NCC233290_NOI Application_20231108

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 11/2/2023 11:12:58 AM (NCG01 NOI Submission)
Approve by Brooklyn.Broussard 11/3/2023 6:21:29 AM (Review-NOI 167251 TL-81 Transmission Line Rebuild
Phase I Carolina to TL 239 Junction)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is: November 7,2023 5:00
PM.The priority is: High 11/2/2023 11:13:06 AM
• The task was assigned to Brooklyn.Broussard by round robin distribution 11/2/2023 11:13:06 AM
Submit by Tev.Holloman 11/8/2023 2:13:18 PM (Payment Verification for NCC233290)
•Elizabeth H Hurst
• The task was assigned to DEMLR NCG01 Payment Team.The due date is: December 15,2023 5:00 PM.
The priority is: High 11/3/2023 6:21:44 AM
• Tev.Holloman assigned the task to Tev.Holloman 11/8/2023 2:12:49 PM

applicationConstruction Stormwater: Notice of Intent (NOI)
National Pollutant Discharge Elimination System(NPDES)
General Permit 1 OOOO:STORMWATER DISCHARGES associated with construction activities
NORTH CAROUNA
Environmental Quality
A. Project Information
Part A.
Project Location and Waterbody Information
...................................................................................................................................................................................................................................................................................................................................................................................................
Are you submitting an NOI that was rejected before?
No
Yes
Previous Rejected NOI No.
167056
Prior Reviewer Name
Brooklyn Broussard
1a. Project Name*
TL-81 Transmission Line Rebuild Phase I Carolina to TL 239 Junction
1b.Specific Lot Numbers
This field may be used to list specifc lot numbers.
Please see tab D. ESC Plan for Halifax County Parcel Numbers
1c.Parcel ID Number(s)(PIN)
List all PINS associated with this project.
Please see tab D. ESC Plan for Halifax County Parcel Numbers
2.County*
Halifax
3.Highway or Street Address*
VEPCO Street to East 5th Street
Street name only is acceptable if no address number assigned yet
4.City or Township*
Halifax
5.State* NC
6.Zip Code* 27870
7. Latitude* Enter the latitude in decimal degrees
36.4799
8. Longitude* Enter the longitude in decimal degrees(MUST be negative)
-77.6477
If you do not know the latitude and longitude coordinates for this project,you can search the location on this map of North
Carolina. Look for the coordinates in the bottom left corner.

9. Date to Begin* 01/01/2024
Estimated Construction Project Start Date
10. Date to End* 01/31/2025
Estimated Construction Project End Date
11.SIC(Primary)*
Other(9999)
Standard Industrial Classification for Development
12.Acres to be 6.60
disturbed* (including off-site borrow and waste areas)
13.Total site area 65.10
(acres)*
14. Post-construction 0.00
impervious area (Estimated)
(acres)*
Project Tracking ID NCC-HALIF-2024-TL-81 Transmission Line Rebuild Phase I
Carolina to TL 239 Junction
Assigned automatically(not used)
Below you must enter waterbody information for surface waters affected by this project. Please consult
DWR's Surface Water Classifications Map Viewer to find waterbody name and corresponding index number. Please enter
only immediate receiving waterbodies-not waters downstream of those unless the project extends there. You may enter
up to 3 waterbodies if needed.
15a.Receiving Waterbody*
Roanoke River
Name of waterbody into which stormwater runoff will discharge
15b.Waterbody Index No.*
23-(25.5)
NC Waterbody Index Number
Stormwater discharges will flow to additional waters*
No
Yes
15c.Additional Receiving Waterbody
Chockoyotte Creek
Waterbody name
15d.Waterbody Index No.
23-29
NC Waterbody Index Number
15e.Additional Receiving Waterbody
Quankey Creek
Waterbody name
15f.Waterbody Index No.
23-30
NC Waterbody Index Number
16a.Is this project subject to the NC Sediment Pollution Control Act?*
Yes
No, not subject to NC SPCA

17. Is this project funded with ARPA(American Rescue Plan Act)grant funds?
No
Yes
This question was added to the eNOl on 1/26/2023 and will not be answered in applications submitted prior to that date.

