NCG200511 - OmniSource Southeast, LLC - Greensboro Facility

FOR AGENCY USE ONLY
V*A
Division of Energy, Mineral & Land Resources Date ReceivedI 1 Year Month Day rl Irl �- Land Quality Section/Stormwater Permitting Program
NCDENR NR National Pollutant Discharge Elimination System
Na CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
RESCISSION REQUEST FORM
Please fill out and return this form if you no longer need to maintain your NPDES stormwater permit
1) Enter the permit number to which this request applies:
Individual Permit (or) Certificate of Coverage
N I c I S c I G F21 010 15 11111
2) Owner/Facility Information: * Final correspondence will be mailed to the address noted below
Owner/Facility Na
Facility Contact
Street Address
City
County
Telephone No.
OmniSource Southeast, LLC / OmniSource - Greensboro Facility
James Winegar
2233 Wal Pat Rd
Smithfield State NC ZIP Code 27577
Johnston E-mail Address iwinegar(aD-omnisource.com
919 796 3023 Fax:
3) Reason for rescission request (This is required information. Attach separate sheet if necessary):
(� Facility closed ocas_closing..on_ ____- --- All industrial activities have ceased such that no discharges of
stormwater are contaminated by exposure to industrial activities or materials
❑ Facility sold to , " ° on)` If the facility will continue operations under the new owner it
may be more appropriate to request an ownership change to reissue to permit to the new owner
❑ Other
4) Certification: —`„e VCLJJULL 10ll
I, as an authorized representative, hereby request rescission o� erage under he NPDES Stormwater Permit for the
subject facility. I am familiar with the information containecjr� b0ftgg�,�Q(the best of my knowledge and belief
such information is true, complete and accurate. ATERPERM'TTING
Signature 4
mes Wi aar /
Print or pffie napeof person signing above
Please return this completed rescission request form to
Date
7/06/17
Environmental Manager
Title
NPDES Permit Coverage Rescission
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
1612 Mail Service Center, Raleigh, North Carolina 27699-1612
Phone [phone] FAX: [phone]
An Equal Opportunity 1 Affirmative Action Employer