NCC192861_NOI Application_20191206

Action History (UTC-05:00)Eastern Time(US&Canada)
Subrrit by Anonymous User 11/20/2019 10:20:24 AM(NCG01 NOI Submission)
Approve by Farkas,Jim J 11/20/2019 3:37:18 PM(Review-Construction NOI 18683)
• The task was assigned to Farkas,Jim J by round robin distribution 11/20/2019 10:20 AM
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is: November 22,2019 5:00
PM.The priority is: High 11/20/2019 10:20 AM
Submit by McCoy, Suzanne 12/6/2019 7:40:03 AM(Payment Verification for NCC192861)
* Terrell S Martin
• McCoy,Suzanne assigned the task to McCoy, Suzanne 12/6/2019 7:39 AM
• The task was assigned to DEMLR NCG01 Payment Team.The due date is:January 1, 2020 5:00 PM.
The priority is: High 11/20/2019 3:37 PM

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1Construction Stormwater: Notice of Intent (NOI)
National Pollutant Discharge Elimination System 'D application for•• - .•-under NorthCarolina's
General Permit 1 1111:STORIVWATER DISCHARGES associated with construction activities(or
NORTH CAROLINA
Enrlrnnmenfu�Qr�arlry
A. Project Information
Part A.
Project Location and Waterbody Information
1. Project Name* Phase III Rogers CCP Landfill Construction
2.County* Cleveland
3. Highway or Street McCraw Road
Address* Street nacre only is acceptable if no address number assigned yet
4. City or Township* Cliffside
5.State* NC
6.Zip Code* 28024
7. Latitude* Enter the latitude in decimal degrees
35.2055
8. Longitude* Enter the longitude in decimal degrees(M.ST be negative)
-81.7700
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* 11/29/2019
Estinated Construction Project Start Date
10. Date to End* 11/30/2025
Estimated Construction Project End Date
11.SIC(Primary)* Industrial(1541)
Standard Industrial aassification for Development
12.Acres to be 37.10
disturbed* (including off-site borrow and waste areas)
13.Total site area 37.10
(acres)*
14. Post- 10.00
construction (Estimated)
impervious area
(acres)*
NCC Project NCC-CLEVE-2019-Phase III Rogers CCP Landfill Construction
Tracking ID Assigned automatically

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. Please
enter only immediate receiving waterbodies-not waters downstream of those unless the project extends there. You
may enter up to 3 waterbodies if needed.
15a. Receiving Suck Creek
Wate rbody* %rre of waterbody into which storrrwater runoff will discharge
15b.Waterbody 9-42
Index No.* NCWaterbody Index N.irrber
Stormwater V No
discharges will flow r Yes
to additional
wate rs*
16a. Is this project F Yes
subject to the NC r No, not subject to NC SPCA
Sediment Pollution
Control Act?*

B. Permittee Information
Part B. ^
Fternittee Inforrration-Legally Fbsponsible Entity and Individual
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 Carolinas, LLC
Name*
2. First Name* Scott
ff Corporation,enter Fbgistered Agent First Barre
3. Last Name* Martin
ff Corporation,enter Faegistered Agent Last%rre
3b.Title Project Director
4. Permitee E-mail [e-mail]
Address*
5. Permittee 704-829-1568
Telephone No.*
6. Permittee Mailing Street Address
Address* 400 South Tryon Street
Address Line 2
Suite 30C
City State/F rovince/Faegion
Charlotte NC
F ostal/Zip Code Country
28202 us
Check box if the rJ Yes
street address the
same as mailing
address
7. Permittee Street Street Address
Address* 400 South Tryon Street
Address Line 2
Suite 30C
City State/Frovince/Fbgion
Charlotte NC
Fbstal/Zip Code Country
28202 us

C. Site Contact Information
Part C. ^
Roject Site Contact Inforrration
.......................................................................................................................................................................................................................................................................................................................................................................................
1.Type of Non-Government
Ownership*
2. Primary Site Robert
Contact-First
Name*
3. Primary Site Wylie
Contact-Last
Name*
4.Title Lead Environmental Specialist
5.Site Contact E- [e-mail]
mail Address*
6.Site Contact 704-382-4669
Telephone No.*
7.Organization Duke Energy Carolinas, LLC
Name
8.Site Contact Street Address
Mailing Address* 526 South Church Street
Address Line 2
ECI-13
C7ty State/Rovince/Fbgion
Charlotte NC
Fbstal/Zip Code Country
28202 us
9. Consultant Name (Optional)
Josh Bell
First and Last narre
10. Consultant E- [e-mail]
mail This person will be copied on all correspondence.
11. Consultant
Telephone No.

D. E&SC Plan
Part D. ^
Erosion&Sediment Control(E&SC)Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 10/11/2019
Approved*
2. E&SC Plan Project CLEVE-2020-006
Number/ID* Assigned by agency or local program
3. E&SC Plan r State DEQ Office
Approved by* r Local Program
4.State DEQ Office* Mooresville(MRO)
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 Cliffside Landfill P3 PERMIT CLEVE2020006.pdf 1.48MB
Approval Wst be RDFforrrat
letter/documentation
6. NOI Certification Scanned from a Xerox Multifunction Printer(009).pdf 63.57KB
Form Mist be R7Fforrrat
This is an Express f No
Review Project* r Yes

E. Certification
North Carolina General Statute 143-215.6E(i) 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 knowingly makes a false statement
of a material fact in a rulemaking proceeding or contested case underthis Artcle;or who falsifies,tampers with,or knowingly renders
inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
Commission implementing this Artcle 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:
17 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.
* 17 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 electronically signs this Certification above must be the same person who signs the NOI
Certification Form. If that person is signing on behalf of the Permittee,that individual must be an authorized responsible
person within the same organization as the Permittee. *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
[` a'fz-
Type Name* Scott Martin
Title Project Director
Organization Duke Energy/CCP
Date* 11/20/2019

F. Tracking and COC Info
NOI Tracking No. 18683
NC Reference No. NCG01-2019-2861
Uses'count_nurrber'variable(increrrented by SP)
Certificate of NCC192861
Coverage (COC) Uses'count number'variable(increrrented by SP)
No.*
Count Number 2861
Sequential nurrber for subrrittal that is incremented by Stored Frocedure
COC Year 2019
Year of date reviewed(used to assign YY digits after"NOC'in COCno.)