B. Permittee Information
Part B.
Permittee Information-Legally Responsible Entity and Individual
......................................................................................................................................................................
Important:The person who signs the NOI Certification Form and signs the Certification in Section E of this application
form must be the same person as listed in THIS SECTION,or an authorized responsible individual within the same
organization. That person must be a responsible corporate officer who owns or operates the construction activity,such as
a president,secretary,treasurer,or vice president,or a manager that is authorized in accordance with Part IV,Section B,
Item(6)of the NCG010000 General Permit. For more information on signatory requirements,see Part IV,Section B,
Item(6)of that permit.
1. Permittee*
Legally Responsible Entity
Virginia Electric&Power Company d/b/a Dominion Energy North Carolina
If permittee is an individual,enter first and last name in this field.Otherwise,enter organization/business name.
Note: If the permittee is a business,the business must be registered with the INC Secretary of State.You can verify the
registration here. Permittee must be the same entity that is responsible for the land-disturbing activity as listed on the NC
SPCA Financial Responsibility/Ownership(FRO)Form.
2. First Name* Kevin
If Corporation,enter Registered Agent First Name
3. Last Name* Field
If Corporation,enter Registered Agent Last Name
3b.Title Authorized Representative, Director-ET Project Management
Organization
4. Permitee E-mail Address*
[e-mail]
5. Permittee Telephone No.*
804-592-9348
6. Permittee Mailing Address*
Street Address
5000 Dominion Boulevard
Address Line 2
City State/Province/Region
Glen Allen VA
Postal/Zip Code Country
23060 us
Check box if the street address the same as mailing address
Yes

7.Permittee Street Address
Street Address
5000 Dominion Boulevard
Address Line 2
City State/Province/Region
Glen Allen VA
Postal/Zip Code Country
23060 US
8.Type of Ownership*
Ownership is only individual if an individual is named in 13.1.above.
Non-Government

C. Site Contact Information
Part C.
Project Site Contact Information
................................................................................................................................................................................................................................................................................................................................................................................................
1. Primary Site Contact-First Name*
Tom
2. Primary Site Contact-Last Name*
Miller
3.Title
[e-mail]
4.Site Contact E-mail Address*
[e-mail]
5.Site Contact Telephone No.*
804-239-6434
6.Organization Name
Dominion Energy North Carolina
7.Site Contact Mailing Address*
Street Address
5000 Dominion Boulevard
Address Line 2
City State/Province/Region
Glen Allen VA
Postal/Zip Code Country
23060 us
8.Consultant Name
(Optional)
Andrew Dahlman
First and Last name
9.Consultant E-mail
[e-mail]
This person will be copied on all correspondence.
10.Consultant Telephone No.
804-767-4712
11. Billing E-mail
(For Annual Fee correspondence)
[e-mail]
Default is legally responsible person e-mail
12. Billing Telephone
(For Annual Fee correspondence)
804-592-9348
Default is legally responsible person telephone

