SW6220801_Supplemental Info Review_20220816

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 8/16/2022 8:06:51 PM (Supplemental Submittal)
Submit by Tran, Kieu M 8/17/2022 7:46:39 AM (Supplemental Info Submittal)
• The task was assigned to Tran, Kieu M 8/16/2022 8:06 PM

Submittal from 8/16/2022
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*
SW6220801
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* Shiloh
Owner/Operator*
BS Land, LLC
County:
Harnett
Submitter Name: *
Fleet Temple
Who is submitting this information?
E-mail Address:*
[e-mail]
Phone Number*
9106582446
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*
Application Form
File Upload
Click the upload button, or drag and drop files to attach
Stormwater ManagementPermit Application Form.pdf 8.21 MB
Only PDF files are accepted.
File Type*
Deed Restriction/Protective Covenant Form
File Upload
Click the upload button, or drag and drop files to attach
Deed Restrictions & Covenants.pdf 730.91 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
O-M-EZ-SIGNED.pdf
726.33KB
Only PDF files are accepted.
File Type*
Plansheet - Grading/Drainage Plan
File Upload
Click the upload button, or drag and drop files to attach
C2.0.pdf
1.88MB
Only PDF files are accepted.
File Type*
Plansheet - Grading/Drainage Plan
File Upload
Click the upload button, or drag and drop files to attach
C2.1.pdf
1.39MB
Only PDF files are accepted.
File Type*
Plansheet - Grading/Drainage Plan
File Upload
Click the upload button, or drag and drop files to attach
C2.2.pdf
1.22MB
Only PDF files are accepted.
File Type*
Plansheet - Misc. Detail
File Upload
Click the upload button, or drag and drop files to attach
C9.1.pdf
4.47MB
Only PDF files are accepted.
File Type*
Property Deed
File Upload
Click the upload button, or drag and drop files to attach
db1178-903.pdf
116.73KB
Only PDF files are accepted.
File Type*
Stormwater Narrative
File Upload
Click the upload button, or drag and drop files to attach
Project Narrative.pdf
137.12KB
.........
Only PDF files are accepted.
......... .........
File Type*
Supplement-EZ Form
File Upload
Click the upload button, or drag and drop files to attach
Supp EZ Signed.pdf
1.95MB
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 Quad with Site.pdf
1.61 MB
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')
o 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');
o I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
o I intend to electronically sign and submit the Supplemental Information Upload form.
Full Name:* Peter E. Norfleet Temple
Signature:
-t cis: ,/ -,, /,
Date Submitted: 08/16/2022

Initial Review
Verify Permit No.* IMPORTANT. REVIEWER SHOULD VERIFY and revise here if necessary.
SW6220801
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* 08/17/2022