SW6200501_Supplemental Info Review_5/7/2020

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 5/7/2020 9:47:34 AM (Supplemental Submittal)
Submit by Strickland, Shane 5/13/2020 6:17:20 PM (Supplemental Info Submittal)
• The task was assigned to Strickland, Shane 5/7/2020 9:47 AM

Submittal Dated: 5/7/2020
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# * Perrrit N irrber
SW6200501
Exarrples: SWxxxxxxx, NC Gxxxxxx, or NCSxxxxxx
Facility Name:* Medlin Self -Storage
County: Harnett
Name: Ed Loeffler
Vft is subrritting the infornation?
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
2020-04-30 NCDEQ Stormwater Submittal.pdf 1.5MB
2020-04-24 Medlin Self Storage CD's 1st
19.74MB
Submittal.pdf
2020-04-24 SW & EC Narrative FINAL - Medlin
4.75MB
SS.pdf
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 infornation cannot be claimed as confidential: the nave and address of any permt applicant or
perrrittee, perrrit applications, perrrits, effluent data, information required by NRDM application forms provided by
the Director inclusive of all forrrs and attachments [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:
Requested files which were mailed in for permit #SW6200501, per Suzanne McCoy e-mail request on 5/5/2020.
* 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
I intend to electronically sign and submit the Supplemental Information form."
Full Name:* Edward Loeffler
Signature:
f Lq,ta
Date Submitted: 5/7/2020

Initial Review
Updated ID#: IWORfANT. RE\/1RAE 2SH0LLDVMFY and revise here if necessary.
SW6200501
Who needs a W 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]