NCG030706_Supplemental Info Review (ROS Renewal)_20210809

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 8/9/2021 4:29:12 PM (Supplemental Submittal)
Submit by Georgoulias, Bethany A 4/1/2022 5:36:01 PM (Supplemental Info Submittal)
P ROS recorded in BIMS and monitoring suspension added to outfall 001.
• Georgoulias, Bethany A reassigned the task to Georgoulias, Bethany A 3/23/2022 9:56 AM
• Georgoulias, Bethany A reassigned the task to DEMLR SW Admin 2/17/2022 11:07 AM
P Disregard - just reassigning to Team
• Reese, Deborah W assigned the task to Reese, Deborah W 2/17/2022 9:19 AM
• Georgoulias, Bethany A reassigned the task to DEMLR SW Admin 2/16/2022 5:14 PM
• The task was assigned to McCoy, Suzanne 8/9/2021 4:29 PM

Submittal from 8/9/2021
Permit Information:
Please provide specific permit details below.
What Type of Permit? Choose one:
* NPDES Industrial or MS4 Permit
State Stormwater (Post -Construction) Permit
• Other
Permit Number* NCG030706
Begins with "SW", "NCG", or "NCS'
What DEQ Office is Reviewer: Please correct if misidentified, close this review form, and reassign task to the appropriate contact.
the Primary Contact? • Central Office
*
Washington Regional Office (Attn: Carl Dunn)
Wilmington Regional Office (Attn: Christine Hall)
Project Name* NCG030706- Representative Outfall Renewal Request
Owner/Operator* Greenheck Fan Corporation
County: Cleveland
Submitter Name: * Jennifer Peplinski
Who is submitting this information?
E-mail Address:* [e-mail]
Phone Number* 715-321-3398
Additional E-mail for [e-mail]
Submittal (Optional)
Confirmation:
Other Information Uploads
Describe file and upload attachment (Reviewer may remove unnecessary submittals)
File Description* Representative Outfall Renewal Request- NCG030706
File name will incorporate this description.
File Upload Click the upload button, or drag and drop files to attach
(NCG030406) Shelby TAP 1001 ROS-Renewal
736.35KB
Certification-Request-FI NAL.pdf
Only PDF files are accepted.
Uploads contain • NO
Confidential YES
Information* NOTE: The following information cannot be claimed as confidential: the name and address of any permit applicant
or permittee, permit applications, permits, effluent data, information required by NPDES application forms provided
by the Director inclusive of all forms and attachments [Ref. 40 CFR 122.7(b) and (c)].

Notes about the attachments:
Please find the Representative Outfall Renewal Request for permit NCG030706
Facility:
Greenheck Fan Corporation 2
1001 Commerce Center Drive,
Shelby NC 28150
* 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")
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');
• 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 Upload form.
Full Name:* Jennifer Peplinski
Signature:
Date Submitted: 08/09/2021

Initial Review
Verify Permit No.* IMPORTANT. REVIEWER SHOULD VERIFY and revise here if necessary.
NCG030706
Who needs a Copy?* Reviewer selections will only be required for offices checked here.
Central Office Staff
Regional Office Stormwater Contact
State Stormwater RO Staff
No Copy Needed
Review Date* 04/01/2022