D. E&SC Plan
Part D.
Erosion&Sediment Control(E&SC)Plan Approval Information
......................................................................................................................................................................
1. Date E&SC Plan 10/23/2023
Approved*
2. E&SC Plan Project HALIF-2024-001
Number/ID* Assigned by agency or local program
3. E&SC Plan State DEQ Office
Approved by* Local Program
4.State DEQ Office* Raleigh (RRO)
Documentation of E&SC Plan approval and the signed Notice of Intent(NOI)Certification Form is required for a
complete application. Please also upload a site map showing the overall extent of the project(for linear projects,can
include the beginning point and end point coordinates in the"Notes"box below).
5. E&SC Plan HALIF-2024-001_20231023_LOA.pdf 313.73KB
Approval letter or Must be PDF format
Grading Permit
6.Signed FRO Financial Responsibility/Ownership Form
Dominion-FRO-TL81 Phase 1 -2023.10.12.pdf 1.04MB
Must be PDF format
7.Site Location Map Must be PDF format(limit 20 MB)
Phase I Overview Map for TL 81.pdf 1.43MB
Please do not upload entire set of E&SC plans.
8. Notes(Optional) Provide any additional information that might help the reviewer better understand how uploaded documents
support the application.Include additional waterbodies if necessary.
MAP ID, HALIFAX PARCEL#, LANDOWNER NAME
301 0600418 HEDGEPETH, MICHAEL A
302 0600351 GARNER, RAYMOND P JR
303 0619997 ROANOKE ELECTRIC MEMBERSHIP
CORPORATION
304 0619855 JONES,JOSEPH M
305 0601245 R.E.A.,
306 0600668 MOHORN, BENTLEY J
307 0601144 RICKS, PHILLIP LEE
308 0600554 JONES, EDMOND F
309 0600166 BRADLEY, RICKY THOMAS
310 0500251 HUX, NANCY MORRIS
311 0600324 HATCHER,GLEN CARLTON JR
312 0500108 BEST,JANNELL J
313 0600843 ELIAS FARMS LLC
314 0500350 GARDNER, ROBERT PAGE
315 0530063 KEENE, SHARON BEST
316 0500728 HEDGEPETH, MICHAEL A
317 0500727 MATTHEWS, DOROTHY WILLIAMS
318 0501098 MATTHEWS, DOROTHY W
319 0530379 FLYNN, ERRON J
320 0500635 MATTHEWS, CATHY L
321 0500101 HEDGEPETH, MICHAEL A
322 0500344 TALL COTTON FARMS LLC
323 0530086 FLEMING. BONNY A

324 0500343 TALL COTTON FARMS LLC
325 0501740 TALL COTTON FARMS LLC
326 0501348 TALL COTTON FARMS LLC
327 0500351 WILSON, MARTHA GARDNER
328 0501630 WARREN, DAN&MARIE
329 0500410 TALL COTTON FARMS LLC
330 0501631 WARREN, GROVER C JR
331 0530155 WARREN, GROVER CLEVELAND JR
332 0500186 J&AM PROPERTY LIMITED LLC
333 0501097 HEWLIN,SEMORA LAVERNE
334 0530279 BENFORD,JERRY ALFORD TRUST
335 0501787 BENFORD,JERRY ALFORD TRUST
336 0501171 HEWLIN, LINETTE
337 0501052 WARREN, FRANK DONALD
338 0501197 NORTH CAROLINA NATURAL GAS,
339 0500099 GARNER, SHERRY B
340 0501174 HEWLIN, RICHARD P
341 0530351 HEWLIN, BENITA
342 0501555 WILLIAMS,JAMES ERIC
343 0501149 WILLIAMS, CAROL
344 0501147 WILLIAMS, CAROL
345 0500899 SCOTT, MARY R HEIRS
346 0501077 WHITEHEAD,J D JR
347 0400789 COLLINS, REGINALD H
348 0401271 WHITETAIL RIDGE FARM LLC
349 0401272 COLLINS, REGINALD H
350 0401273 COLLINS, REGINA H
351 0401923 BARNHILL, MAURICE G 3/5 UNDIV INT
352 0402778 SOLOMON, KARLA L
353 0401162 TALL COTTON FARMS LLC
354 0401950 RIDDLE,VICKIE NEVILLE
355 0403710 WARREN, MARIE
356 0405146 JOHNSON, MITTIE RUTH
357 0405076 BARNES, ERIC L
358 0403665 LOWERY, GEORGE A
359 0405357 WARREN, KIP S
360 0405454 BAKER,ALBERT M JR
361 0405115 WILLIAMS,ALINE HEIRS
362 0404147 BARNES, BRENDA ANN
363 0400393 BELLAMY,VOTTIE D(LIFE ESTATE)
364 0400385 WARREN, KIP S
365 0405447 WARREN, KIP S
366 0403482 WARREN, KIP S
367 0403483 WARREN, KIP S
368 0403485 WARREN, KIP S
369 0403484 WARREN, KIP S
370 0401729 B R&S K TAYLOR FARMS INC,
371 0401136 HALE,JO ANN
372 0402358 PHILIPS, FRANK PARKER III TRUSTEE
373 0403780 ENFIELD COTTON GINNERY, LLC
374 0401141 HALE,JO ANN
375 0402359 PHILIPS, FRANK PARKER III TRUSTEE
376 0400117 JAVALU FARMS INC,
377 0402919 TURNER, HUBERT RAY
378 0402920 TURNER, HUBERT RAY
379 0402186 HEDGEPETH, MICHAEL A
380 0405540 TURNER, HUBERT RAY
381 0405528 HEDGEPETH, MICHAEL A
9. NOI Certification Signed NOI.pdf 61.92KB
Form Must be PDF format

