NCG020783_Supplemental Info Review (Dormant Status Renewal)_20240112

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 1/12/2024 11:25:17 AM (Supplemental Submittal)
Accept by bethany.georgoulias 1/17/2024 12:18:59 PM(Supplemental Info Submittal)
0 Monitoring suspension/Dormancy status already recorded in BIMS for stormwater outfall 001,
effective 7/1/2021.
• The task was assigned to Kaitlin Peck 1/12/2024 11:25:18 AM
• Kaitlin Peck reassigned the task to bethany.georgoulias 1/12/2024 12:14:33 PM

pEQNC Stormwater - Supplemental Information Upload
Submittal from 1/12/2024
Permit Information:
Please provide specific permit details below.
...................................................................................................................................................................................................................................................................................................................................................................................................
What Type of Permit? Choose one:
* 0 NPDES Industrial or MS4 Permit
0 State Stormwater(Post-Construction)Permit
Other
Permit Number* NCG020783
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)
.................................................................................................................................................................................................................................................................................................................................................................................................
Facility Name* Henrietta Quarry
For NPDES permits
Owner/Operator* Rogers Group/Ralp Rogers&Co.
County: Rutherford
Submitter Name:* STeven Turaski
Who is submitting this information?
E-mail Address:* [e-mail]
Phone Number* 8652072695
Additional E-mail for (Optional)
Submittal
Confirmation:
NPDES Permit Information Uploads
Choose file type and upload attachment(Reviewer may remove unnecessary submittals)
......................................................................................................................................................................................................................................
File Type* Dormant Status Recertification
File Upload Click the upload button,or drag and drop files to attach
2023 Dormancy recert form+covlet.pdf 903.86KB
Only PDF files are accepted.
.......................................................................................................................
Is this project funded QQ No
with ARPA grant Q 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:
annual recertification with cover letter. I will mail the hard copy as directed.
* 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:* Steven Turaski
Signature:
Srs►Titl r�.agw
Date Submitted: 01/12/2024

Initial Review
Verify Permit No.* IMPORTANT:REVIEWER SHOULD VERIFY and revise here if necessary.
NCG020783
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
Review Date* 01/17/2024