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HomeMy WebLinkAboutNCC215601_NOT Signed Certification_20240418 NCGO1 Notice of Termination (NOT) Certification Form Directions: Print this form, complete, scan and upload to the electronic NOT(Rescission)form. Then, mail the original signed form to the NC DEMLR Stormwater Program at: Division of Energy, Mineral & Land Resources Stormwater Program • 512 N. Salisbury Street, 6th Floor 1612 Mail Service Center Raleigh, NC 27699-1612 DO NOT MAIL THIS FORM UNTIL YOUR NOT REQUEST HAS BEEN REVIEWED AND APPROVED. THE FORM YOU MAIL MUST BE COMPLETED WITH AN ORIGINAL SIGNATURE(NOT DIGITAL) [40 CFR 122.22] General Permit Certificate of Coverage (COC) No.: NCC215601 Name of Project: Iredell County Gov Gov Center South Parking Lot Per NC General Statute 143-215.6E(i), any person who knowingly makes any false statement, representation, or certification in any application, record, report,plan, or other document filed or required to be maintained under this Article or a rule implementing this Article. . . shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars($10,000). Under penalty of law, I certify that: 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. Legally Responsible Organizational Entity: Iredell County *Legally Responsible Person: Beth Mull Title of Legally Responsible Person: County Manager *Signature: —� D Date: y-11.-20 Zy Print Name and Title of Signed (only if authorized individual signing differs from Legally Responsible Person): * IMPORTANT NOTE: This form must be signed by a responsible corporate officer that owns or operates the construction activity,such as a president,secretary, treasurer, or vice president, or a manager that is authorized in accordance with Part IV, Section 8, Item (6)of the NCG010000 permit. For more information on signatory requirements,see Part IV, Section B, Item (6)of the NCG010000 permit. Sedimentation/Construction Stormwater Inspection Report North Carolina Department of Environmental Quality Land Resources: 610 East Center Avenue, Suite 301, Mooresville, NC 28115 (704) 663-1699 County: Iredell Project: Iredell Co Gov Center South Parking River basin: Yadkin-PeeDce Person financially responsible:Iredell County-Beth Ntull,County Manager Project It: IREDE-2022-004 Address: 200 South Center Street,PO Box 788,Statesville,NC 28677 1. Project Location: Evergreen Street,Mooresville Pictures: No 2. Weather and soil conditions: Sunny.workable soils Initial inspection: No 3. Is site currently under notice of violation? No 4. Is the site in compliance with S.P.C.A.and rules? Yes If no.check violations below: S. violations: 6. Is the site in cnmpli:uace with NI'DES Permit NCG010000 Construction Stormwater requirements? Yes Describe: 7. Has sedimentation damage occurred since last inspection? No If Yes. where? (check all that apple) Degree of damage: 8. Contact made with(name): NONE Title: Inspection report: Sent Report Date given/sent: March 27,2024 9. Corrective action needed: 10. Comments: Permanent ground cover sufficient to restrain erosion has been established.No additional self-monitoring or self-inspections are required. Project is in compliance and released under the SPCA.Termination of coverage under the NPDES General Stonnwater Permit for Construction Activities(NCGO I)must be requested by the permitter via a Notice of Termination(NOT).'the NOT is available at: https://edocs.deq.nc.gov/Forms'NCGOI-Termination.Please note that this correspondence must be uploaded as part ol'completing the NOT process. All projects that have been approved prior to April 01,2019.under the old permit system.areII not required to take any additional actions.The stormwater permit is terminated at the same time as the termination of this erosion control permit. Reported by: Owen Swavely Others present: Date of inspection: March 26,2024 Time arriving on site: 3:00 P\I Time leaving site: 3:05 PM cc: