SW3191101_Supplemental Info Review_20211025

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/25/2021 10:49:28 AM (Supplemental Submittal)
Submit by Georgoulias, Bethany A 11/20/2021 2:25:34 PM (Supplemental Info Submittal)
• Georgoulias, Bethany A reassigned the task to Georgoulias, Bethany A 11/20/2021 12:20 PM
• The task was assigned to McCoy, Suzanne 10/25/2021 10:49 AM

Submittal from 10/25/2021
Permit Information:
Please provide specific hermit details below.
What Type of Permit? Choose one:
* NPDES Industrial or MS4 Permit
• State Stormwater (Post -Construction) Permit
Other
Permit Number* SW3191101
Begins with "SW", "NCG", or "NCS'
What DEQ Office is Reviewer: Please correct if misidentified, close this review form, and reassign task to the appropriate contact.
the Primary Contact? • Central Office
*
Washington Regional Office (Attn: Carl Dunn)
Wilmington Regional Office (Attn: Christine Hall)
Project Name* Cambridge Village Multifamily
Owner/Operator* North Pilot Knob Road, LLC
County: Lincoln
Submitter Name: * Robert L. Griffin, P.E.
Who is submitting this information?
E-mail Address:* [e-mail]
Phone Number* 704-564-3896
Additional E-mail for (Optional)
Submittal
Confirmation:
State Stormwater (Post -Construction) Information Uploads
Choose file type and upload attachment (Reviewer may remove unnecessary submittals)
File Type* Application Form
File Upload Click the upload button, or drag and drop files to attach
SW Permit Minor Mod signed 10-20-2021.pdf 154.65KB
SW O&M Agreement revision signed 10-20-2021.pdf 407.96KB
Dewatering Explanation Letter to NCDEQ.pdf 8.34MB
Only PDF files are accepted.
Uploads contain • NO
Confidential YES
Information* NOTE: The following information cannot be claimed as confidential: the name and address of any permit applicant
or permittee, permit applications, permits, effluent data, information required by NPDES application forms provided
by the Director inclusive of all forms and attachments [Ref. 40 CFR 122.7(b) and (c)].

Notes about the attachments:
* By checking the box and signing box below, I certify that:
• 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
o I intend to electronically sign and submit the Supplemental Information Upload form.
Full Name:* Robert L. Griffin
Signature:
Date Submitted: 10/25/2021

Initial Review
Verify Permit No.* IMPORTANT. REVIEWER SHOULD VERIFY and revise here if necessary.
SW3191101
Who needs a Copy?* Reviewer selections will only be required for offices checked here.
Central Office Staff
Regional Office Stormwater Contact
State Stormwater RO Staff
No Copy Needed
Central Office Reviewer:*
Notifies CO Staff with Email
Jim Farkas
Any Comments or O&M Revision Agreement included in uploads denoted as "Application Form"
Added Info for CO
Staff Reviewer?
Review Date* 11/20/2021