NCS000573_DMR Upload Review_20201105

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 11/3/2020 4:43:19 PM (DMR Submittal)
Submit by McCoy, Suzanne 11/5/2020 8:30:04 AM (DMR Submittal Review)
• The task was assigned to McCoy, Suzanne 11/3/2020 4:43 PM

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DMR Submittal from 11/3/2020
Permit and Facility Information:
Permit Number* Enter ODCor Individual Fbrrrit Ninber
NCS000573
Mast begin w ith NCS or Na,-
Facility Name:* Belews Creek Steam Station
County:* Stokes
Note: Facility name and county are used to help the reviewer verify the permit number entered, and to display the
Regional Office address on the submitter's form (not here). These metadata details will be pulled from current BIMS
information after the DMR(s) are filed. If the submittal is accepted, simply note any errors in the reviewer's comments.
Monitoring Period Information:
Monitoring Period VUTatisthe YEAR ofthe sanpledate(s)?
Year:* 2020
DM R Upload* Oickthe upload button or drag and drop files hereto attach document.
September 2020 signed Stormwater DMR.pdf 104.61 KB
Only R Fs are accepted.
Comments:
* W By checking the box and signing box below, I certify that:
have given true, accurate, and complete information on this form;
• I agree that submission of this Data Monitoring Report (DMR) upload 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 on this upload form 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 this DMR upload form.
Full Name:* Lori Tollie
%rre of person subnitting this form
Email Address:* [e-mail]
Phone Number:* 336-408-2591
Signature:
lPg To&

Date: * 11 /03/2020

Review
Review Date: 11/05/2020
Confirm Permit No.* Correct the perrritIDnurrberifneeded.
NCS000573
ConfirmDMRYear* 2020
Multiple DMRs will be automatically filed in a subfolder denoting the sampling year entered above.
Can submittal be r Yes
accepted?* r No (Explain why below)
Do Central Office r No
staff need to be r Yes
alerted?*
Do Regional Office r No
staff need to be r Yes
alerted?
Type of Permit* Individual
Ensures Wks) filed correctly.