NCC240052_NOI 176765 Payment Verification_20240108

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 1/5/2024 11:43:53 AM(NCG01 NOI Submission)
Approve by Brooklyn.Broussard 1/8/2024 6:43:00 AM(Review-NOI 176765 Pilot Store#549)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is:January 10,2024 5:00
PM 1/5/2024 11:44:02 AM
• The task was assigned to Brooklyn.Broussard by round robin distribution 1/5/2024 11:44:02 AM
Submit by Tev.Holloman 1/8/2024 11:10:24 AM(Payment Verification for NCC240052)
0 Brad Alsup
• The task was assigned to DEMLR NCG01 Payment Team.The due date is: February 19,2024 5:00 PM
1/8/2024 6:43:15 AM
• Tev.Holloman assigned the task to Tev.Holloman 1/8/2024 11:09:59 AM

Payment Verification
NORTH CAROLINA
Environmental Quality
Project Name Pilot Store#549
Is this project funded with ARPA(American Rescue Plan Act)grant funds?
No
Yes
CONFIRMED ARPA Project Number(if applicable)
Lot Numbers (If listed on the eNOl)
NC Reference No.* NCG01-2024-0052
Certificate of NCC240052
Coverage(COC)No.*
Invoice Date 1/8/2024
Initial Invoice No. NCC240052-2024
Initial Fee $ 120.00
Invoice Due Date 2/7/2024
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 1/8/2024
Received* (Or,if not received,date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 727505218
Transaction Number*
NOI Tracking No. 176765
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-SURRY-2024-Pilot Store#549