NCG140476_Supplemental Info Review_10/1/2019

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/1/2019 1:45:58 PM (Supplemental Submittal)
Submit by Strickland, Shane 10/2/2019 9:39:10 AM (Supplemental Info Submittal)
• The task was assigned to Strickland, Shane 10/1/2019 1:46 PM

Submittal Dated: 10/1/2019
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 nunber for this project.
D# * FL-rrrit Ninber
NCG140476
Ecanples: SWxxxxxxx, NO&xxxxx, or NOSxxxxxx
Facility Name:* Eagle Precast
County: Cleveland
Name: David Whittington
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
Curtin C-02 EXCOND_SITE PLAN 2019-09-13.pdf 1.53MB
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, permts, effluent data, information required by Wl 6 application forrrs provided by
the Director inclusive of all fours and attachments [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:
Requested Existing Conditions and Site Plan PDF
* V By checking the box and signing box below, I certify that:
o I have given true, accurate, and complete information on this form;
o 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)
o 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');
o 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:* David Eugene Whittington
Signature:
Date Submitted: 10/1/2019

Initial Review
Updated ID#: IWORfANT: FEVIBAERSHOLLDVERIFY and revise here if necessary.
NCG140476
Who needs a d Central Office
copy?* F Regional Office
Central Office Reviewer:*
Shane Strickland - eads\sstrickland9
Select Reviewing Office*
Mooresville Regional Office — 704-663-1699
Select RO Reviewer:*
[e-mail]