NCG080950_Rescission Request_20190329

Division of Energy, Mineral & Land Resources
»''' Land Quality Section/Stormwater Permitting Program
National Pollutant Discharge Elimination System
Environmental
Quality RESCISSION REQUEST FORM
FOR AGENCY USE ONLY
Date Received
Year
Month
Day
Please fill out and return this form if you no longer need to maintain your NPDES stormwater permit.
MAR 29 2019
1) Enter the permit number to which this request applies:
Individual Permit (or)
N I C I S
Certificate of Coverag DENR-LAND QUALITY
N C c o s o 9 5 o ERMITrING
2) Owner/Facility Information: * Final correspondence will be mailed to the address noted below
Owner/Facility Name.RULLING I.KI IU-LAY 5ALL5 Lf' UAIkOLINAS 8LIZVIt;L UL-N [Lit
Facility Contact
Street Address
City
County
Telephone No.
ROB SAPIENZA
10230 RIDGE CREEK DRIVE
CHARLOTTE
MECKLENBURG
980 244-3736
State NC ZIP Code 28273
E-mail Address [e-mail]
Fax:
3) Reason for rescission request (This is required information. Attach separate sheet if necessary):
❑✓ Facility closed or is closing on 3/25/19 . All industrial activities have ceased such that no discharges of
stormwater are cuntarnlrialed by expusure to kidustrlal a(tivllles ur rnaterlals.
❑ 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:
I, as an authorized representative, hereby request rescission of coverage under the NPDES Stormwater Permit for the
subject facility. I am Fkmiliar with the information contained in this request and to the best of my knowledge and belief
such information is tree; complete and accurate.
Signature Date 3,Z S
Rob Sapienza Regional Fleet Manager
Print or type name of person signing above Title
Please return this completed rescission request form to
DEMLR - Stormwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Revised 2018Jan10

W Frito-Lay
90Vrood f" the
March 25th, 2019
Stormwater Permitting Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Re: Notice of Rescission Submittal
?9 2019
DENR.LANU QUALITY
STORkIWATER PERUITTING
Please accept this letter and attached form as a notice of termination for the following Rolling Frito-
Lay Sales, LP facility:
Carolinas Service 10230 Ridge Creek Drive CHARLOTTE. NC. NC"CT080050
Center
Operator Information:
Owner/operator: Rolling Frito-Lay Sales, LP
Official Contact Person: Rob Sapienza (Fleet Manager)
Mailing Address: 2700 Nevada Blvd. Charlotte, NC 28273
Phone: [phone]
Email: rob. sapienzagpepsico.com
Reason for Termination:
Storm water discharges associated with industrial activity (vehicle maintenance) have been eliminated
and facility has moved.
"I certify under penalty of law that all storm water discharges associated with industrial activity from the
identified facility that are authorized by an NPDES general permit have been eliminated or that I am no longer
the operator of the industrial activity. I understand that by submitting this notice of termination, that I am no
longer authorized to discharge storm water associated with industrial activity under this general permit, and
that discharging pollutants in storm water associated with industrial activity to waters of the State is unlawful
under the Clean Water Act where the discharge is not authorized by an NPDES permit. 1 also understand that
the submittal of this notice of termination does not release an operator from liability for any violations of this
permit or the Clean Water Act. "
Sincere
t
Rob Sapienza
Regional Fleet Manager