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HomeMy WebLinkAboutSW4200702_Supplemental Info Review_20201106Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 11/6/2020 2:27:30 PM (Supplemental Submittal) Submit by McCoy, Suzanne 11/6/2020 2:39:58 PM (Supplemental Info Submittal) • The task was assigned to McCoy, Suzanne 11/6/2020 2:28 PM Submittal Dated: 11/6/2020 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 urolect. D# * Perrrit N irrber SW4200702 Examples: SWxxxxxxx, NC Gxxxxxx, or NCSxxxxxx Facility Name:* Lewisville Community Center County: Forsyth Name: Adam Carroll Vft is subrritting the inforr ation? Email Address:* adam.carroll@timmons.com Please upload all files that need to be submited. Click the upload button or drag and drop files here to attach docurrent Signed & Sealed EZ Form.pdf 231.93KB Stormwater Permit - Signed New Page 3.pdf 1.65MB Lewisville Stormwater _Signed O&M Agreement.pdf 1.02MB Lewisville CC Plan Set for NCDEQ 11.05.20.pdf 25.44MB 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, pernits, effluent data, infornation required by MODES application forr s provided by the Director inclusive of all fours and attachments [Ref. 40 CFR 122.7(b) and (c)]. Describe the attachments: Scans of the O&M Agreement, Stormwater Permit Application with revised page 3, EZ Form, and the full plan set showing the biocell have been provided. * 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:* Joseph A Carroll Signature: Date Submitted: 11/06/2020 Initial Review Updated ID#: WFORfANT. REV1RAERSH0LLDVMFY and revise here if necessary. SW4200702 Who needs a W Central Office copy?* r Regional Office Central Office Reviewer:* Jim Farkas - eads\jjfarkas Review Date * 11/06/2020