SW3191101_Supplemental Info Review_4/14/2020

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 4/14/2020 1:13:45 PM (Supplemental Submittal)
Submit by Strickland, Shane 4/15/2020 1:54:43 PM (Supplemental Info Submittal)
• The task was assigned to Strickland, Shane 4/14/2020 1:20 PM

Submittal Dated: 4/14/2020
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 N irrber
SW3191101
Examples: SWxxxxxxx, NC Gxxxxxx, or NCSxxxxxx
Facility Name:* Cambridge Village Multifamily
County: Lincoln
Name: Allen McDowell
Vft is subrritting the inforrration?
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
200414_NCC172159_Calc Package.pdf
6.26MB
200413 NCDEQ CRL NCC172159.1.pdf
212.54KB
200413_NCC172159_0+M Agreement.pdf
288.46KB
200414_NCC172159_SuppEZ.pdf
219.94KB
200413_NCC172159_SWM App.pdf
475.68KB
200413 NCDEQ Transmittal NCC172159.pdf
133.97KB
200412_NCC 172159_CAMBR I DG E. pdf
97.87 MB
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:
* 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:* Robert Allen McDowell
Signature:
x•tC�lrsa� ����sre�l
Date Submitted: 4/14/2020

Initial Review
Updated ID#: IWORfANT. RE\/1RAE 2SH0LLDVMFY and revise here if necessary.
SW3191101
Who needs a W Central Office
copy?* r Regional Office
Central Office Reviewer:*
Jim Farkas - eads\jjfarkas
Select Reviewing Office*
Mooresville Regional Office — 704-663-1699
Select RO Reviewer:*
[e-mail]