SW5220601_Supplemental Info Review_20220712

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 7/12/2022 8:00:19 AM (Supplemental Submittal)
Submit by Tran, Kieu M 7/13/2022 9:40:11 AM (Supplemental Info Submittal)
• The task was assigned to Tran, Kieu M 7/12/2022 8:00 AM

Submittal from 7/12/2022
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*
SW5220601
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* Community Baptist Church
Owner/Operator* Community Baptist Church of Siler City, Inc.
County: Chatham
Submitter Name: * Zachary Gardner PE - Summey Engineering Associates, PLLC
Who is submitting this information?
E-mail Address:* [e-mail]
Phone Number* 336-328-0902
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*
Application Form
File Upload
Click the upload button, or drag and drop files to attach
2 - NC SW Permit App - Signed.pdf 514.81 KB
.........................
Only PDF files are accepted.
File Type*
O&M Agreement/Plan
File Upload
Click the upload button, or drag and drop files to attach
5 - O&M Agreement.pdf 158.19KB
..........................................
Only PDF files are accepted.
.............................................................
File Type*
Supplement-EZ Form

File Upload
Click the upload button, or drag and drop files to attach
6 - Supplement Form - Signed.pdf
233.93KB
Only PDF files are accepted.
File Type*
Stormwater Report
File Upload
Click the upload button, or drag and drop files to attach
7 - 2022-05-19 SW Report - Comm Baptist.pdf
2.68MB
Only PDF files are accepted.
File Type*
Wetland Determination/Report
File Upload
Click the upload button, or drag and drop files to attach
3 - Wetlands Assessment - Sealed.pdf
101.66KB
Only PDF files are accepted.
File Type*
Plansheet - Cover Sheet
File Upload
Click the upload button, or drag and drop files to attach
7 - Cover.pdf
150.16KB
.................................................
Only PDF files are accepted.
File Type*
Plansheet - Notes
File Upload
Click the upload button, or drag and drop files to attach
8 - Notes.pdf
679.58KB
Only PDF files are accepted.
File Type*
Plansheet - Existing Conditions/Survey
File Upload
Click the upload button, or drag and drop files to attach
9 - Ex Cond.pdf
523.52KB
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
10 - Overall Site.pdf
630.94KB
..............................................................................................................
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
11 -Prop Site Plan.pdf
856.22KB
Only PDF files are accepted.
File Type*
Plansheet - Grading/Drainage Plan
File Upload
Click the upload button, or drag and drop files to attach
12 - Grading.pdf
2.27MB
...........................................................................
Only PDF files are accepted.
.................................
File Type*
Plansheet - Landscape/Planting Plan
File Upload
Click the upload button, or drag and drop files to attach
13 - Landscaping.pdf
1.12MB
Only PDF files are accepted.
File Type*
Plansheet - Misc. Detail

File Upload Click the upload button, or drag and drop files to attach
14 - Details.pdf 8.82MB
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:* Zachary Gardner
Signature:
Date Submitted: 07/12/2022

Initial Review
Verify Permit No.* IMPORTANT. REVIEWER SHOULD VERIFY and revise here if necessary.
SW5220601
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* 07/13/2022