SW7110108_Supplemental Info Review_20210527

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 5/27/2021 10:12:29 AM (Supplemental Submittal)
Submit by Dunn, William C 5/27/2021 10:24:08 AM (Supplemental Info Submittal)
• The task was assigned to Dunn, William C 5/27/2021 10:12 AM

Submittal from 5/27/2021
Permit Information:
Rease provide specific permit details below.
........ ......... ......... .........
What Type of Choose one:
Permit?* r NPDES Industrial or MS4 Permit
r State Stormwater (Post -Construction) Permit
f Other
Permit Number* SW7110108
Begins with "SW', "NOG', or "NOS'
What DEQ Office is Reviewer: Rease correct if nisidentlfied, close this review forrn and reassign taskto the appropriate contact.
the Primary r Central Office
Contact?* r Washington Regional Office (Attn: Carl Dunn)
f Wilmington Regional Office (Attn: Christine Hall)
Project Name* Currituck Club Phase 8A
Owner/Operator* Douglas Anderson
County: Currituck
Submitter Name:* Carl Dunn
Vft is submitting this information?
E-mail Address:*
Phone Number*
[e-mail]
2529483959
Additional E-mail for (Optional)
Submittal
Confirmation:
State Stormwater (Post -Construction) Information Uploads
Choose file type and upload attachment (Reviewer nay rerrove unnecessary subnittals)
File Type* Application Form
File Upload Oickthe upload button, or drag and drop files to attach
WaRO-05242021154434.pdf 2.92MB
Only RDFfiles are accepted.
Uploads contain F NO
Confidential r YES
Information * NOTE The following information cannot be claimed as confidential: the narre and address of any permit applicant or
perrrittee, permt applications, permits, effluent data, information required by NR7ES application forms provided by
the Director inclusive of all forms and attachrrents [Ref. 40 CFR 122.7(b) and (c)].
Notes about the attachments:

Renewal Application
* P By checking the box and signing box below, I certify that:
o I have given true, accurate, and complete information on this form;
o 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');
o I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
o I intend to electronically sign and submit the Supplemental Information Upload form.
Full Name:* Carl Dunn
Signature:
Date Submitted: 05/27/2021

Initial Review
Verify Permit No.* I1\410RfAi T. RE\/lRAE 2SH0LLDVMFY and revise here if necessary.
SW7110108
Who needs a Reviewer selections will only be required for offices checked here.
copy? * Central Office Staff
r Regional Office Stormwater Contact
17 State Stormwater RO Staff
Identify Regional Office: *
Washington Regional Office — 252-946-6481
State Stormwater RO Carl Dunn (WaRO)
Reviewer*
Review Date * 05/27/2021