NCC231015_NOI 135889 Payment Verification_20230414

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 4/5/2023 4:16:43 PM(NCG01 NOI Submission)
Approve by Brooklyn.Broussard 4/6/2023 8:19:00 AM(Review-NOI 135889 The Moses H.Cone Memorial Hospital-
Duke Express Feed)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is:April 10,2023 5:00 PM
4/5/2023 4:16:51 PM
• The task was assigned to Kieu Tran by round robin distribution 4/5/2023 4:16:51 PM
• Brooklyn.Broussard reassigned the task to Brooklyn.Broussard 4/6/2023 6:25:01 AM
Submit by Tev.Holloman 4/14/2023 1:44:58 PM (Payment Verification for NCC231015)
IN Kelway Howard
• The task was assigned to DEMLR NCG01 Payment Team.The due date is: May 18,2023 5:00 PM
4/6/2023 8:19:18 AM
• Tev.Holloman assigned the task to Tev.Holloman 4/14/2023 1:44:24 PM

Payment Verification
NORTH CAROLINA
Environmental Quality
Project Name The Moses H.Cone Memorial Hospital-Duke Express Feed
Lot Numbers (If listed on the eNOl)
7221
NC Reference No.* NCG01-2023-1015
Certificate of NCC231015
Coverage(COC)No.*
Invoice Date 4/6/2023
Initial Invoice No. NCC231015-2023
Initial Fee $ 100.00
Invoice Due Date 5/6/2023
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 4/14/2023
Received* (Or,if not received,date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 684679857
Transaction Number*
NOI Tracking No. 135889
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-GUILF-2023-The Moses H. Cone Memorial Hospital-Duke Express Feed