SW3191104_Supplemental Info Review_11/19/2019

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 11/19/2019 1:43:37 PM (Supplemental Submittal)
Submit by Strickland, Shane 11/20/2019 9:56:30 AM (Supplemental Info Submittal)
• The task was assigned to Strickland, Shane 11/19/2019 1:43 PM

Submittal Dated: 11/19/2019
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 suDDly the Derrrit nunber for this Drolect.
D# * Perrrit N irrber
SW3191104
Ecarrples: SWxxxxxxx, NC Gxxxxxx, or NCSxxxxxx
Facility Name:* The Learning Experience
County: Union
Name: Sean Coldren
Vft is subrritting the infornetion?
Email Address:* [e-mail]
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach docurrent
03 07 2019 FINAL SIGNED CONTRACT -TRUFFLE -
4.09MB
GARCIA[l].pdf
2019.10.22-TLE WaxhawCalcs.pdf
2.27MB
2019.10.22-TLE Waxhaw Plans. pdf
10.32MB
DB1232 PG893.pdf
117.17KB
Supp EZ Form - SIGNED.pdf
884.14KB
USGS Map.pdf
330.99KB
O&M EZ 071414_1.1 - iSeven LLC.pdf
419.65KB
SWM Permit Application -SIG NED.pdf
2.91 MB
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 infornetion cannot be claimed as confidential: the nave and address of any perrrit applicant or
perrrittee, perrrit applications, perrrits, effluent data, information required by WCM application forms provided by
the Director inclusive of all forrrs and attachments [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:
I have uploaded the plans, calcs, pending purchase agreement, deed, USGS map, O&M Form, Supplemental EX
Form and the SWM Permit application.

* V 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');
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
• I intend to electronically sign and submit the Supplemental Information form."
Full Name:* Sean Coldren
Signature:
Date Submitted: 11/19/2019

Initial Review
Updated ID#: IWORfANT. RE\/1RAE 2SH0LLDVMFY and revise here if necessary.
SW3191104
Who needs a W Central Office
copy?* r Regional Office
Central Office Reviewer:*
Corey Anen - eads\scanen
Select Reviewing Office*
Mooresville Regional Office — 704-663-1699
Select RO Reviewer:*
[e-mail]