SWA000171_Supplemental Info Review_20221011

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/11/2022 2:06:08 PM (Supplemental Submittal)
Submit by Tran, Kieu M 10/14/2022 2:35:26 PM (Supplemental Info Submittal)
• The task was assigned to Tran, Kieu M 10/11/2022 2:06 PM

Submittal from 10/11/2022
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*
SWA000171
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* Faith Charter School
Owner/Operator*
Faith Charter School
County:
Rowan
Submitter Name: *
Don Sever
Who is submitting this information?
E-mail Address:*
[e-mail]
Phone Number*
9198107950
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
SSW Fast Track ATC Form 20180210 FINAL Faith
787.46KB
Charter updated .pdf
Only PDF files are accepted.
File Type* Plansheet - Cover Sheet
File Upload Click the upload button, or drag and drop files to attach
2022-08-05 21-0196-Faith-Charter-School-Plans to
6.16MB
deq updated.pdf
Only PDF files are accepted.

File Type*
File Upload
File Type*
File Upload
File Type*
File Upload
File Type*
File Upload
Property Deed
Click the upload button, or drag and drop files to attach
db1401 pg385.pdf
Only PDF files are accepted.
Property Deed
Click the upload button, or drag and drop files to attach
dbl40lpg386.pdf
Only PDF files are accepted.
USGS Topographic Site Map
Click the upload button, or drag and drop files to attach
faith charter usgs.pdf
Only PDF files are accepted.
Signing Official Title & Position Information
223.62KB
232.82KB
532.84KB
Click the upload button, or drag and drop files to attach
North Carolina Secretary of State Search Results.pdf 72.47KB
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: * Donald Allen Sever
Signature:
Date Submitted: 10/11/2022

Initial Review
Verify Permit No.* IMPORTANT. REVIEWER SHOULD VERIFY and revise here if necessary.
S WA000171
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 Owner name doesnt match with BIMS
Added Info for CO
Staff Reviewer?
Review Date* 10/14/2022