20190752 Ver 6_Modification Request_20220720

Staff Review Form
NORTH CAROLINA
Envlronm¢ntcl Qvofiry
Updated September 4, 2020
Staff Review
Does this application have all the attachments needed to accept it into the review process?*
Yes No
ID# *
20190752
Version* 6
Is this project a public transportation project?*
Yes
• No
Reviewer List: * Paul Wojoski:EADS\pawojoski
Select Reviewing Office: * Central Office - [phone]
Does this project require a request for payment to be sent?*
Yes
No
How much is owed?* $240.00
$570.00

Project Submittal Form
*
Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all
mandatory questions are answered.
Project Type: *
For the Record Only (Courtesy Copy)
New Project
Modification/New Project with Existing ID
More Information Response
Other Agency Comments
Pre -Application Submittal
Re-Issuance\Renewal Request
Stream or Buffer Appeal
Pre -Filing Meeting Date Request was submitted on:
Project Contact Information
Name:
chris butler
Who is submitting the information?
Email Address: [e-mail]
Project Information
Existing ID #:
20190752
20170001 (no dashes)
Existing Version:
5
Project Name: Chemours - Seep C Flow -through Cell - Pilot Study Project and Flow
Is this a public transportation project?
Yes
No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
Yes No Unknown
County (ies)
Bladen
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach document
Chemours Fayetteville - Barrier Wall Project - 404
Mod Application.pdf
TR0795 GW Model Simulated Water Table
Assessment-Rev.pdf
Only pdf or kmz files are accepted.
Describe the attachments or
comments:
29.34MB
6.03MB
404 application and groundwater map

Sign and Submit
By checking the box and signing box below, I certify that:
• I, the project proponent, hereby certifies that all information contained herein is true, accurate, and complete to the
best of my knowledge and belief.
• I, the project proponent, hereby requests that the certifying authority review and take action on this CWA 401
certification request within the applicable reasonable period of time.
• I agree that submission of this online 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 online form.
Signature:
Submittal Date: 7/20/2022
Is filled in automatically.