NCS000030_Owner Affiliation Change Request_20201123

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 11/23/2020 4:15:52 PM (Owner Affiliation Change Submission)
Approve by McCoy, Suzanne 12/2/2020 9:59:54 AM (Notification to Admin)
• The task was assigned to McCoy, Suzanne 11/23/2020 4:16 PM

1 S
�i.
mnvV��
NORTH CARCLINA
Emlmnm MI Quat<ty
Default Page
NPDES Permit
Enter your WDES storrrwater pernit nunber or Certificate of Coverage (COC) nunber.
Number*
NCS000030
NCSX)0000(or NCC)00000(
Submittor's Name*
Rease enter your FIRST and LAST narre
Stephen Arceneaux
Phone Number*
Rease, enter your phone nurrber
985-212-2148
Any format is fine.
Email Address *
Rease enter a valid e-mail address
[e-mail]
A confirmation of submssion will be e-mailed to this address.
Need a copy of the Permit Owner Affiliation Designation Form? You must upload a signed copy of that form below.
Questions? Call Bethany Georgoulias at [phone] or e-mail her at.bethany.georgouliasencdenr.gov.
Completed Form Rease upload the signed "Rarrrit CWner Affiliation Designation Form'
Upload* Signed_NPDES Permit Owner Designation Form.pdf 622.47KB
pdf only

Initial Review
Project ID * Reviewer may revise permt nunber below if incorrect.
NCS000030