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HomeMy WebLinkAboutNCC200046_Notice of Termination_20220106Action History (UTC-05:00) Eastern Time (US & Canada) Submit by Anonymous User 1/6/2022 9:23:08 AM (NOT Submittal) Approve by Morman, Alaina 1/7/2022 4:34:48 PM (NOT Request Review - NCC200046) • The task was assigned to Morman, Alaina. The due date is: January 11, 2022 5:00 PM 1 /6/2022 9:23 AM NORTH CAROLINA Rrf OmFkm&tral Qualrly Certificate of NCC200046 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). 2022 Annual Fee OPEN Status May be blank (if not yet billed). Information associated with this permit Project Name FedEx Freight Address 5203 Chin Page Road, Durham, NC County Durham Latitude 35.8971 Longitude -78.8349 Permittee Listed Kirkland Legally Responsible Jason Sims Individual NC Reference No. NCG01-2020-0046 E&SC Plan ID 6059-09 Original NOI Tracking 20214 No. Date COC Issued 1/7/2020 Prior Rescission Date Date populates only if COC was already rescinded at time of submittal.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 new COC) Coverage* Mistake or Invalid Coverage Other Additional More information about the basis of this request, if needed. Explanation This project was closed out on 9/1/2021. Supporting Upload Supporting Documentation if applicable. Documentation Must be PDF format Project Close-out Information: Final Close-out 9/1/2021 Inspection Approval Project Close-out Letter of Termination Fed Ex Freight.pdf 49.98KB Approval Must be PDF format Documentation 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; 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 0-1 6;"l 9ftf Type Name* Jason Sims Title* Director of Field Operations/Project Executive Organization* Kirkland Date * 01 /06/2022 Email for jsims@kirklandinc.com Confirmation* Contact Telephone* 3364546131 NOT Certification FedEx NOT.pdf Form Must be PDF Format Is this COC 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 jsims@kirklandinc.com 579.91 KB Original Site Contact CC'd on Notificaiton Emails Email jsims@kirklandinc.com