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HomeMy WebLinkAboutNCC203243_Notice of Termination_20230908 Action History (UTC-05:00)Eastern Time(US&Canada) Submit by Anonymous User 9/8/2023 1:50:22 PM(NOT Submittal) Approve by Kieu Tran 9/12/2023 12:49:51 PM(NOT Request Review-NCC203243) • The task was assigned to DEMLR NCG01 NOT Review Team.The due date is:September 13,2023 5:00 PM 9/8/2023 1:50:23 PM • The task was assigned to Kieu Tran by round robin distribution 9/8/2023 1:50:23 PM NPDE,�tz- Stormwater Permit for . • 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 NCG010000(or NCG250000). If approved,the Certificate of Coverage (COC)will be rescinded. Certificate of NCC203243 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 PAID PAID May be blank if N/A May be blank if N/A 2023 Annual Fee Status OPEN May be blank if N/A This permittee has an OPEN fee. If this NOT request is acceptable,you will have the option to waive that fee, but that is only available AFTER the Notice of Termination(NOT)has been approved(when the permit status becomes INACTIVE). If it is appropriate to waive the OPEN fee,it may help to assign that annual fee task to yourself immediately following this approval so you remember to resolve the outstanding fee. Information associated with this permit: Project Name Sanitary Sewer Improvements for the Corporate Park 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 NC-65, US220/1-73, Madison, NC County Rockingham Latitude 36.2656 Longitude -79.9356 Permittee Listed Rockingham County Legally Responsible Ronald Tate Individual NC Reference No. NCG01-2020-3243 E&SC Plan ID ROCKI-2021-003 Original NOI Tracking 29015 No. Date COC Issued 8/4/2020 Prior Rescission Date Date populates only if COC was already rescinded at time of submittal.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 8/29/2023 Close-out Date Erosion Control Plan ROCKI-2021-003 Sanitary Sewer for Corporate Park- Close-out 30.55KB inspection report 08-29-2023.pdf Documentation Must be PDF format North Carolina General Statute 143-215.613(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;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* Ronald E.Tate Title* Director of Dept.of Engineering&Utilities Organization* Rockingham County Date* 09/08/2023 Email for rtate@co.rockingham.nc.us Confirmation Contact Telephone* 3363428104 NOT Certification NCG01 eNOT Certification Form-RoCo Corporate Form Park.pdf 396.41 KB Must be PDF Format Is this COC Already Ensure this COC has not been rescinded since submittal! Rescinded? Additional Email CC'd on Notification Emails (Optional) stephen@lkcengineering.com Original Permittee CC'd on Notification Emails Email rtate@co.rockingham.nc.us Original Site Contact CC'd on Notificaiton Emails Email rtate@co.rockingham.nc.us