SW6200401_Supplemental Info Review_20201007

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/7/2020 8:40:19 AM (Supplemental Submittal)
Submit by McCoy, Suzanne 10/7/2020 1:23:43 PM (Supplemental Info Submittal)
• The task was assigned to McCoy, Suzanne 10/7/2020 8:40 AM

Submittal Dated: 10/7/2020
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 urciect.
D# * Perait N irrber
SW6200401
Examples: SWxxxxxxx, NC Gxxxxxx, or NCSxxxxxx
Facility Name:* DSI Properties, LLC
County: Cumberland
Name: Jeffrey Nobles
Vft is subrritting the inforrretion?
Email Address:* [e-mail]
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach docurrent
2020-09-11 DSI Submittal Documents.pdf 1.76MB
2020-09-11 DSI Revised DWG Sheets.pdf 737.86KB
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 inforrretion cannot be clairred as confidential: the narre and address of any pernit applicant or
perrrittee, perrrit applications, permits, effluent data, inforrretion required by MODES application forrrs provided by
the Director inclusive of all forms and attachments [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:
Revised plans sheets C04 and C10
Revised Drawdown Calculations
Revised Supplement EZ Form
Revised SWU-101 (Page 3 only)
Letter explaining how comments were addressed.
* V 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');
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:* Jeffrey A Nobles
Signature:
c�
7,159t-
Date Submitted: 10/07/2020

Initial Review
Updated ID#: IWORfANT. RE\/1RAE 2SH0LLDVMFY and revise here if necessary.
SW6200401
Who needs a W Central Office
copy?* r Regional Office
Central Office Reviewer:*
Corey Anen - eads\scanen
Review Date * 10/07/2020