NCG140031 - Asheboro Ready Mix, Inc.

FOR AGENCY USE ONLY
so WA Division of Energy, Mineral & Land Resources Date Received
�r Land Quality Section/Stormwater Permitting Program Year Montn Day
NC®ENR National Pollutant Discharge Elimination System g
NORTH 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 stormvtt F it.
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3)- Enter -the -permit num ber-tb-which-this request applies:�j�pC��l/fir
Individual Permit (or) Certificate of Coverage
N I C I S N I C I G 0 1^
2) Owner/Facility Information: * Final correspondence will be mailed to the address noted below
Owner/Facility Name h5bitkVitz "Ready rn►`) /t'lc-.
Facility Contact
Street Address
City
County
Telephone No.
State iv[�,
E-mail Address
Fax: 330
3) Reason for rescission request (This is required information. Attach separate sheet if necessary):
❑ Facility closed or is 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
r l -Cv-kl
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 6ee allaCl ed -
4) Certification:
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. T_
Signatur(
Print or type name of person signing above
Please return this completed rescission request form to:
Date & ".8 -11
fav idU, occne
r
Title
NPDES Permit Coverage Rescission
Stormwater Permitting Program
1612 Mail Service Center D� MW
Raleigh, North Carolina 27699-1612
1612 Mail Service Center, Raleigh, North Carolina 27699-1612
Phone: [phone] FAX- 919-807-6492
An Equal Opportunity 1 Affirmative Action Employer

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Inc.
524 W. BAILEY ST. — ASHEBORO, N. C. 27203 — TELEPHONE [phone] — FAX [phone]
June 8, 2017
NPDES Permit Coverage Rescission
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, NC 276.9-9-1612
RE: NCG140031
Permit Rescission
To Whom It May Concern:
Asheboro- Ready Mix has contained- our wastewater into- an- area- that will- no- longer allow
run off, specifically to Haskett's Creek. A concrete barrier has been erected that prevents
the stormwater run off from entering the wastewater pits where we wash out trucks. The
pits are cleaned out frequently keeping the water level way below run off. With the
addition of the concrete barrier, there will no longer be any water run off that will expose
the creek or any wetlands.
With this letter, we -respectfully request that a permit no longer be required of Asheboro -
Ready Mix.
Please feel free to contact me at 336-672-0957.
Sincerely,
Todd F. Richardson
President/Owner