NCS000332_Supplemental Info Review_20200909

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 9/9/2020 12:01:22 PM (Supplemental Submittal)
Submit by Gwinn, Matt 9/9/2020 12:57:04 PM (Supplemental Info Submittal)
• The task was assigned to Gwinn, Matt 9/9/2020 12:01 PM

Submittal Dated: 9/9/2020
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
NCS000332
Examples: SWxxxxxxx, NCacxxxxx, or NCSxxxxxx
Facility Name:* Hexaon Inc. - Morganton Facility
County: Burke
Name: Caleb Stoker
Vft is subrritting the inforr ation?
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
Hexaon 2020-1 DMR .pdf 4.15MB
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 I FDES application forms provided by
the Director inclusive of all forrrs and attachments [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:
2020 - Period 1 Stormwater Discharge Outfall Monitoring Report
* W 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');
o 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:* Caleb Stoker
Signature:
Date Submitted: 09/09/2020

Initial Review
Updated ID#: IWC�ANT. REVIEVVERSHOULDVERFYand revise here iFnecessary.
NCS000332
Who needs a W Central Office
copy?* r Regional Office
Central Office Reviewer:*
Matt GWnn - eads\mbgWnn
Review Date* 09/09/2020