SWA000097_Supplemental Info Review_20210324

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 3/24/2021 11:31:49 AM (Supplemental Submittal)
Submit by McCoy, Suzanne 3/25/2021 8:35:03 AM (Supplemental Info Submittal)
• The task was assigned to McCoy, Suzanne 3/24/2021 11:32 AM

Submittal Dated: 3/24/2021
Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all
mandatory questions are answered.
Existing Project Information:
Rease suDDly the Derrrit nunber for this Drolect.
D# * Perrrit N irrber
SWA000097
Examples: Sftxxxxxx, NC Gxxxxxx, or NCSxxxxxx
Facility Name:* Hennessy International Warehouse
County: Alamance
Name: Nick Scheopner
Vft is subrritting the inforr ation?
Email Address:* [e-mail]
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach docurrent
signed stormwater app.pdf 7.21 MB
21-03-24_SIT E_REVIEW. pdf 12.07MB
Only pdf files are accepted.
Please alert us to any confidential information contained in the uploaded documents.
Uploads contain r NO
Confidential r YES
Information * NOTE The following information cannot be clairred as confidential: the narre and address of any perrrit applicant or
perrrittee, perrrit applications, pernits, effluent data, infornation required by MODES application forr s provided by
the Director inclusive of all fours and attachrrents [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:
THE STORMWATER APPLICATION SIGNED BY A DESIGN PROFESSIONAL
SITE PLAN WITH THE REQUESTED REVISIONS
* V By checking the box and signing box below, I certify that:
o I have given true, accurate, and complete information on this form;
o I agree that submission of this Supplemental Information form is a "transaction" subject to Chapter 66, Article 40 of the
NC General Statutes (the "Uniform Electronic Transactions Act)
o I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes
(the "Uniform Electronic Transactions Act');
o I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written

signature; AND
o I intend to electronically sign and submit the Supplemental Information form."
Full Name:* NICHOLAS WILLIAM SCHEOPNER
Signature:
Date Submitted: 03/24/2021

Initial Review
Updated ID#: WFORfANT. REV1RAERSH0LLDVMFY and revise here if necessary.
SWA000097
Who needs a W Central Office
copy?* r Regional Office
Central Office Reviewer:*
Corey Anen - eads\scanen
Review Date * 03/25/2021