NCG180029_Rescission request_20190819

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.
1) Enter the permit number to which this request applies:
Individual Permit (or) Certificate of Coverage
N C SI I N I C I G 1 18 10 10 12 19
2) Owner/Facility Information: * Final correspondence will be mailed to the address noted below
Owner/Facility Name LIAT, LLC
Facility Contact Brian Lish
Street Address PO Box 70
City Barium Springs State NC ZIP Code 28010
County Iredell E-mail Address [e-mail]
Telephone No. 704 528-4506 Fax:
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 Gateway Recovery on 2/21/16. 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 familiar with the information contained in this request and to the best of my knowledge and belief
such information is true, complete and accurate.
Signature
Brian Lish
Print or type name of person signing above
Please return this completed rescission request form to:
Date 8/19l19
President
Title
DEMLR - Stormwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Revised 2018Jan10

NORTH CAROLINA DEPARTMENT OF
ENVIRONMENTAL QUALITY
INVOICE
Annual Permit Fee
Open
This annual fee is required by the North Carolina Administrative Code. It covers the administrative costs associated with
your permit. It is required of any person holding a permit for any time during the annual fee period, regardless of the facility's
operating status. Failure to pay the fee by the due date will subject the permit to revocation. Operating without a valid
permit is a violation and is subject to a $10,000 per day fine. If the permit is revoked and you later decide a permit is
needed, you must reapply, with the understanding the permit request may be denied due to changes in environmental,
regulatory, or modeling conditions.
Invoice Number: 2019PR007171 Annual Fee Period: 2019-09-01 to 2020-08-31
Permit Number: NCG180029 Invoice Date: 08/08/2019
Alexander County
LIAT, LLC-Jasper Library Furniture Plant 2
Due Date: 09107/2019'
Brian Lish Annual Fee: $100.00
Liat LLC -Jasper Library Furniture
PO Box 70
Barium Springs, NC 28010
Payment Options:
1. Electronic payment is convenient and quick. To pay by ePayment, type "https://deq.ne.gov/epayments/stormwater" into your
browser. If you select eCheck, there will be no convenience fee. The convenience fee for a credit card is $2.65 and the
convenience fee for a debit card is $3.95. You will receive a receipt immediately after payment via email.
2. To pay by mail, please make your check payable to "DEMLR Stormwater Program" and include the invoice number on the check.
Then, detach the invoice below and write the check number on the invoice. A $25.00 processing fee will be charged
for returned checks in accordance with N.C. General Statute 25-3-512.
Remit payments by mail to:
NCDEQ - Division of Energy, Mineral and Land Resources
Attn: Stormwater Billing
512 N. Salisbury Street
1612 Mail Service Center
Raleigh, NC 27699-1612
3. Non-payment of this fee by the payment due date will initiate the permit fQ. a'
4. Please include your permit number in all correspondence. C�nator
5. Should you have any questions, please contact the Fee Coor919) 707-9220.
(Return This Portion With Check)
111 11� 11 111 II II 1[� 1 1111
* 2 0 1 9 P R 0 0 7 1 7 1
ANNUAL PERMIT INVOICE
Open
Invoice Number: 2019PR007171 Annual Fee Period: 2019-09-01 to 2020-08-31
Permit Number: NCG180029
Alexander County `�. Invoice Date: 8/8/2019
LIAT, LLC-Jasper Library Furniture Plant 2 Due Date: 9/7/2019
d �.
Annual Fee: $100.00
Brian Lish
Liat LLC -Jasper Library Furniture
PO Box 70 Check Number:
Barium Springs, NC 28010