SWA000125_Supplemental Info Review_20211208

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 12/8/2021 1:41:55 PM (Supplemental Submittal)
Submit by Georgoulias, Bethany A 12/10/2021 1:40:45 PM (Supplemental Info Submittal)
• Georgoulias, Bethany A reassigned the task to Georgoulias, Bethany A 12/10/2021 1:38 PM
• The task was assigned to McCoy, Suzanne 12/8/2021 1:41 PM

Submittal from 12/8/2021
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*
SWA000125
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* Cleveland County Water Operations Center
Owner/Operator*
Cleveland County Water
County:
Cleveland
Submitter Name: *
B. Chad Houser, PE,PLS
Who is submitting this information?
E-mail Address:*
[e-mail]
Phone Number*
704-476-0003 ext 311
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*
Property Deed
File Upload
Click the upload button, or drag and drop files to attach
CCW Deed.pdf 96.78KB
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
CCW Site Plan 12-03-21.PDF 529.41 KB
Only PDF files are accepted.
File Type*
Construction Sequence

File Upload Click the upload button, or drag and drop files to attach
Construction Sequence.pdf 88.81KB
Only PDF files are accepted.
File Type* Plansheet - Grading/Drainage Plan
File Upload Click the upload button, or drag and drop files to attach
Erosion Control Plan Sheet.pdf 1.03MB
Only PDF files are accepted.
...............................................................................................................
File Type* Application Form
File Upload Click the upload button, or drag and drop files to attach
Fast Track ATC Permit.pdf 1.63MB
Only PDF files are accepted.
File Type* USGS Topographic Site Map
File Upload Click the upload button, or drag and drop files to attach
NC_Shelby_2019_Quad2.pdf 1.95MB
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
• I intend to electronically sign and submit the Supplemental Information Upload form.
Full Name: * Bobby Chad Houser, PE, PLS
Signature:
Date Submitted: 12/08/2021

Initial Review
Verify Permit No.* IMPORTANT. REVIEWER SHOULD VERIFY and revise here if necessary.
SWA000125
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* 12/10/2021