SW6191201_Supplemental Info Review_3/19/2020

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 3/19/2020 3:44:45 PM (Supplemental Submittal)
Submit by Strickland, Shane 3/23/2020 3:42:36 PM (Supplemental Info Submittal)
• The task was assigned to Strickland, Shane 3/19/2020 3:44 PM

Submittal Dated: 3/19/2020
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 urolect.
D# * Perrrit Nurrber
SW6191201
Examples: SWxxxxxxx, NC Gxxxxxx, or NCSxxxxxx
Facility Name:* Lynn Ridge
County: Harnett
Name: Fleet Temple
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
Lynn Ridge Stormwater Application.pdf 533.54KB
Lynn Ridge Low Density Supplement.pdf 292.39KB
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 perrrit applicant or
perrrittee, perrrit applications, permits, effluent data, inforrretion required by NR7ES application forms provided by
the Director inclusive of all forms and attachments [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:
Revised Sheet 3 of Stormwater Management Permit Application
Revised Sheet 2 of Low Density Supplement
* 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');
• 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:* Peter E NTemple
Signature:
a
Date Submitted: 3/19/2020

Initial Review
Updated ID#: IWORfANT. RE\/1RAE 2SH0LLDVMFY and revise here if necessary.
SW6191201
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]