization * BRUNSWICK COUNTY SCHOOLS Date * 12/06/2021 Email for CECKERT@BCSWAN.NET Confirmation* Contact Telephone* 910-253-1078 NOT Certification revnot211206.pdf Form Must be PDF Format Is this CDC Already Ensure this COC has not been rescinded since submittal! Rescinded? Additional Email CC'd on Notification Emails (Optional) Original Permittee CC'd on Notification Emails Email ceckert@bcswan.net Original Site Contact CC'd on Notificaiton Emails Email ceckert@bcswan.net 24.57KB