SW3190901_Supplemental Info Review_9/30/2019

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 9/30/2019 9:55:22 AM (Supplemental Submittal)
Submit by Strickland, Shane 9/30/2019 10:00:16 AM (Supplemental Info Submittal)
• The task was assigned to Strickland, Shane 9/30/2019 9:55 AM

Submittal Dated: 9/30/2019
Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all
mandatory questions are answered.
Existing Project Information:
Rease supply the perrrit nun-ber for this project.
D# * Flarrrit Ninber
SW3190901
Exarrples: SWxxxxxxx, NOC;axxxx, or NCSxxxxxx
Facility Name:* Dollar General - Salisbury
County: Rowan
Name: Jennifer Edwards
Who is submitting the information?
Email Address:* [e-mail]
Please upload all files that need to be submited.
Oick the upload button or drag and drop files here to attach document
DG_SALISBURY_21350. pdf
20.85MB
SIG NED_SUPPLEMENTAL.pdf
539.64KB
STORM_CALCS.pdf
1.59MB
OPERATION_MAINTENANCE_AGREEMENT.pdf
925.73KB
DB_375_227.pdf
193.36KB
DB_546_250.pdf
137.16KB
STORMWATER MANAGEMENT_app.pdf
567.77KB
Only pdf files are accepted.
Please alert us to any confidential information contained in the uploaded documents.
Uploads contain r NO
Confidential r YES
Information * NOTE The following information cannot be clairred as confidential: the narre and address of any perrrit applicant or
perrrittee, permit applications, permits, effluent data, information required by NOES application forms provided by
the Director inclusive of all forms and attachn ents [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:
Stormwater application and all supporting documents. Plans and calculations.
* V By checking the box and signing box below, I certify that:
o 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:* Jennifer Edwards
Signature:
Date Submitted: 9/30/2019

Initial Review
Updated ID#: IWORfANT: FEVIBAERSHOLLDVERIFY and revise here if necessary.
SW3190901
Who needs a d Central Office
copy?* F Regional Office
Central Office Reviewer:*
Corey Anen - eads\scanen
Select Reviewing Office*
Mooresville Regional Office — 704-663-1699
Select RO Reviewer:*
[e-mail]