SW4210801_Supplemental Info Review_20220105

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 1/5/2022 1:53:05 PM (Supplemental Submittal)
Submit by Georgoulias, Bethany A 1/5/2022 4:27:55 PM (Supplemental Info Submittal)
• Georgoulias, Bethany A reassigned the task to Georgoulias, Bethany A 1/5/2022 4:26 PM
• The task was assigned to McCoy, Suzanne 1/5/2022 1:53 PM

Submittal from 1/5/2022
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*
SW4210801
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* Holt Farms
Owner/Operator*
Cimland, LLC
County:
Alamance
Submitter Name: *
Joel Sain
Who is submitting this information?
E-mail Address:*
[e-mail]
Phone Number*
919-987-6178
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 - Existing Conditions/Survey
File Upload
Click the upload button, or drag and drop files to attach
C-1.1 Existing EC.pdf 1.3MB
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
C-1.3 Pre plat.pdf 1004.23KB
..........................................
Only PDF files are accepted.
File Type*
Response To Comments

File Upload
Click the upload button, or drag and drop files to attach
B - Response to comments.pdf 548.08KB
..................................................................................................................................................................
Only PDF files are accepted.
File Type*
O&M Agreement/Plan
File Upload
Click the upload button, or drag and drop files to attach
D - O&M.pdf 1.19MB
Only PDF files are accepted.
File Type*
Supplement-EZ Form
File Upload
Click the upload button, or drag and drop files to attach
C - EZ.pdf 1.43MB
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: * Joel Sain
Signature:
Date Submitted: 01/05/2022

Initial Review
Verify Permit No.* IMPORTANT. REVIEWER SHOULD VERIFY and revise here if necessary.
S W4210801
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* 01/05/2022