NCC200610_NOI Application_20200218

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 2/14/2020 12:57:37 PM (NCG01 NOI Submission)
Approve by Morman, Alaina 2/17/2020 8:39:07 AM (Review- Construction NOI 21937)
• The task was assigned to Morman, Alaina by round robin distribution 2/14/2020 12:57 PM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: February 18, 2020 5:00
PM 2/14/2020 12:57 PM
Submit by McCoy, Suzanne 2/18/2020 7:35:40 AM (Payment Verification for NCC200610)
* John David Devere
• McCoy, Suzanne assigned the task to McCoy, Suzanne 2/18/2020 7:35 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: March 30, 2020 5:00 PM
2/17/2020 8:39 AM

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1
NORTH CAROLINA
EnrlronmertW quallly
A. Project Information
Part A.
Project Location and Waterbody Information
1. Project Name * P-235 Flightline Utility Modernization
2. County* Craven
3. Highway or Street 5th, 6th Ave., 4th St., Center St., East St.
Address * Street narre only is acceptable if no address number assigned yet
4. City or Township* Havelock
5. State * NC
6. Zip Code * 28533
7. Latitude * Enter the latitude in decimal degrees
34.9090
8. Longitude* Enter the longitude in decimal degrees (M. ST be negative)
-76.8980
If you do not know the latitude and longitude coordinates for this project, you can search the location on this map of
North Carolina. Look for the coordinates in the bottom left corner.
9. Date to Begin*
03/02/2020
Estimated Construction Project Start Date
10. Date to End*
07/14/2022
Estimated Construction Project End Cute
11. SIC (Primary)*
Commercial (1542)
Standard Industrial aassification for Developrrent
12. Acres to be
65.00
disturbed*
(including off -site borrow and waste areas)
13. Total site area
65.00
(acres) *
14. Post-
3.00
construction
(Estimated)
impervious area
(acres) *
NCC Project
NCC-CRAVE-2020-P-235 Flightline Utility Modernization
Tracking ID
Assigned autorTatically

Below you must enter waterbody information for surface waters affected by this project. Please consult
DWR's Surface Water Classifications Map Viewer to find waterbody name and corresponding index number. Please
enter only immediate receiving waterbodies - not waters downstream of those unless the project extends there. You
may enter up to 3 waterbodies if needed.
15a. Receiving Slocum Creek
Waterbody * %rre of waterbody into which stornwater runoff will discharge
15b. Waterbody 27-112
Index No.* NCWaterbody Index Nurrber
Stormwater r No
discharges will flow Pf Yes
to additional
wate rs *
15c. Additional Waterbodynarre
Receiving
Waterbody
15d. Waterbody NCWaterbody Index Nurrber
Index No.
15e. Additional Waterbody narre
Receiving
Waterbody
15f. Waterbody NCWaterbody Index Nurrber
Index No.
16a. Is this project r Yes
subject to the NC r No, not subject to NC SPCA
Sediment Pollution
Control Act?*

B. Permittee Information
Part B. ^
Fternittee Inforrration - Legally Fbsponsible Entity and Individual
Important: The person who signs the NOI Certification Form and signs the Certification in Section E of this application
form should be the same person as listed in THIS SECTION, or an authorized responsible individual within the same
organization. That person must be a responsible corporate officer who owns or operates the construction activity, such
as a president, secretary, treasurer, or vice president, or a manager that is authorized in accordance with Part IV,
Section B, Item (6) of the NCG010000 General Permit. For more information on signatory requirements, see Part
IV, Section B, Item (6) of that permit.
1. Organization Walsh Federal LLC
Name *
2. First Name* Brian
If Corporation, enter Pegistered Agent First Barre
3. Last Name* McGinty
If Corporation, enter Faegistered Agent Last %rre
3b. Title Operations Manager
4. Permitee E-mail [e-mail]
Address *
5. Permittee 412-275-8800
Telephone No.*
6. Permittee Mailing Street Address
Address* 4 Penn Center Boulevard
Address Line 2
Suite 100
City
State / Frovince / Region
Pittsburgh
PA
Fbstal / Zip Code
Country
15205
us
Check box if the rJ Yes
street address the
same as mailing
address
7. Permittee Street
Street Address
Address*
4 Penn Center Boulevard
Address Line 2
Suite 100
City
State / Frovince / Fbgion
Pittsburgh
PA
Fbstal / Zip Code
Country
15205
us
8. Type of
Individual
Ownership*

