NCC202992_Modification Review (Address Change)_20220118

Georgoulias, Bethany
From: Tony Eason <[e-mail]>
Sent: Tuesday, January 18, 2022 10:41 AM
To: Georgoulias, Bethany
Cc: [e-mail]; Spivey, Donnie; [e-mail]
Subject: [External] Re: Construction SW Modification Request Received
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Yes thanks
Sent from my Whone
Tony Eason
Pee Dee Electric
575 Hwy 52 South
Wadesboro, NC 28170
Office 910.997.8941
Cell 704.690.3030
On Jan 18, 2022, at 10:37 AM, Georgoulias, Bethany <[e-mail]>
wrote:
CAUTION: This email originated from outside of the organization. Do
not click links or open attachments unless you recognize the sender and
know the content is safe.
Good morning,
I wanted to confirm that this Modification request was a request to update the MAILING/STREET
ADDRESS for Donnie Spivey associated with this permit.
The previous address was: 575 U.S. 52, Wadesboro, NC 28170-6467
The new address is: 9825 US Hwy74 East, Lilesville, NC 28091
Is that correct?
Bethany Georgoulias (she/her)
Environmental Engineer
Stormwater Program, Division of Energy, Mineral, and Land Resources
N.C. Department of Environmental Quality
919 707 3641 office
[e-mail]
512 N. Salisbury Street, Raleigh, NC 27604 (location)
1

1612 Mail Service Center, Raleigh, NC 27699-1612 (mailing)
Website: http://deq.nc.gov/about/divisions/energy-mineral-land-resources/stormwater
t�xvrw N iwrws�rAwy��
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties
Based on the current guidance to minimize the spread of COVID-19, the Department of Environmental
Quality has adjusted operations to protect the health and safety of the staff and public. Many
employees are working remotely or are on staggered shifts. To accommodate these staffing changes, all
DEQ office locations are limiting public access to appointments only. Please check with the appropriate
staff before visiting our offices, as we may be able to handle your requests by phone or email. We
appreciate your patience as we continue to serve the public during this challenging time.
From: [e-mail] [mailto:[e-mail]]
Sent: Friday, January 14, 2022 9:41 AM
To: [e-mail]
Cc: [e-mail]; [e-mail]; [e-mail]
Subject: Construction SW Modification Request Received
Thank you for submitting a Modification request for Pee Dee Electric in Anson County,
Certificate of Coverage (COC) no. NCC202992.
Modification Reason: Other Revision(s) to E&SC Plan
Additional Details (fprovided): Change of address: New mailing/office address is 9825 US
Hwy74 East, Lilesville, NC 28091
If your submittal is accepted, you will receive e-mail confirmation. You will also be notified if
additional information is needed or if the modification request or documents cannot be accepted.
If you have any questions, please contact bethany_geor og uliaskncdenr.gov.
Be sure to add laserfiche(a�ncdenr.gov to your contacts to avoid future e-mails about this
application from going into Spam filters.
The NC DEMLR Stormwater Program
512 N. Salisbury Street, Archdale Building 6th Floor, 1612 Mail Service Center, Raleigh,
NC 27699-1612
El
This email was automatically generated by Laserfiche. Please do not respond to this email
address, as responses are not monitored.

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 1/14/2022 9:41:03 AM (ADD TO FILE Submittal)
Approve by Georgoulias, Bethany A 1/18/2022 10:54:02 AM (Construction COC ADD TO FILE Review - NCC202992)
* Mailing/street address for legally responsible individual updated on 1/18/2022.
The task was assigned to Georgoulias, Bethany A. The due date is: January 19, 2022 5:00 PM
1/14/2022 9:41 AM

i �M1
itowl�a
NORTH CAROLINA
EnNlmnmrnfel QuoN1y
Certificate of NCC202992
Coverage (COC) No.* Enter the Certificate of Coverage Number (Use capital letters)
Information associated with this permit:
Project Name Pee Dee Electric
Address Vintage Road, Lilesville, NC
County Anson
Latitude 34.9526
Longitude-79.9058
Permittee Listed Pee Dee Electric Membership Corporation
Legally Responsible Donnie Spivey
Individual
NC Reference No. NCG01-2020-2992
E&SC Plan ID ANSON-2020-007
Original NOI Tracking 28202
No. *
Date COC Issued * 07/16/2020
Prior Rescission Date This field will populate only if COC has already been rescinded.
Modification Information:
Reason for Closed -Out Lots/Outparcels in E&SC Plan
Modification* Additional Lots/Outparcels Approved - E&SC Revised
Other Revision(s) to E&SC Plan
Legally Responsible Individual and/or Site Contact Has Changed
Multiple Reasons (List)
Addional Explanation More information (e.g., new Site Contact details). If lots are being added, please include specific lot numbers.
Change of address: New mailing/office address is 9825 US Hwy74 East, Lilesville,
NC 28091
You must upload supporting documentation below. Do not upload E&SC Plans unless specific plan
sheets are the only documentation with approval for revised acres of disturbance, etc. (only upload
applicable sheets).
For changes to the legally responsible individual, you must upload this form

Supporting Upload Supporting Documentation (Revised E&SC Approval, Close -Out Doc, etc.)
Documentation Lilesville_LOA_12.8.2021.pdf 832.14KB
Must be PDF format
North Carolina General Statute 143-215.613 (i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan, or other document
filed or required to be maintained under this Article or a rule implementing this Article; or who knowingly makes a false statement of a material
fact in a rulemaking proceeding or contested case under this Article; or who falsifies, tampers with, or knowingly renders inaccurate any recording
or monitoring device or method required to be operated or maintained under this Article or rules of the Commission implementing this Article shall
be guilty of a Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars ($10,000).
* I hereby request modification to coverage under the NPDES Stormwater Permit for the
subject project site. I am familiar with the information contained in this request and to
the best of my knowledge and belief such information is true, complete and accurate.
Specify if you are:* The Legally Responsible Individual
• Authorized Responsible Person*
*This form must be signed by a responsible corporate officer that owns or operates the construction activity, such as a
president, secretary, treasurer, or vice president, or a manager that is authorized in accordance with Part IV, Section B,
Item (6) of the NCGO10000 General Permit. For more information on signatory requirements, see Part IV, Section B, Item
(6) of that permit.
Signature
S
Type Name* Anthony Eason
Title* VP of Engineering and Operations
Organization*
Pee Dee Electric Membership Corporation
Date *
01 /14/2022
Email Address*
[e-mail]
Email for confirmation
Telephone Number*
910-997-8941
Contact number if we need to reach you
Note: Original permittee and site contact are copied on modification correspondence.
Additional Email [e-mail]
(Optional) Additional email for confirmation
Original Permittee [e-mail]
Email
Original Site Contact [e-mail]
Email
Review Date 01/18/2022
Rescinded Since
Submitted?
Request Date 20220114
Formatted

Review Date 20220118
Formatted