NCC223336_NOI 106177 Payment Verification_20220923

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 9/22/2022 8:37:50 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 9/22/2022 9:10:26 AM (Review - NOI 106177 4617 Archdale Road (Lancaster
Customworks))
• The task was assigned to Broussard, Brooklyn C by round robin distribution 9/22/2022 8:38 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: September 27, 2022 5:00
PM 9/22/2022 8:38 AM
by Workflow 9/22/2022 9:10:32 AM (Workflow Start Event)
Submit by Holloman, Tevye L 9/23/2022 8:17:25 AM (Payment Verification for NCC223336)
* Lancaster Customworks Inc
• Holloman, Tevye L assigned the task to Holloman, Tevye L 9/23/2022 8:16 AM
• The task was assigned to DEMLR NCG01 Payment Team. The due date is: November 3, 2022 5:00 PM
9/22/2022 9:10 AM

STA—
NORTH CAROLINA
Environmental Quallty
Project Name 4617 Archdale Road (Lancaster Customworks)
Lot Numbers (If listed on the eNOI)
NC Reference No.* NCG01-2022-3336
Certificate of NCC223336
Coverage (COC) No.*
Invoice Date 9/22/2022
Initial Invoice No. NCC223336-2022
Initial Fee $ 100.00
Invoice Due Date 10/22/2022
Important: If you change the choice below to Payment NOT RECEIVED, the application will be rejected, and a COC will
not be issued. This is the ONLY way to reject an eNOI at this step.
Payment Received* Payment Received.
Payment NOT RECEIVED.
Payment Status PAID
Date Payment 9/23/2022
Received * (Or, if not received, date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 654375609
Transaction Number*
NOI Tracking No. 106177
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-RANDO-2022-4617 Archdale Road (Lancaster Customworks)