SW3220306_Supplemental Info Review_20230612

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 6/12/2023 7:27:29 AM (Supplemental Submittal)
Accept by Kaitlin Peck 6/12/2023 11:35:13 AM (Supplemental Info Submittal)
• The task was assigned to bethany.georgoulias 6/12/2023 7:27:30 AM
• bethany.georgoulias reassigned the task to Kaitlin Peck 6/12/2023 10:49:49 AM

=DEQ •
Submittal from 6/12/2023
Permit Information:
Please provide specific permit details below.
................................................................................................................................................................................................................................................................................................................................................................................................
What Type of Permit? Choose one:
* NPDES Industrial or MS4 Permit
State Stormwater(Post-Construction)Permit
Other
Permit Number* SW3220306
Begins with"SW","NCG",or"NCS"
What DEQ Office is Reviewer:Please correct if misidentified,close this review form,and reassign task to the appropriate contact.
the Primary Contact? Central Office
*
Washington Regional Office(Attn: Carl Dunn)
Wilmington Regional Office(Attn:Christine Hall)
................................................................................................................................................................................................................................................................................................................................................................................................
Project Name* Preserve at Forest Creek Phase 1
Owner/Operator* Waxhaw Ventures, LLC
County: Union
Submitter Name:* Frank McMahan
Who is submitting this information?
E-mail Address:* [e-mail]
Phone Number* 704-333-0325
Additional E-mail for [e-mail]
Submittal (Optional)
Confirmation:
State Stormwater (Post-Construction) Information Uploads
Choose file type and upload attachment(Reviewer may remove unnecessary submittals)
File Type* Application Form
File Upload Click the upload button,or drag and drop files to attach
SSW-SWU-1 0 1-Application-DEMLR-SPU Oct 2013
472.04K6
(06.06.23).pdf
Only PDF files are accepted.
File Type* Design Calculations
File Upload Click the upload button,or drag and drop files to attach
Preserve at Forest Creek Calculation Book
51.62MB
(06.07.23).pdf
Only PDF files are accepted.

File Type* Plansheet-SCM Detail
File Upload Click the upload button,or drag and drop files to attach
20233_PLN_POND(06.07.2023).pdf 1.99MB
Only PDF files are accepted.
File Type* O&M Agreement/Plan
File Upload Click the upload button,or drag and drop files to attach
O&M EZ 071414_1.1 (10.20.22).pdf 121.3KB
Only PDF files are accepted.
File Type* Deed Restriction/Protective Covenant Form
File Upload Click the upload button,or drag and drop files to attach
SSW-DeedRestric-HDResid-2015061 1-DEMLR-SW
159.21 KB
(Updated 06.07.23).pdf
Only PDF files are accepted.
File Type* Supplement-EZ Form
File Upload Click the upload button,or drag and drop files to attach
SuppEZ-2020-Version-2.1.3(06.05.23).pdf 162.93KB
Only PDF files are accepted.
Is this project funded No
with ARPA grant Yes
funds?
Uploads contain NO
Confidential YES
Information* NOTE:The following information cannot be claimed as confidential:the name and address of any permit applicant
or permittee,permit applications,permits,effluent data,information required by NPDES application forms provided
by the Director inclusive of all forms and attachments[Ref.40 CFR 122.7(b)and(c)].
Notes about the attachments:
* 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 Upload form.
Full Name:* David Gusty
Signature:
��AL1'C�C�l�Jt�
Date Submitted: 06/12/2023

Initial Review
Verify Permit No.* IMPORTANT:REVIEWER SHOULD VERIFY and revise here if necessary.
SW3220306
Who needs a Copy?* Reviewer selections will only be required for offices checked here.
Central Office Staff
Regional Office Stormwater Contact
State Stormwater RO Staff
No Copy Needed
Central Office Reviewer:*
Notifies CO Staff with Email
Jim Farkas
Any Comments or
Added Info for CO
Staff Reviewer?
Review Date* 06/12/2023