NCC191598_Modification Review_20200720

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 7/17/2020 1:08:19 PM (ADD TO FILE Submittal)
Approve by Georgoulias, Bethany 7/20/2020 2:21:37 PM (Construction COC ADD TO FILE Review- NCC191598)
• The task was assigned to Georgoulias, Bethany. The due date is: July 22, 2020 5:00 PM
7/17/2020 1:08 PM

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NORTH CAPOLINA
EnYlrenmemf& Qualay
Certificate of
NCC191598
Coverage (COC)
Enter the Certificate of Coverage Ninber (Use capital letters)
No.*
Information associated
with this permit:
Project Name
Line 451 - Duke Marshall Steam Plant Pipeline (Express)
Address
NC Highway 150, Sherrills Ford, NC
County
Catawba
Latitude
35.5976
Longitude
-80.9720
Permittee Listed
Piedmont Natural Gas Company
Legally Responsible
Jason Brown
Individual
NC Reference No.
NCG01-2019-1598
E&SC Plan ID
CATAW-2020-001
Original NOI
15303
Tracking No.*
Date COC Issued*
08/28/2019
Prior Rescission
This field will populate only if COChas already been rescinded.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
O Other Revision(s) to E&SC Plan
r Legally Responsible Individual Has Changed
r Multiple Reasons (List)
Addional Mire information if necessary
Explanation Agricultural landowners requested their parcels released for farming activities to
resume per attached Supporting Documentation.
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). For changes to the legally responsible individual, you must upload this form.

Supporting Upload Supporting Documentation (%vised ESCApproval, (lose -Out Doc, etc.)
Documentation new doc 2020-06-19 10.33.16.pdf 921.71KB
Mast be FDFfon-rat
North Carolina General Statute 143-215.66 (1) provides that:
Anyperson who knowinglymakes any false 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 knowingly makes a false statement
of a material fact in a rulemaking proceeding or contested case underthis Article; or who falsifies, tampers with, or knowingly renders
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 not to exceed ten thousand
dollars ($10,000).
17 I 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.
Specify if you are:* r The Legally Responsible Individual
f Authorized Responsible Person*
*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
Type Name* Jason Brown
Title * Project Manager
Organization* Piedmont Natural Gas
Date * 07/17/2020
Email Address* [e-mail]
Errail for confirmation
Telephone Number* 704-431-4681
Contact nun ber if we need to reach you
Note: Original permittee and site contact are copied on modification correspondence.
Additional Email Alicia. [e-mail]
(Optional) Additional email for confirmation
Original Permittee [e-mail]
Email
Original Site Contact [e-mail]
Email
Review Date 07/20/2020
Rescinded Since
Submitted?

Request Date 20200717
Formatted
Review Date 20200720
Formatted