SW6200501_Supplemental Info Review_20201008 (2)

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/8/2020 9:49:26 AM (Supplemental Submittal)
Submit by McCoy, Suzanne 10/8/2020 10:32:38 AM (Supplemental Info Submittal)
• The task was assigned to McCoy, Suzanne 10/8/2020 9:49 AM

Submittal Dated: 10/8/2020
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 urolect.
D# * Perrrit N irrber
SW6200501
Examples: SWxxxxxxx, NC Gxxxxxx, or NCSxxxxxx
Facility Name:* Medlin Self -Storage
County: Wake
Name: Donald L. Curry, Jr.
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
2020-10-08 Medlin Self Storage CD's REV #3.pdf 33.46MB
2020-10-08 NCDEQ Medlin Submittal Pkg.pdf 992.57KB
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 inforrretion cannot be clairred as confidential: the narre and address of any perrrit applicant or
perrrittee, permt applications, pernits, effluent data, infornation required by MODES application forr s provided by
the Director inclusive of all fours and attachments [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:
Revised site plans & permit forms, per comments.
* 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:* Donald L. Curry, Jr.
Signature:
,0�wal".era t'&Y, 04.
Date Submitted: 10/08/2020

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
Review Date * 10/08/2020