NCS000346_Supplemental Info Review_20200629

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 6/29/2020 12:41:25 PM (Supplemental Submittal)
Submit by Strickland, Shane 7/6/2020 10:00:52 AM (Supplemental Info Submittal)
• The task was assigned to Strickland, Shane 6/29/2020 12:41 PM

Submittal Dated: 6/29/2020
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 Nurrber
NCS000346
Examples: Sftxxxxxx, NCacxxxxx, or NCSxxxxxx
Facility Name:* Insteel Wire Products Company
County: Surry
Name: Stephanie J Ellis
Vft is subrritting the infornetion?
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
NCW - Stormwater DMR - 2020 Period 1.pdf 150.39KB
NCW - Stormwater Analytical - 2020 Period 1 -
1.24MB
NCS000346. 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 infornetion cannot be claimed as confidential: the nave and address of any perrrit applicant or
perrrittee, perrrit applications, perrrits, 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:
Completed DMR and Analytical Data (Lab Report) for Insteel Wire Products Company facility in Surry County.
Covered under individual stormwater permit NCS000346.
* 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:* Stephanie J Ellis
Signature:
Date Submitted: 06/29/2020

Initial Review
Updated ID#: IWORfANT. RE\/1RAE 2SH0LLDVMFY and revise here if necessary.
NCS000346
Who needs a W Central Office
copy?* r Regional Office
Central Office Reviewer:*
Shane Strickland - eads\sstrickland9
Review Date * 07/06/2020