HomeMy WebLinkAboutNCC190772_NOI Application_20190627Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 6/27/2019 1:54:23 PM (NCG01 NOI Submission)
Approve by Clark, Paul 6/27/2019 4:01:25 PM (Review- Construction NOI 12886)
• The task was assigned to Clark, Paul by round robin distribution 6/27/2019 1:54 PM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: July 1, 2019 5:00 PM.
The priority is: High 6/27/2019 1:54 PM
Submit by Clark, Paul 6/27/2019 4:23:39 PM (Payment Verification - NCG01-2019-0772)
• The task was assigned to Clark, Paul. The due date is: June 28, 2019 5:00 PM. The priority is: High
6/27/2019 4:01 PM
117-8) fTiT 2,0) M 111 f_T1II a 1010
NORTH CAROLINA
Ernvlronmentol qualily
A. Project Information
Part A.
Project Location and Waterbody Information
1. Project Name * Grifton 115kV Substation - Permanent Flood Mitigation
2. County* Lenoir
3. Highway or Street 5155 Skeeter Pond Rd
Address * Street narre only is acceptable if no address nurrber assigned yet
4. City or Township* Grifton
5. State * NC
6. Zip Code* 28530
7. Latitude * Enter the latitude in decirral degrees
35.3658
8. Longitude * Enter the longitude in decirral degrees (MJSTbe negative)
-77.4648
If you do not know the latitude and longitude coordinates for this project, you can search the location on this map of
North Carolina. Look for the coordinates in the bottom left corner.
9. Date to Begin*
06/27/2019
Estimated Construction Project Start Date
10. Date to End*
09/20/2019
Estimated Construction Project End Date
11. SIC (Primary)*
Other (0000)
Standard Industrial aassification for Development
12. Acres to be
1.25
disturbed*
(including off -site borrow and waste areas)
13. Total site area
6.47
(acres)*
14. Post-
0.60
construction
(Estimated)
impervious area
(acres) *
NCC Project
NCC-LENOI-2019-Grifton 115kV Substation - Permanent Flood
Tracking ID
Mitigation
Assigned autorratically
Below you must enter waterbody information for surface waters affected by this project. Please consult
DWR's Surface Water Classifications Map Viewer to find waterbody name and corresponding index number. You may
enter up to 3 waterbodies.
15a. Receiving Eagle Swamp
Waterbody* Nbrre of waterbody into which stormuater runoff will discharge
15b. Waterbody 27-86-27
Index No.* NC Waterbody Index Nunter
Stormwater V No
discharges will flow r- Yes
to additional
wate rs *
16a. Is this project r Yes
subject to the NC f No, not subject to NC SPCA
Sediment Pollution
Control Act?*
B. Permittee Information
Part B.
Perrrittee Information - Legally Responsible Entity and Individual
.....................................................................................................................................................................
h
Important: The person who signs the NOI Certification Form and signs the Certification in Section E of this application
form should be the same person as listed in THIS SECTION, or an authorized responsible individual within the same
organization. That person must be a responsible corporate officer who owns or operates the construction activity, such
as a president, secretary, treasurer, or vice president, or a manager that is authorized in accordance with Part IV,
Section B, Item (6) of the NCG010000 General Permit. For more information on signatory requirements, see Part
IV, Section B, Item (6) of that permit.
1. Organization Duke Energy Progress
Name *
2. First Name* Tim
ff Corporation, enter Registered Agent First l\brre
3. Last Name * Same
ff Corporation, enter Registered Agent Last Barre
3b. Title Manager
4. Permitee E-mail Tim.Same@duke-energy.com
Address*
5. Permittee 919-546-7468
Telephone No.*
6. Permittee Mailing Street Address
Address* 410 S. Wilmington Street
Address Line 2
City
Raleigh
Postal / Zip Code
27601
Check box if the
street address the
same as mailing
address
7. Permittee Street
Address*
V Yes
Street Address
410 South Wilmington Street
Address Line 2
City
Raleigh
Fbstal / Zip Code
27601
State / Province / Region
North Carolina
Country
United States
State / Province / Region
North Catolina
Country
United States
C. Site Contact Information
Part C.
