NCC192187_Annual Fee Payment Record_20201202

Action History (UTC-05:00) Eastern Time (US & Canada)
by Workflow 11/23/2020 4:46:58 PM (Workflow Start Event)
Submit by Selkane, Aziza 12/2/2020 9:43:59 AM (Annual Fee Payment Verification for NCC192187-2020)
* PS West Construction Co., Inc
• Selkane, Aziza assigned the task to Selkane, Aziza 12/2/2020 9:43 AM
The task was assigned to DEMLR NCG01 Annual Fee Team. The due date is: January 4, 2021 5:00
PM 11 /23/2020 4:47 PM

NORTH CAROLINA
Environmental Quvllty
Certificate of
NCC192187
Coverage (COC)
This is passed fromtheworlflowwhen the invoice isfiled.
No.*
NC Reference COC
NCG01-2019-2187
No.*
Permit Status:
Active
Project Name*
Carolina Specialty Care, LLC
Project Address*
293 Old Mocksville Road, Statesville, NC
Permittee *
P.S. West Construction Company Inc.
County
Iredell
Invoice No.*
NCC192187-2020
This is passed fromthe workflow when the invoice is filed.
Annual Fee *
$ 100.00
Invoice Date*
11/24/2020
This is passed fromthe workflow when the invoice is filed.
Invoice Due Date*
12/24/2020
This is passed fromthe workflow when the invoice is filed.
An automated email reminder is sent to the permittee when the invoice is due. Wait until invoice is 15 days overdue
before proceeding to a Notice of Deficiency.
Important: If you change the choice below to Payment NOT RECEIVED, the fee status becomes PAST DUE, and the
permittee will receive a Notice of Deficiency.
Annual Fee Payment r Fee Payment Received or Not Applicable.
Received* r Fee Payment NOT RECEIVED.
Date Payment 12/2/2020
Received * Or, if WANBD or NOT FECBV®, this is the date that status is recorded.
Method of Payment* r electronic
r check
f other
Check Number* 90770
Fee Status* PAID
Legally Responsible Keith Bartlein
Person (Orig.)

Original Permittee E- [e-mail]
mail *
CONFIRM Permittee [e-mail]
E-mail * Opportunity to rrodify problem e-mail address or perrrittee contact info
Original Site Contact [e-mail]
E-mail *
CONFIRM Site [e-mail]
Contact E-mail * Opportunity to correct problem e-rrail address or site contact info
Additional Billing Contact E-mails
Additional E-mail for
CC:
Review Date * 12/2/2020