NCC215506_NOI 67642 Payment Verification_20211005

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 10/1/2021 9:30:24 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 10/4/2021 8:43:14 AM (Review- Construction NOI 67642)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 10/1/2021 9:31 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: October 5, 2021 5:00
PM. The priority is: High 10/1/2021 9:31 AM
Submit by Evans, Shaundra M 10/5/2021 10:38:55 AM (Payment Verification for NCC215506)
* Jonathan Powers
• Evans, Shaundra M assigned the task to Evans, Shaundra M 10/5/2021 10:37 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: November 15, 2021 5:00
PM. The priority is: High 10/4/2021 8:43 AM

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VerificationPayrmnt
NORTH CAROLINA
Environmental Quvllly
Project Name
Drill Test Site (Project Carolina Belle, LLC)
Lot Numbers
(If listed on the eNOI)
NC Reference No.*
NCG01-2021-5506
Certificate of
NCC215506
Coverage (COC)
No.*
Invoice Date
10/4/2021
Initial Invoice No.
NCC215506-2021
Initial Fee
$ 100.00
Invoice Due Date
11/3/2021
Important: If you change the choice below to Payment NOT RECEIVED, the application will be rejected, and a COC will
not be issued. This is the ONLY way to reject an eNOI at this step.
Payment Received*
r Payment Received.
f Payment NOT RECEIVED.
Payment Status
PAID
Date Payment
10/5/2021
Received*
(Or, if not received, date rejected for no payrrent)
Method of Payment*
r electronic
f check
f Other
ePayment
596060329
Transaction
Number*
NOI Tracking No.
67642
Tracking ID referenced upon subrrittal
This is an Express
f No
Review Project
r Yes
Project Tracking ID
NCC-MONTG-2021-Drill Test Site (Project Carolina Belle, LLC)