HomeMy WebLinkAboutNCC215258_Notice of Termination_20220124Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 1/24/2022 1:22:59 AM (NOT Submittal)
Approve by Morman, Alaina 2/1/2022 10:54:09 AM (NOT Request Review - NCC215258)
• The task was assigned to Morman, Alaina. The due date is: January 27, 2022 5:00 PM
1 /24/2022 1:23 AM
NORTH CAROLINA
Rrf OmFkm&tral Qualrly
Certificate of NCC215258
Coverage (COC) No.* Enter the Certificate of Coverage Number
2020 Annual Fee Status
2021 Annual Fee Status May be blank (if not yet billed).
2022 Annual Fee May be blank (if not yet billed).
Status
Information associated with this permit:
Project Name
The Home Depot Parking Lot - Charlotte, NC
Address
9501 Albemarle Rd., Charlotte, NC
County
Mecklenburg
Latitude
35.2116
Longitude
-80.6823
Permittee Listed
Home Depot U.S.A., Inc.
Legally Responsible
David Kazerooni
Individual
NC Reference No.
NCG01-2021-5258
E&SC Plan ID
LDGP-2021-00137
Original NOI Tracking
65048
No.
Date COC Issued
9/20/2021
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Date populates only if COC was already rescinded at time of submittal.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
Repaving project is completed.
Supporting
Upload Supporting Documentation if applicable.
Documentation
Must be PDF format
Project Close-out Information:
Final Close-out 12/14/2021
Inspection Approval
Project Close-out charlotte
Approval 85.17KB
Grad ingPermitNoticeOfTermination_20211214_1...
Documentation
Must be PDF format
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
Type Name* David S Kazerooni
Title* Sr. Manager Civil / Stormwater
Organization* The Home Depot USA, Inc.
Date * 01 /24/2022
Email for David_Kazerooni@homedepot.com
Confirmation*
Contact Telephone* 4044447388
NOT Certification charlotte NC-100_Page_2.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 david_kazerooni@homedepot.com
Original Site Contact CC'd on Notificaiton Emails
Email david_kazerooni@homedepot.com
442.61 KB