NCC233761_NOI 174268 Payment Verification_20231220

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 12/19/2023 12:05:43 PM (NCG01 NOI Submission)
Approve by Brooklyn.Broussard 12/20/2023 6:51:53 AM (Review-NOI 174268 WNC Dental Expansion)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is: December 22,2023 5:00
PM 12/19/2023 12:05:51 PM
• The task was assigned to Brooklyn.Broussard by round robin distribution 12/19/2023 12:05:51 PM
Submit by Tev.Holloman 12/20/2023 10:26:15 AM (Payment Verification for NCC233761)
0 Ashley Westmoreland
• The task was assigned to DEMLR NCG01 Payment Team.The due date is:January 31,2024 5:00 PM
12/20/2023 6:52:08 AM
• Tev.Holloman assigned the task to Tev.Holloman 12/20/2023 10:25:16 AM

Payment Verification
NORTH CAROLINA
Environmental Quality
Project Name WNC Dental Expansion
Is this project funded with ARPA(American Rescue Plan Act)grant funds?
No
Yes
CONFIRMED ARPA Project Number(if applicable)
Lot Numbers (If listed on the eNOl)
NC Reference No.* NCG01-2023-3761
Certificate of NCC233761
Coverage(COC)No.*
Invoice Date 12/20/2023
Initial Invoice No. NCC233761-2023
Initial Fee $ 120.00
Invoice Due Date 1/19/2024
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 12/20/2023
Received* (Or,if not received,date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 724767604
Transaction Number*
NOI Tracking No. 174268
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-BUNCO-2023-WNC Dental Expansion