NCC192882_Modification Review_20200415

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 4/15/2020 9:03:02 AM (ADD TO FILE Submittal)
Approve by Georgoulias, Bethany 4/15/2020 1:47:51 PM (Construction COC ADD TO FILE Review- NCC192882)
• The task was assigned to Georgoulias, Bethany. The due date is: April 20, 2020 5:00 PM
4/15/2020 9:03 AM

Y. ,
NORTH CAPCLINA
Emlremmentel Quality
Certificate of NCC192882
Coverage (COC) Enter the Certificate of Coverage N nber (Use capital letters)
No.*
Information associated with this permit
Project Name
Duke Marion Ops Abatement and Renovation
Address
27 Stroud Street, Marion, NC
County
McDowell
Latitude
35.6682
Longitude
-82.0177
Permittee Listed
Duke Energy Carolinas, LLC
Legally Responsible
Otis'Buster; Allen
Individual
NC Reference No.
NCG01-2019-2882
E&SC Plan ID
MCDOW 2020-003
Original NOI
18748
Tracking No.*
Date COC Issued*
11/22/2019
Prior Rescission
This field will populate only ff OOChas already been rescinded.
Date
Modification Information:
Reason for f Closed -Out Lots/Outparcels in E&SC Plan
Modification* r Additional Lots/Outparcels Approved - E&SC Revised
r Other Revision(s) to E&SC Plan
r Multiple Reasons (List)
Addional ivbre infornation if necessary
Explanation Minor disturbed area addition.
You must upload supporting documentation below. Do not upload E&SC Plans unless specific plan
sheets are the only documentation with approval for revised acres of disturbance, etc. (only upload applicable
sheets).

Supporting Upload Supporting Documentation (%vised ERSC Approval, (lose -Out Doc, etc.)
Documentation LOAwM revision 4-13-2020.pdf 1002.94KB
Mast be FDFfon-rat
North Carolina General Statute 143-215.66 (1) provides that:
Anyperson who knowinglymakes anyfalse statement, representation, or certification in anyapplication, record, report, plan, or other
documentfiled or required to be maintained under this Article or a rule implementing this Article; or who knowinglymakes a false statement
of a material fact in a rulemaking proceeding or contested case underthis Article; orwho 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 Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine notto exceed ten thousand
dollars ($10,000).
17 I, as an authorized representative, hereby request modification to coverage
under the NPDES Stormwater Permit for the subject project site. I am familiar
with the information contained in this request and to the best of my knowledge
and belief such information is true, complete and accurate.
*This form must be signed by a responsible corporate officer that 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
'on't. �t
Type Name* Otis Buster Allen
Title * Regional Manager Land Services
Organization* Duke Energy Carolinas, LLC
Date * 04/15/2020
Email Address* [e-mail]
Email for Confirrration
Telephone Number* 704-395-4385
Contact Nurrber if we need to reach you
Review Date 04/15/2020
Request Date 20200415
Formatted
Review Date 20200415
Formatted