SW6230401_Supplemental Info Review_20230509

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 5/9/2023 5:08:22 PM(Supplemental Submittal)
Accept by bethany.georgoulias 5/10/2023 9:25:04 AM (Supplemental Info Submittal)
• The task was assigned to bethany.georgoulias 5/9/2023 5:08:24 PM

=DEQ •
Submittal from 5/9/2023
Permit Information:
Please provide specific permit details below.
................................................................................................................................................................................................................................................................................................................................................................................................
What Type of Permit? Choose one:
* NPDES Industrial or MS4 Permit
State Stormwater(Post-Construction)Permit
Other
Permit Number* SW6230401
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* Phalanx Crossfit
Owner/Operator* Tammy Luikart
County: Harnett
Submitter Name:* Jarrod E. Hilliard, PE, CFM
Who is submitting this information?
E-mail Address:* [e-mail]
Phone Number* 919-352-2834
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* Response To Comments
File Upload Click the upload button,or drag and drop files to attach
Storm Water PERMITTING TRANSMITTAL-
30.85KB
230419.pdf
Only PDF files are accepted.
File Type* Plansheet-Notes
File Upload Click the upload button,or drag and drop files to attach
sheet C3.3 of plans.pdf 982.83KB
Only PDF files are accepted.

File Type* Plansheet-Proposed Conditions/Site Plan
File Upload Click the upload button,or drag and drop files to attach
sheet C2.0 of plans.pdf 2.91 MB
Only PDF files are accepted.
File Type* Supplement-EZ Form
File Upload Click the upload button,or drag and drop files to attach
Phalanx SuppEZ-2020-Version-2.1.3-revised
82.14KB
drainage areas sheet.pdf
Only PDF files are accepted.
Is this project funded No
with ARPA grant Yes
funds?
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)
cl 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');
o I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature;AND
cl I intend to electronically sign and submit the Supplemental Information Upload form.
Full Name:* Jarrod E. Hilliard
Signature:
r,4?r
Date Submitted: 05/09/2023

Initial Review
Verify Permit No.* IMPORTANT:REVIEWER SHOULD VERIFY and revise here if necessary.
SW6230401
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
Brianna Holland
Any Comments or
Added Info for CO
Staff Reviewer?
Review Date* 05/10/2023