NCG050280_Rescission Request_20231027

FOR AGENCY USE ONLY
Assigned to: • GOCKy1a�
ARO FRO MRO(±O>VARO WIRO WSRO
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 assigned in Item(4)below:
Berry Global Corporation Mike Howarth
Street address: City: State and zip code:
2890 Maplevale Road Brookville PA 15825
Telephone number: Email address:
[phone] [e-mail]
2. Industrial Facility(facility requesting rescission):
Facility name:
BPRex Healthcare Packaging,Inc.
Street address:
6941 Corporation Parkway
City: State: Zip Code: County:
Battleboro NC 27809 Nash
Permit Number to which this request applies:
NCG050280
3. Reason for rescission Request
This is required information.Attach separate sheets if necessary.
M 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: 06/3023
❑Facility sold.
Sold to:
On date:
E3 other(please explain):

4. Applicant Certification:
North Carolina General Statute 143-215.6B(1)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 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: Mike Howarth
Title: Plant Manager/CPI North America Operations Coordinator
X L, WM)V 10 s-aoa3
(Signature of Applicant) (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

Berry'
Berry Global
2890 Maplevale Road
le,PA 15825
�a0e [e-mail]
October 24, 2023 4-WR
DEMLR-Stormwater Program
Department of Environmental Quality
Attn:Joyce Sanford
1612 Mail Service Center
Raleigh, NC 27699-1612
Re: NPDES/Stormwater Permit Recission
Recission Request
Permit No: NCG050280
Dear Sir/Madam:
Berry Global is submitting this second request Recission Request form on behalf for our facility, BPRex
Healthcare Packaging Inc., located at 6941 Corporation Parkway, Battleboro, NC 27809. The site has a
General Industrial Stormwater NPDES permit(Permit#NCG050280).The facility closed on May 31st, 2023 and
ceased all industrial activities on June 30th, 2023 (06/30/2023). Berry has removed all equipment and is in
the process of selling the facility. The legally responsible person listed on the permit is no longer with the
company which is why a new legally responsible person has signed this form.This letter serves as notice of this
request for recission/termination of the stormwater permit.
If there is any additional information necessary to complete this recission of thee permit, do not hesitate to
contact me Doug Fitzgerald, Regional EHS Manger at [phone] or our environmental consultant
Jonathan Lewis at(317)489-5005.
Best Regards,
Mike Howarth
lW14n)J:— 1 as_a o a_3
Plant Manager/CPI North America Operations Coordinator
CC: Doug Fitzgerald, Berry Regional EHS Manager
Jonathan Lewis, Cornerstone Environmental

Cornerstone
ENVIRONMENTAL HEALTH AND SAFETY, INC
ISO 1"1:2015 REGISIESEO QUALITY SYSTEM
September21, 2023
DEMLR—Stormwater Program
Department of Environmental Quality
ATTN:Joyce Sanford
1612 Mail Service Center
Raleigh, NC 27699-1612
Re: NPDES/Stormwater Permit Recission
Recission Request
Permit No: NCG050280
Dear Sir/Madam:
Cornerstone Environmental, Health and Safety Inc. is pleased to submit this Recission Request form on behalf of
Berry Plastics Corporation, for their facility, BPRex Healthcare Packaging Inc., located at 6941 Corporation
Parkway, Battleboro, NC 27809,for their General Industrial Stormwater NPDES permit(Permit#NCG050280).The
facility closed on May 31EU,2023 and ceased all industrial activities on June 301", 2023(06/30/2023).The company
will be removing equipment until the end of September when it will be fully vacated.The legally responsible person
listed on the permit is no longer with the company which is why a new legally responsible person has signed this
form.This letter serves as notice of this request for recission/termination of their stormwater permit.
If there is any additional information necessary to complete this recission of their permit, do not hesitate to contact
me at(317)489-5005 orjlewis@corner-enviro.00m.
Best regards,
Jonathon Lewis
EHS and Sustainability,Associate
8801-ennoxcourt,Zionsville,IN 46077 [phone] Fax[phone]GR1 www.corner-enviro.cam