SW5210402_Supplemental Info Review_20210421

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 4/21/2021 3:13:26 PM (Supplemental Submittal)
Submit by McCoy, Suzanne 4/22/2021 7:33:29 AM (Supplemental Info Submittal)
• The task was assigned to McCoy, Suzanne 4/21/2021 3:14 PM

Submittal Dated: 4/21/2021
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# * Perait Nurrber
SW5210402
Examples: SWxxxxxxx, NC Gxxxxxx, or NCSxxxxxx
Facility Name:* Siler City Municipal Airport - Obstruction
Clearing
County: Chatham
Name: Benjamin Bothell
VVAio is subnitting the inforrration?
Email Address:* [e-mail]
Please upload all files that need to be submited.
aick the upload button or drag and drop files here to attach document
2021-03-05 RFC Sealed Dyvgs Siler City.pdf 15.1 MB
Stormwater Narrative.pdf 30.01 MB
2021-04-09 NCDENR Permit Appl.pdf 2.03MB
2021-04-12 LOT NCDEQ.pdf 117.66KB
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 claimed as confidential: the narre and address of any perrrit applicant or
pernittee, pernit applications, permits, effluent data, information required by WCM application forms provided by
the Director inclusive of all forrrs and attachments [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:
"2021-04-12 LOT NCDEQ" - Transmittal indicating items submitted
"2021-03-05 RFC Sealed Dwgs Siler City" - Sealed/Released for Construction Plan Drawings
"2021-04-09 NCDENR Permit Appl" - Copy of Permit Application
"Stormwater Narrative" - Narrative for Reference
* V By checking the box and signing box below, I certify that:
o 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:* Benjamin Bothell, P.E.
Signature:
Date Submitted: 04/21/2021

Initial Review
Updated ID#: IWORfANT. RE\/1RAE 2SH0LLDVMFY and revise here if necessary.
SW5210402
Who needs a W Central Office
copy?* r Regional Office
Central Office Reviewer:*
Jim Farkas - eads\jjfarkas
Review Date * 04/22/2021