This is an Express No
Review Project* Yes

E. Certification
North Carolina General Statute 143-215.613(1)provides that:
Any person who knowingly makes any false statement,representation,or certification in any application,record,report,plan,or other document
filed or required to be maintained under this Article or a rule implementing this Article;or who knowingly makes a false statement of a material
fact in a rulemaking proceeding or contested case under this Article;or who falsifies,tampers with,or knowingly renders inaccurate any recording
or monitoring device or method required to be operated or maintained under this Article or rules of the Commission implementing this Article shall
be guilty of a Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars($10,000).
Under penalty of law, I certify that:
* I am the person responsible for the construction activities of this project,for satisfying
the requirements of this permit,and for any civil or criminal penalties incurred due to
violations of this permit.
* The information submitted in this NOI is,to the best of my knowledge and belief,true,
accurate,and complete based on my inquiry of the person or persons who manage the
system,or those persons directly responsible for gathering the information.
* I will abide by all conditions of the NCG010000 General Permit and the approved
Erosion and Sediment Control Plan.
* I hereby request coverage under the NCG010000 General Permit and understand that
coverage under this permit will constitute the permit requirements for the discharge(s)
and is enforceable in the same manner as an individual permit.
Specify if you are:* The Legally Responsible Person named on this Notice of Intent
Authorized Responsible Person'(signing on behalf of Legally Responsible Person
named in Part B)
Important:The person who electronically signs this Certification above must be the same person who signs the NOI
Certification Form. If that person is signing on behalf of the Permittee,that individual must be an authorized responsible
person within the same organization as the Permittee.
'An authorized individual is a responsible corporate officer who owns or operates the construction activity,such as a
president,secretary,treasurer,or vice president,or a manager that is authorized in accordance with Part IV, Section B,
Item(6)of the NCG010000 General Permit. For more information on signatory requirements,see Part IV,Section B,
Item(6)of that permit.
Signature
G)16�;W q"11
Type Name* Kevin Fields
Title Authorized Representative, Director-ET Project Management
Organization
Organization Legally Responsible Entity
Virginia Electric&Power Company d/b/a Dominion Energy North
Carolina
Date* 11/02/2023

F. Tracking and COC Info
NOI Tracking No. 167251
NC Reference No. NCG01-2023-3290
Indicates NCG01 or NCG25.Uses NOI number until approved,then uses NUMBER incremented by SIP(passed
from workflow if eNOI approved)
Certificate of NCC233290
Coverage(COC) No.* Uses NOI number until approved,then uses NUMBER incremented by SIP(formatted and passed from workflow if
eNOI approved)
Initial Invoice No. NCC233290-2023
Invoice Due Date 12/3/2023
Initial Fee $ 120.00
Fee increased to$120,effective October 3,2023
Invoice Status OPEN