NCC230243_NOI 124239 Payment Verification_20230127

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 1/26/2023 9:12:04 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 1/26/2023 9:20:19 AM (Review - NOI 124239 Circle K - Elk Rd & Legion Rd.)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 1/26/2023 9:12 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: January 31, 2023 5:00
PM. The priority is: High 1/26/2023 9:12 AM
by Workflow 1/26/2023 9:20:32 AM (Workflow Start Event)
Submit by Holloman, Tevye L 1/27/2023 7:49:04 AM (Payment Verification for NCC230243)
F Andrea Gonzalez
• Holloman, Tevye L assigned the task to Holloman, Tevye L 1/27/2023 7:48 AM
• The task was assigned to DEMLR NCG01 Payment Team. The due date is: March 9, 2023 5:00 PM. The
priority is: High 1/26/2023 9:20 AM

STA—
NORTH CAROLINA
Environmental Quallty
Project Name Circle K - Elk Rd & Legion Rd.
Lot Numbers (If listed on the eNOI)
NC Reference No.* NCG01-2023-0243
Certificate of NCC230243
Coverage (COC) No.*
Invoice Date 1/26/2023
Initial Invoice No. NCC230243-2023
Initial Fee $ 100.00
Invoice Due Date 2/25/2023
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 1/27/2023
Received * (Or, if not received, date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 673536795
Transaction Number*
NOI Tracking No. 124239
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-CUMBE-2022-Circle K - Elk Rd & Legion Rd.