NCG140500_Supplemental Info Review_20230713

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 7/13/2023 10:07:13 AM (Supplemental Submittal)
Accept by bethany.georgoulias 7/17/2023 3:22:36 PM (Supplemental Info Submittal)
0 This is a rescission request.We also just received the original signed paper copy in our office.
• The task was assigned to Kaitlin Peck 7/13/2023 10:07:14 AM
• Kaitlin Peck reassigned the task to bethany.georgoulias 7/13/2023 10:08:50 AM
0 Hi Bethany! I don't this that this is PCSW.

pEQNC Stormwater - Supplemental Information Upload
Submittal from 7/13/2023
Permit Information:
Please provide specific permit details below.
...................................................................................................................................................................................................................................................................................................................................................................................................
What Type of Permit? Choose one:
* 0 NPDES Industrial or MS4 Permit
0 State Stormwater(Post-Construction)Permit
Other
Permit Number* NCG140500
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)
.................................................................................................................................................................................................................................................................................................................................................................................................
Facility Name* CW Matthews Greensboro Ohenry Blvd Concrete Batch plant
For NPDES permits
Owner/Operator* C.W. Matthews
County: Guilford
Submitter Name:* James Higgins
Who is submitting this information?
E-mail Address:* [e-mail]
Phone Number* 678-296-3513
Additional E-mail for [e-mail]
Submittal (Optional)
Confirmation:
NPDES Permit Information Uploads
Choose file type and upload attachment(Reviewer may remove unnecessary submittals)
......................................................................................................................................................................................................................................
File Type* Other(Not Listed)
File Upload Click the upload button,or drag and drop files to attach
NCG140500 Notice of Termination.pdf 92.66KB
Only PDF files are accepted.
.......................................................................................................................
Is this project funded QQ No
with ARPA grant Q 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:
o I have given true,accurate,and complete information on this form;
o 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)
o 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');
o 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 Upload form.
Full Name:* James Higgins
Signature:
,7.4A" ffiKrw/s
Date Submitted: 07/13/2023

Initial Review
Verify Permit No.* IMPORTANT:REVIEWER SHOULD VERIFY and revise here if necessary.
NCG 140500
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
Brittany Cook
Identify Regional Office:*
Winston-Salem Regional Office—336-776-9800
Any Comments or Rescission request.We also just received the original signed paper copy in our
Added Info for CO office.
Staff Reviewer?
Select RO Stormwater Contact(s):
[e-mail]
Kicks off e-mail notification
Review Date* 07/17/2023