NCC206015_Modification Review_20210222

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 2/22/2021 8:49:30 AM (ADD TO FILE Submittal)
Approve by Georgoulias, Bethany 2/22/2021 9:39:15 AM (Construction COC ADD TO FILE Review- NCC206015)
• The task was assigned to Georgoulias, Bethany. The due date is: February 25, 2021 5:00 PM
2/22/2021 8:49 AM

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NORTH CAPOLINA
EnYlrenmemf& Qualay
Certificate of NCC206015
Coverage (COC) Enter the Certificate of Coverage Ninber (use capital letters)
No.*
Information associated with this permit:
Project Name Louisburg 115kV Capacitor Bank
Address 480 West River Road, Louisburg, NC
County Franklin
Latitude 36.1008
Longitude-78.3177
Permittee Listed Duke Energy Progress, LLC
Legally Responsible Alan Lewis
Individual
NC Reference No. NCG01-2020-6015
E&SC Plan ID
Original NOI
Tracking No.
F RANK-2021-014
39951
Date COC Issued* 01/04/2021
Prior Rescission This field will populate only if CCChas already been rescinded.
Date
Modification Information:
Reason for r Closed -Out Lots/Outparcels in E&SC Plan
Modification * r Additional Lots/Outparcels Approved - E&SC Revised
F Other Revision(s) to E&SC Plan
r Legally Responsible Individual and/or Site Contact Has Changed
r Multiple Reasons (List)
Addional We inforrration (e.g., new Site Contact details). If lots are being added, please include specific lot nunbers.
Explanation Limits of disturbance were expanded to 19.5 AC to accommodate grounding wire
installation and additional danger tree clearing
You must upload supporting documentation below. Do not upload E&SC Plans unless specific plan
sheets are the only documentation with approval for revised acres of disturbance, etc. (only upload applicable
sheets).
For changes to the legally responsible individual, you must upload this form

Supporting Upload Supporting Documentation (Pevised E&SCApproval, rose -Out Doc, etc.)
Documentation FRANK-2021-014_20210221_LOA.pdf 266.39KB
Mist be FDFfornat
North Carolina General Statute 143-215.6B (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 Article; 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 Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine not to exceed ten thousand
dollars ($10,000).
� I hereby request modification to coverage under the NPDES Stormwater Permit
for the subject project site. I am familiar with the information contained in this
request and to the best of my knowledge and belief such information is true,
complete and accurate.
Specify if you are:* r The Legally Responsible Individual
r Authorized Responsible Person*
*This form must be signed by a responsible corporate officer that 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 NCGO10000 General Permit. For more information on signatory requirements, see Part IV, Section B,
Item (6) of that permit.
Signature
AZAA) IV �CJ-T
Type Name* Alan Lewis
Title * Manager Substation Engineering
Organization* Duke Energy Progress, LLC
Date * 02/22/2021
Email Address* [e-mail]
En -ail for confirmation
Telephone Number* 919-546-7451
Contact nunber if we need to reach you
Note: Original permittee and site contact are copied on modification correspondence.
Additional Email [e-mail]
(Optional) Additional email for confirmation
Original Permittee [e-mail]
Email
Original Site Contact [e-mail]
Email
Review Date 02/22/2021
Rescinded Since
Submitted?

Request Date 20210222
Formatted
Review Date 20210222
Formatted