NCC223787_NOI 112159 Payment Verification_20221109

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 11/8/2022 10:25:56 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 11/8/2022 10:36:17 AM (Review - NOI 112159 Wake Veterinary Hospital)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 11/8/2022 10:26 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: November 11, 2022 5:00
PM 11/8/2022 10:26 AM
by Workflow 11/8/2022 10:36:24 AM (Workflow Start Event)
Submit by Holloman, Tevye L 11/9/2022 8:10:59 AM (Payment Verification for NCC223787)
F Rowdy Ridgebacks
Holloman, Tevye L assigned the task to Holloman, Tevye L 11/9/2022 8:10 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 20, 2022 5:00
PM 11/8/2022 10:36 AM

STA—
NORTH CAROLINA
Environmental Quallty
Project Name Wake Veterinary Hospital
Lot Numbers (If listed on the eNOI)
NC Reference No.* NCG01-2022-3787
Certificate of NCC223787
Coverage (COC) No.*
Invoice Date 11/8/2022
Initial Invoice No. NCC223787-2022
Initial Fee $ 100.00
Invoice Due Date 12/8/2022
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 11/9/2022
Received * (Or, if not received, date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 661612048
Transaction Number*
NOI Tracking No. 112159
Tracking ID referenced upon submittal
This is an Express • No
Review Project Yes
Project Tracking ID NCC-WAKE-2022-Wake Veterinary Hospital