NCC213518_Notice of Termination_20220902

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 9/2/2022 12:09:20 PM (NOT Submittal)
Approve by Clark, Paul B 9/6/2022 11:29:52 AM (NOT Request Review - NCC213518)
* 7/1/2022 - invoice due date, 8/10/2022 - inspection closeout report. Waive fee
• The task was assigned to Clark, Paul B by round robin distribution 9/2/2022 12:09 PM
The task was assigned to DEMLR NCG01 NOT Review Team. The due date is: September 7, 2022 5:00
PM 9/2/2022 12:09 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(COC) will be rescinded.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 NCC213518
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 May be blank if N/A WAIVED
May be blank if N/A
Information associated with this permit:
Project Name Frito Lay PEC - Roxboro
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
Old Durham Road, Roxboro, NC
County
Person
Latitude
36.3449
Longitude
-78.9814
Permittee Listed
Chadco Builders, LLC
Legally Responsible
Chad Porterfield
Individual
NC Reference No.
NCG01-2021-3518
E&SC Plan ID
PERSO-2021-020
Original NOI Tracking
55082
No.
Date COC Issued
6/9/2021
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Date populates only if COC was already rescinded at time of submittal.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

Supporting Upload Supporting Documentation if applicable.
Documentation Must be PDF format
Project Close-out Information:
Erosion Control Plan 8/26/2022
Close-out Date
Erosion Control Plan PERSO-2021-020_20220826_InspRpt.pdf
197.55KB
Close-out (1) 2021-12-23 Frito Roxboro - SITE COMPLIANCE
Documentation
1.35MB
Plan.pdf
(1) 2021-12-29 Frito Roxboro - POND ASBUILT
3.4MB
Plan.pdf
(2) 2021-12-29 Frito Roxboro - POND ASBUILT
1.9MB
Details.pdf
2021-12-29 Frito Roxboro Pond As -Built
37.11 KB
Comparison.pdf
2022-01-03 Frito Roxboro Pond AsBuilt Photo
6.93MB
Essay.pdf
ASBUILT POND ROUTE 12-29-2021.pdf
31.02KB
CCF01212022- Signed Document Cover Sheet.pdf
44.47KB
Must be PDF format
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 NCG010000 General Permit. For more information on signatory requirements, see Part IV, Section B, Item
(6) of that permit.
Signature
Type Name* Chad Porterfield
Title* President
Organization * CHADCO Builders
Date * 09/02/2022
Email for [e-mail]
Confirmation *
Contact Telephone* 336-516-1324

NOT Certification PERSO-2021-020_20220826_InspRpt.pdf
Form Must be PDF Format
197.55KB
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]