NCG140169_Rescission Request_20221220

FOR AGENCY USE ONLY
Assigned to: S. C00%"
ARO FRO MRO RRO WARO WIRO SRO DEC 2 0 2022
Division of Energy, Mineral, and Land Resources 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:
Argos USA LLC
Benjamin Hartman
Street address:
City:
State and zip code:
3015 Windward Piz, Ste 300
Alpharetta
GA 30005
Telephone number:
Email address:
4706120193
[e-mail]
2. Industrial Facility (facility requesting rescission):
Facility name:
(Formerly) Ready Mixed Concrete Co - Rural Hall, Plant 73
Street address:
633 Angus St
City:
State:
Zip Code:
County:
Rural Hall
NC
27025
Forsyth
Permit Number to which this request applies:
NCG140169
3. Reason for rescission Request
This 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
by exposure to industrial activities or materials.
Date closed/closing:
El Facility sold.
Sold to: AXG LLC
On date: December 2, 2021
11 Other (please explain):

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:
O 1, 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: Benjamin Hartman
Title: Environmental Manager
(Signature of Applicant)
12/09/2022
(Date Signed)
Mail the entire package to: DEMLR — Stormwater Program
Department of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
Page 2 of 2

ARGOS
December 9, 2022
Brittany Carson
Division of Water Resources
Water Quality Permitting Section — NPDES
1617 Mail Service Center
Raleigh, NC 27699-1617
RE: Permit Rescission — NCG140169
Dear Mr. Montebello,
Argos USA, LLC is requesting a rescission of NPDES Permit NCG140169. Please find the included
Recission Request Form with all the applicable information requested.
If you have any questions or need any additional information please call me at 470-612-0193 or
email at [e-mail].
Sincerely,
Benjamin Hartman
Environmental Manager
Argos USA LLC
Argos USA
3015 Windward Plaza, Suite 300
Alpharetta, GA 30005
Argos-us.com