NCC216273_NOI 72717 Payment Verification_20211122

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 11/8/2021 6:04:39 PM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 11/9/2021 8:39:03 AM (Review - Construction NOI 72717)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 11/8/2021 6:05 PM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: November 10, 2021 5:00
PM 11/8/2021 6:05 PM
Submit by Evans, Shaundra M 11/22/2021 8:30:13 AM (Payment Verification for NCC216273)
P Fleet Temple
• Evans, Shaundra M assigned the task to Evans, Shaundra M 11/22/2021 8:29 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 21, 2021 5:00
PM 11/9/2021 8:39 AM

STA—
NORTH CAROLINA
Environmental Quallty
Project Name Clayton — Flowers Smithfield's Chicken and Bar-B-Q
Lot Numbers (If listed on the eNOI)
NC Reference No.* NCG01-2021-6273
Certificate of NCC216273
Coverage (COC) No.*
Invoice Date 11/9/2021
Initial Invoice No. NCC216273-2021
Initial Fee $ 100.00
Invoice Due Date 12/9/2021
Important: If you change the choice below to Payment NOT RECEIVED, the application will be rejected, and a COC will
not be issued. This is the ONLY way to reject an eNOI at this step.
Payment Received* Payment Received.
Payment NOT RECEIVED.
Payment Status PAID
Date Payment 11/22/2021
Received * (Or, if not received, date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 603882415
Transaction Number*
NOI Tracking No. 72717
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-JOHNS-2021-Clayton — Flowers Smithfield's Chicken and Bar-B-Q