NOI 22380_Email RE Re-submitting eNOI_20200225

Georgoulias, Bethany
From: Clark, Paul
Sent: Tuesday, February 25, 2020 1:29 PM
To: [e-mail]
Cc: Morman, Alaina; McCoy, Suzanne
Subject: NCC-CABAR-2020-NC Highway 29 30" Water Main
Attachments: NCG010000 NOI - 22380.pdf
Mr. Helms (Wayne),
Hi. Please see a copy of the application that you submitted. It should be helpful to you when recompleting and
resubmitting the application. Your fee will be able to applied to your next submission. Please contact me with any
questions. Thank you.
Paul Clark
Water Supply Watershed Protection Coordinator
Stormwater Program
Division of Energy, Mineral, and Land Resources
Department of Environmental Quality
[phone]
[e-mail]
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to
third parties.
Before printing this email, please consider your budget and the environment.
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1
NORTH CAROLINA
EnrlronmertW quallly
A. Project Information
Part A.
Project Location and Waterbody Information
la. Project Name * NC Highway 29 30" Water Main
1 b. Specific Lot This field may be used to list specifc lot numbers.
Numbers
2. County* Cabarrus
3. Highway or Street NC Hwy 49
Address* Street narre only is acceptable if no address nunber assigned yet
4. CityorTownship* Concord
5. State * NC
6. Zip Code* 28025
7. Latitude* Enter the latitude in decinal degrees
35.3749
8. Longitude * Enter the longitude in decinal degrees (MJSTbe negative)
-80.5438
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*
02/24/2020
Estimated Construction Project Start Date
10. Date to End *
06/30/2020
Estinated Construction Project End Date
11. SIC (Primary) *
Other (0000)
Standard Industrial C]assification for Development
12. Acres to be
2.10
disturbed*
(including off -site borrow and waste areas)
13. Total site area 2.10
(acres)*
14. Post- 2.10
construction (Estirated)
impervious area
(acres) *

Project Tracking ID NCC-CABAR-2020-NC Highway 29 30" Water Main
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 Cold Water Creek
Waterbody* Name of waterbody into which stormwater runoff will discharge
15b. Waterbody C
Index No. * NCWaterbody Index Number
Stormwater V No
discharges will flow r Yes
to additional
wate rs *
16a. Is this project r Yes
subject to the NC r No, not subject to NC SPCA
Sediment Pollution
Control Act?*
Note: Stormwater discharges from construction activities associated with oil and gas exploration, production,
processing, treatment, or transmission facilities are eligible for the exemption from NPDES permit coverage except
in very limited instances. Do not proceed with this application before consulting this EPA fact sheet and verifying a
permit applies.

B. Permittee Information
Part B. ^
F2rnittee 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 Hall Contracting Corporation
Name *
2. First Name* Wayne
IF Corporation, enter Fbgistered Agent First Barre
3. Last Name* Helms
If Corporation, enter FZegistered Agent Last %rre
3b. Title * SR. Vice President
4. Permitee E-mail [e-mail]
Address *
5. Permittee 7045980818
Telephone No.*
6. Permittee Mailing Street Address
Address* 6415 Lakeview Road
Address Line 2
City
Charlotte
Fbstal / Zip Code
28269-2602
Check box if the
street address the
same as mailing
address
7. Permittee Street
Address*
r Yes
Street Address
6415 Lakeview Road
Address Line 2
City
Charlotte
Fbstal / Zip Code
28269-2602
8. Type of Non -Government
Ownership*
State / Frovince / Faegion
NC
Country
us
State / Frovince / Fbgion
NC
Country
us

C. Site Contact information
Part C.
Roject Site Contact Inforrration
....................................................................................................................................................................................................
1. Primary Site
Tommy
Contact - First
Name *
2. Primary Site
Johnson
Contact - Last
Name *
3. Title
Superintendent
4. Site Contact E-
[e-mail]
mail Address*
This person will be copied on all correspondence.
5. Site Contact
336-215-9713
Telephone No.
6. Organization
Hall Contracting Corporation
Name
9. Site Contact
Street Address
Mailing Address*
6415 Lakeview Road
Address Line 2
city
Charlotte
Fbstal / Zip Code
28269-2602
10. Consultant Name
(Optional)
First and Last nacre
11. Consultant E-
This person will be copied on all correspondence.
mail
12. Consultant
Telephone No.
State / Rovince / Region
NC
Country
us

D. E&SC Plan
Part D.
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 05/01/2019
Approved *
2. E&SC Plan Project CABAR-2019-080
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 Regional Office (MRO)
Documentation of E&SC Plan approval and the signed Notice of Intent (NOI) Certification Form is required for a
complete application. For linear projects, please also upload a site map showing the overall extent of the project.
5. E&SC Plan 2017-002 NCDEQ Approval.pdf 929.09KB
Approval Mast be FDFfornal
letter/documentation *
Notes (Optional) Frovide any additional information that night help the reviewer better understand how uploaded documents support
the application.
6. NOI Certification Notice of Intent.pdf 45.15KB
Form* Mast be Ft7Fformat
YOU MUST MAIL THE ORIGINAL SIGNED NOI CERTIFICATION FORM (click on this link) to The Stormwater Program
at the address on the form for the application to fulfill federal application requirements. The Certification Form must be
signed by the person listed in Section B (Permittee Information) or by an authorized responsible person within the same
organization. NOTE: The person who signs the paper form must be the same person to electronically certify
and sign the eNO1.
This is an Express r No
Review Project* r Yes

E. Certification
North Carolina General Statute 143-215.6E (i) provides that:
Any person who knowingly makes anyfalse statement, representation, or certification in any application, record, report, plan, or other
document filed 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 under this 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 guilty ofa Class 2 misdemeanor which may include a fine not to e)ceed ten thousand
dollars ($10,000).
Under penalty of law, I certify that
rJ 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.
* rJ 1 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:* IT The Responsible Person named on this Notice of Intent
f 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 *
Type Name * Wayne E. Helms
Title * SR. Vice President
Organization* Hall Contracting. Corporation
Date * 02/25/2020