SW6191005_Supplemental Info Review_2/17/2020

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 2/17/2020 10:12:38 AM (Supplemental Submittal)
Submit by Strickland, Shane 2/19/2020 11:25:10 AM (Supplemental Info Submittal)
• The task was assigned to Strickland, Shane 2/17/2020 10:12 AM

Submittal Dated: 2/17/2020
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
SW6191005
Examples: SWxxxxxxx, NC Gxxxxxx, or NCSxxxxxx
Facility Name:* Fort Bragg - SOTF
County: Cumberland
Name: Dan Saltsman
Vft is subrritting the information?
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
d Iq_swm_letter_20200211. pdf 109.73KB
G-001. pdf 1.02 MB
SSW-SWU-1 01 -Application- DEML R-SPU Oct 2013-
106.73K6
DFAC-SeclV.pdf
Supplemental_E-Z SW6191005.pdf 264.18KB
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 claimed as confidential: the narre and address of any perrrit applicant or
peraittee, pernit applications, permits, effluent data, information required by NRJES application forms provided by
the Director inclusive of all forrrs and attachments [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:
1) Cover Letter
2) Plan Set Cover sheet Wth revision date
3) Revised SWM application
4) Revised Supplemental E-Z
* W By checking the box and signing box below, I certify that:
o 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:* Dan Saltsman
Signature:
Date Submitted: 2/17/2020

Initial Review
Updated ID#: IWORfANT. RE\/1RAE 2SH0LLDVMFY and revise here if necessary.
SW6191005
Who needs a V Central Office
copy?* r Regional Office
Central Office Reviewer:*
Jim Farkas - eads\jjfarkas
Select Reviewing Office*
Fayetteville Regional Office — 910-433-3300
Select RO Reviewer:*
[e-mail]