C. Site Contact Information
Part C.
Project Site Contact Inforrration
....................................................................................................................................................................................................
1. Primary Site
John
Contact - First
Name *
2. Primary Site
Devere
Contact - Last
Name *
3. Title
Senior Project Manager
4. Site Contact E-
[e-mail]
mail Address*
5. Site Contact
412-275-8855
Telephone No.
6. Organization
Walsh Federal, LLC
Name
7. Site Contact
Street Address
Mailing Address*
4 Penn Center Boulevard
Address Line 2
Suite 100
city
Pittsburgh
Postal / Zip Code
15205
8. Consultant Name
(Optional)
First and Last narre
9. Consultant E-mail
This person will be copied on all correspondence.
10. Consultant
Telephone No.
State / Province / Region
PA
Country
us

D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 06/04/2019
Approved *
2. E&SC Plan Project Crave-2019-035
Number/ID * Assigned by agency or local program
3. E&SC Plan r State DEQ Office
Approved by* r Local Program
4. State DEQ Office * Washington (WaRO)
Documentation of E&SC Plan approval and the signed Notice of Intent (NOI) Certification Form is required for a
complete application. For linear projects, please also upload a site map showing the overall extent of the project.
5. E&SC Plan P235 Erosion Control Permit Crave-2019-035.pdf 1.22MB
Approval Wst be FDFfornat
letter/documentation
Notes (Optional) Frovide any additional information that night help the reviewer better understand how uploaded documents support
the application.
6. NOI Certification P235 FUM - NCG01 Notice of Intent NOI Form.pdf 71.09KB
Form Mast be FDFfon-rat
This is an Express F No
Review Project* r Yes

E. Certification
North Carolina General Statute 143-215.6E (i) provides that:
Any person who knowingly makes anyfalse statement, representation, or certification in any application, record, report, plan, or other
document filed or required to be maintained under this Article or a rule implementing this Atide; or who knowingly makes a false statement
of a material fact in a rulemaking proceeding or contested case under this Atcle; or who falsifies, tampers with, or knowingly renders
inaccurate any recording or monitoring device or method required to be operated or maintained under this Atide or rules of the
Commission implementing this Atcle shall be guilty ofa Class 2 misdemeanor which may include a fine not to exceed ten thousand
dollars ($10,000).
Under penalty of law, I certify that:
17 I am the person responsible for the construction activities of this project, for
satisfying the requirements of this permit, and for any civil or criminal penalties
incurred due to violations of this permit.
rJ The information submitted in this NOI is, to the best of my knowledge and belief,
true, accurate, and complete based on my inquiry of the person or persons who
manage the system, or those persons directly responsible for gathering the
information.
* 17 I will abide by all conditions of the NCG010000 General Permit and the
approved Erosion and Sediment Control Plan.
* rJ I hereby request coverage under the NCG010000 General Permit and
understand that coverage under this permit will constitute the permit
requirements for the discharge(s) and is enforceable in the same manner as an
individual permit.
Specify if you are:* r The Responsible Person named on this Notice of Intent
f Authorized Responsible Person*
Important: The person who electronically signs this Certification above must be the same person who signs the NOI
Certification Form. If that person is signing on behalf of the Permittee, that individual must be an authorized responsible
person within the same organization as the Permittee. *An authorized individual is a responsible corporate officer who
owns or operates the construction activity, such as a president, secretary, treasurer, or vice president, or a manager
that is authorized in accordance with Part IV, Section B, Item (6) of the NCG010000 General Permit. For more
information on signatory requirements, see Part IV, Section B, Item (6) of that permit.
Signature
Type Name *
Brian McGinty
Title
Operations Manager
Organization
Walsh Federal, LLC
Date *
02/14/2020

F. Tracking and COC Info
NOI Tracking No. 21937
NC Reference No. NCG01-2020-0610
Uses 'count number' variable (incremrented by SP)
Certificate of NCC200610
Coverage (COC) Uses 'count number' variable (incremented by SP)
No.*
Count Number 610
Sequential number for submittal that is incremented by Stored Frocedure
COC Year 2020
Year of date reviewed (used to assign YY digits after "NOC' in COCno.)