SW6200903_Supplemental Info Review_20201022

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/22/2020 10:23:21 AM (Supplemental Submittal)
Submit by McCoy, Suzanne 10/29/2020 11:06:11 AM (Supplemental Info Submittal)
• The task was assigned to McCoy, Suzanne 10/22/2020 10:23 AM

Submittal Dated: 10/22/2020
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 N irrber
SW6200903
Examples: SWxxxxxxx, NC Gxxxxxx, or NCSxxxxxx
Facility Name:* Winchester Subdivision
County: Hoke
Name: Drafting and Design Services, Inc. - Michael Blakley
Vft is subrritting the information?
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
2020.10.16 - WINCHESTER - COVER LETTER TO
149.98KB
NCDEQ STORMWATER 2nd SUBMITTAL.pdf
2020.10.16 SIA Report.pdf 10.21 MB
2020.10.21 - Winchester Subdivision CDs.pdf 26.42MB
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 information cannot be clairred as confidential: the narre and address of any perrrit applicant or
perrrittee, perrrit applications, permits, effluent data, information required by MODES application forms provided by
the Director inclusive of all fours and attachrrents [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:
* 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:* Michael Blakley
Signature:
Date Submitted: 10/22/2020

Initial Review
Updated ID#: IWORfANT. RE\/1RAE 2SH0LLDVMFY and revise here if necessary.
SW6200903
Who needs a W Central Office
copy?* r Regional Office
Central Office Reviewer:*
Corey Anen - eads\scanen
Review Date * 10/29/2020