NCC202908_NOI Application_20200714

Action History (UTC-05:00)Eastern Time(US&Canada)
Subrrit by Anonymous User 7/9/2020 12:12:38 PM(NCG01 NOI Submission)
Approve by Garcia, Lauren V 7/9/2020 7:06:32 PM(Review-Construction NOI 28031)
• The task was assigned to Garcia, Lauren V by round robin distribution 7/9/2020 12:14 PM
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is:July 13,2020 5:00 PM.
The priority is: High 7/9/2020 12:14 PM
Submit by Selkane,Aziza 7/14/2020 8:14:17 AM(Payment Verification for NCC202908)
* Mason H McKnight
• Selkane,Aziza assigned the task to Selkane,Aziza 7/14/2020 8:13 AM
• The task was assigned to DEMLR NCG01 Payment Team.The due date is:August 21, 2020 5:00 PM.
The priority is: High 7/10/2020 7:04 AM

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1Construction Stormwater: Notice of Intent (NOI)
National Pollutant Discharge Elimination System 'D application for•• - .•-under NorthCarolina's
General Permit 1 1111:STORIVWATER DISCHARGES associated with construction activities(or
NORTH CAROLINA
Enrlrnnmenfu�Qr�arlry
A. Project Information
Part A.
Project Location and Waterbody Information
Are you submitting r No
an NOI that was r Yes
rejected before?
Previous Rejected 27914
NOI No.
Prior Reviewer Jim Farkas
Name
1a. Project Name* FB-PN 80774 SOF SERE Resistance Training Complex
1 b.Specific Lot This field may be used to list spedc lot numbers.
Numbers
2.County* Scotland
3. Highway or Street Rowe Lane
Address* Street nacre only is acceptable if no address number assigned yet
4. City or Township* Fort Bragg
5.State* NC
6.Zip Code* 28310
7. Latitude* Enter the latitude in decimal degrees
35.0355
8. Longitude* Enter the longitude in decimal degrees(MJSTbe negative)
-79.4611
If you do not know the latitude and longitude coordinates for this project,you can search the location on this map of
North Carolina. Look for the coordinates in the bottom left corner.
9. Date to Begin* 07/13/2020
Estimated Construction Project Start Date
10. Date to End* 12/31/2021
Estimated Construction Project End Cute
11.SIC(Primary)* Other(9999)
Standard Industrial Classification for lkveloprrent

12.Acres to be 9.75
disturbed* (including off-site borrow and waste areas)
13.Total site area 9.75
(acres)*
14. Post- 4.58
construction (Estirrated)
impervious area
(acres)*
NCC Project NCC-SCOTL-2020-FB-PN 80774 SOF SERE Resistance Training
Tracking ID Complex
Assigned automatically
Below you must enter waterbody information for surface waters affected by this project. Please consult
DWR's Surface Water Classifications Map Viewer to find waterbody name and corresponding index number. Please
enter only immediate receiving waterbodies-not waters downstream of those unless the project extends there. You
may enter up to 3 waterbodies if needed.
15a. Receiving Drowning Creek
Wate rbody* %rre of waterbody into which stormwater runoff will discharge
15b.Waterbody 14-2-(10.5)
Index No.* NCWaterbody Index Number
Stormwater V No
discharges will flow r Yes
to additional
wate rs*
16a. Is this project F Yes
subject to the NC r No, not subject to NC SPCA
Sediment Pollution
Control Act?*

B. Permittee Information
Part B. ^
Fbrnittee Inforrration-Legally Fbsponsible Entity and Individual
Important:The person who signs the NOI Certification Form and signs the Certification in Section E of this application
form should be the same person as listed in THIS SECTION, or an authorized responsible individual within the same
organization. That person must be a responsible corporate officer who 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.
1.Organization Legally Pesponsible Entity
Name* Fort Bragg Directorate of Public Works
It pernittee is an individual(i.e.,organization does not apply),enter first and last narre in this field.
2. First Name* Monica
If Corporation,enter Faegistered Agent First%rre
3. Last Name* Stephenson
It Corporation,enter F;bgistered Agent Last Iona
3b.Title Director
4. Permitee E-mail [e-mail]
Address*
5. Permittee 910-396-4009
Telephone No.*
6. Permittee Mailing Street Address
Address* 2175 Reilly Road Stop A
Address Line 2
City State/Rovince/F;bgion
Fort Bragg NC
Fbstal/Zip Code Country
28310-5000 us
Check box if the F Yes
street address the
same as mailing
address
7. Permittee Street Street Address
Address* 4300 Butner Road
Address Line 2
City State/Frovince/Region
Fort Bragg NC
Fbstal/Zip Code Country
28310 us
8.Type of Government- Federal
Ownership*

