SW3190703_Supplemental Info Review_10/29/2019

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/29/2019 4:16:28 PM (Supplemental Submittal)
Submit by Strickland, Shane 10/31/2019 11:16:25 AM (Supplemental Info Submittal)
• The task was assigned to Strickland, Shane 10/29/2019 4:17 PM

Submittal Dated: 10/29/2019
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 supply the perrrit nunber for this project.
D# * FL-rrrit Narrber
SW3190703
Exarrples: SWxxxxxxx, NOC;xxxxxx, or NCSaxxxx
Facility Name:* Hemby Place
County: Union
Name: Robert Bell
Who is subnitting the inforrration?
Email Address:* [e-mail]
Please upload all files that need to be submited.
Qick the upload button or drag and drop files here to attach docurrant
2019_10_29 CALC_BOOK.pdf
19.85MB
2019_10_29_NCDEQ HEMBY PLACE.pdf
136.02MB
NCDEQ Stormwater Permit Comment Response.pdf
138.26KB
O&M EZ 0714141.1 (4).pdf
66.2KB
SSW-DeedRestric-HDResid-20150611-DEMLR-
95.59KB
SW.pdf
STORMWATER MANAGEMENT PERMIT
1017.19KB
APPLICATION.pdf
Stormwater Treatment Narrative.pdf
44.5KB
SuppEZ Form.pdf
211 KB
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 inforrration cannot be clairred as confidential: the narre and address of any perrrit applicant or
pernittee, perrrit applications, pernits, effluent data, inforrration required by ICES application fours provided by
the arector inclusive of all forrrs and attachrrants [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:

Attached is one set of construction documents, one set of engineering calculations, and one set of stormwater permit
application forms, including permit application, Operations & Maintenance Agreement, High Density Deed
Restrictions, Stormwater Narrative, and Supplemental EZ Form. Signed originals will be sent with hard copy submittal.
* P 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)
• 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
• I intend to electronically sign and submit the Supplemental Information form."
Full Name:* Robert Bell
Signature:
r or -
Date Submitted: 10/29/2019

Initial Review
Updated ID#: IWORfANT: FEVIBAERSHOLLDVERIFY and revise here if necessary.
SW3190703
Who needs a d Central Office
copy?* F Regional Office
Central Office Reviewer:*
Corey Anen - eads\scanen
Select Reviewing Office*
Mooresville Regional Office — 704-663-1699
Select RO Reviewer:*
[e-mail]