Roiect Site Contact Information
1. Type of Non -Government
Ownership*
2. Primary Site Brian
Contact - First
Name *
3. Primary Site LovAher, PE
Contact - Last
Name *
4. Title Senior Engineer
5. Site Contact E- brian.lowther@duke-energy.com
mail Address*
6. Site Contact 919-546-7169
Telephone No.*
7. Organization Duke Energy Progress
Name
8. Site Contact Street Address
Mailing Address* 410 South Wilmington Street
Address Line 2
city
Raleigh
Fbstal / Zip Code
27601
State / Province / Region
NC
Country
us
D. E&SC Plan
Part D.
Erosion & Sediment Control (E&SC) Ran Approval Information
.......................................................................................................................................................................................................................................
1. Date E&SC Plan 06/26/2019
Approved *
2. E&SC Plan Project Lenoi-2019-005
Number/ID* Assigned by agency or local program
3. E&SC Plan f• State DEQ Office
Approved by r Local Program
4. State DEQ Office * Washington (WaRO)
Documentation of E&SC Plan approval and the signed Notice of Intent (NOI) Certification Form is required for a
complete application.
5. E&SC Plan Lenoi-2019-005 Grifton 115kV Substation -
Approval 1.22MB
Permanent Flood Mitigation - 0.... pdf
letter/documentation
Mist be RJF format
6. NOI Certification Grifton-eNOI.pdf 64.46KB
Form Mist be RJFformat
This is an Express f No
Review Project* r Yes
E. Certification
North Carolina General Statute 143-215.613 (1) provides that:
Anyperson who knowinglymakes any false statement, representation, or certification in anyapplication, record, report, plan, or other
documentfiled or required to be maintained under this Article or a rule implementing this Article; or who knowinglymakes a false statement
of a material fact in a rulemaking proceeding or contested case under this Article; or who falsifies, tampers with, or knowingly renders
inaccurate any recording or monitoring deice or method required to be operated or maintained under this Article or rules of the
Commission implementing this Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine not to exceed ten thousand
dollars ($10,000).
Under penalty of law, I certify that:
rJ I am the person responsible for the construction activities of this project, for
satisfying the requirements of this permit, and for any civil or criminal penalties
incurred due to violations of this permit.
* rJ The information submitted in this NOI is, to the best of my knowledge and belief,
true, accurate, and complete based on my inquiry of the person or persons who
manage the system, or those persons directly responsible for gathering the
information.
* I7 I will abide by all conditions of the NCG010000 General Permit and the
approved Erosion and Sediment Control Plan.
* rJ I hereby request coverage under the NCG010000 General Permit and
understand that coverage under this permit will constitute the permit
requirements for the discharge(s) and is enforceable in the same manner as an
individual permit.
Specify if you are:* r The Responsible Person named on this Notice of Intent
r Authorized Responsible Person*
Important: The person who signs this Certification above and signs the NOI Certification Form should be the same
person (or authorized responsible person within the same organization) as listed in Section B (Permittee Information)
of this form. *An authorized individual is a responsible corporate officer who owns or operates the construction activity,
such as a president, secretary, treasurer, or vice president, or a manager that is authorized in accordance with Part IV,
Section B, Item (6) of the NCG010000 General Permit. For more information on signatory requirements, see Part
IV, Section B, Item (6) of that permit.
Signature
Type Name *
Tim Same
Title
Manager
Organization
Duke Energy Progress
Date *
06/27/2019
F. Tracking and COC Info
NOI Tracking No. 12886
NC Reference No. NCG01-2019-0772
Uses 'count number variable (incremrented by SP)
Certificate of NCC190772
Coverage (COC) Uses'count_nunber'variable (incremented by SF)
No. *
Count Number 772
Sequential nunber for subrrittal that is incremented by Stored Procedure
COC Year 2019
Year of date reviewed (used to assign YY digits after "NGC' in OOCno.)