SW1190801_Supplemental Info Review_10/17/2019

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/17/2019 1:49:23 PM (Supplemental Submittal)
Submit by Strickland, Shane 10/17/2019 2:19:34 PM (Supplemental Info Submittal)
• The task was assigned to Strickland, Shane 10/17/2019 1:49 PM

Submittal Dated: 10/17/2019
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# * Permit Namber
SW 1190801
Ecanples: SWxxxxxxx, NOC;axxxx, or NCSxxxxxx
Facility Name:* Leicester Volunteer Fire Department
County: Buncombe
Name: Jacob Grieb
Who is submitting the information?
Email Address:* [e-mail]
Please upload all files that need to be submited.
Qick the upload button or drag and drop files here to attach document
3827 FULL SET 10-04-2019.pdf 23.68MB
3827 Review Responses.pdf 719.13KB
3827 SW NARRATIVE 10022019.pdf 9.88MB
Signed Paperwork.pdf 538.82KB
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 claimed as confidential: the narre and address of any permit applicant or
peraittee, perrrit applications, permits, effluent data, information required by WDES application forms provided by
the Director inclusive of all forms and attachments [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:
Revised plans and documents based on comments received.
* P By checking the box and signing box below, I certify that:
• 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');

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:* Jacob Grieb
Signature:
Date Submitted: 10/17/2019

Initial Review
Updated ID#: IWORfANT: FEVIBAERSHOLLDVERIFY and revise here if necessary.
SW 1190801
Who needs a d Central Office
copy?* r- Regional Office
Central Office Reviewer:*
Jim Farkas - eads\jjfarkas
Select Reviewing Office*
Asheville Regional Office — 828-296-4500
Select RO Reviewer:*
[e-mail]