NCC201779_NOT Signed Certification_20230524

NCG01 Notice of Termination (NOT) Certification Form
Directions:
Print this form, complete, scan and upload to the electronic NOT (Rescission) form.
Then, mail the original signed form to the NC DEMLR Stormwater Program at:
Division of Energy, Mineral & Land Resources Stormwater Program
512 N. Salisbury Street, 6t" Floor
1612 Mail Service Center
Raleigh, NC 27699-1612
DO NOT MAIL THIS FORM UNTIL YOUR NOT REQUEST HAS BEEN REVIEWED AND APPROVED.
THE FORM YOU MAIL MUST BE COMPLETED WITH AN ORIGINAL SIGNATURE (NOT DIGITAL) [40 CFR 122.22]
General Permit Certificate of Coverage (COC) No.:
Name of Project: Watkins Borrow Pit
NCC201779
Per NC General Statute 143-215.6E (i), 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).
Under penalty of law, I certify that:
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.
Legally Responsible Organizational Entity: C. M. Mitchell Construction Co. Inc.
*Legally Responsible Person:
Charles M. Mitchell
Title of Legally
%Responsible �P,ers�on: ,P-r,e�sii/dent
*Signature:// , 'M l Tr L�s�CLw Date:
05/24/2023
Print Name and Title of Signed (only if authorized individual signing differs from Legally Responsible Person):
* IMPORTANT NOTE: 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 permit.
For more information on signatory requirements, see Part IV, Section B, Item (6) of the NCGO10000 permit.

Sedimentation/Construction Stormwater Inspection Report
North Carolina Department of Environmental Quality
Land Resources: 127 Cardinal Drive Extension, Wilmington,NC 28405 [phone]
County: Onslow Project: Watkins Borrow Pit River basin: White Oak
Person financially responsible:Gary Watkins Project#: ONSLO-2020-035
Address:3200 Wilmington Highway,Jacksonville,NC 28540
1. Project Location: 2051 Dawson Cabin Road,Jacksonville
Pictures: No
2. Weather and soil conditions: 90 clear thy Initial inspection: Yes
3. Is site currently under notice of violation? No
4. Is the site in compliance with S.P.C.A.and rules? Yes If no,check violations below:
5. Violations:
6. Is the site in compliance with NPDES Permit NCG010000 Construction Stormwater requirements? Yes
Describe:
7. Has sedimentation damage occurred since last inspection? No If Yes,where? (check all that apply)
Degree of damage:
8. Contact made with(name): Chad Watkins Title: Owner
Inspection report: Sent Report Date given/sent: September 20,2022
9. Corrective action needed:
10. Comments: File closed.
Site re-permitted with mining permit 67-83 and a corresponding NCG020000 permit.
Reported by: Brian Lambe Others present:
Date of inspection: September 19,2022 Time arriving on site: 3:00 PM Time leaving site: 3:30 PM
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