SW6211203_Supplemental Info Review_20211227

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 12/27/2021 10:14:22 AM (Supplemental Submittal)
Submit by Georgoulias, Bethany A 12/29/2021 12:08:30 PM (Supplemental Info Submittal)
• Georgoulias, Bethany A reassigned the task to Georgoulias, Bethany A 12/28/2021 3:36 PM
• The task was assigned to McCoy, Suzanne 12/27/2021 10:14 AM

Submittal from 12/27/2021
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*
SW6211203
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* McCain Gas Station
Owner/Operator*
211 Shopping Center, LLC
County:
Hoke
Submitter Name: *
Lee Humphrey
Who is submitting this information?
E-mail Address:*
[e-mail]
Phone Number*
910-684-8646
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*
Plansheet - SCM Detail
File Upload
Click the upload button, or drag and drop files to attach
McCain Gas Station_SW Plan.pdf 2.44MB
Only PDF files are accepted.
File Type*
Plansheet - Cover Sheet
File Upload
Click the upload button, or drag and drop files to attach
McCain Gas Station -Full Set 11.11.21 1-Cover.pdf 124.24KB
Only PDF files are accepted.
File Type*
Plansheet - Existing Conditions/Survey

File Upload
Click the upload button, or drag and drop files to attach
McCain Gas Station -Full Set 11.11.21 2-C1.pdf
235.16KB
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
McCain Gas Station -Full Set 11.11.21 3-C2.pdf
194.78KB
.........
Only PDF files are accepted.
......... ......... ......... .........
File Type*
Plansheet - Other
File Upload
Click the upload button, or drag and drop files to attach
McCain Gas Station -Full Set 11.11.21 4-EC1.pdf
384.85KB
Only PDF files are accepted.
File Type*
Plansheet - Misc. Detail
File Upload
Click the upload button, or drag and drop files to attach
McCain Gas Station -Full Set 11.11.21 6-D1.pdf
175.05KB
.................................................
Only PDF files are accepted.
File Type*
Plansheet - Other
File Upload
Click the upload button, or drag and drop files to attach
McCain Gas Station -Full Set 11.11.21 5-EC2-7.pdf
2.12MB
Only PDF files are accepted.
File Type*
Plansheet - Landscape/Planting Plan
File Upload
Click the upload button, or drag and drop files to attach
McCain_LANDSCAPE_2021-11-10.pdf
783.92KB
Only PDF files are accepted.
File Type*
Soils/Geotechnical Report
File Upload
Click the upload button, or drag and drop files to attach
McCain Gas Station Soils Report.pdf
2.66MB
......................................
Only PDF files are accepted.
...................................................
File Type*
Design Calculations
File Upload
Click the upload button, or drag and drop files to attach
McCain Gas Station_Calculations.pdf
3.27MB
Only PDF files are accepted.
File Type*
Property Deed
File Upload
Click the upload button, or drag and drop files to attach
McCain Gas Station_Deed.pdf
146.79KB
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
McCain Gas Station_LLC.pdf
313.57KB
Only PDF files are accepted.
File Type*
Supplement-EZ Form

File Upload Click the upload button, or drag and drop files to attach
McCain Gas Station_Supplement E-Z.pdf 329.16KB
Only PDF files are accepted.
..................................................................................
File Type* O&M Agreement/Plan
File Upload Click the upload button, or drag and drop files to attach
Signed O & M Agreement - McCain Gas.pdf 164.01 KB
Only PDF files are accepted.
File Type* Application Form
File Upload Click the upload button, or drag and drop files to attach
Signed Permit Application - McCain Gas.pdf 289.5KB
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 304.16KB
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:* Lee Humphrey
Signature:
Date Submitted: 12/27/2021

Initial Review
Verify Permit No.* IMPORTANT. REVIEWER SHOULD VERIFY and revise here if necessary.
SW6211203
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 Uploads correctly identified as State Post -construction files.
Added Info for CO
Staff Reviewer?
Review Date* 12/29/2021