NCGNE1039_Rescission Request_20190830

FOR AGENCY USE ONLY
Division of Energy, Mineral & Land Resources Year Month Day Ua_te Received
Land Quality Section/Stormwater Permitting Program
' National Pollutant Discharge Elimination System
Environmental
Quality 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 C S N C G 1 0 3 9
2) Owner/Facility Information: * Final correspondence will be mailed to the address noted below
Owner/Facility Name Purdue Pharma Manufacturing L.P.
Facility Contact
Street Address
City
County
Telephone No.
Adam Postvn
5235 International Dr.
Durham State NC ZIP Code 27712
Durham E-mail Address [e-mail]
252-265-1680 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 Novo Nordisk on 12/1/19 . 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:
rt i.A'17 01,iALI T Y
I, as an authorized representative, hereby request rescission of coverage under the NPDthe
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.
Signatu
Print or type name of person signing above
Please return this completed rescission request form to
el ^ilDate A U-1
�P I ec%r� cal era+� Itxs
Title
DEMLR - Stormwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Revised 2018Jan10

Purdue Pha► na Manufactuwifiy L.P.
5235 International Drive
Durham, NC 27712
www.purduepharma.com
VIA CERTIFIED MAIL
# 7009 2250 0003 3935 1894
August 26, 2019
DEMLR — Stormwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699 1612
Subject: Site Closure
Purdue Pharma Manufacturing L.P. — Durham, North Carolina
To Whom It May Concern:
Purdue Pharma Manufacturing L.P. (Purdue) would like to formally notify you that we have sold
our Durham facility to Novo Nordisk. Purdue plans to operate the site until about December 1,
2019.
As such, we have attached a completed Rescission Request Form for your files.
If you have any questions regarding this activity or if more information is required, please do not
hesitate to contact me by phone at [phone] or via email at adam.postMamharma.com.
Sincerely,
Adam S. Postyn, CSP, CHMM
Associate Director, Environmental, Health & Safety
Purdue Pharma Manufacturing L.P.
Attachment
Dedicated to Physician and Patient