SW1210802_Supplemental Info Review_20231107

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 11/7/2023 4:32:54 PM (Supplemental Submittal)
Accept by Kaitlin Peck 11/8/2023 7:32:52 AM(Supplemental Info Submittal)
• The task was assigned to Kaitlin Peck 11/7/2023 4:32:55 PM

=DEQ •
Submittal from 11/7/2023
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* SW1210802
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* Pardee Partners Mills River-Site
Owner/Operator* Henderson County
County: Henderson
Submitter Name:* Jared DeRidder, PE
Who is submitting this information?
E-mail Address:* [e-mail]
Phone Number* [phone]
Additional E-mail for (Optional)
Submittal
Confirmation:
State Stormwater (Post-Construction) Information Uploads
Choose file type and upload attachment(Reviewer may remove unnecessary submittals)
File Type* Recorded Document
File Upload Click the upload button,or drag and drop files to attach
!Pardee MR Closeout—Private Drainage Easement-
2.53MB
High Density SW1210802-3.20.2023.pdf
Only PDF files are accepted.
File Type* O&M Agreement/Plan
File Upload Click the upload button,or drag and drop files to attach
!Pardee MR Closeout—O&M Agreement-High
3.86M6
Density SW1210802-3.20.2023-2.pdf
Only PDF files are accepted.

File Type* As-Built-Certification
File Upload Click the upload button,or drag and drop files to attach
!Pardee MR Closeout—Certifications-High Density
4.65M6
SW1210802-3.20.2023.pdf
Only PDF files are accepted.
File Type* Recorded Document
File Upload Click the upload button,or drag and drop files to attach
!Pardee MR Closeout—Plat-High Density
307.8KB
SW1210802-3.20.2023.pdf
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:
Copies of hard-copy documents sent to Mr.Jim Farkas on 3-14-2023. Records include:
-Recorded Plat
-Recorded Maintenance Access Easement
-Recorded Operation and Maintenance Agreement
-Signed As-Built Permittee Certification
-Signed As-Built Designers Certification General MDC
-Signed As-Built Designers Certification for Bioretention Cell Project.
* 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)
d 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:* Jared L. DeRidder
Signature:
o1,?wW e drift
Date Submitted: 11/07/2023

Initial Review
Verify Permit No.* IMPORTANT:REVIEWER SHOULD VERIFY and revise here if necessary.
SW 1210802
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* 11/08/2023