SW6200704_Supplemental Info Review_20210325

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 3/25/2021 4:10:12 PM (Supplemental Submittal)
Submit by McCoy, Suzanne 3/26/2021 6:51:22 AM (Supplemental Info Submittal)
• The task was assigned to McCoy, Suzanne 3/25/2021 4:10 PM

Submittal Dated: 3/25/2021
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
SW6200704
Examples: SWxxxxxxx, NC Gxxxxxx, or NCSxxxxxx
Facility Name:* Cypress Pointe
County: Cumberland
Name: Jeffrey Nobles
Vft is subrritting the infornation?
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
2021-03-25 Cypress Pointe Sheet CO3C.pdf 458.26KB
2021-03-25 Cypress Pointe Revised Supplement.pdf 666.63KB
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 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:
Revised Stormwater Supplement form.
Revised Sheet C-03C.
* 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

o I intend to electronically sign and submit the Supplemental Information form."
Full Name:* Jeffrey Nobles
Signature:
M-Avl
Date Submitted: 03/25/2021

Initial Review
Updated ID#: IWORfANT. RE\/1RAE 2SH0LLDVMFY and revise here if necessary.
SW6200704
Who needs a W Central Office
copy?* r Regional Office
Central Office Reviewer:*
Jim Farkas - eads\jjfarkas
Review Date * 03/26/2021