NCG020442_Rescission Request_20240925

FOR AGENCY USE ONLY RECEIVED
Assigned to: CeYO� �s 1!1
ARO FRO MRO RRO WAR WIRO WSRO SEP 25 2924
DEFALP S!nrmim'o'program
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 27699-1622. 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 a al oXganizational entity: Le ally responsible person as signed in Item (4( below:
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Street address: j City: State and zip code:
D 6t237 C NG 2?115�
Telephone number: Email address:
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2. Industrial Facility(facility requesting rescission):
Facility nam
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Street ad a s:
6
Cif State:
Permit Nuppbe[to which thlsrequest applies: C�
3. Reason for rescission Request
This is required information. Attach separate sheets if necessary.
Macility 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: (P 20 2 Se. i—Gt
❑Facility sold.
Sold to:
On date:
❑Other(please explain):

4. Applicant Certification:
North Carolina General Statute 143-215.66(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.
Unde penalty of law, I certify that:
f 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 off,Person Signing:Title: P( (St r 7C 6+ W ClL)q ✓1C r L.
V 2- 0/2 �1
(Signs ure of Applicant) (Date—r 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

ROY COOPER
Governor - S
---- -EL-IZABE-THS.BIS ,
Secretary
WILLIAM E.TOBY VINSON,JR. NORTH CAROLINA
Interim Director Environmental Quality
March 6, 2024
Certified Mail
Return Receipt Requested
7022 0410 0003 1066 6655
Ms. Stephanie Waff
Waff Contracting Inc.
PO Box 237
Edenton,NC 27932
RE: Waff Mine No. 2
Mining Permit No. 21-11
Chowan County
Chowan River Basin
Dear Ms. Stephanie Waff:
A release of the above referenced mining permit was requested on January 15,2024. An inspection was made of
the above mine on February 2,2024 in accordance with G.S. §74-56 of the Mining Act of 1971.
The mine was found to be satisfactorily reclaimed. Therefore,your company is released from further reclamation
responsibility for this site with respect to the Mining Act of 1971. I am returning your company's surety bond,No.
14BSBDP8151 issued by Hartford Fire Insurance Company in the sum of$33,500.00 to you for your disposal.
Thank you for your cooperation in this matter.
Sincerely,
Adam Parr, PE
State Mining Engineer
Enclosures: Surety Bond#14BSBDP8151
cc: Mr. Samir Dumpor, PE
Mr.Mike Lawyer
Mr.Beau Thomas-DOL, Mine and Quarry Bureau
D_EQ North Carolina Department of Environmental Quality I Division of Energy,Mineral and Land Resources
512 North Salisbury Street 1 1612 Mail Service Center I Raleigh.North Carolina 2 76 9 9-1612
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919.707.9200