NCC221882_Contact Update Record_20240507

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by bethany.georgoulias 5/7/2024 10:09:24 AM (Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC221882
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2022-1882
Original NOI No.* 91274
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
Duke Energy Carolinas,LLC
Project Name Marshall CAMA CAP Well Installation-Phase II (Express Review)
Address 8320 NC 150,Sherrils Ford, NC
County Catawba
Latitude 35.5969
Longitude -80.9663
Date COC Issued* 04/01/2024
Prior Rescission Date This field will populate only if COC has already been rescinded.
Which Contacts Have Billing Only
Changed?* Legally Responsible Individual Only
Site Contact Only
BOTH Legally Responsible Individual and Site Contact
Has Billing Contact Choose'Yes'to revise Billing Contact details.
Changed? Q No
0 Yes
Billing Email [e-mail]
NEW Billing Email [e-mail]
Billing Telephone No. [phone]
NEW Billing [phone]
Telephone No. (Optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible David Dellario
Individual(Previous)
First Name(New)* David
Last Name(New)* Dellario

NEW Legally Reflects any revisions above
Responsible David Dellario
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No.(Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 400 South Tryon Street,0, Charlotte, NC
Address(Previous) 28285
NEW Permittee Street Address
Mailing Address* 410 S.Wilmington Street
Address Line 2
City State/Province/Region
Raleigh NC
Postal/Zip Code Country
27601 us
Permittee Street 400 South Tryon Street,0, Charlotte, NC
Address(Previous) 28285
NEW Permittee Street Street Address
Address* 410 S.Wilmington Street
Address Line 2
City State/Province/Region
Raleigh NC
Postal/Zip Code Country
27601 us
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Chris Randazzo
(Previous)
Site Contact Title CCP Environmental Field Support
(Previous)
Organization Duke Energy Carolinas, LLC
(Previous)
First Name(New)* Joseph Scott
Last Name(New)* La Sala
NEW Site Contact* Reflects any revisions above
Joseph Scott La Sala

NEW Site Contact
Title
NEW Organization Duke Energy Carolinas, LLC
This field is not required on the NOI form and may not pre-populate.
Site Contact Email [e-mail]
(Previous)
NEW Site Contact [e-mail]
Email*
Site Contact [phone]
Telephone No.
(Previous)
NEW Site Contact [phone]
Telephone No.*
Site Contact Mailing 8320 NC-150,0,Sherrills Ford, NC 28673
Address(Previous)
NEW Site Contact Street Address
Mailing Address* 8320 E NC HWY 150
Address Line 2
City State/Province/Region
Terrell NC
Postal/Zip Code Country
28682 us
Change Requested Issa J.Zarzar via Modification request submitted 5/3/2024.
by:* Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 05/07/2024