NCC202471_Notice of Termination_20220718

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 7/18/2022 4:57:58 PM (NOT Submittal)
Approve by Clark, Paul B 7/19/2022 3:47:25 PM (NOT Request Review - NCC202471)
• The task was assigned to Clark, Paul B by round robin distribution 7/18/2022 4:58 PM
The task was assigned to DEMLR NCG01 NOT Review Team. The due date is: July 21, 2022 5:00 PM
7/18/2022 4:58 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(COC) will be rescinded.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 NCC202471
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 OPEN
May be blank if N/A May be blank if N/A
This permittee has an OPEN fee. If this NOT request is acceptable, you will have the option to waive that fee, but that is
only available AFTER the Notice of Termination (NOT) has been approved (when the permit status becomes INACTIVE).
If it is appropriate to waive the OPEN fee, it may help to assign that annual fee task to yourself immediately following this
approval so you remember to resolve the outstanding fee.
Information associated with this permit:
Project Name CCEP - Lot #3
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 Enterprise Park Drive, Sanford, NC
County Lee
Latitude 35.5620
Longitude-79.1580
Permittee Listed CC Enterprise Park, LLC
Legally Responsible Kirk Bradley
Individual
NC Reference No. NCG01-2020-2471
E&SC Plan ID LEE-2020-024
Original NOI Tracking 26913
No.
Date COC Issued 6/15/2020
Prior Rescission Date Date populates only if COC was already rescinded at time of submittal.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
New owner/operator NCC215378
COC No. Enter the COC number obtained by the new owner
New Owner Name First and last name
Kimball Hall - Abezna (North Carolina) LLC
New Owner Phone [phone]
Number
New Owner Email
[e-mail]
Additional
More information about the basis of this request, if needed.
Explanation
The subject property was sold on July 28th, 2021 the deed is attached below. A new
Erosion Control Plan was approved for the new owner's (Abzena) building
construction in September 2021 under COC No. NCC215378. An additional plan
was approved in February 2022 and the DEQ Letter of approval is attached below.
Supporting
Upload Supporting Documentation if applicable.
Documentation
LEE-2022-002_20220214_LOA.pdf 259.62KB
Abzena Deed.pdf 166.82KB
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 143-215.6B (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
Af } • A4Cf
Type Name* Kirk Bradley

Title*
Manager
Organization *
CC Enterprise Park, LLC
Date *
07/18/2022
Email for
[e-mail]
Confirmation
Contact Telephone*
[phone]
NOT Certification
NCG01-eNot-Certification Form DEMLR.KJB
Form
71.1 KB
signed.pdf
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)
[e-mail]
Original Permittee
CC'd on Notification Emails
Email
[e-mail]
Original Site Contact
CC'd on Notificaiton Emails
Email
[e-mail]