SW6210501_Supplemental Info Review_20210518

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 5/18/2021 1:32:18 PM (Supplemental Submittal)
Submit by McCoy, Suzanne 5/18/2021 3:10:35 PM (Supplemental Info Submittal)
• The task was assigned to McCoy, Suzanne 5/18/2021 1:32 PM

Submittal Dated: 5/18/2021
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 Nurrber
SW6210501
Examples: SWxxxxxxx, NC Gxxxxxx, or NCSaxxxx
Facility Name:* Rolling Springs Section 7
County: Harnett
Name: Scott Brown
Vft is subrritting the information?
Email Address:* [e-mail]
Please upload all files that need to be submited.
dick the upload button or drag and drop files here to attach docurrent
1736-PERMITTING (DO NOT RELEASE).pdf
18.11 MB
1736-DITCH CALCS.pdf
64.45KB
1736-EC MATTING CALCS.pdf
3.92MB
1736-PIPE CALCS.pdf
53.83KB
1736-SOS. pdf
44.1 KB
1736-SSW-Deed Restric-LDResid-2015061 1 -
8.76KB
DEMLR-SW (2).pdf
1736-SSW-Permit-LowDen-Su pp-200130730-
177.72 KB
DEMLR-SPU.pdf
1736-SSW-SWU-1 01 -Application-DEMLR-SPU Oct
223.24KB
2013 (3).pdf
1736-Stormvvater Narrative.pdf
157.72KB
DB 863-792 SUBJECT DEED.pdf
819.4KB
Pipe 1.pdf
19.19KB
Pipe 2.pdf
19.21KB
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 claimed as confidential: the narre and address of any permit applicant or
perrrittee, perrrit applications, permits, effluent data, information required by MODES application forms provided by
the Director inclusive of all forms and attachments [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:
Data that was submitted with the storm water permit.
* V By checking the box and signing box below, I certify that:
• I have given true, accurate, and complete information on this form;
• 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)
• 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');
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
• I intend to electronically sign and submit the Supplemental Information form."
Full Name:* Scott Brown
Signature:
�7`• �DDQ'�il
Date Submitted: 05/18/2021

Initial Review
Updated ID#: IWORfANT. RE\/1RAE 2SH0LLDVMFY and revise here if necessary.
SW6210501
Who needs a W Central Office
copy?* r Regional Office
Central Office Reviewer:*
Corey Anen - eads\scanen
Review Date * 05/18/2021