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HomeMy WebLinkAboutNCS000508_Supplemental Info Review_20200122Action History (UTC-05:00) Eastern Time (US & Canada) Submit by Anonymous User 1/22/2020 2:32:30 PM (Supplemental Submittal) Submit by Strickland, Shane 1/23/2020 9:44:15 AM (Supplemental Info Submittal) • The task was assigned to Strickland, Shane 1/22/2020 2:32 PM Submittal Dated: 1/22/2020 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 NCS000508 Examples: SWxxxxxxx, NCacxxxxx, or NCSxxxxxx Facility Name:* Piedmont Triad International Airport County: Guilford Name: Richard Darling Vft is subrritting the infornation? Email Address:* rdarling@mbakerintl.com Please upload all files that need to be submited. Click the upload button or drag and drop files here to attach docurrent 20E1.pdf 282.5KB 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 infornation cannot be claimed as confidential: the nave and address of any perrrit applicant or perrrittee, perrrit applications, perrrits, effluent data, information required by WCM application forms provided by the Director inclusive of all forrrs and attachments [Ref. 40 CFR 122.7(b) and (c)]. Describe the attachments: First 2020 Deicing Event DMR * W 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'); 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:* Richard Darling Signature: Date Submitted: 1/22/2020 Initial Review Updated ID#: IWORfANT. RE\/1RAE 2SH0LLDVMFY and revise here if necessary. NCS000508 Who needs a W Central Office copy?* r Regional Office Central Office Reviewer:* Shane Strickland - eads\sstrickland9 Select Reviewing Office* Winston-Salem Regional Office — 336-776- 9800 Select RO Reviewer:* brandon.Wse@ncdenr.gov