NCG020828 Rescission Request

UNITED STATES MARINE CORPS
MARINE CORPS INSTALLATIONS EAST -MARINE CORPS BASE
PSC BOX 20005
CAMP LEJEUNE NC 28542-0005
Mrs. Bethany Georgoulias
North Carolina Department of Environment
And Natural Resources
Division of Energy, Mineral and Land Resources
Stormwater Permitting Section
Non -Discharge Permitting Program
1612 Mail Service Center
Raleigh, NC 27699-1612
Dear Mrs. Georgoulias:
5090.20
G-F/BEMD
JAN 2 3 2010
Marine Corps Installations East -Marine Corps Base Camp
Lejeune (MCIEAST-MCB CAMLEJ) was issued a certificate of
coverage (COC), number NCG020828, on 17 December 2017. This COC
authorized MCIEAST-MCB CAMLEJ to discharge Stormwater and mine
dewatering wastewater from borrow pit 7 under North Carolina's
National Pollutant Discharge Elimination System (NPDES) general
permit NCG020000.
All work at this location is complete and there is no
further need to maintain this COC, NCG020828. MCIEAST-MCB
CAMLEJ requests a permit rescission for this facility. A
completed rescission request form is enclosed.
If you have any questions or need any clarification on the
information provided, contact Mr. Michael Taylor, Environmental
Compliance Branch, Environmental Management Division, G -F, at
[phone].
Sincerely,
JOHN R. TOWNSON
Director, Environmental Management
By direction of
the Commanding General
Enclosure: Rescission Request Form

FOR AGENCY USE ONLY
• 5�)714
Division of Energy, Mineral &Land Resources Date Received
Land Quality Section/Stormwater Permitting Program Year Month Day
RCDENRNational Pollutant Discharge Elimination System
NORTH CAROLINA DEPARTMENT OF � �� � � ���
ENVIRONMENT AND NPPJRAL RESOURCES
RESCISSION REQUEST FORM
IAN1 �W min
Please fill out and return this form if you no longer need to maintain your NPDES stormwater perD&R-LAND WALITy
1) Enter the permit number to which this request applies: SWATER PERM17TING
Individual Permit (or) Certificate of Coverage
N I C I S N I C I G 0 1 2 1 0 1 8 1 2 1 8
2) Owner/Facility Information: * Final correspondence will be mailed to the address noted below
Owner/Facility Name Marine Corps Installations East -Marine Corps Base Camp Lejeune MCIEAST-MCB CAMLEJ
Facility Contact
Street Address
City
County
Telephone No.
Commandiwz General MCIEAST-MCB CAMLEJ — Attention Mr. John R Townson
PSC 20005
Camp Lejeune
Onslow
(910) _451-5003
State NC ZIP Cade 28542-0005_
E-mail Address [e-mail]
Fax: [phone]
3) Reason for rescission request (This is required information. Attach separate sheet if necessary):
® Facility closed or is closing on 19 December 2017 . All industrial activities have ceased such that no
discharges of stormwater are contaminated by exposure to industrial activities or materials.
❑ 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 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 _ r r/� Date 23'14uzAie,
Peca John R. Townson Director, EMD_ (1-17
Print or type name of person signing above Title
Please return this completed rescission request form to: NPDES Permit Coverage Rescission
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
1612 Mail Service, Raleigh, North Carolina 27699-1612
Phone: [phone] FAX: [phone]
An Equal Opportunity 1 Affirmative Action Employer
Enclosure (2)