C. Site Contact Information
Part C. ^
Roject Site Contact Inforrration
.......................................................................................................................................................................................................................................................................................................................................................................................
1. Primary Site Lee
Contact-First
Name*
2. Primary Site Ward
Contact-Last
Name*
3.Title Chief,Water Management Branch
4.Site Contact E- lee.p.\&[e-mail]
mail Address*
5.Site Contact 910-908-5286
Telephone No.*
6.Organization Fort Bragg Directorate of Public Works
Name
7.Site Contact Street Address
Mailing Address* 2175 Reilly Road Stop A
Address Line 2
City State/Rovince/Region
Fort Bragg NC
Postal/Zip Code Country
28310-5000 us
8. Consultant Name (Optional)
Crystal Hill, PE
First and Last nacre
9. Consultant E-mail [e-mail]
This person will be copied on all correspondence.
10. Consultant 804-822-3020
Telephone No.

D. E&SC Plan
Part D. ^
Erosion&Sediment Control(E&SC)Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 07/02/2020
Approved*
2. E&SC Plan Project SCOTL-2020-007
Number/ID* Assigned by agency or local program
3. E&SC Plan r State DEQ Office
Approved by* r Local Program
4.State DEQ Office* Fayetteville(FRO)
Documentation of E&SC Plan approval and the signed Notice of Intent(NOI)Certification Form is required for a
complete application. For linear projects, please also upload a site map showing the overall extent of the project or
include the beginning point and end point coordinates in the"Notes"box below.
5. E&SC Plan scotl-2020-007exap.pdf 798.05KB
Approval letter or Mast beRDFformat
Grading Permit
6.Site Location Map Helpful for linear project review
(Optional) Mist be FCFfornat.Rease do not upload entire set of E&SCplans.
7. Notes(Optional) Frovide any additional information that night help the reviewer better understand how uploaded docurrents support
the application.Include additional waterbodies for linear projects if necessary.
8. NOI Certification Signed NOI Certification Form FB-PN 80774 SERE
Form 466.95KB
Resistance Training Complexpdf
Mist be FCFforrrat
This is an Express f No
Review Project* F Yes

E. Certification
North Carolina General Statute 143-215.6E(i) provides that:
Anyperson who knowinglymakes any false 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 knowingly makes a false statement
of a material fact in a rulemaking proceeding or contested case underthis Artcle;or who 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 Artcle shall be guiltyofa Class 2 misdemeanor which mayinclude a fine not to exceed ten thousand
dollars($10,000).
Under penalty of law, I certify that:
17 I am the person responsible for the construction activities of this project,for
satisfying the requirements of this permit,and for any civil or criminal penalties
incurred due to violations of this permit.
rJ The information submitted in this NOI is,to the best of my knowledge and belief,
true,accurate, and complete based on my inquiry of the person or persons who
manage the system,or those persons directly responsible for gathering the
information.
* 17 I will abide by all conditions of the NCG010000 General Permit and the
approved Erosion and Sediment Control Plan.
* rJ I hereby request coverage under the NCG010000 General Permit and
understand that coverage under this permit will constitute the permit
requirements for the discharge(s)and is enforceable in the same manner as an
individual permit.
Specify if you are:* r The Responsible Person named on this Notice of Intent
r Authorized Responsible Person*
Important:The person who electronically signs this Certification above must be the same person who signs the NOI
Certification Form. If that person is signing on behalf of the Permittee,that individual must be an authorized responsible
person within the same organization as the Permittee. *An authorized individual is a responsible corporate officer who
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
Type Name* Lee Ward
Title Chief,Water Management Branch
Organization Legally Pesponsible Entity
Fort Bragg Directorate of Public Works
Date* 07/09/2020

F. Tracking and COC Info
NOI Tracking No. 28031
NC Reference No. NCG01-2020-2908
Uses'count_nurrber'variable(increrrented by SP)
Certificate of NCC202908
Coverage (COC) Uses'count_nurrber'variable(increrrented by SP)
No.*
Count Number 2908
Sequential nurrber for subrrittal that is incremented by Stored Frocedure
COC Year 2020
Year of date reviewed(used to assign YY digits after"NOC'in COCno.)
Initial Invoice No. NCC202908-2020
Invoice Due Date 8/8/2020
Initial Fee $ 100.00
Invoice Status OPEN