NCC202254_Notice of Termination_20220707

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 7/7/2022 5:31:04 PM (NOT Submittal)
Approve by Clark, Paul B 7/11/2022 10:55:34 AM (NOT Request Review - NCC202254)
• The task was assigned to Clark, Paul B by round robin distribution 7/7/2022 5:31 PM
The task was assigned to DEMLR NCG01 NOT Review Team. The due date is: July 12, 2022 5:00 PM
7/7/2022 5:31 PM

Use this form to submit a Notice of Termination (NOT) request for a project covered under the N.C. NPDES
General Permit for Construction Activities NCGO10000 (or NCG250000). If approved, the Certificate of Coverage
(COC) will be rescinded.
Certificate of NCC202254
Coverage (COC) No.* Enter the Certificate of Coverage Number
2020 Annual Fee Status 2021 Annual Fee Status 2022 Annual Fee Status
May be blank if N/A PAID WAIVED
May be blank if N/A May be blank if N/A
Information associated with this permit:
Project Name Granite Falls, NC - Dollar General
Lots Covered by this This information is especially helpful when more lots were added with Modifications since the original permit
Permit COC (if issuance.
applicable) No longer visible on the initial form (data not captured from initial application)
Address Dudley Shoals Road, Granite Falls, NC
County Caldwell
Latitude 35.8378
Longitude-81.4096
Permittee Listed The Broadway Group LLC
Legally Responsible Robert Broadway
Individual
NC Reference No. NCG01-2020-2254
E&SC Plan ID CALDW-2020-016
Original NOI Tracking 26329
No.
Date COC Issued 5/29/2020
Prior Rescission Date Date populates only if COC was already rescinded at time of submittal.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 Project Closed -Out - Not Constructed
Additional More information about the basis of this request, if needed.
Explanation This project was never constructed or built due to the denial of rezoning. Attached is
the letter from the engineer who issue the E&SC Plan and a rezone denial letter
from Caldwell County.

Supporting Upload Supporting Documentation if applicable.
Documentation Broadway Group LLC Rezoning Denial Letter
86.77KB
2.8.2021 BOC Meeting.pdf
Granite Falls NC DG Site Project Termination Letter
435.33KB
King Eng Ltr-.pdf
Must be PDF format
Project Close-out Information:
Erosion Control Plan
Close-out Date
Erosion Control Plan Must be PDF format
Close-out
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
wat Pica
Type Name* Robert Broadway
Title* Member
Organization* The Broadway Group of Alabama, LLC
Date * 07/07/2022
Email for [e-mail]
Confirmation*
Contact Telephone* 2565337287
NOT Certification Granite Fall, NC NCDEQ NOT Certification Form.pdf 79.83KB
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 [e-mail]
Original Site Contact cc'd on Notificaiton Emails
Email [e-mail]