SW5211201_Supplemental Info Review_20211221

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 12/21/2021 1:32:26 PM (Supplemental Submittal)
Submit by Georgoulias, Bethany A 12/21/2021 2:23:01 PM (Supplemental Info Submittal)
• Georgoulias, Bethany A reassigned the task to Georgoulias, Bethany A 12/21/2021 2:17 PM
• The task was assigned to McCoy, Suzanne 12/21/2021 1:32 PM

Submittal from 12/21 /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*
SW5211201
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* Dollar General
Owner/Operator*
Glandon Forest Equity, LLC
County:
Nash
Submitter Name: *
Carlo Pardo -Bowman
Who is submitting this information?
E-mail Address:*
[e-mail]
Phone Number*
9195536570
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*
Plansheet - Cover Sheet
File Upload
Click the upload button, or drag and drop files to attach
DG-Middlesex_Base C-1-Cover.pdf 925.44KB
Only PDF files are accepted.
File Type*
Plansheet - Grading/Drainage Plan
File Upload
Click the upload button, or drag and drop files to attach
DG-Middlesex_Base C-4-Grade.pdf 8.92MB
.........
Only PDF files are accepted.
......... .........
File Type*
Plansheet - SCM Detail

File Upload Click the upload button, or drag and drop files to attach
DG-Middlesex_Base C-10-StrmDtl.pdf 1.53MB
Only PDF files are accepted.
File Type* Plansheet - Proposed Drainage Area
File Upload Click the upload button, or drag and drop files to attach
DG-Middlesex_Base C-12 DA MAP.pdf 5.01 MB
Only PDF files are accepted.
................................................................................................................
File Type* O&M Agreement/Plan
File Upload Click the upload button, or drag and drop files to attach
O&M Agreement_Middlesex_signed.pdf 319.25KB
Only PDF files are accepted.
File Type* Application Form
File Upload Click the upload button, or drag and drop files to attach
SSW-SWU-1 01 -Application_Revised.pdf 124.81KB
Only PDF files are accepted.
...................................................................................................................................................
File Type* Pending Sales Agreement
File Upload Click the upload button, or drag and drop files to attach
PSA - Middlesex.pdf 8.25MB
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:* Carlo Pardo
Signature:
Goo cV
Date Submitted: 12/21/2021

Initial Review
Verify Permit No.* IMPORTANT. REVIEWER SHOULD VERIFY and revise here if necessary.
SW5211201
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 Permit/File uploads identified as State Stormwater Post -construction
Added Info for CO
Staff Reviewer?
Review Date* 12/21/2021