SWG010033_Supplemental Info Review_20200918

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 9/18/2020 7:14:01 AM (Supplemental Submittal)
Submit by Gwinn, Matt 9/22/2020 9:04:36 AM (Supplemental Info Submittal)
• The task was assigned to Gwinn, Matt 9/18/2020 7:14 AM

Submittal Dated: 9/18/2020
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
SWG010033
Exarrples: SWxxxxxxx, NC Gxxxxxx, or NCSxxxxxx
Facility Name:* Blue Property - Residence & Pasture
County: Transylvania
Name: Allan Epps
Vft is subrritting the information?
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
20002 SWM Application Signed.pdf 1.77MB
20002 Transmittal NCDEQ Raleigh 08-14-20.pdf 63.21 KB
20002 03 USGS Map.pdf 2.3MB
Blue Property Single -Family SWM Plans.pdf 6.04MB
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 information cannot be clairred as confidential: the narre and address of any perrrit applicant or
perrrittee, permt applications, permits, effluent data, information required by MODES application forms provided by
the Director inclusive of all fours and attachrrents [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:
Transmittal Letter
Signed Application
USGS Map
Plans
* 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:* Allan E Epps
Signature:
Date Submitted: 09/18/2020

Initial Review
Updated ID#: IWORfANT. RE\/1RAE 2SH0LLDVMFY and revise here if necessary.
SWG010033
Who needs a W Central Office
copy?* r Regional Office
Central Office Reviewer:*
Corey Anen - eads\scanen
Review Date * 09/22/2020