NCG210414_Rescission Request_20221108

FOR AGENCY USE ONLY pp� RECE v D
Assigned to: 6' C041 0,V ���� � � � � Nov � 18 202?
ARO RO MRO RRO WARD WIRO WSRO
DEMLR-Stormwater Program
Division of Energy, Mineral, and _._., urces Land Quality Section
National Pollutant Discharge Elimination System
Rescission Request Form
Please fill out and return this form if you no longer need to maintain your NPDES stormwater permit.
Directions: Print or type all entries on this application form. Send the original, signed application to: NCDEMLR
Stormwater Program, 1612 Mail Service Center, Raleigh, NC 27699-1612. The submission of this form does not
guarantee recission of your NPDES stormwater permit. Prior to the recission of your NPDES stormwater permit, a
site inspection will be conducted.
1. Owner/Operator (to whom all permit correspondence will be mailed):
Name of legal organizational entity:
Legally responsible person as signed in Item (4) below:
Anson da 1uclr In z .
12 o eiI Jo l
Street addre s:
City:
State and zip code:
31 ro SF.
njb,,o
L— 201^10
Telephone number:
Gl I
Email address:
l- 43 11- t a
o ✓c, ancc G/ d n ✓.
W,
2. Industrial Facility (facility requesting rescission):
Facility name:
Street address:
City:
State:
Zip Code:
County:
bo
Ivy
-,7
Permit N tuber to which this request applies:
�a
I�L I noo
3. Reason for rescission Request
Thi; is required information. Attach separate sheets if necessary
Facility is closed or closing. All industrial activities have ceased such that no discharges of stormwater are contaminated
Vy exposure to industrial activities or materials.
Date closed/closing: I o 3 2o21
Facility sold.
Soldto:Jo/aa� LLLt6ei 4- S-iopcy Inc
On date: 1 o 1 1 7 2oZ I
❑ Other (please explai ):

4. Applicant Certification:
North Carolina General Statute 143-215.68 (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 ... shall be guilty of a Class 2 misdemeanor which may include a fine not
to exceed ten thousand dollars ($10,000). 1 hereby request exclusion from NPDES stormwater permitting.
Under penalty of law, I certify that:
0 I, as an authorized representative, hereby request recission 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.
Printed Name of Person Signing:
Title: �Xtel,�7(.M.tIo1+7t
D Zbzz
(Signature of Applicant (Date igne )
Mail the entire package to: DEMLR —Stormwater Program
Department of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
Page 2 of 2

NORTH CAROLINA
SPECIAL WARRANTY DEED
Excise Tax: $ 0.00
Parcel Identifier Nos. 6484 09 16 0870, 6484 00 26 8226
Mail after recording to: Grantee
Prepared by: Hollers & Atkinson, P.C., 110 N. Main St., Troy, NC 27371 (NO TITLE EXAM)
THIS DEED made this the 13th day of October, 2021 by and between
GRANTOR
Anson Wood Products, Inc.
1939 Hwy 109 S
Mount Gilead, NC 27306
GRANTEE
Jordan Lumber & Supply, Inc.
1939 Hwy 109 South
Mount Gilead, NC 27306
The designation Grantor and Grantee as used herein shall include said parties, their heirs,
successors, and assigns, and shall include singular, plural, masculine, feminine or neuter as required
by context,
WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of
which is hereby acknowledged, has and by these presents does grant, bargain, sell and convey unto
the Grantee in fee simple, all those certain lots or parcels of land situated in Wadesboro Township,
Anson County, North Carolina, and more particularly described as follows:

Tract 1 (PIN 6484 09 16 0870): BEGINNING at a point in the center of the main line
track of the Seaboard -Coastline Railroad leading from Wadesboro to Florence, South
Carolina, said beginning point being South 58-20 West 232,68 feet from the northwest
corner of the Little Manufacturing Company property also a point on the eastern edge
of Parsons Street, and runs thence along the center of the Seaboard -Coastline
Railroad tracks North 32-12 West 1191.01 feet, North 40-19 West 139.78 feet, North
45-07 West 175.38 feet, North 49-53 West 617.58 feet, and North 56-49 West 131.08
feet to a point where said track intersects the Seaboard -Coastline Railroad track
leading from Hamlet to Monroe; thence along the center of said Seaboard -Coastline
tracks South 65-04 East 238.08 feet, South 69-46 East 168.78 feet, South 73-04 East
369.48 feet. South 74-48 East 229.03 feet, South 76-36 East 235.98 feet, South 79-07
East 246.68 feet, South 81-58 East 297.58 feet, and South 84-45 East 200 feet to a
stake in the center of said tracks, a point in the line of other Hardison property; thence
along the Hardison line South 05-15 West 984 feet to a stake; thence South 58-20
West 181.83 feet along the Little Manufacturing Company line to a point in the eastern
edge of Parsons Street; thence the same course of South 58-20 West continued an
additional 232.58 feet to the point of BEGINNING, containing 20.02 acres, more or
less.
Tract 2 (PIN 6484 00 26 8226): BEING a tract of land in Wadesboro Township and
being bounded as follows: Lying to the south of the Seaboard -Coastline Railroad
Company; lying to the west of the Winston-Salem Southbound Railroad Company;
lying to the north of the Stanback Ferry Road and also adjoining on the south the
property of Wadesboro Manufacturing Company and Reeves Brothers, Inc.; bounded
by the eastern edge of Parsons Street and Little Manufacturing Company; and.
bounded on the west by the property of Anson Wood Products, Inc.
THERE IS EXCEPTED from Tract 2 those parcels that have been previously
conveyed, including but not limited to the tract conveyed by deed recorded in Book
227, Page 144.
The property hereinabove described was acquired by Grantor by deeds recorded in Book 166,
Page 607 and Book 194, Page 440.
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances
thereto belonging to the Grantee in fee simple.
And the Grantor covenants with the Grantee, that Grantor has done nothing to impair such title as
Grantor received, and that Grantor will warrant and defend the title against the lawful claims of all
persons claiming by, under or through Grantor, except for the exceptions hereinafter stated.
Title to the property hereinabove described is hereby conveyed subject to all valid and subsisting
restrictions, reservations, covenants, conditions, rights -of -ways and easements properly of record,
if any, and current year ad valorem taxes.
IN WITNESS WHEREOF, the Grantor has hereunto set its hand and seal, or, if corporate, has
caused this Deed to be executed by its duly authorized officer(s) and its seal to be hereunto
affixed, the day and year first above written.

Anson Wo Products, Inc.
By: (Seal)
Jord resident
STATE OF NQRTH CAROLINA )
COUNTY OF r )
�-
I, cx r a. L- . -H r,h e N [u44- a Notary Public of the State and County named
aiae", do certify that on this I day of o Gi-n Ser , 2021, before me personally
appeared Jack P. Jordan, and being duly sworn says that he is the President of Anson Wood
Products, Inc., a North Carolina business corporation, and that he signed the foregoing document
on behalf of the corporation in the capacity indicated and acknowledged the writing to be the act
and deed of the corporation.
/lJQ/00rj,' 4ti.x 1 My commission expires:.�eo+ernt.a zZ-ZoZ�
Notary Publ'
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