NCG030465_recission request_20230428

RECEIVE
FOR AGENCY USE ONLY APR 2 8 2023
Assigned to:
ARO FRO MRO RRO WARO IRO WSRO DEUR-SformwaierProgram
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:
DENSO Manufacturing North Carolina-Statesville Plant John Brown
Street address: City: State and zip code:
470 Crawford Road £tatcsvillo NC,2E3025
Telephone number: Email address:
[phone] [e-mail]
2. Industrial Facility(facility requesting rescission):
Facility name:
DENSO Manufacturing North Carolina-Greenville Plant
Street address:
1125 Sugg Parkway
City: State: Zip Code: FCounty:
Greenville NC 27834 tt
Permit Number to which this request applies:
NCG03Do00 Permit COC=NCGO30465
3. Reason for rescission Request
This is required information_Attach separate sheets if necessary.
Il 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: Manufacturing ceased 3-20-23
I]Facility sold.
Sold to:
On date:
[]Other(please explain):