SW5140801_Annual Certification Summary (2024)_20240111

Section A-Project Information
Permit Number: SW5140801 Project Town/City: Butner
Project Name: NCNG Camp Butner Training Center ACFT Project County: Granville
Permit issued: 12/8/2022 Project Status: underway
Section B-Permittee Information
Name: North Carolina National Guard Street Address: Mailing Address:
Signing Official: Rodney Newton 1636 Gold Star Dr 1636 Gold Star Dr
Title: CFMO Suite 3600,CFMO Suite 3600,CFMO
Phone Number: 919-345-6137 Raleigh,NC 276076410 Raleigh,NC 27607
Email Address: [e-mail]
Section C-Property Owner Information
Name: North Carolina National Guard Street Address: Mailing Address:
Signing Official: Rodney Newton 1636 Gold Star Dr 1636 Gold Star Dr
Title: CFMO Suite 3600,CFMO Suite 3600,CFMO
Phone Number: 919-345-6137 Raleigh,NC 27607 Raleigh,NC 27607
Email Address: [e-mail]
Section D-Site Conformance with Permitting Conditions
Max BUA not exceeded? Yes Veg.setbacks per plans? Yes Site is as shown on plans? Yes
SCM BUA not exceeded? Yes Easements recorded? NA Designer Cert.submitted? NA
Lot BUA not exceeded? Yes O&M Agreemt recorded? Yes O&M being performed? Yes
BUA as shown on plans? Yes O&M Agreemt on plats? NA No maintenance issues? Yes
SCM/LD area per plans? Yes Deed Restrict.recorded? NA Maint.records being kept? Yes
SCM/LD area accessible? Yes O&M done per E&SC? Yes Permit is active? Yes
Stormwater outlets stable? Yes SCMs fixed when done? Yes Other conditions met? Yes
See Attachment A for a list of all N/A explanations to the above items.
Section E-Plan to Bring the Project info Conformance
Project is in conformance with all permit conditions.
Section F-Project Certifier Information
Certifier Signing: FRANCIS SLINSKY Street Address: Mailing Address:
Title: PE,CIVIL ENGINEER 5410 TRINITY RD 5410 TRINITY RD
Phone Number: 919-866-4505 SUITE 102 SUITE 102
Email Address: [e-mail] RALEIGH,NC 27607 RALEIGH,NC 27607
Section G-Certification
The information in this form is true,accurate,and complete? Yes
The project is in conformance with all permit conditions? Yes
Electronically signed by FRANCIS SLINSKY on January 11,2024.

ATTACHMENT A
Explanation about why"NIA"items above are not applicable to this project.
Max BUA not exceeded N/a:
SCM BUA not exceeded N/a:
Lot BUA not exceeded N/a:
BUA as shown on plans N/a:
SCM/LD area per plans N/a:
SCM/LD area accessible N/a:
Stormwater outlets stable N/a:
Veg.setbacks per plans N/a:
Easements recorded N/a: This is state property and no easement was required by NCDEQ
O&M Agreemt recorded N/a:
O&M Agreemt on plats N/a: This is state property.There is no final plat associated with this project.
Deed Restrict.recorded N/a: This is state property.There is no Deed restrictions/protective covenances associated with this project.
O&M done per E&SC N/a:
SCMs fixed when done N/a:
Site is as shown on plans N/a:
Designer Cert.submitted N/a: The project is still under construction.The certification will be issued shortly when the project is completed
O&M being performed N/a:
No maintenance issues N/a:
Maint.records being kept N/a:
Permit is active N/a:
Other conditions met N/a: