NCS000330_Supplemental Info Review_20200122

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 1/22/2020 4:25:59 PM (Supplemental Submittal)
Submit by Strickland, Shane 1/23/2020 10:36:00 AM (Supplemental Info Submittal)
• The task was assigned to Strickland, Shane 1/22/2020 4:26 PM

Submittal Dated: 1/22/2020
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 Nurrber
NCS000330
Exarrples: SWxxxxxxx, NCacxxxxx, or NCSxxxxxx
Facility Name:* ATI Specialty Materials - Monroe Plant
County: Union
Name: Tyler Mercer
Vft is subrritting the infornation?
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
2019-12 (Tier 2) Monthly Monitoring Report -Updated
3.01 MB
Revision of SWU-242.pdf
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, perrrit applications, pernits, effluent data, infornation required by MODES application forr s provided by
the Director inclusive of all fours and attachrrents [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:
This upload only contains Qualitative monitoring information because the entire packet with all required information
was mailed and uploaded previously. SWU-242 was revised and this upload reflects the revision.
* Pr 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:* Gregory Tyler Mercer
Signature:
Date Submitted: 1/22/2020

Initial Review
Updated ID#: IWORfANT. RE\/1RAE 2SH0LLDVMFY and revise here if necessary.
NCS000330
Who needs a W Central Office
copy?* r Regional Office
Central Office Reviewer:*
Shane Strickland - eads\sstrickland9
Select Reviewing Office*
Mooresville Regional Office — 704-663-1699
Select RO Reviewer:*
[e-mail]