SW6231104_Supplemental Info Review_20231115

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 11/15/2023 11:58:43 AM(Supplemental Submittal)
Accept by Kaitlin Peck 11/16/2023 10:02:49 AM(Supplemental Info Submittal)
• The task was assigned to Kaitlin Peck 11/15/2023 11:58:44 AM

=DEQ •
Submittal from 11/15/2023
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* SW6231104
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* Tractor Supply Store-West End
Owner/Operator* West End Development Group, LLC
County: Moore
Submitter Name:* Branch Smith
Who is submitting this information?
E-mail Address:* [e-mail]
Phone Number* 9107916707
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* Application Form
File Upload Click the upload button,or drag and drop files to attach
Application.pdf 2.08MB
Only PDF files are accepted.
File Type* Design Calculations
File Upload Click the upload button,or drag and drop files to attach
SW-EC Narrative WE TSC.pdf 5.86MB
Only PDF files are accepted.
File Type* Development Agreement

File Upload Click the upload button,or drag and drop files to attach
Deeds-Purchase Agreement.pdf 3.84MB
Only PDF files are accepted.
File Type* O&M Agreement/Plan
File Upload Click the upload button,or drag and drop files to attach
O-M Signed.pdf 295.76KB
Only PDF files are accepted.
File Type* Plansheet-Grading/Drainage Plan
File Upload Click the upload button,or drag and drop files to attach
SW-1.pdf 998.51 KB
Only PDF files are accepted.
File Type* Plansheet-Misc. Detail
File Upload Click the upload button,or drag and drop files to attach
SW-2 DET.pdf 862.26KB
Only PDF files are accepted.
File Type* Property Deed
File Upload Click the upload button,or drag and drop files to attach
Deeds-Purchase Agreement.pdf 3.84MB
Only PDF files are accepted.
File Type* Supplement-EZ Form
File Upload Click the upload button,or drag and drop files to attach
Supplement.pdf 722.46KB
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:
o I have given true,accurate,and complete information on this form;
o 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")
o 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
o I intend to electronically sign and submit the Supplemental Information Upload form.

Full Name:* Branch Smith
Signature:
�tarr/�iir�7f
Date Submitted: 11/15/2023

Initial Review
Verify Permit No.* IMPORTANT:REVIEWER SHOULD VERIFY and revise here if necessary.
SW6231104
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
Jim Farkas
Any Comments or
Added Info for CO
Staff Reviewer?
Review Date* 11/16/2023