NCC221769_NOI 90482 Payment Verification_20220512

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 5/4/2022 4:33:27 PM (NCG01 NOI Submission)
Approve by Clark, Paul B 5/5/2022 2:11:06 PM (Review - NOI 90482 Panera Bread - Harrisburg)
• Broussard, Brooklyn C reassigned the task to Clark, Paul B 5/5/2022 6:11 AM
• The task was assigned to Broussard, Brooklyn C by round robin distribution 5/4/2022 4:33 PM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: May 9, 2022 5:00 PM
5/4/2022 4:33 PM
by Workflow 5/5/2022 2:11:16 PM (Workflow Start Event)
Submit by Selkane, Aziza 5/12/2022 3:33:20 PM (Payment Verification for NCC221769)
F E-payment was submitted on 5/3 per a -report 5/4 for NCC221721, which was cancelled, so I am
applying the payment to the new one NCC221769.
• Selkane, Aziza assigned the task to Selkane, Aziza 5/12/2022 3:31 PM
• The task was assigned to DEMLR NCG01 Payment Team. The due date is: June 16, 2022 5:00 PM
5/5/2022 2:11 PM

STA—
NORTH CAROLINA
Environmental Quallty
Project Name Panera Bread - Harrisburg
Lot Numbers (If listed on the eNOI)
NC Reference No.* NCG01-2022-1769
Certificate of NCC221769
Coverage (COC) No.*
Invoice Date 5/5/2022
Initial Invoice No. NCC221769-2022
Initial Fee $ 100.00
Invoice Due Date 6/4/2022
Important: If you change the choice below to Payment NOT RECEIVED, the application will be rejected, and a COC will
not be issued. This is the ONLY way to reject an eNOI at this step.
Payment Received* Payment Received.
Payment NOT RECEIVED.
Payment Status PAID
Date Payment 5/12/2022
Received * (Or, if not received, date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 631805431
Transaction Number*
NOI Tracking No. 90482
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-CABAR-2022-Panera Bread - Harrisburg