Atlantic Coast Pipeline - 2/26/2018 10:45:38 AM

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upplemental Information Upload Fon
Staff Review:
Updated ID#: SWG040102
Updated Version: 1
Who needs a copy?* 17 Central Office
r Regional Office
Select Reviewing Office*
Fayetteville Regional Office — 910-433-3300
Central Office Reviewer:
Robert Patterson - eads\rdpatterson
Select RO Reviewer:*
[e-mail]
SUBMITTED PROJECT INFORMATION
Existing Project Information:
ID# SWG040102
Version: 1
Facility Name: Atlantic Coast Pipeline
County: Cumberland
Name: Scott Robinson
Vft is subrritting the inforrration?
Email Address: [e-mail]
Describe the attachments:
SWU-101 Permit Application for the Fayetteville Contractor Yard.
Please upload all files that need to be submitted.
Fayetteville CY10A SWU-101 Permit Applciation Package.pdf
Only pdf files are accepted.
W By checking the box and signing box below, I certify that:
19.3MB
Water Resources
ENVIRONMENTAL QUALITY
• 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
o I intend to electronically sign and submit the Supplemental Information form.
Full Name: Scott Robinson
Signature: