SW5200201_Supplemental Info Review_2/13/2020

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 2/13/2020 9:34:58 AM (Supplemental Submittal)
Submit by Strickland, Shane 2/13/2020 9:56:50 AM (Supplemental Info Submittal)
• The task was assigned to Strickland, Shane 2/13/2020 9:35 AM

Submittal Dated: 2/13/2020
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# * Perait Nurrber
SW5200201
Exarrples: SWxxxxxxx, NC Gxxxxxx, or NCSxxxxxx
Facility Name:* Lee Street Athletic Complex
County: Johnston
Name: Zak Shipman, PE
Vft is subrritting the inforrretion?
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
Stormwater Application-Signed.pdf
7.46MB
Stormuater Narrative.pdf
47.08KB
DB 02788 PG 0134.pdf
105.3KB
DB 05346 PG 0631.pdf
175.07KB
2019-10-21 Lee Street Athletic Park -Civil Permit Set-
14.55MB
Compressed.pdf
USGS Screenshot-Benson Quad.pdf
586KB
USGS Screenshot-Dunn Quad.pdf
456.75KB
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 inforrretion cannot be clairred as confidential: the narre and address of any pernit applicant or
perrrittee, perrrit applications, permits, effluent data, inforrretion required by NR7ES application forrrs provided by
the Director inclusive of all forms and attachrrents [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:
Application materials as requested.
* 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');
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
• I intend to electronically sign and submit the Supplemental Information form."
Full Name:* Zak Shipman
Signature:
�16 QJ�PJ I?Ort
Date Submitted: 2/13/2020

Initial Review
Updated ID#: IWORfANT. RE\/1RAE 2SH0LLDVMFY and revise here if necessary.
SW5200201
Who needs a W Central Office
copy?* r Regional Office
Central Office Reviewer:*
Jim Farkas - eads\jjfarkas
Select Reviewing Office*
Raleigh Regional Office — 919-791-4200
Select RO Reviewer:*
[e-mail]