NCC230268_NOI 124479 Payment Verification_20230131

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 1/27/2023 10:23:11 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 1/27/2023 10:30:17 AM (Review - NOI 124479 Stratford Richardson YMCA -
Clinic)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 1/27/2023 10:24 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: February 1, 2023 5:00
PM 1/27/2023 10:24 AM
by Workflow 1/27/2023 10:30:36 AM (Workflow Start Event)
Submit by Holloman, Tevye L 1/31/2023 12:20:06 PM (Payment Verification for NCC230268)
F Jon Bontrager
• Holloman, Tevye L assigned the task to Holloman, Tevye L 1/31/2023 12:19 PM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: March 10, 2023 5:00 PM
1/27/2023 10:30 AM

STA—
NORTH CAROLINA
Environmental Quallty
Project Name Stratford Richardson YMCA - Clinic
Lot Numbers (If listed on the eNOI)
NC Reference No.* NCG01-2023-0268
Certificate of NCC230268
Coverage (COC) No.*
Invoice Date 1/27/2023
Initial Invoice No. NCC230268-2023
Initial Fee $ 100.00
Invoice Due Date 2/26/2023
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 1/31/2023
Received * (Or, if not received, date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 674102691
Transaction Number*
NOI Tracking No. 124479
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-MECKL-2023-Stratford Richardson YMCA - Clinic