SW5200701_Supplemental Info Review_20211026

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/26/2021 9:11:48 AM (Supplemental Submittal)
Submit by Georgoulias, Bethany A 11/21/2021 1:46:08 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 10/26/2021 9:11 AM

Submittal from 10/26/2021
Permit Information:
Please provide specific permit details below.
What Type of Permit?
Choose one:
*
NPDES Industrial or MS4 Permit
• State Stormwater (Post -Construction) Permit
Other
Permit Number*
SW5200701
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* Bojangles at Spring Hope,NC
Owner/Operator* Herritage, LLC.
County: Nash
Submitter Name: * Isaac Mitchel Hardison
Who is submitting this information?
E-mail Address:* [e-mail]
Phone Number* 2522177821
Additional E-mail for [e-mail]
Submittal (Optional)
Confirmation:
State Stormwater (Post -Construction) Information Uploads
Choose file type and
upload attachment (Reviewer may remove unnecessary submittals)
File Type*
Stormwater Narrative
File Upload
Click the upload button, or drag and drop files to attach
Stormwater Narrative per modification.pdf 187.13KB
Only PDF files are accepted.
File Type*
Supplement-EZ Form
File Upload
Click the upload button, or drag and drop files to attach
Signed and Sealed Supp EZ form.pdf 1.35MB
Only PDF files are accepted.
File Type*
USGS Topographic Site Map

File Upload
Click the upload button, or drag and drop files to attach
USGS Map.pdf
1.61MB
Only PDF files are accepted.
File Type*
Property Deed
File Upload
Click the upload button, or drag and drop files to attach
Herritage LLC DEED.pdf
416.51 KB
Only PDF files are accepted.
File Type*
Design Calculations
File Upload
Click the upload button, or drag and drop files to attach
Signed and Sealed Calculation package.pdf
1.3MB
Only PDF files are accepted.
.......................................................... .........
File Type*
Application Form
File Upload
Click the upload button, or drag and drop files to attach
Bojangles stormwater permit application.pdf
3.23MB
Only PDF files are accepted.
File Type*
Plansheet - Cover Sheet
File Upload
Click the upload button, or drag and drop files to attach
Cover.pdf
375.44KB
.................. .........
Only PDF files are accepted.
......... ......... ......... .........
File Type*
Plansheet - Other
File Upload
Click the upload button, or drag and drop files to attach
CE-01.pdf
411.61 KB
runoff map.pdf
849.25KB
CE-07.pdf
440.48KB
CE-08.pdf
337.67KB
CE-09.pdf
539.02KB
.........
Only PDF files are accepted.
......... .........
File Type*
Plansheet - Proposed Conditions/Site Plan
File Upload
Click the upload button, or drag and drop files to attach
CE-02.pdf
455.81 KB
CE-03.pdf
326.64KB
_..................................................................................................................................
Only PDF files are accepted.
File Type*
Plansheet - Grading/Drainage Plan
File Upload
Click the upload button, or drag and drop files to attach
CE-04.pdf
396.13KB
.............................................................................................................................
Only PDF files are accepted.
File Type*
Plansheet - Landscape/Planting Plan
File Upload
Click the upload button, or drag and drop files to attach
CE-05.pdf
519.19KB
Only PDF files are accepted.
File Type*
Signing Official Title & Position Information

File Upload
Click the upload button, or drag and drop files to attach
Herritage Certification of Delegation of Authority.pdf 505.78KB
Only PDF files are accepted.
File Type*
Plansheet - SCM Detail
File Upload
Click the upload button, or drag and drop files to attach
CE-10.pdf 262.14KB
Only PDF files are accepted.
File Type*
Plansheet - Misc. Detail
File Upload Click the upload button, or drag and drop files to attach
D-01.pdf
1.14MB
D-02.pdf
1.42MB
D-03.pdf
503.43KB
D-04.pdf
228.64KB
D-05.pdf
131.13KB
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:
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')
o 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:* Isaac Mitchel Hardison
Signature:
CM4 61,t&,, ,•,
Date Submitted: 10/26/2021

Initial Review
Verify Permit No.* IMPORTANT. REVIEWER SHOULD VERIFY and revise here if necessary.
SW5200701
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
Added Info for CO
Staff Reviewer?
Review Date* 11/21/2021