NCC192226_Modification Review_20200302

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 2/28/2020 10:31:15 AM (ADD TO FILE Submittal)
Approve by Georgoulias, Bethany 3/2/2020 9:51:41 AM (Construction COC ADD TO FILE Review- NCC192226)
• The task was assigned to Georgoulias, Bethany. The due date is: March 4, 2020 5:00 PM
2/28/2020 10:31 AM

Y. ,
NORTH CAPCLINA
Emlremmentel Quality
Certificate of NCC192226
Coverage (COC) Enter the Certificate of Coverage N nber (Use capital letters)
No.*
Information associated with this permit
Project Name
Heglar Road Substation
Address
1920 Heglar Road, Concord, NC
County
Cabarrus
Latitude
35.3890
Longitude
-80.5270
Permittee Listed
City of Concord
Legally Responsible
Andrea Cline
Individual
NC Reference No.
NCG01-2019-2226
E&SC Plan ID
CABAR-2020-019
Original NOI
16837
Tracking No.*
Date COC Issued*
10/10/2019
Prior Rescission
This field will populate only ff OOChas already been rescinded.
Date
Modification Information:
Reason for f Closed -Out Lots/Outparcels in E&SC Plan
Modification* r Additional Lots/Outparcels Approved - E&SC Revised
r Other Revision(s) to E&SC Plan
r Multiple Reasons (List)
Addional ivbre infornation if necessary
Explanation Increased denuded limits from 4.5 to 5.25 acres with erosion control measures for
increased area.
You must upload supporting documentation below. Do not upload E&SC Plans unless specific plan
sheets are the only documentation with approval for revised acres of disturbance, etc. (only upload applicable
sheets).

Supporting Upload Supporting Documentation (%vised ESCApproval, (lose -Out Doc, etc.)
Documentation Letter of Approval.pdf 1.02MB
Mast be FDFfon-rat
North Carolina General Statute 143-215.66 (1) provides that:
Anyperson who knowinglymakes anyfalse statement, representation, or certification in anyapplication, record, report, plan, or other
documentfiled or required to be maintained under this Article or a rule implementing this Article; or who knowinglymakes a false statement
of a material fact in a rulemaking proceeding or contested case underthis Article; orwho falsifies, tampers with, or knowinglyrenders
inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
Commission implementing this Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine notto exceed ten thousand
dollars ($10,000).
17 I, as an authorized representative, hereby request modification to coverage
under the NPDES Stormwater Permit for the subject project site. I am familiar
with the information contained in this request and to the best of my knowledge
and belief such information is true, complete and accurate.
*This form must be signed by a responsible corporate officer that 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
0'ef C1;k
Type Name* Andrea Cline
Title * Substation SCADA Coordinator
Organization * City of Concord
Date * 02/28/2020
Email Address* [e-mail]
Email for Confirmation
Telephone Number* 704-920--5311
Contact Nbrrber if we need to reach you
Review Date 03/02/2020
Request Date 20200228
Formatted
Review Date 20200302
Formatted