NCC215566_Annual Fee NOD Review_20221117

Action History (UTC-05:00) Eastern Time (US & Canada)
by Workflow 9/29/2022 9:03:57 AM (Workflow Start Event)
Submit by Holloman, Tevye L 11/16/2022 11:16:40 AM (2022 Annual Fee Payment Verification for NCC215566-
2022)
• Holloman, Tevye L assigned the task to Holloman, Tevye L 11/16/2022 11:16 AM
• The task was assigned to DEMLR NCG01 Annual Fee Team. The due date is: November 10, 2022 5:00
PM 9/29/2022 9:04 AM
Submit by Clark, Paul B 11/17/2022 11:01:35 PM (NOD Review Step - 2022 Fees)
0 COC to be rescinded
• Clark, Paul B assigned the task to Clark, Paul B 11/17/2022 11:01 PM
• The task was assigned to DEMLR NCG01 NOD Team. The due date is: January 15, 2023 5:00 PM
11/16/2022 11:17 AM

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NORTH CAROLINA
Envlrmmm(af Quafhy
Certificate of NCC215566
Coverage (COC) No.*
NC Reference COC NCG01-2021-5566
No.*
Permit Status:
Active
This status is updated (not passed from Payment Form)
Already Rescinded?
Look -up re -checks this date (it is not passed from the Payment Form)
Project Name*
Good Hope Hospital
Project Address*
410 Denim Drive, Erwin, NC
Permittee*
Good Hope Hospital, Inc
County Harnett
Invoice No.* NCC215566-2022
Annual Fee* $ 100.00
Invoice Date* 10/1/2022
Invoice Due Date* 11/1/2022
Date NOD sent for no 11/16/2022
payment*
At the time non -receipt was recorded and the NOD was sent, the payment was 15 days overdue. At that time, the permit
status was Active. The fee status remains PAST DUE unless resolved at this review step.
Permittee E-mail* [e-mail]
(Where NOD letter was sent)
Permittee E-mail [e-mail]
(Current) * Looked up again in case there have been changes.
CONFIRM Permittee [e-mail]
E-mail * Opportunity to modify problem e-mail address or legally responsible person
Site Contact E-mail*
[e-mail]
(Where NOD letter was sent)
Site Contact E-mail
[e-mail]
(Current) *
Looked up again in case there have been changes.
CONFIRM Site
[e-mail]
Contact E-mail*
Opportunity to correct problem e-mail address or site contact info

Billing E-mail [e-mail]
(If available)
Billing E-mail [e-mail]
(Current) (If available) Looked up again in case there have been changes.
CONFIRM Billing E- [e-mail]
mail Opportunity to correct problem e-mail address or billing contact info
Billing Telephone No. 910-897-6996
Additional Billing Contact E-mails
Additional E-mail for
CC:
Days Overdue 16
This is how many days overdue the fee is now (at NOD review).
Days Since NOD 1
Sent* Wait 30 days before proceeding to NOV.
Has Payment Been Payment has been resolved (PAID).
Resolved?* Payment has been resolved (WAIVED).
NO. Payment has not been resolved (PROCEED TO NOV).
Date Payment 11/17/2022
Received or
Resolved *
ePayment
Transaction Number*
Check Number*
Fee Status* WAIVED
Compliance Review 11/17/2022
Date *